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3.
Ecology ; 103(4): e3640, 2022 04.
Article in English | MEDLINE | ID: mdl-35060633

ABSTRACT

Data papers and open databases have revolutionized contemporary science, as they provide the long-needed incentive to collaborate in large international teams and make natural history information widely available. Nevertheless, most data papers have focused on species occurrence or abundance, whereas interactions have received much less attention. To help fill this gap, we have compiled a georeferenced data set of interactions between 93 bat species of the family Phyllostomidae (Chiroptera) and 501 plant species of 68 families. Data came from 169 studies published between 1957 and 2007 covering the entire Neotropical Region, with most records from Brazil (34.5% of all study sites), Costa Rica (16%), and Mexico (14%). Our data set includes 2571 records of frugivory (75.1% of all records) and nectarivory (24.9%). The best represented bat genera are Artibeus (28% of all records), Carollia (24%), Sturnira (10.1%), and Glossophaga (8.8%). Carollia perspicillata (187), Artibeus lituratus (125), Artibeus jamaicensis (94), Glossophaga soricina (86), and Artibeus planirostris (74) were the bat species with the broadest diets recorded based on the number of plant species. Among the plants, the best represented families were Moraceae (17%), Piperaceae (15.4%), Urticaceae (9.2%), and Solanaceae (9%). Plants of the genera Cecropia (46), Ficus (42), Piper (40), Solanum (31), and Vismia (27) exhibited the largest number of interactions. These data are stored as arrays (records, sites, and studies) organized by logical keys and rich metadata, which helped to compile the information on different ecological and geographic scales, according to how they should be used. Our data set on bat-plant interactions is by far the most extensive, both in geographic and taxonomic terms, and includes abiotic information of study sites, as well as ecological information of plants and bats. It has already facilitated several studies and we hope it will stimulate novel analyses and syntheses, in addition to pointing out important gaps in knowledge. Data are provided under the Creative Commons Attribution 4.0 International License. Please cite this paper when the data are used in any kind of publication related to research, outreach, and teaching activities.


Subject(s)
Chiroptera , Ficus , Piper , Animals , Brazil , Costa Rica , Humans
4.
Nat Commun ; 11(1): 3215, 2020 06 25.
Article in English | MEDLINE | ID: mdl-32587246

ABSTRACT

Changes in global and regional precipitation regimes are among the most pervasive components of climate change. Intensification of rainfall cycles, ranging from frequent downpours to severe droughts, could cause widespread, but largely unknown, alterations to trophic structure and ecosystem function. We conducted multi-site coordinated experiments to show how variation in the quantity and evenness of rainfall modulates trophic structure in 210 natural freshwater microcosms (tank bromeliads) across Central and South America (18°N to 29°S). The biomass of smaller organisms (detritivores) was higher under more stable hydrological conditions. Conversely, the biomass of predators was highest when rainfall was uneven, resulting in top-heavy biomass pyramids. These results illustrate how extremes of precipitation, resulting in localized droughts or flooding, can erode the base of freshwater food webs, with negative implications for the stability of trophic dynamics.


Subject(s)
Bromelia , Ecosystem , Floods , Fresh Water , Animals , Biodiversity , Biomass , Climate Change , Droughts , Food Chain , Hydrology , South America
5.
Ecology ; 101(4): e02984, 2020 04.
Article in English | MEDLINE | ID: mdl-31958151

ABSTRACT

There is growing recognition that ecosystems may be more impacted by infrequent extreme climatic events than by changes in mean climatic conditions. This has led to calls for experiments that explore the sensitivity of ecosystems over broad ranges of climatic parameter space. However, because such response surface experiments have so far been limited in geographic and biological scope, it is not clear if differences between studies reflect geographic location or the ecosystem component considered. In this study, we manipulated rainfall entering tank bromeliads in seven sites across the Neotropics, and characterized the response of the aquatic ecosystem in terms of invertebrate functional composition, biological stocks (total invertebrate biomass, bacterial density) and ecosystem fluxes (decomposition, carbon, nitrogen). Of these response types, invertebrate functional composition was the most sensitive, even though, in some sites, the species pool had a high proportion of drought-tolerant families. Total invertebrate biomass was universally insensitive to rainfall change because of statistical averaging of divergent responses between functional groups. The response of invertebrate functional composition to rain differed between geographical locations because (1) the effect of rainfall on bromeliad hydrology differed between sites, and invertebrates directly experience hydrology not rainfall and (2) the taxonomic composition of some functional groups differed between sites, and families differed in their response to bromeliad hydrology. These findings suggest that it will be difficult to establish thresholds of "safe ecosystem functioning" when ecosystem components differ in their sensitivity to climatic variables, and such thresholds may not be broadly applicable over geographic space. In particular, ecological forecast horizons for climate change may be spatially restricted in systems where habitat properties mediate climatic impacts, and those, like the tropics, with high spatial turnover in species composition.


Subject(s)
Climate Change , Ecosystem , Animals , Droughts , Invertebrates , Rain
6.
Int J Pharm ; 562: 86-95, 2019 May 01.
Article in English | MEDLINE | ID: mdl-30885651

ABSTRACT

Coumestrol is a polyphenol with promising therapeutic applications as phytoestrogen, antioxidant and potential cancer chemoprevention agent. The presence of two hydroxyl groups on its chemical structure, with orientation analogous to estradiol, is responsible of both, its antioxidant capacity and its estrogenic activity. However, several studies show that the interaction of polyphenols with food and plasma proteins reduces their antioxidant efficacy. We studied the interaction of coumestrol with bovine serum albumin protein (BSA) by fluorescence spectroscopy and circular dichroism techniques, and the effect of this interaction on its antioxidant activity as a hydroxyl radical scavenger. In addition, coumestrol antioxidant capacity profile using different assays (DPPH, ORAC-FL and ORAC-EPR) was studied. To explain its reactivity we used several methodologies, including DFT calculations, to define its antioxidant mechanism. Coumestrol antioxidant activity unveiled interesting antioxidant properties. BSA interaction with coumestrol reduces significantly photolytic degradation in several media thus preserving its antioxidant properties. Results suggest no significant changes in BSA structure and activity when interacting with coumestrol. Furthermore, this interaction is stronger than for other phytoestrogens such as daidzein and genistein. Considering our promising results, we reported for the first time the fabrication and characterization of coumestrol-loaded albumin nanoparticles. The resulting spherical and homogeneous nanoparticles showed a diameter close to 96 nm. The coumestrol incorporation efficiency in BSA NPs was 22.4%, which is equivalent to 3 molecules of coumestrol for every 10 molecules of BSA.


Subject(s)
Antioxidants/chemistry , Coumestrol/chemistry , Drug Carriers/chemistry , Nanoparticles/chemistry , Phytoestrogens/chemistry , Serum Albumin, Bovine/chemistry , Hydroxyl Radical/chemistry
7.
J AOAC Int ; 101(1): 235-241, 2018 Jan 01.
Article in English | MEDLINE | ID: mdl-28766479

ABSTRACT

In this work, we developed an HPLC method to simultaneously quantify and hence evaluate the stability, distribution, and antioxidant capacity of six isoflavones: genistein, genistin, daidzein, daidzin, glycitin, and biochanin A. Isoflavones have been described as having an important estrogenic activity to treat menopausal symptoms and can reduce postmenopausal bone loss and also participate in the prevention of cardiovascular diseases. These beneficial properties are believed derived from their capacity to act as free-radical scavengers. Isoflavones are formulated in capsules and creams and also can be used as antioxidants in liposomes. HPLC separation was achieved on an Agilent Hypersil ODS C18 column. The mobile phase consisted of 0.02-0.2% orthophosphoric acid in water-acetonitrile with gradient elution. The diode array detector was operated at 260 nm. The hydrophobicity of isoflavones was determined through their distribution in octanol-buffer. These results allowed us to establish a relation between chemical structure, pKa, lipophilicity, and the characteristics of the dispersion medium. Photolysis of hydrogen peroxide was used to measure the HO• scavenging capability of isoflavones. In liposomes, the order of reactivity of the studied compounds was genistein > biochanin A > genistin > daidzein > daidzin > glycitin.


Subject(s)
Antioxidants/analysis , Free Radical Scavengers/analysis , Isoflavones/analysis , Antioxidants/pharmacology , Chromatography, High Pressure Liquid , Free Radical Scavengers/pharmacology , Hydrogen Peroxide/antagonists & inhibitors , Hydroxyl Radical/chemistry , Isoflavones/pharmacology , Liposomes/antagonists & inhibitors , Molecular Structure , Photolysis , Time Factors
8.
PLoS One ; 10(6): e0129749, 2015.
Article in English | MEDLINE | ID: mdl-26098745

ABSTRACT

In this work, the relationship between the molecular structure of three flavonoids (kaempferol, quercetin and morin), their relative location in microheterogeneous media (liposomes and erythrocyte membranes) and their reactivity against singlet oxygen was studied. The changes observed in membrane fluidity induced by the presence of these flavonoids and the influence of their lipophilicity/hydrophilicity on the antioxidant activity in lipid membranes were evaluated by means of fluorescent probes such as Laurdan and diphenylhexatriene (DPH). The small differences observed for the value of generalized polarization of Laurdan (GP) curves in function of the concentration of flavonoids, indicate that these three compounds promote similar alterations in liposomes and erythrocyte membranes. In addition, these compounds do not produce changes in fluorescence anisotropy of DPH, discarding their location in deeper regions of the lipid bilayer. The determined chemical reactivity sequence is similar in all the studied media (kaempferol < quercetin < morin). Morin is approximately 10 times more reactive than quercetin and 20 to 30 times greater than kaempferol, depending on the medium.


Subject(s)
Flavonoids/chemistry , Free Radical Scavengers/chemistry , Singlet Oxygen/chemistry , Flavonoids/pharmacology , Free Radical Scavengers/pharmacology , Liposomes/chemistry
9.
Rev. psicoanál. (Madr.) ; (59): 219-241, jun. 2010.
Article in Spanish | IBECS | ID: ibc-92002

ABSTRACT

Las diferentes reacciones que generan los procesos inconscientes que dan cuenta del envejecimiento originan la mediana edad propiamente dicha, irrumpiendo el trauma por la propia muerte futura como consecuencia. Se establecería de un organizador psíquico adulto en la mediana edad, basado en Freud, cuando postula tres caminos de tramitación posible ante lo transitorio o perecedero, surgiendo una transición de mediana edad y dos subtipos de crisis de mediana edad. La primera ligada a la continuidad del desarrollo y las segundas preponderantemente con la psicopatología. Los invariantes metapsicológicos universales en la mediana edad implican el trabajo de duelo, la actualización del ideal del yo y su conexión con el yo ideal, la reactivación de la conflictiva preedípica (angustia de abandono) y edípica (angustia de castración), y la revisión de la historia de las identificaciones y la desidentificación. Existen algunos indicadores que darían cuenta de la tramitación (relativa) del trauma por la propia muerte futura: la tolerancia de la incertidumbre de vivir, la aceptación del odio y la destructividad en la naturaleza humana, el cambio en la percepción subjetiva del tiempo, una nueva integración de la historia personal, y el anclaje de la historia individual en la historia generacional (AU)


The different reactions that generate the unconscious processes that reveal that one is growing old, originate middle age, there irrupts the trauma due to facing one´s own death in the future. An adult psychic organizer is established in middle age, following Freud which postulates three ways of coping with one´s own death; transition in middle age, and two subtypes of the crisis of middle age. The first one linked to the continuity of growth and evolution, and the second ones mainly with psychopathology. The universal metapsychologica constants in middle age imply the work of mourning, the actualization of the ideal of the ego, and its connection with the ego ideal, the re-activation of the pre-edipic conflict (abandonment anxiety) and edipic (castration anxiety) as well as the review of the history of identification and of de-identification. There exist some indicators that would give account of the relative tramitation of the trauma for one´s own death in the future; toleration of the uncertainty of living, acceptance of hate and destructivity within human nature, change in the subjective perception of time, a new integration of the personal history and the binding of the individual and generational history (AU)


Subject(s)
Humans , Middle Aged/psychology , Freudian Theory , Aging/psychology , Attitude to Death , Anxiety, Castration/psychology , Anxiety Disorders/psychology , Grief
10.
Psychoanal Study Child ; 62: 329-58, 2007.
Article in English | MEDLINE | ID: mdl-18524098

ABSTRACT

The intent of this paper is to add to the psychoanalytic understanding of midlife by exploring the relationships among transience, uncertainty and time limitation; and their effect on intra-psychic conflict and change. After a presentation of definitions and relevant midlife development tasks, the focus shifts to a discussion of two of Freud's papers, "On Transience" (1916 [1915]) and "The Uncanny" (1919) in which Freud introduced important concepts that provide a foundation for psychoanalytic exploration of attitudes toward transience, uncertainty and death. A major focus of the paper is a conceptualization of a developmental continuum from midlife transition to midlife crisis, rather than dichotomizing the midlife developmental process as either transition or crisis, followed by a discussion of three basic ways of processing the continuum and six common ways in which midlife pathology and/or more normative developmental progression are expressed. Two detailed, clinical examples illustrate the theoretical concepts and focus, in particular on clinical presentation and transference and counter-transference. The intention is to link theory with clinical understanding and technique.


Subject(s)
Conflict, Psychological , Personality Development , Psychoanalysis/history , Psychoanalytic Interpretation , Adult , Austria , History, 19th Century , History, 20th Century , Humans , Middle Aged
11.
Rev. psicoanál. (Madr.) ; (44): 233-259, ene.-abr. 2005.
Article in Spanish | IBECS | ID: ibc-125586

ABSTRACT

El paper es un intento d3e psicoanálisis aplicado a la novela Juegos de la edad tardía de Luis Landero, en elque elautor releva todas aquellas características que la emparentan con la elaboración de las ansiedades específicas de la mediana edad. Comenzando por definir la mediana edad de las personas a partir del trabajo psíquico que generan las incipientes señales de envejecimiento que evidencian la transitoriedad de la vida individual, continúa con un planteo teórico que permite comprender la complejidad tanto de la transición como de la crisi de mediana edad partiendo en todos los casos de La passagerete (Lo perecedero) de Freud. En este ensayo Freud plantea diferentes decursos posibles de elaboración ante aquello que es efímero, los que sirven de prototipo para formular tres modalidades diferenciadas de tránsito por la mediana edad. A continuación detalla el Síndrome Faroni propiamente dicho como una de estas modalidades patognomónicas de la mediana edad, caracterizado por el establecimiento de un doble con características mistas de doble inmortal y doble ideal cone l que la persona interactúa intentando promover la expresión, elaboración e integración de los contenidos psíquicos reprimidos y disociados, tanto como la promoción en simultáneo de transformaciones autoplásticas y aloplásticas. Luego de una síntesis argumental y biografía del personaje, el paper detalla la historia de la neurosis infantil y las identificaciones, el vínculo de la adolescencia con la misma edad, una particular modalidad de vínculo con el ideal generada en la infancia (afán) y sus consecuencias, el Síndrome Faroni y la expresión del doble en la mediana edad, tanto como un vértice psicopatologico. Todos estos acápites pretenden explicitarr los que el autor denomina Síndrome Faroni (AU)


The paper is an attempt at applying psychoanalysis to the novel Juegos de la edad tardía by Luis Landero, in which the authors describes all the characteristics related to the working out of anxieties specific to middle age. The writer begins by making a definition of middle age as from the psychical work generated as a result of incipient signs of aging that take the transience of individual life evident. Taking as a reference Freud´s work On transience the author then continues from a theoretical point of view, enabling us to understand the complexity of both the transition and the crisis of middle –age. Freud, in his previously-mentioned work, suggest different possible courses of working out what is short-lived, courses that act as prototype to formulate three differentiated modalities of passage through middle age. In continuation, the writer details the Faroni Syndrome as such, as one of those pathognomonical modalities of middle age, characterized by the establishment of a double with mixed characteristics of double immortal and double ideal with which the person interacts, trying to advance the expression, elaboration and integration of repressed and dissociated psychical contents, as well as the simultaneous promotion of autoplastic and alloplastic transformations. Following and argumental and biographical synthesis of the character, the paper details the history of child neurosis and identifications, the adolescent bond with middle age, a particular modality of bond with the ideal generated during childhood (afán) and its consequences, the Faroni Syndrome, and the expression of the double during middle age, the visissitudes of the self as the regulator of self steem during middle age, as well as a psychopathological vertex. All of these captions aim to explain what the author denominates the Faroni Syndrome (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Psychoanalysis/methods , Psychoanalysis/trends , Anxiety/psychology , Anxiety Disorders/psychology , Psychoanalysis/organization & administration , Aging/psychology , Freudian Theory , Psychopathology/methods , Psychopathology/standards , Psychopathology/trends
12.
TRIEB ; 4(1/2): 205-229, mar.-set. 2005.
Article in Portuguese | Index Psychology - journals | ID: psi-35745

ABSTRACT

O trabalho que apresento pretende ser abrangente da série de fenómenos psíquicos que se ativam ante a necessidade de reconhecer a transitoriedade da vida individual. A partir do texto de Freud, conceituo três diferentes vicissitudes ante a transitoriedade, centrando o foco especialmente no corpo percebido como ameaça a partir das inequívocos sinais de envelhecimento. A inscrição psíquica da transitoriedade me permite também oferecer uma definição de meia-idade que, mais do que cronológica, pretende compreender-se dentro de um tipo de temporalidade mais especificamente psicanalítica. Dou especial importância à angústia de morte e sua irrupção durante a meiaidade. Assim mesmo caracterizo uma transição e uma crise de meia-idade, formulando-as como um continuum no qual ambos pólos mantêm entre si uma relação inversamente proporcional, implicando a transição os fenómenos próprios do desenvolvimento e da crise, aqueles mais proximamente ligados à psicopatologia. Proponho formular um 'organizador' psíquico adulto que sintetize à maneira de ponto nodal a confluência de múltiplos fatores que acontecem sincronicamente no tempo. Sustento a ideia de que que os processos de luto normal e de re-significação são o verdadeiro motor do desenvolvimento psíquico, e serão os processos que derivarão na série de aquisições psíquicas que detalho. Considero que a continuidade do desenvolvimento durante a meiaidade implica considerar uma transformação (evolução) do narcisismo, uma atualização do ideal do ego, uma reativação da conflitiva pré-edípica e edípica, assim como uma revisão da história das identificações e desidentificação. Finalmente, apresento quatro aquisições específicas, que caracterizam a continuidade da individuação durante a meia-idade, a saber: a mudança na percepção subjetiva do tempo, a tolerância da incerteza de viver, um«J nova integração da história pessoal e a ancoragem da história individual na história geracional(AU)

14.
Technol Cancer Res Treat ; 2(4): 339-44, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12892517

ABSTRACT

Thirty-one [31] patients with local recurrent or residual adenocarcinoma of the prostate, with no evidence of distant metastases, were treated with second permanent implant using a stereotactic three dimensional system and posterior pararectal CT-guided method. All patients had extensive under local anesthesia or IV sedation pararectal CT-guided biopsy of the prostate and seminal vesicles. All patients except one had 3 month neoadjuvant androgen ablation prior to salvage reimplantation. Twenty [20] of these patients had local recurrence in the prostate and eleven [11] patients had seminal vesicle invasion which was not diagnosed nor treated with the initial brachytherapy. In addition, the patients had PSA failure or local palpable disease, "cold spots" with CT imaging or areas of dosage less than 80% of the prescribed dose with DVH (dose volume histogram). Initial prescribed dose was 120 Gy with (103)Pd loose seeds in 26 patients and 144 Gy with (125)I loose seeds in 5 patients. For the reimplant the dosage in the recurrent site was 100-144 Gy with (125)I seeds in strand in 24 patients (77%) and 100-120 Gy with (103)Pd loose seeds in 7 patients (23%). The preference of (125)I seeds in the second treatment was because only (125)I in strand was available at the time of the reimplant. Eleven [11] patients had second implant twelve to twenty-four months after the initial implant and 20 patients had after twenty-five to eighty-seven months and median follow-up was thirty months. A high level of biochemical control (87%) was achieved in all of these patients who are recognized as high risk due to local recurrence. Four [4] patients experienced grade 2 or 3 GI or GU complications and two [2] patients experienced grade 4 GI complications. Patients with local recurrent prostate cancer following initial brachytherapy including those with seminal vesicle invasion can be successfully treated with pararectal stereotactic CT-guided reimplantation. Assessment of seminal vesicle status is an essential part of staging for local recurrence.


Subject(s)
Brachytherapy/methods , Prostatic Neoplasms/radiotherapy , Salvage Therapy/methods , Tomography, X-Ray Computed/methods , Aged , Humans , Imaging, Three-Dimensional , Iodine Radioisotopes/therapeutic use , Male , Middle Aged , Palladium/therapeutic use , Radioisotopes/therapeutic use , Recurrence , Time Factors
15.
Radiother Oncol ; 67(3): 303-8, 2003 Jun.
Article in English | MEDLINE | ID: mdl-12865178

ABSTRACT

PURPOSE: To report post-brachytherapy results in high and intermediate risk patients of prostatic adenocarcinoma. METHODS AND MATERIALS: From June 1994 to June 2000, 356 consecutive high and intermediate risk patients were treated with three-dimensional computed tomography-guided stereotactic pararectal brachytherapy. The age was 42-90 years (median, 68 years), the initial prostate volume was 14-180 cm3 (median, 59 cm3), and initial PSA was 1.7-143 ng/ml (median, 10.5 ng/ml). Three hundred forty-eight patients were available for follow-up for 2-8 years (median, 4.5 years). Two hundred eighty patients had one or more high risk factors (PSA >20 ng/ml, Gleason>7, Stage T2b, T3a, or T3b). Sixty-eight patients had only one intermediate risk factor (PSA 10-20 ng/ml or Gleason=7). Patients with both intermediate risks were considered high risk. The high-risk group was further stratified into subgroups with similar risk profile. A dose of 144 Gy with 125I or 120 Gy with 103Pd was achieved in 90-100% of the target. Thirty (30) patients (9%) had prior transurethral resection and 229 (64%) were treated with 3 months neoadjuvant androgen ablation. RESULTS: Biochemical disease-free survival was 92% of 280 high risk patients and 96% of 68 intermediate risk patients. Seven patients (2%) required catheterization during the first year for urinary retention, nine patients (3%) required TUR 1-3 years post-implant, three patients (1%) developed grade 1 or 2 incontinence after a second TUR, and four patients (1%) developed grade 3 rectal complications. CONCLUSION: This method produces a high level of biochemical control 2-8 years (median 4.5 years). Morbidity is acceptable regardless of risk profile or initial prostate volume.


Subject(s)
Brachytherapy/methods , Prostatic Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Brachytherapy/adverse effects , Disease-Free Survival , Follow-Up Studies , Humans , Imaging, Three-Dimensional/methods , Male , Middle Aged , Risk Factors , Tomography, X-Ray Computed/methods , Urination Disorders/etiology
16.
Ciudad de La Habana; Acuario Nacional de Cuba; jun, 2003. 76 p. ilus, tab.
Monography in Spanish | CUMED | ID: cum-28024

ABSTRACT

El Proyecto de Educación Ambiental en Comunidades Costeras tuvo su origen en las actividades de educación que el Acuario realizaba en las áreas costeras donde efectuaba la captura de los ejemplares que posteriormente se exhibirían en el centro.Particularmente y ante el interés que despertaba en la población de aquellas áreas costeras las actividades educacionales y después de constatar la necesidad de trabajar con los niños y jóvenes como uno de los sectores dentro de las comunidades que más lo necesitaban por su acción futura dentro de esas localidades, surge la idea de desarrollar un proyecto que permitiera vincular las líneas de conocimiento marinos con la formación de valores, actitudes y convicciones por preservar y proteger su comunidad, propiciándole las herramientas para desarrollar la investigación y en ella la necesidad de rescatar sus tradiciones tanto históricas como sociales- culturales, aspecto importante para amar su localidad(AU)


Subject(s)
Environmental Health Education , Cuba , Coasts , Risk Groups
18.
J Urol ; 169(4): 1331-6, 2003 Apr.
Article in English | MEDLINE | ID: mdl-12629354

ABSTRACT

PURPOSE: We report post-brachytherapy results in patients with cancer in a large prostate. MATERIALS AND METHODS: From June 1, 1994 to June 30, 2000, 331 consecutive patients with a large prostate of 50 to 180 cm.3 (median 69) were treated with 3-dimensional computerized tomography guided brachytherapy. Patient age was 42 to 90 years (median 69). Of these patients 327 were available for followup for 2 to 8 years (median 4.5). Patients were stratified according to risk profile. The high risk group had 1 or more high risk factors (prostate specific antigen [PSA] greater than 20 ng./ml., Gleason greater than 7, stage T2b, T3a or T3b) or 2 intermediate risk factors (PSA 10 to 20 ng./ml. and Gleason 7). The high risk group was further stratified into subgroups with a similar risk profile. The intermediate risk group had only 1 high risk factor (PSA 10 to 20 ng./ml. or Gleason 7). The low risk group had PSA less than 10 ng./ml., Gleason less than 7 and stage T1a, b, c or T2a. A dose of 144 Gy. with 125I or 120 Gy. with 103Pd was achieved in 90% to 100% of the target. A total of 31 patients (9%) had previously undergone transurethral resection and 198 (60%) were treated with 3 months of neoadjuvant androgen ablation. RESULTS: Biochemical disease-free survival was achieved in 90% of the 182 patients at high risk, 96% of the 52 at intermediate risk and 99% of the 93 at low risk. Seven patients (2%) required catheterization during year 1 for urinary retention, 11 (3%) required transurethral prostate resection 1 to 4 years after implantation, 3 patients (1%) had grade 1 or 2 incontinence after repeat transurethral prostate resection and 4 (1%) had grade 3 or 4 rectal complications. CONCLUSIONS: The 3-dimensional computerized tomography guided pararectal permanent implant results in a high level of biochemical control with low morbidity at 2 to 8 years in patients with prostate cancer who have a large prostate. There was less favorable biochemical control in patients with PSA greater than 20 ng./ml., Gleason 7 or greater and seminal vesicle invasion.


Subject(s)
Brachytherapy/methods , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Prostatic Neoplasms/radiotherapy , Radiotherapy Planning, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/blood , Combined Modality Therapy , Disease-Free Survival , Humans , Male , Middle Aged , Neoplasm Staging , Prostate/diagnostic imaging , Prostate/pathology , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgery , Radiotherapy, Adjuvant , Risk Factors , Transurethral Resection of Prostate
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