• 제목/요약/키워드: biochemical failure

검색결과 64건 처리시간 0.026초

Comparison between Use of PSA Kinetics and Bone Marrow Micrometastasis to Define Local or Systemic Relapse in Men with Biochemical Failure after Radical Prostatectomy for Prostate Cancer

  • Murray, Nigel P;Reyes, Eduardo;Fuentealba, Cynthia;Orellana, Nelson;Jacob, Omar
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8387-8390
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    • 2016
  • Background: Treatment of biochemical failure after radical prostatectomy for prostate cancer is largely empirically based. The use of PSA kinetics has been used as a guide to determine local or systemic treatment of biochemical failure. We here compared PSA kinetics with detection of bone marrow micrometastasis as methods to determine local or systemic relapse. Materials and Methods: A transversal study was conducted of men with biochemical failure, defined as a serum PSA >0.2ng/ml after radical prostatectomy. Consecutive patients having undergone radical prostatectomy and with biochemical failure were enrolled and clinical and pathological details were recorded. Bone marrow biopsies were obtained from the iliac crest and touch prints made, micrometastasis (mM) being detected using anti-PSA. The clinical parameters of total serum PSA, PSA velocity, PSA doubling time and time to biochemical failure, age, Gleason score and pathological stage were registered. Results: A total of 147 men, mean age $71.6{\pm}8.2years$, with a median time to biochemical failure of 5.5 years (IQR 1.0-6.3 years) participated in the study. Bone marrow samples were positive for micrometastasis in 98/147 (67%) of patients at the time of biochemical failure. The results of bone marrow micrometastasis detected by immunocytochemistry were not concordant with local relapse as defined by PSA velocity, time to biochemical failure or Gleason score. In men with a PSA doubling time of < six months or a total serum PSA of >2,5ng/ml at the time of biochemical failure the detection of bone marrow micrometastasis was significantly higher. Conclusions: The detection of bone marrow micrometastasis could be useful in defining systemic relapse, this minimally invasive procedure warranting further studies with a larger group of patients.

Comparison of the Walz Nomogram and Presence of Secondary Circulating Prostate Cells for Predicting Early Biochemical Failure after Radical Prostatectomy for Prostate Cancer in Chilean Men

  • Murray, Nigel P;Reyes, Eduardo;Orellana, Nelson;Fuentealba, Cynthia;Jacob, Omar
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권16호
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    • pp.7123-7127
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    • 2015
  • Purpose: To determine the utility of secondary circulating prostate cells for predicting early biochemical failure after radical prostatectomy for prostate cancer and compare the results with the Walz nomagram. Materials and Methods: A single centre, prospective study of men with prostate cancer treated with radical prostatectomy between 2004 and 2014 was conducted, with registration of clinical-pathological details, total serum PSA pre-surgery, Gleason score, extracapsular extension, positive surgical margins, infiltration of lymph nodes, seminal vesicles and pathological stage. Secondary circulating prostate cells were obtained using differential gel centrifugation and assessed using standard immunocytochemistry with anti-PSA. Biochemical failure was defined as a PSA >0.2ng/ml, predictive values werecalculated using the Walz nomagram and CPC detection. Results: A total of 326 men participated, with a median follow up of 5 years; 64 had biochemical failure within two years. Extracapsular extension, positive surgical margins, pathological stage, Gleason score ${\geq}8$, infiltration of seminal vesicles and lymph nodes were all associated with higher risk of biochemical failure. The discriminative value for the nomogram and circulating prostate cells was high (AUC >0.80), predictive values were higher for circulating prostate cell detection, with a negative predictive value of 99%, sensitivity of 96% and specificity of 75%. Conclusions: The nomagram had good predictive power to identify men with a high risk of biochemical failure within two years. The presence of circulating prostate cells had the same predictive power, with a higher sensitivity and negative predictive value. The presence of secondary circulating prostate cells identifies a group of men with a high risk of early biochemical failure. Those negative for secondary CPCs have a very low risk of early biochemical failure.

Possible Role of HER-2 in the Progression of Prostate Cancer from Primary Tumor to Androgen Independence

  • Murray, Nigel P;Reyes, Eduardo;Fuentealba, Cynthia;Jacob, Omar;Orellana, Nelson
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6615-6619
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    • 2015
  • Background: The expression of HER-2 in prostate cancer has been linked to disease progression. We analysed the presence of HER-2 expression in primary tumors in men undergoing radical prostatectomy, its association with clinical and pathological findings, and its expression in secondary circulating prostate cells (CPCs) during follow up, as well as links with biochemical failure and the effects of androgen blockade. Materials and Methods: Consecutive men undergoing radical prostatectomy for histologically confirmed prostate cancer were analyzed. HER-2 expression in the primary tumor was assessed using the HercepTest(R), CPCs were identified from blood samples using standard immunocytochemistry with anti-PSA and positive samples with the HercepTest(R) to determine HER-2 expression. The influence of HER-2 expression on the frequency of biochemical failure and effects of androgen blockade was determined. Results: 144 men with a mean age of $64.8{\pm}10.3$ years participated, with a median follow up of 8.2 years. HER-2 was expressed in 20.8% of primary tumors; it was associated with vascular infiltration and older age, but not with other clinical pathological findings. Some 40.3% of men had secondary CPCs detected, of which 38% expressed HER-2. Men CPC (+) had a higher frequency of biochemical failure, but there was no difference in HER-2 expression of CPCs with the frequency of biochemical failure. After androgen blockade, men with HER-2 (+) positive secondary CPCs had a higher frequency of disease progression to castrate resistant disease. Conclusions: HER-2 plays a dual role in the progression of prostate cancer; firstly it may increase the potential of tumor cells to disseminate from the primary tumor via the blood by increasing vascular infiltration. In the presence of androgens, there is no survival advantage of expressing HER-2, but once biochemical failure has occurred and androgen blockade started, HER-2 positive cells are resistant to treatment, survive and grow leading to castration resistant disease.

개에서 포도 및 건포도 섭취가 신부전에 미치는 영향 (Renal failure associated with ingestion of grapes and raisins in dogs)

  • 육진엽;김철호;김태융;강정부
    • 대한수의학회지
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    • 제45권2호
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    • pp.287-296
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    • 2005
  • This experiments was designed to observe the effect of period and dose of ingestion of grapes on renal failure in dog. After the dogs had been mixed of general feed, raisins from U.S.A and fresh grapes from Chile selling in Korea. We observed the clinical sign, and analyzed the blood and urine using by biochemical test. The experiment was executed by the two following groups. The experiment group 1. derived renal failure by supplying the mixed general feed with fresh grapes and dry grapes 15 g per weight kg, 2 times a day (AM 09, PM 21), the experiment group 2. executed to derive renal failure by supplying the mixed general feed with fresh grapes and dry grapes 40 g per weight kg, 2 times a day. Extraction of blood for analysis was conducted one time a day and clinical test for renal failure was executed by means of a blood analysis, biochemical analysis, urine analysis, excretory urography (E.U) and E.R.D-$screen^{TM}$ urine test (Heska, USA). The results of group 1 were normal ranges (BUN 9.0~22.6 mg/dl, creatinine 0.8~1.2 mg/dl, Ca 9.7~12.3 mg/dl, Pi 2.9~4.6 mg/dl), renal failure was not observed. On the 3rd day in group 2, azotemia was arisen from the increasing BUN 83 mg/dl (7~25 mg/dl), creatinine 2.3 mg/dl (0.5~1.4 mg/dl), when executed urine was tested by E.R.D-$screen^{TM}$ test using in the early kidney disease diagnosis, microalbumine state was high positive, and it showed stale delay by using excretory urography (EU). This study demonstrated that acute renal failure by grapes and raisins dependent on food dose, and specific characters of individual.

Kidney reconstruction using kidney cell transplantation in kidney failure animal model

  • Kim, Sang-Soo;Park, Heung-Jae;Han, Joung-Ho;Choi, Cha-Yong;Kim, Byung-Soo
    • 한국생물공학회:학술대회논문집
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    • 한국생물공학회 2003년도 생물공학의 동향(XIII)
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    • pp.347-350
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    • 2003
  • 본 연구에서는 신장세포를 이용하여 신장을 재생하는 조직공학적인 신장 재생 방법을 개발하기 위해 신생 rat으로부터 분리한 신장세포를 피브린 고분자와 혼합하여 신부전 rat의 신장에 주사 이식하였고 4주 후에 신장 구조의 형성 및 개선된 BUN, creatinine 수치를 확인하였다. 이는 이식된 세포에 의해 신부전의 증상이 완화(치료)된 것으로, 앞으로 이에 대한 추가적인 장기간의 실험이 필요하다.

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장치이상을 고려한 동적 생산계획 최적화 모델 개발 (A Development of the Optimization Model for Reactive Scheduling Considering Equipment Failure)

  • 하진국;이의수
    • Korean Chemical Engineering Research
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    • 제43권5호
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    • pp.571-578
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    • 2005
  • 불연속 화학공정은 소비자 수요에 탄력성 있게 대처할 수 있는 장점이 있는 반면에 그 특유의 동특성 때문에 복잡하고, 계획된 조업 시간과 실제 조업 시간 사이에서 외란(disruption) 또는 불확실 변수(uncertainty)에 의한 차이가 자주 발생하는 단점이 있다. 이에, 본 논문에서는 예측 생산계획(predictive scheduling)에 의해 결정된 생산계획에서 미래에 발생하는 공정 변수 값의 변화를 실시간으로 예측 생산계획을 수정, 제시하여 주는 생산 계획 시스템인 동적 생산계획(reactive scheduling) 기법을 개발하였다. 불확실 인자를 고려한 동적 생산계획에서, 본 논문에서는 장치 이상(equipment failure)이 발생하였을 때 공정 운전조건의 변화를 실시간으로 반영하여, 예측 생산계획(predictive scheduling) 모델에 의하여 제시된 전체 생산 계획을 최대한 유지하고 공정 변수의 변화를 실시간으로 반영하기 위하여 right shift rescheduling과 total regeneration 기법을 사용하였다. 또한, 불확실 인자의 발생 전후의 predictive scheduling과 reactive scheduling 간의 변화 정도를 측정하는 수단인 schedule stability 위하여, 본 논문에서는 수정된 sequence deviation과 percentage change in makespan을 사용하여 제안된 동적 생산계획의 안정성을 측정하였다. 본 논문에서 제안한 동적 생산계획 시스템은 기존에 제시되었던 경험 법칙에 의한 결과값에 비해 좋은 결과를 보여주었다.

진행된 원발성 간암 환자에서 방사선 치료 및 온열 요법에 따른 간 기능의 변화 (Biochemical Changes of Liver Function in Patients with Hepatocellular Carcinoma Following Radiotherapy and Hyperthermia)

  • 오영택;성진실;신현수;김귀언
    • Radiation Oncology Journal
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    • 제11권1호
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    • pp.109-117
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    • 1993
  • To analyze biochemical changes of liver function following combined radiotherapy and hyperthermia, we reviewed retrospectively 37 patients with hepatocellular carcinoma treated with radiotherapy and hyperthermia between July 1988 and December 1990 at Department of Radiation Oncology, Yonsei University College of Medicine. Mean age was 52.7 years and male to female ratio was 11:1. The patients were classified as follows; to A and B group by Child's classification, to M and L group by irradiated volume, and subclassified into BM, BL, AM and AL group according to the combination of Child's classification and irradiated volume. Radiation dose to the primary tumor was 3060 cGy with daily 180 cGy, 5 fraction per week using 10 MV or 4 MV linear accelerator. Hyperthermia (Thermotron RF-8) was performed more than 4 times in all patients. Biochemical parameters including albumin (Alb), total bilirubin (T. Bil), aspartate aminotransferase (AST or SGOT), alanine aminotransferase (ALT or SGPT), and alkaline phosphatase (ALP) were regularly followed from 1 week before the treatment to 3 months after the treatment. The results are summerized as follows; 1) In all the patient, mean ALP level peaked at 1 month, decreased at 2 months, slightly increased at 3 months after the treatment. Mean SGOT and SGPT levels peaked at 1 month after the treatment. Mean T. Bil level increased continuously and highest at 3 months after the treatment. Mean Alb level did not show significant changes.; 2) Mean ALP level retured to normal level at 3 month after the treatment in A but increased in B group and the differences were statistically significant (p<0.01). Mean SGOT and SGPT levels peaked 1 month in A and 2 months after the treatment in B group. All the biochemical parameters did not show significant difference between M and L group. Mean ALP level increased at 3 months after the treatment in BM and BL groups and decreased in AM and AL groups. Mean SGOT level increased at 3 months after the treatment in BL groups.; 3) Hepatic failure occurred within 3 months after the treatment in 4 patients, all of whom were in BL group. It is suggested that pre-treatment liver function and irradiated volume influence biochemical changes of liver in patients with hepatocellular carcinoma following combined radiotherapy and hyperthermia, and this treatment modality appears generally to be safe but might cause hepatic failure particularly in patient with poor liver function and large treatment volume.

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타이로신 혈증 2례; 간암이 유발된 1례와 급성 간부전으로부터 회복된 1례의 비교 (Two Cases of Tyrosinemia; One with Hepatocellular Carcinoma and the other with Acute Liver Failure)

  • 김숙자;송웅주;전영미
    • 대한유전성대사질환학회지
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    • 제13권1호
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    • pp.48-53
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    • 2013
  • Tyrosinemia I (fumarylacetoacetate hydrolase deficiency) is an autosomal recessive inborn error of tyrosine metabolism that produces liver failure in infancy or a more chronic course of liver disease with cirrhosis, often complicated by hepatocellular carcinoma in childhood or early adolescence. We studied a 37-year-old woman with tyrosinemia I whose severe liver disease in infancy and rickets during childhood were resolved with dietary therapy. From 14 years of age, she resumed unrestricted diet with the continued presence of the biochemical features of tyrosinemia, yet maintained normal liver function. In adult years, she accumulated only a small amount of succinylacetone. Despite this evolution to a mild biochemical and clinical phenotype, she eventually developed hepatocellular carcinoma. Her fumarylacetoacetate hydrolase genotype consists of a splice mutation, IVS6-1G>T, and a novel missense mutation, p.Q279R. Studies of resected liver revealed the absence of hydrolytic activity and immunological expression of fumarylacetoacetate hydrolase in tumour. In the non-tumoral areas, however, 53% of normal hydrolytic activity and immunologically present fumarylacetoacetate hydrolase were found. This case demonstrates the high risk of liver cancer in tyrosinemia I even in a seemingly favorable biological environment. In this study of tyrosinemia I, Case 2 with negative succinylacetone accumulation and the recovery of acute liver failure was compared with Case 1. Diet restriction and NTBC treatment are crucial to prevent hepatocellular carcinoma until liver transplant can take place and cure the condition. Further studies are needed to examine cases where liver cancer did not result despite clinical symptoms/signs of tyrosinemia type I.

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Prognostic significance of lymphovascular invasion in patients with prostate cancer treated with postoperative radiotherapy

  • Jeong, Jae-Uk;Nam, Taek-Keun;Song, Ju-Young;Yoon, Mee Sun;Ahn, Sung-Ja;Chung, Woong-Ki;Cho, Ick Joon;Kim, Yong-Hyub;Cho, Shin Haeng;Jung, Seung Il;Kwon, Dong Deuk
    • Radiation Oncology Journal
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    • 제37권3호
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    • pp.215-223
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    • 2019
  • Purpose: To determine prognostic significance of lymphovascular invasion (LVI) in prostate cancer patients who underwent adjuvant or salvage postoperative radiotherapy (PORT) after radical prostatectomy (RP) Materials and Methods: A total of 168 patients with prostate cancer received PORT after RP, with a follow-up of ≥12 months. Biochemical failure after PORT was defined as prostate-specific antigen (PSA) ≥0.2 ng/mL after PORT or initiation of androgen deprivation therapy (ADT) for increasing PSA levels regardless of the value. We analyzed the clinical outcomes including survivals, failure patterns, and prognostic factors affecting the outcomes. Results: In total, 120 patients (71.4%) received salvage PORT after PSA levels were >0.2 ng/mL or owing to clinical failure. The 5-year biochemical failure-free survival (BCFFS), clinical failure-free survival (CFFS), distant metastasis-free survival (DMFS), overall survival, and cause-specific survival rates were 78.3%, 94.3%, 95.0%, 95.8%, and 97.3%, respectively, during a follow-up range of 12-157 months (median: 64 months) after PORT. On multivariate analysis, PSA level of ≤1.0 ng/mL at the time of receiving PORT predicted favorable BCFFS, CFFS, and DMFS. LVI predicted worse CFFS (p = 0.004) and DMFS (p = 0.015). Concurrent and/or adjuvant ADT resulted in favorable prognosis for BCFFS (p < 0.001) and CFFS (p = 0.017). Conclusion: For patients with adverse pathologic findings, PORT should be initiated as early as possible after continence recovery after RP. Even after administering PORT, LVI was an unfavorable predictive factor, and further intensive adjuvant therapy should be considered for these patients.