New Therapeutic Approaches to the Treatment of Dyslipidemia 2: LDL-C and Lp(a)

Dyslipidemia is an important risk factor for atherosclerotic cardiovascular disease (ASCVD).There are abundant and unequivocal data to indicate that low-density lipoproteins (LDL) are a cause of ASCVD. Reduction of plasma low-density lipoprotein cholesterol (LDL-C) by medical therapy such as statins, ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have proven to significantly reduce the risk of cardiovascular events. However, for many reasons, many patients are not able to achieve LDL-C levels recommended by guidelines on currently available therapies. This has led to the development of new drugs lowering LDL-C, such as inclisiran, bempedoic acid, and evinacumab, in the hope of reducing cardiovascular (CV) risk. Drugs targeting lipoprotein (a) (Lp[a]) also have a role in the prevention of atherosclerosis, with genetic studies having established that 20%–30% of the human population inherits plasma Lp(a) levels in the atherogenic range.In this paper, we will review the recent progress made in the approaches to LDL-C and Lp(a) therapeutic modulation.

Assessment of Screening for Prostatic Cancer in Men with Prostatism more than 50 years old / 대한비뇨기과학회지

Screening for prostatic cancer remains controversial because a decrease in the mortality rate is not demonstrated in screened populations. During a 2 year period, 172 men with prostatism more than 50 years old, were examined for prostatic cancer prospectively. A prostatic biopsy was performed on 77 men and 13 malignant tumor were detected, of which 85 per cent were clinically localized. Sensitivity of digital rectal examination, serum PSA, and transrectal ultrasonography for detection of prostatic cancer was 46.2%, 76.9%, and 53.8% respectively. A combination of abnormal ultrasonographic findings, an elevated PSA value, and abnormal findings on rectal examination carried a positive predictive value of 62.5%. These results suggest that screening examination may benefit for early detection of prostatic cancer in men with Prostatism more than 50 years old. Screening program should include digital rectal examination, serum PSA initially. Transrectal ultrasonography is reserved for cases with abnormal finding on rectal examination or elevated PSA value.

A Case of Primary Carcinoid Tumor of the Rete Testis / 대한비뇨기과학회지

Testicular carcinoid tumor is uncommon and most of these tumors occur in fourth decade' of life. A 33-year-old man presented with intrascrotal painless mass, which was initially misdiagnosed as epididymal tumor. Epididymectomy including the mass was performed and pathologic examination revealed a carcinoid tumor confined to the rete testis. There was no evidence of carcinoid syndrome. The 24 hour urinary 5-HIAA level was normal. Abdominal CT scan and GI contrast study showed no evidence of carcinoid in other organ including the gut. Radical orchiectomy and hemiscrotectomy were undergone as a curative therapy. He has been well for 40 months without recurrence.