Prostate-specific antigen kinetics after hypofractionated stereotactic body radiotherapy for localized prostate cancer

Background: stereotactic body radiotherapy [SBRT] has emerged as an effective treatment for localized prostate cancer. However, prostate-specific antigen [PSA] kinetics after SBRT has not been well characterized. The objective of the current study is to analyze the rate of PSA decline and PSA nadir following hypofractonated SBRT in localized prostate cancer

Materials and Methods: from 2008 to 2014, thirty-nine patients newly diagnosed, localized prostate [25.6% low risk, 66.7% intermediate risk and 7.7% high risk] cancer were treated with SBRT using Cyberknife. Total dose of 36.25 Gy in 5 fractions of 7.25 Gy were administered. No one received androgen deprivation therapy [ADT]. PSA nadir and rate of change in PSA [slope] were calculated and compared

Results: with a median follow-up of 52 months [range, 13-71], the median rates of decline of PSA were -0.372, -0.211 and -0.128 ng/mL/month, respectively, for durations of 1, 2 and 3 years after radiotherapy, respectively. The decline of PSA was maximal in the first year and continuously decreased for durations of 2 and 3 year. The median PSA nadir was 0.28 ng/mL after a median 33 months. There was one biochemical failure, occurring in a high risk patient. 5-year actuarial biochemical failure [BCF] free survival was 94.2%

Conclusion: in this report of localized prostate cancer, continuous decrease of PSA level for duration 1, 2 and 3 year following SBRT using Cyberknife resulted in lower PSA nadir. Also, SBRT leaded to long-term favorable BCF-free survival

Assessments of myocardial perfusion in human using stress intravenous PESDA myocardial contrast echocardiography and Pulse Inversion Harmonic Imaging: A Comparison study with Tc-99m sestamibi SPECT

OBJECTIVE: The object of this study was to assess the accuracy of dipyridamole stress intravenous (IV) myocardial contrast echocardiography (MCE) using pulse inversion harmonic imaging and PESDA in the detection of perfusion defect in the patients with coronary artery disease in comparison with dipyridamole stress Tc-99m sestamibi SPECT. METHODS: Total 46 patients (29 males, mean age 64 years old) were consecutively enrolled. Patients with prior myocardial infarction were excluded. MCE and Tc-99m sestamibi SPECT were performed at the same day during rest and after 0.56 or 0.84mg/Kg dipyridamole infusion. Continuous IV infusion of PESDA (2-5 mL/min) was administered while obtaining triggered (1:1) end-systolic apical 2, 4 chamber and long axis views. Tc-99m sestamibi was injected 3 minutes after dipyridamole. Tc-99m sestamibi SPECT images were obtained one hour later. Coronary angiography was followed within two days in all patients. Tc-99m sestamibi SPECT images were matched to the sixteen segments of left ventricle according to American Society of Echocardiography for segmental comparison. Both images were analyzed visually. Results Using coronary angiography as the standard, MCE showed overall sensitivity of 70.7%, specificity of 95.8%, positive predictive value (PPV) of 87.8% and negative predictive value (NPV) of 88.5% in the detection of coronary atherosclerosis (70% stenosis). Tc-99m sestamibi SPECT showed sensitivity of 75.6%, specificity of 98.9%, PPV of 96.8% and NPV of 90.6%. The overall concordance rate between MCE and Tc-99m sestamibi SPECT for the detection of perfusion defects was 86.9% (Cohen's kappa value 0.63) according to the coronary territory and 86.8% (Cohen's kappa value 0.55) according to segmental analysis. CONCLUSION: Dipyridamole stress IV MCE using pulse inversion harmonic imaging and PESDA is feasible and comparable to Tc-99m sestamibi SPECT in identifying significant coronary stenosis and inducible myocardial perfusion defects in the patients with coronary artery disease. MCE using pulse inversion harmonic imaging seems to be a promising modality for assessing myocardial perfusion in the patients with suspected coronary artery disease.

A Clinical Study of Topical Minoxidil Therapy in Alopecia: Multicenter Trials / 대한피부과학회지

No abstract available.

The Effect of Combination Treatment with Oral Etretinate (Ro 10 - 9359) and Vitamin E on Psoriasis Vulgaris / 대한피부과학회지

Etretinate(Ro 10-9359), an aromatic analogue of vitamin A acid, has been known to be effective in the treatment of psoriasis, Darier's disease, pityriasis rubra pilaris, ichthyosis, and palmoplantar keratoderma when administered orally. In this experiment, we compared the therapeutic and side effects between a group with high dose therapy(initially 75mg of etretinate a day) and an another group with low dose therapy(initially 40mg of etretinate a day). We also observed whether the pretreatment followed by combined treatment with vitamin E could potentiate the therapeutic effect as well as reduce the side effects of oral etretinate. This experiment comprised 102 moderate to severe psoriatic patients. The following results were obtained from this experiment. 1. Fifty-six among 92 patients(61%) who were treated with etretinate for more than 4 weeks showed good to excellent therapeutic effect. 2 The high dose therapy was more effective, but showed more side effects than low dose therapy. 3 Vitamin E did not potentiate the effect of etretinate. In low dose therapy, the pretreatment followed by combined treatment with vitamin E showed a tendency to reduce the side effects of etretinate.