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Sobańska Z, Sitarek K, Gromadzińska J, Świercz R, Szparaga M, Domeradzka-Gajda K, Kowalczyk K, Zapór L, Wąsowicz W, Grobelny J, Ranoszek-Soliwoda K, Tomaszewska E, Celichowski G, Roszak J, Stępnik M. Biological effects of molybdenum(IV) sulfide nanoparticles and microparticles in the rat after repeated intratracheal administration. J Appl Toxicol 2024; 44:595-608. [PMID: 37968889 DOI: 10.1002/jat.4563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 11/17/2023]
Abstract
In this study, molybdenum(IV) sulfide (MoS2 ) nanoparticles (97 ± 32 nm) and microparticles (1.92 ± 0.64 μm) stabilized with poly (vinylpolypyrrolidone) (PVP) were administered intratracheally to male and female rats (dose of 1.5 or 5 mg/kg bw), every 14 days for 90 days (seven administrations in total). Blood parameters were assessed during and at the end of the study (hematology, biochemistry including glucose, albumins, uric acid, urea, high density lipoprotein HDL, total cholesterol, triglycerides, aspartate transaminase, and alanine transaminase ALT). Bronchoalveolar lavage fluid (BALF) analyses included cell viability, biochemistry (total protein concentration, lactate dehydrogenase, and glutathione peroxidase activity), and cytokine levels (tumor necrosis factor α, TNF-α, macrophage inflammatory protein 2-alpha, MIP-2, and cytokine-induced neutrophil chemoattractant-2, CINC-2). Tissues were subjected to routine histopathological and electron microscopy (STEM) examinations. No overt signs of chronic toxicity were observed. Differential cell counts in BALF revealed no significant differences between the animal groups. An increase in MIP-2 and a decrease in TNF-α were observed in BALF in the exposed males. The histopathological changes in the lung evaluated according to a developed classification system (based on severity of inflammation, range 0-4, with 4 indicating the most severe changes) showed average histopathological score of 1.33 for animals exposed to nanoparticles and microparticles at the lower dose, 1.72 after exposure to nanoparticles at the higher dose, and 2.83 for animals exposed to microparticles at the higher dose. In summary, it was shown that nanosized and microsized MoS2 can trigger dose-dependent inflammatory reactions in the lungs of rats after multiple intratracheal instillation irrespective of the animal sex. Some evidence indicates a higher lung pro-inflammatory potential of the microform.
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Affiliation(s)
- Z Sobańska
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - K Sitarek
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | | | - R Świercz
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - M Szparaga
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | | | - K Kowalczyk
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - L Zapór
- Central Institute for Labour Protection-National Research Institute, Warsaw, Poland
| | - W Wąsowicz
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - J Grobelny
- Faculty of Chemistry, Department of Materials Technology and Chemistry, University of Łódź, Łódź, Poland
| | - K Ranoszek-Soliwoda
- Faculty of Chemistry, Department of Materials Technology and Chemistry, University of Łódź, Łódź, Poland
| | - E Tomaszewska
- Faculty of Chemistry, Department of Materials Technology and Chemistry, University of Łódź, Łódź, Poland
| | - G Celichowski
- Faculty of Chemistry, Department of Materials Technology and Chemistry, University of Łódź, Łódź, Poland
| | - J Roszak
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - M Stępnik
- Nofer Institute of Occupational Medicine, Łódź, Poland
- QSAR Lab Ltd., Gdańsk, Poland
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2
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Stangl-Kremser J, Kowalczyk K, Schaeffer EM, Alla M, Scherr D, Yan X, Matos A, Azumi N, Robinso B, Vickers A, Hu JC. Study protocol for a prospective, multi-centered randomized controlled trial comparing pelvic fascia-sparing radical prostatectomy with conventional robotic-assisted prostatectomy: The PARTIAL trial. Contemp Clin Trials 2023; 128:107168. [PMID: 37015291 DOI: 10.1016/j.cct.2023.107168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Pelvic fascia-sparing robotic-assisted radical prostatectomy (PFS-RARP) is a novel approach that spares the endopelvic fascia ventral to the prostate. The preservation of more native structures compared to conventional robotic-assisted radical prostatectomy (RARP) may lead to faster recovery of urinary function, fewer penile changes, and decreased inguinal hernia sequelae, but may have a higher risk for positive surgical margins and poorer cancer control. However, high-level evidence is absent. The PARTIAL trial is a surgical randomized controlled trial (RCT) aiming to bridge this evidence gap (NCT05155501). METHODS We describe a prospective RCT with a projected enrollment of 600 men randomized to PFS-RARP vs. RARP. The primary outcome is cancer control (positive surgical margins and prostate-specific antigen failure) and secondary outcomes include health-related quality of life pertaining to urinary and sexual function, decision regret, and adverse events (30-day complications, inguinal hernias, penile shortening, and Peyronie's disease). The anticipated duration of trial participation is 24 months. Study participation is incentivized with the use of innovative methodologies such as a novel, two-stage informed consent and a validated web-based interface to monitor patient-reported symptoms and empower individuals to improve their recovery. CONCLUSION If PFS-RARP is non-inferior to RARP in terms of cancer control and has better functional outcomes, it should be the surgical standard of care for men with localized prostate cancer. Using the innovative two-stage consent process, completion of the trial will not only provide much needed evidence on one of the most common cancer surgeries but also insight on improving surgical RCT methodology. Trial status This trial is registered at ClinicalTrials.gov (NCT05155501; first posted on December 13, 2021); Institutional approval number: WCM IRB # 21-07023781, BRANY's initial approval event ID # 186333. The trial is not yet recruiting.
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Affiliation(s)
- Judith Stangl-Kremser
- Department of Urology, Weill Cornell Medicine, 525 E 68(th) Street, New York, NY 10065, USA
| | - Keith Kowalczyk
- Department of Urology, Georgetown University, 3800 Reservoir Road, NW, Washington, DC 20007, USA
| | - Edward M Schaeffer
- Department of Urology, Northwestern University, 676 N Saint Clair, Chicago, IL 60611, USA
| | - Mohamad Alla
- Department of Urology, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Douglas Scherr
- Department of Urology, Weill Cornell Medicine, 525 E 68(th) Street, New York, NY 10065, USA
| | - Ximing Yan
- Department of Urology, Northwestern University, 676 N Saint Clair, Chicago, IL 60611, USA
| | - Andres Matos
- Department of Pathology, Weill Cornell Medicine, 525 E 68(th) Street, New York, NY 10065, USA
| | - Norio Azumi
- Department of Urology, Northwestern University, 676 N Saint Clair, Chicago, IL 60611, USA
| | - Brian Robinso
- Department of Pathology, Weill Cornell Medicine, 525 E 68(th) Street, New York, NY 10065, USA
| | - Andrew Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, New York, NY 10017, USA
| | - Jim C Hu
- Department of Urology, Weill Cornell Medicine, 525 E 68(th) Street, New York, NY 10065, USA.
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Cheema AK, Li Y, Ventimiglia M, Kowalczyk K, Hankins R, Bandi G, Janowski EM, Grindrod S, Villagra A, Dritschilo A. Radiotherapy Induces Innate Immune Responses in Patients Treated for Prostate Cancers. Clin Cancer Res 2023; 29:921-929. [PMID: 36508164 PMCID: PMC9975665 DOI: 10.1158/1078-0432.ccr-22-2340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/03/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Radiotherapy is a curative therapeutic modality used to treat cancers as a single agent or in combination with surgery and chemotherapy. Advanced radiotherapy technologies enable treatment with large fractions and highly conformal radiation doses to effect free-radical damage to cellular DNA leading to cell-cycle arrest, cell death, and innate immune response (IIR) stimulation. EXPERIMENTAL DESIGN To understand systemic clinical responses after radiation exposure, proteomic and metabolomic analyses were performed on plasma obtained from patients with cancer at intervals after prostate stereotactic body radiotherapy. Pathway and multivariate analyses were used to delineate molecular alterations following radiotherapy and its correlation with clinical outcomes. RESULTS DNA damage response increased within the first hour after treatment and returned to baseline by 1 month. IIR signaling also increased within 1 hour of treatment but persisted for up to 3 months thereafter. Furthermore, robust IIR and metabolite elevations, consistent with an early proinflammatory M1-mediated innate immune activation, were observed in patients in remission, whereas patients experiencing prostate serum antigen-determined disease progression demonstrated less robust immune responses and M2-mediated metabolite elevations. CONCLUSIONS To our knowledge, these data are the first report of longitudinal proteomic and metabolomic molecular responses in patients after radiotherapy for cancers. The data supports innate immune activation as a critical clinical response of patients receiving radiotherapy for prostate cancer. Furthermore, we propose that the observed IIR may be generalized to the treatment of other cancer types, potentially informing multidisciplinary therapeutic strategies for cancer treatment.
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Affiliation(s)
- Amrita K. Cheema
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC
- Department of Biochemistry, Molecular and Cellular Biology, Georgetown University Medical Center, Washington DC
- Corresponding Author: Amrita K. Cheema, GC2, Pre-clinical Science Building, 3900 Reservoir Road NW, Washington DC 20007. Phone: 202-687-2756; E-mail:
| | - Yaoxiang Li
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC
| | - Mary Ventimiglia
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC
| | - Keith Kowalczyk
- Department of Radiation Medicine, LL Bles, MedStar-Georgetown University Hospital, Washington DC
| | - Ryan Hankins
- Department of Radiation Medicine, LL Bles, MedStar-Georgetown University Hospital, Washington DC
| | - Gaurav Bandi
- Department of Radiation Medicine, LL Bles, MedStar-Georgetown University Hospital, Washington DC
| | - Einsley-Marie Janowski
- Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, Virginia
| | | | - Alejandro Villagra
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC
| | - Anatoly Dritschilo
- Department of Radiation Medicine, LL Bles, MedStar-Georgetown University Hospital, Washington DC
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Marra G, Rajwa P, Montefusco G, Van Den Bergh R, Zattoni F, Dal Moro F, Magli A, Affentranger A, Grogg J, Hermanns T, Malkiewicz B, Kowalczyk K, Shariat S, Bianchi A, Antonelli A, Gallina S, Berchiche W, Cathelineau X, Afferi L, Fankhauser C, Mattei A, Scuderi S, Briganti A, Gontero P, Gandaglia G. Impact of pre-operative PSMA PET/CT for men with cN0M0 conventional imaging and pN+ prostate cancer: Results from a multicenter study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00296-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Jung M, Kowalczyk K, Hankins R, Bandi G, Kallakury B, Carrasquilla MA, Banerjee PP, Grindrod S, Dritschilo A. Novel paired normal prostate and prostate cancer model cell systems
derived from African American patients. Cancer Research Communications 2022; 2:1617-1625. [PMID: 36970725 PMCID: PMC10035501 DOI: 10.1158/2767-9764.crc-22-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/27/2022] [Accepted: 11/30/2022] [Indexed: 12/07/2022]
Abstract
Abstract
Prostate cancer is the most frequently diagnosed solid malignancy in men. African American (AA) men are at greater risk for developing prostate cancer, and experience higher mortality rates, as compared to Caucasian American (CA) men. However, mechanistic studies to understand this health disparity have been limited by the lack of relevant in vitro and in vivo models. There is an urgent need for preclinical cellular models to investigate molecular mechanisms underlying prostate cancer in AA men. We collected clinical specimens from radical prostatectomies of AA patients and established ten paired tumor-derived and normal epithelial cell cultures from the same donors, which were further cultivated to extend the growth under “conditional reprogramming (CR)”. Clinical and cellular annotations characterized these model cells as intermediate risk and predominantly diploid. Immunocytochemical analyses demonstrated variable expression levels of luminal (CK8) and basal (CK5, p63) markers in both normal and tumor cells. However, expression levels of TOPK, c-MYC, and N-MYC were markedly increased only in tumor cells. To determine cell utility for drug testing, we examined viability of cells following exposure to the anti-androgen (Bicalutamide) and two PARP-inhibitors (Olaparib and Niraparib) and observed decreased viability of tumor-derived cells as compared to viability of normal prostate derived cells.
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Affiliation(s)
- Mira Jung
- Georgetown University Medical Center, Washington, DC, United States
| | - Keith Kowalczyk
- Georgetown University Medical Center & MedStar Georgetown University Hospital, Washington, DC, United States
| | - Ryan Hankins
- Georgetown University Medical Center & MedStar Georgetown University Hospital, Washington, DC, United States
| | - Gaurav Bandi
- MedStar Georgetown University Hospital, Washington, United States
| | | | - Michael A Carrasquilla
- Georgetown University Medical Center & MedStar Georgetown University Hospital, Washington, DC, United States
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Kowalczyk K, Roszak J, Sobańska Z, Stępnik M. Review of mechanisms of genotoxic action of dibenzo[def,p]chrysene (formerly dibenzo[a,l]pyrene). TOXIN REV 2022. [DOI: 10.1080/15569543.2022.2124419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - J. Roszak
- Department of Translational Research, Nofer Institute of Occupational Medicine, Łódź, Poland
| | - Z. Sobańska
- Department of Translational Research, Nofer Institute of Occupational Medicine, Łódź, Poland
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Sholklapper TN, Creswell ML, Payne AT, Markel M, Pepin A, Carrasquilla M, Zwart A, Danner M, Ayoob M, Yung T, Collins B, Kumar D, Aghdam N, Suy S, Hankins RA, Kowalczyk K, Collins SP. Patient-Reported Financial Burden Following Stereotactic Body Radiation Therapy for Localized Prostate Cancer. Front Oncol 2022; 12:852844. [PMID: 35402242 PMCID: PMC8990911 DOI: 10.3389/fonc.2022.852844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/28/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction and Objectives In patients with localized prostate cancer, 5-fraction, stereotactic body radiation therapy (SBRT) has been found to offer comparable oncologic outcomes and potential for improved treatment compliance compared to conventional, 40-plus fraction radiation therapy (RT). Recent studies of oncologic patient experiences have highlighted both the impact of therapy-associated financial toxicity (FT) on treatment adherence and health-related quality of life (HRQOL). Methods A cross-sectional assessment of FT after SBRT was performed using the 12-item COST questionnaire. The total questionnaire score (range 0–44) was used to evaluate the FT grade (0–3), with a higher COST value representing lower grade. The patient zip code was used to approximate the distance from the index hospital. Univariate and multivariate analyses of the average COST score (0–4) are performed. Results The response rate was 57.5% (332 of 575 consented patients) with 90.7%, 8.2%, and 1.1% experiencing grade 0, 1, and 2 FT, respectively, with no grade 3. Unemployment or disability, non-white race, low income, and concurrent hormonal therapy were associated with a statistically significant worse FT (lower COST value) on univariate and multivariate analyses (p < 0.05). Education level and insurance status significant were evaluated on univariate analysis only. There was a non-statistically significant difference in age, marital status, time since treatment, and distance from the index hospital. Conclusions SBRT was associated with low FT. However, statistically significant socioeconomic disparities in FT remain despite ultra-hypofractionated treatment.
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Affiliation(s)
| | | | - Alexandra T Payne
- Georgetown University School of Medicine, Washington, DC, United States
| | - Michael Markel
- Georgetown University School of Medicine, Washington, DC, United States
| | - Abigail Pepin
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States
| | - Michael Carrasquilla
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States
| | - Alan Zwart
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States
| | - Malika Danner
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States
| | - Marilyn Ayoob
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States
| | - Thomas Yung
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States
| | - Brian Collins
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States
| | - Deepak Kumar
- Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina Central University, Durham, NC, United States
| | - Nima Aghdam
- Department of Radiation Medicine, Beth Israel Deaconess, Boston, MA, United States
| | - Simeng Suy
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States
| | - Ryan A Hankins
- Department of Urology, Georgetown University Hospital, Washington, DC, United States
| | - Keith Kowalczyk
- Department of Urology, Georgetown University Hospital, Washington, DC, United States
| | - Sean P Collins
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, United States
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Forsthoefel M, Hankins R, Ballew E, Frame C, DeBlois D, Pang D, Krishnan P, Unger K, Kowalczyk K, Lynch J, Dritschilo A, Collins SP, Lischalk JW. Prostate Cancer Treatment with Pencil Beam Proton Therapy Using Rectal Spacers sans Endorectal Balloons. Int J Part Ther 2022; 9:28-41. [PMID: 35774493 PMCID: PMC9238133 DOI: 10.14338/ijpt-21-00039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/01/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose Proton beam radiotherapy (PBT) has been used for the definitive treatment of localized prostate cancer with low rates of high-grade toxicity and excellent patient-reported quality-of-life metrics. Technological advances such as pencil beam scanning (PBS), Monte Carlo dose calculations, and polyethylene glycol gel rectal spacers have optimized prostate proton therapy. Here, we report the early clinical outcomes of patients treated for localized prostate cancer using modern PBS–PBT with hydrogel rectal spacing and fiducial tracking without the use of endorectal balloons. Materials and Methods This is a single institutional review of consecutive patients treated with histologically confirmed localized prostate cancer. Prior to treatment, all patients underwent placement of fiducials into the prostate and insertion of a hydrogel rectal spacer. Patients were typically given a prescription dose of 7920 cGy at 180 cGy per fraction using a Monte Carlo dose calculation algorithm. Acute and late toxicity were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE), version 5. Biochemical failure was defined using the Phoenix definition. Results From July 2018 to April 2020, 33 patients were treated (median age, 75 years). No severe acute toxicities were observed. The most common acute toxicity was urinary frequency. With a median follow-up of 18 months, there were no high-grade genitourinary late toxicities; however, one grade 3 gastrointestinal toxicity was observed. Late erectile dysfunction was common. One treatment failure was observed at 21 months in a patient treated for high-risk prostate cancer. Conclusion Early clinical outcomes of patients treated with PBS–PBT using Monte Carlo–based planning, fiducial placement, and rectal spacers sans endorectal balloons demonstrate minimal treatment-related toxicity with good oncologic outcomes. Rectal spacer stabilization without the use of endorectal balloons is feasible for the use of PBS–PBT.
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Affiliation(s)
- Matthew Forsthoefel
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
| | - Ryan Hankins
- Department of Urology, Georgetown University Hospital, Washington, DC, USA
| | - Elizabeth Ballew
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
| | - Cara Frame
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
| | - David DeBlois
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
| | - Dalong Pang
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
| | - Pranay Krishnan
- Department of Radiology, Georgetown University Hospital, Washington, DC, USA
| | - Keith Unger
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
| | - Keith Kowalczyk
- Department of Urology, Georgetown University Hospital, Washington, DC, USA
| | - John Lynch
- Department of Urology, Georgetown University Hospital, Washington, DC, USA
| | - Anatoly Dritschilo
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
| | - Sean P. Collins
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, USA
| | - Jonathan W. Lischalk
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital – Long Island, New York, NY, USA
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Kaliszewicz A, Karaban K, Sierakowski M, Maciaszek R, Kur M, Pyffel Z, Wolny L, Chmiel K, Łuciuk P, Rusin P, Kowalczyk K. Effect of dietary supplementation with fatty acids on growth, survival, and fatty acid patterns in Procambarus clarkii and Procambarus virginalis: the first comparison of two invasive crayfish species. The European Zoological Journal 2022. [DOI: 10.1080/24750263.2022.2030420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- A. Kaliszewicz
- Institute of Biological Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - K. Karaban
- Institute of Biological Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - M. Sierakowski
- Center for Ecology and Ecophilosophy, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - R. Maciaszek
- Department of Animal Genetics and Conservation, Institute of Animal Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - M. Kur
- Faculty of Biology and Environmental Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - Z. Pyffel
- Faculty of Biology and Environmental Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - L. Wolny
- Faculty of Biology and Environmental Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - K. Chmiel
- Faculty of Biology and Environmental Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - P. Łuciuk
- Faculty of Biology and Environmental Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - P. Rusin
- Institute of Biological Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - K. Kowalczyk
- Faculty of Biology and Environmental Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
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Basourakos SP, Kowalczyk K, Moschovas MC, Dudley V, Hung AJ, Shoag JE, Patel V, Hu JC. Robot-Assisted Radical Prostatectomy Maneuvers to Attenuate Erectile Dysfunction: Technical Description and Video Compilation. J Endourol 2021; 35:1601-1609. [PMID: 34015959 PMCID: PMC8820193 DOI: 10.1089/end.2021.0081] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Erectile dysfunction (ED) remains a significant problem in up to 63% of men after robot-assisted radical prostatectomy (RARP). After the discovery of the neurovascular bundle (NVB), additional anatomic description and variation in nerve-sparing (NS) techniques have been described to improve post-RARP ED. However, it remains questionable whether ED rates have improved over time, and this is concerning as competing treatments are introduced that have better ED outcomes. In this review, we describe RARP NS technical modifications that improve erectile function recovery. We focused on reports that included detailed anatomical descriptions as well as video illustrations to disseminate technique. We found that the alternative RARP NS surgical techniques provide better outcomes compared with standard NS RARP. The use of validated quality of life questionnaires is necessary for the appropriate comparison of outcomes. However, the retrospective character and inherent weaknesses of the included studies do not allow one to conclude which is the best NS approach. Overall, there is significant variation in RARP NS techniques and outcomes, and the ideal technical maneuvers to optimize outcomes remains subject to debate. However, there is a consensus on the importance of anatomically dissecting the NVB, minimizing traction and thermal injury as well as preserving the periprostatic fascia. Well-designed randomized controlled trials with videos describing details of different surgical techniques for generalizability are needed to consistently and objectively evaluate sexual function outcomes after RARP to optimize postoperative potency.
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Affiliation(s)
- Spyridon P. Basourakos
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
| | - Keith Kowalczyk
- Department of Urology, MedStar Georgetown University Hospital, Lombardi Cancer Center, Washington, District of Columbia, USA
| | | | - Vanessa Dudley
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
| | - Andrew J Hung
- Center for Robotic Simulation & Education, Catherine & Joseph Aresty Department of Urology, University of Southern California Institute of Urology, Los Angeles, California, USA
| | - Jonathan E. Shoag
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA.,Department of Urology, Case Western University Hospital, Cleveland, Ohio, USA
| | - Vipul Patel
- AdventHealth Global Robotics Institute, Celebration, Florida, USA
| | - Jim C. Hu
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA.,Address correspondence to: Jim C. Hu, MD, Department of Urology, New York Presbyterian Hospital-Weill Cornell Medicine, 525 East 68th Street, Starr 900, New York, NY 10021, USA
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11
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Galfano A, Tappero S, Dell’Oglio P, Eden C, Fransis K, Guo H, Kowalczyk K, Madi R, Rha K, Secco S, Bocciardi A. Multicentric experience in Retzius-sparing robot assisted radical prostatectomy performed by expert surgeons for high risk prostate cancer. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01477-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Creswell ML, Ilagan CJL, Downs SG, Dainty LA, Kowalczyk K, Shaw NM. Giant primary vaginal tubulovillous adenoma: A case report and review of literature. Urol Case Rep 2021; 38:101734. [PMID: 34141588 PMCID: PMC8184522 DOI: 10.1016/j.eucr.2021.101734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/19/2021] [Indexed: 11/20/2022] Open
Abstract
Primary adenomas are common in the gastrointestinal tract but exceedingly rare on the periurethral surface and vagina. The pathogenesis remains unknown but vaginal adenomas are hypothesized to arise from vaginal adenosis or embryonic cloacal remnants and possess malignant potential. We present a case of a large primary vaginal tubulovillous adenoma in an eighty-one-year-old, likely diethylstilbestrol naïve patient. To the best of our knowledge the patient's 7.4 x 4.5 × 1.4 cm primary vaginal tubulovillous adenoma is the largest ever reported in literature. Primary vaginal adenomas in diethylstilbestrol naïve patients are exceedingly rare Vaginal adenomas have malignant potential and must be fully resected There is no consensus on management of primary vaginal adenomas
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Affiliation(s)
| | - Charmaine JL. Ilagan
- Department of Pathology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Sarah G. Downs
- Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Louis A. Dainty
- Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Keith Kowalczyk
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Nathan M. Shaw
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC, USA
- Corresponding author. 3800 Reservoir Rd NW, Washington, D.C., 20007, USA.
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13
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Goldman CC, Dall CP, Sholklapper T, Brems J, Kowalczyk K. Complex space of Retzius lymphocele resulting in iliac compression and submassive pulmonary embolism after robotic Retzius sparing prostatectomy. Urol Case Rep 2021; 36:101598. [PMID: 33659187 PMCID: PMC7890136 DOI: 10.1016/j.eucr.2021.101598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 11/25/2022] Open
Abstract
Lymphoceles are common following prostatectomy with lymph node dissection, but the vast majority are asymptomatic. We present a unique case of a large complex lymphocele tracking into the anterior space of Retzius following Retzius sparing prostatectomy and bilateral pelvic lymphadenectomy. The patient initially presented with shortness of breath and subsequent diagnosis of a submassive pulmonary embolism. Further evaluation revealed compression of the iliac vessels by the fluid collection. Following multiple failed attempts of drainage percutaneously, the patient required return to the operating room for peritoneal marsupialization, drainage of fluid collection, and evacuation of large amounts of clot within the collection.
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Affiliation(s)
- Charlotte C Goldman
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC, USA.,Department of Urology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Christopher P Dall
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC, USA.,Department of Urology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Tamir Sholklapper
- Georgetown University School of Medicine, Georgetown University, Washington, DC, USA
| | - Jacob Brems
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC, USA.,Department of Urology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Keith Kowalczyk
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC, USA.,Georgetown University School of Medicine, Georgetown University, Washington, DC, USA
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14
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Sobańska Z, Sitarek K, Gromadzińska J, Świercz R, Szparaga M, Domeradzka-Gajda K, Kowalczyk K, Zapór L, Wąsowicz W, Grobelny J, Ranoszek-Soliwoda K, Tomaszewska E, Celichowski G, Roszak J, Stępnik M. Assessment of acute toxicological effects of molybdenum(IV) disulfide nano- and microparticles after single intratracheal administration in rats. Sci Total Environ 2020; 742:140545. [PMID: 32629262 DOI: 10.1016/j.scitotenv.2020.140545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/01/2020] [Accepted: 06/24/2020] [Indexed: 06/11/2023]
Abstract
Despite growing applications of molybdenum(IV) sulfide (MoS2) nano- and microparticles in their capacity as lubricants, data available on their safety are scarce. In this study the effect of MoS2 nano- and microparticles after single intratracheal instillation in rats has been analyzed. MoS2 suspensions were administered at the dose of 1.5 or 5 mg MoS2/kg body weight. The analysis after 24 h and 7 days included: blood biochemical parameters, hematological parameters, bronchoalveolar lavage fluid (BALF) parameters with selected cytokines, a comet assay and histopathological examination. In the BALF cells isolated from animals exposed to both forms, numerous macrophages loaded with particles were observed. The hematological and biochemical parameters analyzed 24 h or 7 days after the exposure to both forms did not show any biologically meaningful changes. Comet assay results showed no genotoxic effect. The histopathological analysis of the lungs revealed inflammatory changes in the respiratory system of the treated animals, slightly stronger for the microsized form. The deposits of particles observed in the lung tissue up to 7 days after the instillation indicate their easy penetration through the epithelium and prolonged clearance. Concluding, no meaningful acute systemic effects were observed, however some pathological changes were noted in the lung tissue.
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Affiliation(s)
- Z Sobańska
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - K Sitarek
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | | | - R Świercz
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - M Szparaga
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | | | - K Kowalczyk
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - L Zapór
- Central Institute for Labour Protection-National Research Institute, Warsaw, Poland
| | - W Wąsowicz
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - J Grobelny
- University of Łódź, Department of Materials Technology and Chemistry, Faculty of Chemistry, Łódź, Poland
| | - K Ranoszek-Soliwoda
- University of Łódź, Department of Materials Technology and Chemistry, Faculty of Chemistry, Łódź, Poland
| | - E Tomaszewska
- University of Łódź, Department of Materials Technology and Chemistry, Faculty of Chemistry, Łódź, Poland
| | - G Celichowski
- University of Łódź, Department of Materials Technology and Chemistry, Faculty of Chemistry, Łódź, Poland
| | - J Roszak
- Nofer Institute of Occupational Medicine, Łódź, Poland
| | - M Stępnik
- Nofer Institute of Occupational Medicine, Łódź, Poland.
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15
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Galfano A, Secco S, Dell'Oglio P, Rha K, Eden C, Fransis K, Sooriakumaran P, De La Muela PS, Kowalczyk K, Miyagawa T, Assenmacher C, Matsubara A, Chiu KY, Boylu U, Lee H, Bocciardi AM. Retzius-sparing robot-assisted radical prostatectomy: early learning curve experience in three continents. BJU Int 2020; 127:412-417. [PMID: 32745367 DOI: 10.1111/bju.15196] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To assess the effect of surgical experience on peri-operative, functional and oncological outcomes during the first 50 Retzius-sparing robot-assisted radical prostatectomy (RsRARP) cases performed by surgeons naïve to this novel approach. MATERIALS AND METHODS We retrospectively evaluated the initial cases operated by 14 surgeons in 12 different international centres. Pre-, peri- and postoperative features of the first 50 patients operated by each surgeon in all the participating centres were collected. The effect of surgical experience on peri-operative, functional and oncological outcomes was firstly evaluated after stratification by level of surgical experience (initial [≤25 cases] and expert [>25 cases]) and after using locally weighted scatterplot smoothing to graphically explore the relationship between surgical experience and the outcomes of interest. RESULTS We evaluated 626 patients. The median follow-up was 13 months in the initial group and 9 months in the expert group (P = 0.002). Preoperative features overlapped between the two groups. Shorter console time (140 vs 120 min; P = 0.001) and a trend towards lower complications rates (13 vs 5.5%; P = 0.038) were observed in the expert group. The relationship between surgical experience and console time, immediate urinary continence recovery and Clavien-Dindo grade ≥2 complications was linear, without reaching a plateau, after 50 cases. Conversely, a non-linear relationship was observed between surgical experience and positive surgical margins (PSMs). CONCLUSIONS In this first report of a multicentre experience of RsRARP during the learning curve, we found that console time, immediate urinary continence recovery and postoperative complications are optimal from the beginning and further quickly improve during the learning process, while PSM rates did not clearly improve over the first 50 cases.
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Affiliation(s)
| | | | | | - Koon Rha
- Urology, Yonsei University, Seoul, Korea
| | | | - Karen Fransis
- Urology, UZA - University Hospital, Antwerp, Belgium
| | | | | | - Keith Kowalczyk
- Urology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Tomoaki Miyagawa
- Urology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | | | | | - Kun-Yuan Chiu
- Urology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ugur Boylu
- Urology, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Harry Lee
- Urology, MedStar Georgetown University Hospital, Washington, DC, USA
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16
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Marinaro J, Zeymo A, Egan J, Carvalho F, Krasnow R, Stamatakis L, Lynch J, Hwang J, Williams S, Kowalczyk K. Sex and Racial Disparities in the Treatment and Outcomes of Muscle-invasive Bladder Cancer. Urology 2020; 151:154-162. [PMID: 32810481 DOI: 10.1016/j.urology.2020.06.087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/16/2020] [Accepted: 06/28/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To identify racial and sex disparities in the treatment and outcomes of muscle-invasive bladder cancer (MIBC) using a nationwide oncology outcomes database. METHODS Using the National Cancer Database, we identified patients with muscle invasive bladder cancer from 2004 to 2014. Treatments analyzed included no treatment, cystectomy, neoadjuvant chemotherapy plus cystectomy ("optimal treatment"), cystectomy plus adjuvant chemotherapy, and chemoradiation. Propensity matching compared mortality outcomes between sexes. Logistic models evaluated predictors of receiving optimal treatment, as well as mortality. RESULTS Forty seven thousand two hundred and twenty nine patients were identified. Most patients were male (73.4%) and underwent cystectomy alone (69.0%). Propensity score matching demonstrated increased 90-day mortality in women vs men (13.0% vs 11.6%, P = .009), despite adjusting for differences in treatments between sexes. Logistic regression models showed no difference in receipt of optimal treatment between sexes (odds ratio [OR] 1.01, 95% confidence interval [CI] 0.83-1.22) although black patients were less likely to receive optimal treatment (OR 0.15, 95% CI 0.05-0.48). Logistic regression models confirmed increased 90-day mortality in female (OR 1.17, CI 1.08-1.27, P < .001) and black (OR 1.29, CI 1.11-1.50, P = .001) patients. Females had a lower overall survival on Cox regression analysis (Hazard Ratio 0.92, 95% CI 0.87-0.97). CONCLUSION While there do not appear to be significant treatment disparities between sexes, women experience higher 90-day mortality and lower overall survival. Black patients are less likely to receive optimal treatment and have a higher risk of 90-day mortality. Additional research is needed to determine the variables leading to worse outcomes in females and identify impediments to black patients receiving optimal treatment.
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Affiliation(s)
- Jessica Marinaro
- MedStar Georgetown University Hospital, Department of Urology, Washington, DC.
| | | | - Jillian Egan
- MedStar Georgetown University Hospital, Department of Urology, Washington, DC
| | - Filipe Carvalho
- MedStar Georgetown University Hospital, Department of Urology, Washington, DC
| | - Ross Krasnow
- MedStar Washington Hospital Center, Department of Urology, Washington, DC
| | - Lambros Stamatakis
- MedStar Washington Hospital Center, Department of Urology, Washington, DC
| | - John Lynch
- MedStar Georgetown University Hospital, Department of Urology, Washington, DC
| | - Jonathan Hwang
- MedStar Washington Hospital Center, Department of Urology, Washington, DC
| | - Stephen Williams
- Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, TX
| | - Keith Kowalczyk
- MedStar Georgetown University Hospital, Department of Urology, Washington, DC
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17
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Sobańska Z, Domeradzka-Gajda K, Szparaga M, Grobelny J, Tomaszewska E, Ranoszek-Soliwoda K, Celichowski G, Zapór L, Kowalczyk K, Stępnik M. Comparative analysis of biological effects of molybdenum(IV) sulfide in the form of nano- and microparticles on human hepatoma HepG2 cells grown in 2D and 3D models. Toxicol In Vitro 2020; 68:104931. [PMID: 32640262 DOI: 10.1016/j.tiv.2020.104931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/18/2020] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Abstract
Significance of MoS2 nanoparticles as a lubricant or drug carriers indicates the need to assess their safety. In the study we analyzed the effects of MoS2 nano- and microparticles and their internalization in vitro, using 2D and 3D culture models of human hepatoma HepG2 cell line. MoS2 micro- and nanoparticles were characterized with high resolution electron microscopy (HR-SEM), X-ray diffraction (XRD) and Energy Dispersive X-Ray Spectroscopy (EDS). The cells were exposed to a range of concentrations of the nano-and microparticles suspensions (maximum of 250 μg/mL) for 72 h. Cell viability was assessed using WST-1 reduction test and LDH release assay. Particle internalization was analyzed using scanning transmission electron microscopy (STEM). The nanoparticles were internalized into the 2D and 3D cultured cells, in spheroids more efficiently into the outer layer. For microparticles mainly particles of less than 1 μm in diameter underwent internalization. This process, however, did not affect cell viability as measured with the WST-1 and LDH assays. STEM observation showed well preserved integrity of the cell membrane and no apparent cytotoxic effect. Although the particles seemed to be safely sequestered in vacuoles or the cytoplasm, their fate and eventual biological effects are not certain and deserve further studies.
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Affiliation(s)
- Z Sobańska
- Toxicology and Carcinogenesis Dept., Nofer Institute of Occupational Medicine, Sw. Teresy 8 St, Łódź, Poland
| | - K Domeradzka-Gajda
- Toxicology and Carcinogenesis Dept., Nofer Institute of Occupational Medicine, Sw. Teresy 8 St, Łódź, Poland
| | - M Szparaga
- Toxicology and Carcinogenesis Dept., Nofer Institute of Occupational Medicine, Sw. Teresy 8 St, Łódź, Poland
| | - J Grobelny
- Department of Materials Technology and Chemistry, Faculty of Chemistry, University of Łódź, 163 Pomorska St, Łódź 90-236, Poland
| | - E Tomaszewska
- Department of Materials Technology and Chemistry, Faculty of Chemistry, University of Łódź, 163 Pomorska St, Łódź 90-236, Poland
| | - K Ranoszek-Soliwoda
- Department of Materials Technology and Chemistry, Faculty of Chemistry, University of Łódź, 163 Pomorska St, Łódź 90-236, Poland
| | - G Celichowski
- Department of Materials Technology and Chemistry, Faculty of Chemistry, University of Łódź, 163 Pomorska St, Łódź 90-236, Poland
| | - L Zapór
- Central Institute for Labour Protection-National Research Institute, Czerniakowska 16 St, Warsaw, Poland
| | - K Kowalczyk
- Toxicology and Carcinogenesis Dept., Nofer Institute of Occupational Medicine, Sw. Teresy 8 St, Łódź, Poland
| | - M Stępnik
- Toxicology and Carcinogenesis Dept., Nofer Institute of Occupational Medicine, Sw. Teresy 8 St, Łódź, Poland.
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18
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Roszak J, Smok-Pieniążek A, Spryszyńska S, Kowalczyk K, Domeradzka-Gajda K, Świercz R, Grobelny J, Tomaszewska E, Ranoszek-Soliwoda K, Celichowski G, Cieślak M, Puchowicz D, Stępnik M. Cytotoxic effects in transformed and non-transformed human breast cell lines after exposure to silver nanoparticles in combination with selected aluminium compounds, parabens or phthalates. J Hazard Mater 2020; 392:122442. [PMID: 32193110 DOI: 10.1016/j.jhazmat.2020.122442] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/18/2020] [Accepted: 02/29/2020] [Indexed: 05/23/2023]
Abstract
This study was undertaken to assess cytotoxic effects of selected aluminium compounds, parabens and phthalates in combination with silver nanoparticles (AgNP, 15 and 45 nm by STEM, Ag15 and Ag45, respectively) on cell lines of the human breast epithelium, normal (MCF-10A) and transformed (MDA-MB-231 and MCF-7). Combination indices were the most spectacular at effective concentrations (ED) inducing 25 % decrease in viability for the combinations of Ag15 with AlCl3 for MDA-MB-231 cells or aluminium zirconium tetrachlorohydrex Gly (AlZr) for MCF-10A and MCF-7 cells, where rather strong antagonism was revealed. As the ED values increased, those effects were enhanced (e.g. Ag15+AlCl3 for MDA-MB-231) or reversed into synergism (e.g. Ag15+AlZr for MCF-7). Another strong effect was observed for aluminium chloride hydroxide, which increasing ED, induced synergistic effect with both Ag15 and Ag45 on MCF-10A cells. Another interesting synergistic effect was observed for DBPh, but only in combination with Ag45 on MCF-10A and MCF-7. The results on cytotoxicity, cell cycle and oxidative stress induction indicate complex response of the cell lines to combined treatment with silver nanoparticles and the chemicals, which were influenced by diverse factors, such as physico-chemical characteristics of AgNP, method of their synthesis, concentrations used, and finally cell type.
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Affiliation(s)
- J Roszak
- Toxicology and Carcinogenesis Dept, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - A Smok-Pieniążek
- Toxicology and Carcinogenesis Dept, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - S Spryszyńska
- Toxicology and Carcinogenesis Dept, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - K Kowalczyk
- Toxicology and Carcinogenesis Dept, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - K Domeradzka-Gajda
- Toxicology and Carcinogenesis Dept, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - R Świercz
- Toxicology and Carcinogenesis Dept, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - J Grobelny
- Department of Materials Technology and Chemistry, Faculty of Chemistry, University of Lodz, Poland
| | - E Tomaszewska
- Department of Materials Technology and Chemistry, Faculty of Chemistry, University of Lodz, Poland
| | - K Ranoszek-Soliwoda
- Department of Materials Technology and Chemistry, Faculty of Chemistry, University of Lodz, Poland
| | - G Celichowski
- Department of Materials Technology and Chemistry, Faculty of Chemistry, University of Lodz, Poland
| | - M Cieślak
- Scientific Department of Unconventional Technologies and Textiles, Łukasiewicz-Textile Research Institute, Lodz, Poland
| | - D Puchowicz
- Scientific Department of Unconventional Technologies and Textiles, Łukasiewicz-Textile Research Institute, Lodz, Poland
| | - M Stępnik
- Toxicology and Carcinogenesis Dept, Nofer Institute of Occupational Medicine, Lodz, Poland.
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19
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Pluta D, Lemm M, Franik G, Kowalczyk K, Blukacz Ł, Tekieli-Balon A, Madej P. Mayer-Rokitansky-Küster-Hauser syndrome - case studies, methods of treatment and the future prospects of human uterus transplantation. Eur Rev Med Pharmacol Sci 2020; 24:549-563. [PMID: 32016956 DOI: 10.26355/eurrev_202001_20031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We aimed to present patients with the Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) coming from one center and presenting all the possibilities of its treatment, at the forefront with the uterine transplantation. PATIENTS AND METHODS The presented work is an example of different types of MRKH syndrome diagnosed in 25 women who were diagnosed in the Department of Gynecological Endocrinology due to the primary amenorrhea from 01/2001 to 06/2018. RESULTS Patients suffering from MRKH syndrome are capable of having genetic offspring but are unable to give birth to their own child, due to an absence of the uterus, blindly terminated vagina, and normal ovaries. Patients suffering from this syndrome have the opportunity to receive treatment in accordance with their current needs. However, there are many medical, technical, and ethical limitations in achieving the most important therapeutic target: uterine transplantation and childbirth. CONCLUSIONS Until a few years ago, patients with an absolute uterine factor of infertility, including women with MRKH syndrome, had a real choice of only two equally controversial options giving a chance for motherhood - surrogacy and adoption. However, modern transplantation has shown that a third option - a uterine transplant - exists and is available.
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Affiliation(s)
- D Pluta
- Department of Endocrinological Gynaecology Śląski Uniwersytet Medyczny w Katowicach, Katowice, Poland.
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20
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Kowalczyk K, Kwarciany M, Jablonski B, Narkiewicz K, Karaszewski B, Gasecki D. PULSE WAVE VELOCITY CHANGES AFTER ACUTE ISCHEMIC STROKE. J Hypertens 2019. [DOI: 10.1097/01.hjh.0000570520.09398.f4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Pluta D, Franik G, Blukacz Ł, Kowalczyk K, Witkowska A, Wysocka M, Madej P. The correlation between the concentration of hepcidin in serum and the occurrence of insulin resistance and hyperandrogenemia in women with polycystic ovary syndrome. Eur Rev Med Pharmacol Sci 2018; 22:7379-7384. [PMID: 30468484 DOI: 10.26355/eurrev_201811_16276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Scarce clinical and experimental studies suggest that hepcidin can be a protein participating in the development of metabolic disorders, while its synthesis and concentration in the circulation outside of the iron metabolism parameters can be influenced by hormones. The aim of the present study was to determine the correlation between the concentration of hepcidin in serum and the occurrence of insulin resistance and hyperandrogenemia in women with PCOS. PATIENTS AND METHODS Five groups of women with PCOS were divided based on: correct body mass (17 without hyperandrogenemia and insulin resistance - G1; 17 with hyperandrogenemia and without insulin resistance - G2; 11 without hyperandrogenemia and with insulin resistance - G3; 10 with hyperandrogenemia and insulin resistance - G4), metabolic and hormonal parameters and selected markers of iron metabolism. RESULTS Serum glucose levels were significantly higher in the group G3 than G1 and in the group G4 than G1 and G2. Serum insulin levels and HOMA-IR values were significantly higher in the groups G3 and G4 than G1 and G2. Serum androstenedione levels were significantly higher in the group G2 than G1 and G3 than G2. Serum transferrin levels were significantly lower in the group G1 than in the reaming study groups. CONCLUSIONS It has been demonstrated that insulin resistance and hyperandrogenemia appear to be the factors decreasing the concentration of transferrin circulation, but not the remaining parameters of the iron metabolism in the studied women. No relationship between the concentration of hepcidin circulation and other studied parameters of the iron metabolism and the parameters of the carbohydrate metabolism was discovered. Androstenedione can stimulate hepcidin synthesis in women with PCOS with correct body mass.
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Affiliation(s)
- D Pluta
- Department of Endocrinological Gynecology, Medical University of Silesia, Katowice, Poland.
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22
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Franik G, Bizoń A, Włoch S, Kowalczyk K, Biernacka-Bartnik A, Madej P. Hormonal and metabolic aspects of acne vulgaris in women with polycystic ovary syndrome. Eur Rev Med Pharmacol Sci 2018; 22:4411-4418. [PMID: 30058676 DOI: 10.26355/eurrev_201807_15491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Acne vulgaris in women can indicate a systemic disease, such as polycystic ovary syndrome (PCOS), which is associated with hormonal and metabolic disorders. The aim of this study was to investigate the influence of hormonal and metabolic disorders on acne vulgaris in women with PCOS. PATIENTS AND METHODS The study included 110 women with PCOS. Women were divided according to their androstenedione concentration: within reference range (n=66) or higher (n=44). All patients were between 17-36 years old. Acne was graded according to the US FDA scale for a five-category global system (acne global severity scale). Hirsutism was defined using a modified Ferriman-Gallwey method. Fasting plasma glucose, insulin, luteinizing hormone, follicle-stimulating hormone, 17α-hydroxyprogesterone, 17-beta-estradiol, sex hormone-binding globulin and androgen (androstenedione, total testosterone, free testosterone, dehydroepiandrosterone sulfate) were assessed, as were prolactin and cortisol concentrations. Thyrotropin and free thyroxine concentrations were also measured. The free androgen index (FAI) and homeostatic model assessment-insulin resistance (HOMA-IR) index were calculated. RESULTS The average age and rating on the hirsutism scale were similar in both analyzed groups. A higher percentage of severe acne was observed in the group of women with an androstenedione concentration within reference range than in the group with the higher concentration. Meanwhile, the severity of acne in the group of PCOS women with the higher androstenedione concentration was correlated with higher concentrations of total testosterone, free testosterone, dehydroepiandrosterone sulfate, and cortisol. Increased glucose concentration was also proportional to the severity of acne. We did not observe a statistically significant correlation between the severity of acne and the androstenedione concentration. In the group of PCOS women as a whole, the severity of acne was correlated only with higher dehydroepiandrosterone sulfate concentration; other androgens did not affect the severity. CONCLUSIONS The acne global severity scale in PCOS women is associated with higher concentrations of total testosterone, free testosterone, dehydroepiandrosterone sulfate, and FAI value. Higher concentrations of androstenedione did not affect acne severity.
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Affiliation(s)
- G Franik
- Department of Endocrinological Gynecology, Medical University of Silesia, Katowice, Poland.
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Cheema A, Grindrod S, Suy S, Zhong X, Jain S, Mehta K, Bandi G, Kowalczyk K, Lynch J, Collins S, Dritschilo A. MP35-11 METABOLIC BIOMARKERS ARE PREDICTIVE OF RESPONSE TO RADIATION THERAPY IN PROSTATE CANCER PATIENTS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wright HC, McGeagh K, Richter LA, Hwang JJ, Venkatesan K, Pysher A, Koch GE, Kowalczyk K, Bandi G, Marchalik D. Transobturator sling for post-prostatectomy incontinence: radiation's effect on efficacy/satisfaction. Can J Urol 2017; 24:8998-9002. [PMID: 28971786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION We review our experience with the AdVance sling in patients with post- prostatectomy incontinence, comparing the role that adjuvant radiation therapy plays in sling success and patient satisfaction at short and long term follow ups. MATERIALS AND METHODS Men who underwent AdVance sling placement for post-prostatectomy incontinence from 2007 to present were identified using Current Procedural Terminology (CPT) codes. Manual chart review was performed. Level of incontinence was assessed using Expanded Prostate Cancer Index Composite (EPIC) and pads per day (PPD) use. Satisfaction was assessed by willingness to recommend the procedure to a friend. Outcomes in men who received radiation were compared to radiation-naïve men. RESULTS Fifty-two men underwent AdVance sling placement. Eighteen men received adjuvant radiation. Thirty-six men were available for short term (19.4 months) and 16 men for long term (61.5 months) follow up. Overall, significant improvement was seen in post-sling EPIC score (24.6, p < 0.001), EPIC incontinence score (39.1, p < .001), and pad use (3.2 PPD to 1.4 PPD, p < .001). Greater improvement in EPIC scores and PPD use was seen in radiation-free men. Irradiated men were less satisfied with the procedure at both short and long term follow up. Diminished efficacy and satisfaction occurred at extended follow up for both groups but was more pronounced with radiation. CONCLUSIONS The majority of patients undergoing the AdVance sling procedure for post-prostatectomy urinary incontinence saw a significant reduction in pad use, and were overall satisfied in both radiated and non-radiated groups at short and long term follow up. However, improvements were greater in the non-radiated groups and diminished with time.
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Affiliation(s)
- Henry C Wright
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC, USA
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Cetner MD, Kalaji HM, Goltsev V, Aleksandrov V, Kowalczyk K, Borucki W, Jajoo A. Effects of nitrogen-deficiency on efficiency of light-harvesting apparatus in radish. Plant Physiol Biochem 2017; 119:81-92. [PMID: 28850868 DOI: 10.1016/j.plaphy.2017.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 08/21/2017] [Accepted: 08/21/2017] [Indexed: 05/12/2023]
Abstract
Nitrogen starvation has been stated to reduce chlorophyll a and accessory pigments, decrease photosynthetic efficiency, as well as modify chloroplast thylakoid membranes. However, the impact of N-deficiency on light-dependent reactions of photosynthesis has not been well understood. In this study, efficiency and structure of light-harvesting complex under N-deficiency conditions were investigated in two radish cultivars (Raphanus sativus var. sativus 'Fluo HF1' and 'Suntella F1'). Light-dependent reactions of photosynthesis were investigated by measuring in vivo chlorophyll a prompt fluorescence signal. Acquired data were utilised in two ways: by plotting fast induction curves and calculating OJIP-test biophysical parameters. Detailed analysis of difference curves as well as OJIP-test results showed that major disturbances were associated with photosystem II and its subunits, including decoupling of light-harvesting complexes, dysfunction of oxygen-evolving complex, and reaction centres inactivation. The maximum quantum yield of photosystem II primary photochemistry was severely restricted, causing an inhibition in electron transport through successive protein complexes in the thylakoid membrane. Structural changes were demonstrated by recording images using Transmission Electron Microscopy (TEM). TEM investigations showed intensive starch accumulation under N-deficiency. Rare thylakoid stacks distributed in tiny layers of stroma around grains and chloroplast periphery were observed in cells of N-deficient plants. The application of principal component analysis (PCA) on OJIP-test results allowed characterizing the dynamics of stress response and separating parameters according to their influence on plants stress response. 'Suntella F1' genotype was found to be more sensitive to nitrogen deficiency as compared to 'Fluo HF1' genotype.
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Affiliation(s)
- M D Cetner
- Department of Plant Physiology, Warsaw University of Life Sciences WULS-SGGW, 159 Nowoursynowska Street, 02-776 Warsaw, Poland
| | - H M Kalaji
- Department of Plant Physiology, Warsaw University of Life Sciences WULS-SGGW, 159 Nowoursynowska Street, 02-776 Warsaw, Poland.
| | - V Goltsev
- Department of Biophysics and Radiobiology, Faculty of Biology, St. Kl. Ohridski University of Sofia, 8 DraganTzankov Blvd., Sofia 1164, Bulgaria
| | - V Aleksandrov
- Department of Biophysics and Radiobiology, Faculty of Biology, St. Kl. Ohridski University of Sofia, 8 DraganTzankov Blvd., Sofia 1164, Bulgaria
| | - K Kowalczyk
- Department of Vegetable and Medicinal Plants, Warsaw University of Life Sciences WULS-SGGW, 159 Nowoursynowska Street, 02-776 Warsaw, Poland
| | - W Borucki
- Department of Botany, Warsaw University of Life Sciences WULS-SGGW, 159 Nowoursynowska Street, 02-776 Warsaw, Poland
| | - A Jajoo
- School of Life Science, Devi Ahilya University, Indore 452017, India.
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Gasecki D, Kwarciany M, Kowalczyk K, Nowicki T, Rojek A, Szurowska E, Botouyrie P, Laurent S, Karaszewski B, Narkiewicz K. [PP.29.26] AORTIC STIFFNESS IS INDEPENDENTLY RELATED TO INTRACRANIAL ATHEROSCLEROSIS IN PATIENTS WITH ISCHEMIC STROKE. J Hypertens 2017. [DOI: 10.1097/01.hjh.0000523975.13188.ee] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tsai HT, Philips G, Taylor KL, Kowalczyk K, Huai-Ching K, Potosky AL. Utilization and predictors of expectant management among elderly men with low-and intermediate-risk localized prostate cancer in U.S. urological practice. Urol Pract 2017; 4:132-139. [PMID: 28808670 DOI: 10.1016/j.urpr.2016.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Expectant management (EM) reduces overtreatment in low-risk but not intermediate-risk localized prostate cancer (PCa). We assessed the use and predictors of EM to understand its uptake in U.S. practice. METHODS Using the U.S. SEER-Medicare database, we conducted a retrospective cohort study of men 66 years and older diagnosed with low-risk (N=25,506) or intermediate-risk (N=25,597) localized PCa between 2004 - 2011 and followed through December 31, 2012. We defined EM as no definitive therapy (DT) and at least one prostate-specific antigen (PSA) test or re-biopsy 4 - 12 months post diagnosis; or receiving DT after PSA testing or re-biopsy 7 - 12 months after diagnosis. We performed separate analyses for low-risk and intermediate-risk groups using multiple logistic regressions. RESULTS For men diagnosed with PCa in 2004-2011, EM increased from 22% to 43% in the low-risk group and from 15% to 18% in the intermediate-risk group. In the low-risk group, EM increased with patients' age (adjusted odds ratio [aOR] = 1.26 for 71-75 years; 2.21 for 76-80 years; 6.33 for older then 80, p<0.0001, compared to 66-70 years). EM uptake was higher among men with comorbidities (aOR=1.29), and residing in the Pacific region (aOR=0.56, compared to the East Coast). CONCLUSIONS In U.S. practice, the utilization of EM steadily increased in low-risk PCa and remained low in the intermediate-risk group over time. While patients with advanced age or comorbidities were more likely to receive EM, its use varied substantially by geographic region. Our findings bring attention to the presence of multiple barriers for EM implementation.
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Affiliation(s)
- Huei-Ting Tsai
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Georgetown University, Washington D.C., USA
| | - George Philips
- Department of Medicine, Georgetown University Medical Center, Georgetown University, Washington D.C., USA
| | - Kathryn L Taylor
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Georgetown University, Washington D.C., USA
| | - Keith Kowalczyk
- Department of Urology, Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007 USA
| | - Kuo Huai-Ching
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Georgetown University, Washington D.C., USA
| | - Arnold L Potosky
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Georgetown University, Washington D.C., USA
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Kim A, Kowalczyk K, Lynch J, Spies J. Single-center, FDA approved, prospective evaluation of the safety and efficacy of PAE for LUTS from BPH. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kowalczyk K, Franik G, Kowalczyk D, Pluta D, Blukacz Ł, Madej P. Thyroid disorders in polycystic ovary syndrome. Eur Rev Med Pharmacol Sci 2017; 21:346-360. [PMID: 28165551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Thyroid disorders, especially Hashimoto's thyroiditis (HT), are observed significantly more often in patients with polycystic ovary syndrome (PCOS) than in the general population - approximately 27% and 8%, respectively. This is extremely important in young women, because both disorders are connected with fertility problems. As HT and PCOS occur together, fertility problems may become a serious clinical issue in these patients. MATERIALS AND METHODS A systematic literature review in PubMed of PCOS- and HT-related articles in English, published until December 2015 was conducted. RESULTS The reasons for joint prevalence still remain unclear. Genetic and autoimmune backgrounds are recognized to be possible common etiological factors. Three genetic polymorphisms have been described to play a role in PCOS as well as in HT. They are polymorphism of the gene for fibrillin 3 (FBN3) regulating the activity of transforming growth factor-b (TGF-b) and regulatory T cell levels, gonadotropin-releasing hormone receptor (GnRHR) polymorphism and CYP1B1 polymorphism standing for estradiol hydroxylation. High estrogen-to-progesterone ratios owing to anovulatory cycles, as well as high estrogen levels during prenatal life, disrupt development of the thymus and its function in maintaining immune tolerance, and are suspected to enhance autoimmune response in PCOS. Vitamin D deficiency could be also involved in the pathogenesis of HT and PCOS. CONCLUSIONS The above-mentioned common etiological factors associated with fertility problems in HT and PCOS require further research.
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Affiliation(s)
- K Kowalczyk
- Department of Gynaecological Endocrinology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland.
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Autorino R, Zargar H, Mariano MB, Sanchez-Salas R, Sotelo RJ, Chlosta PL, Castillo O, Matei DV, Celia A, Koc G, Vora A, Aron M, Parsons JK, Pini G, Jensen JC, Sutherland D, Cathelineau X, Nuñez Bragayrac LA, Varkarakis IM, Amparore D, Ferro M, Gallo G, Volpe A, Vuruskan H, Bandi G, Hwang J, Nething J, Muruve N, Chopra S, Patel ND, Derweesh I, Champ Weeks D, Spier R, Kowalczyk K, Lynch J, Harbin A, Verghese M, Samavedi S, Molina WR, Dias E, Ahallal Y, Laydner H, Cherullo E, De Cobelli O, Thiel DD, Lagerkvist M, Haber GP, Kaouk J, Kim FJ, Lima E, Patel V, White W, Mottrie A, Porpiglia F. Perioperative Outcomes of Robotic and Laparoscopic Simple Prostatectomy: A European–American Multi-institutional Analysis. Eur Urol 2015; 68:86-94. [DOI: 10.1016/j.eururo.2014.11.044] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/21/2014] [Indexed: 12/17/2022]
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Abstract
Three hundred and seventy-two patients aged from 24-80 years were examined 10-15 years after past craniocerebral trauma. Of that number 355 subjects had concussion and 17 subjects brain contusion. Posttraumatic epilepsy was diagnosed by 8 cases (2.15%) only. It affected 4 females, aged from 40-60 years, and 3 males aged 30-48 years after the brain concussion, as well as 1 man, 30 years old, after the brain contusion. That first epileptic attack in 4 cases occurred after the lapse of 1-2 years, in 3 persons after the lapse of 6-10 months, and 1 patient having had brain contusion after 4 months. All posttraumatic patients were treated prophylactically with phenobarbital 0.1 twice a day for a period of several weeks.
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Pokrywka A, Cholbinski P, Kaliszewski P, Kowalczyk K, Konczak D, Zembron-Lacny A. Metabolic modulators of the exercise response: doping control analysis of an agonist of the peroxisome proliferator-activated receptor δ (GW501516) and 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR). J Physiol Pharmacol 2014; 65:469-476. [PMID: 25179079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 07/01/2014] [Indexed: 06/03/2023]
Abstract
In 2008, the team of Ronald Evans, a professor at the Salk Institute Gene Expression Laboratory, published an article about the effects of two metabolic modulators branded as GW501516 and AICAR on physical endurance of laboratory animals. Both substances, also called 'exercise pills' or 'exercise mimetics', showed the ability to cause multidirectional changes in muscle metabolism. In particular, they stimulated fatty acid oxidation and promoted muscle remodelling. These compounds were regarded as very promising drug candidates for the treatment of diseases such as obesity and type 2 diabetes. GW501516 and AICAR have received considerable attention in doping control due to assumed performance-enhancing properties and recent confiscations of illicitly distributed drugs containing AICAR. Therefore, the World Anti-Doping Agency added GW501516 and AICAR to the Prohibited List in 2009. This review covers the cellular and systemic effects of the metabolic modulators' administration with special emphasis on their role in exercise metabolism. It also presents the advancements in development of methodologies for the detection of their abuse by athletes.
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Affiliation(s)
- A Pokrywka
- Department of Anti-Doping Research, Institute of Sport, Warsaw, Poland.
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Arscott WT, Chen LN, Wilson N, Bhagat A, Kim JS, Moures RA, Yung TM, Lei S, Collins BT, Kowalczyk K, Suy S, Dritschilo A, Lynch JH, Collins SP. Obstructive voiding symptoms following stereotactic body radiation therapy for prostate cancer. Radiat Oncol 2014; 9:163. [PMID: 25056726 PMCID: PMC4118163 DOI: 10.1186/1748-717x-9-163] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 07/17/2014] [Indexed: 11/29/2022] Open
Abstract
Background Obstructive voiding symptoms (OVS) are common following prostate cancer treatment with radiation therapy. The risk of urinary retention (UR) following hypofractionated radiotherapy has yet to be fully elucidated. This study sought to evaluate OVS and UR requiring catheterization following SBRT for prostate cancer. Methods Patients treated with SBRT for localized prostate cancer from February 2008 to July 2011 at Georgetown University were included in this study. Treatment was delivered using the CyberKnife® with doses of 35 Gy-36.25 Gy in 5 fractions. UR was prospectively scored using the CTCAE v.3. Patient-reported OVS were assessed using the IPSS-obstructive subdomain at baseline and at 1, 3, 6, 9, 12, 18 and 24 months. Associated bother was evaluated via the EPIC-26. Results 269 patients at a median age of 69 years received SBRT with a median follow-up of 3 years. The mean prostate volume was 39 cc. Prior to treatment, 50.6% of patients reported moderate to severe lower urinary track symptoms per the IPSS and 6.7% felt that weak urine stream and/or incomplete emptying were a moderate to big problem. The 2-year actuarial incidence rates of acute and late UR ≥ grade 2 were 39.5% and 41.4%. Alpha-antagonist utilization rose at one month (58%) and 18 months (48%) post-treatment. However, Grade 3 UR was low with only 4 men (1.5%) requiring catheterization and/or TURP. A mean baseline IPSS-obstructive score of 3.6 significantly increased to 5.0 at 1 month (p < 0.0001); however, it returned to baseline in 92.6% within a median time of 3 months. Late increases in OVS were common, but transient. Only 7.1% of patients felt that weak urine stream and/or incomplete emptying was a moderate to big problem at two years post-SBRT (p = 0.6854). Conclusions SBRT treatment caused an acute increase in OVS which peaked within the first month post-treatment, though acute UR requiring catheterization was rare. OVS returned to baseline in > 90% of patients within a median time of three months. Transient Late increases in OVS were common. However, less than 10% of patients felt that OVS were a moderate to big problem at two years post-SBRT.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sean P Collins
- Department of Radiation Medicine, Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007, USA.
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Chen LN, Suy S, Wang H, Bhagat A, Woo JA, Moures RA, Kim JS, Yung TM, Lei S, Collins BT, Kowalczyk K, Dritschilo A, Lynch JH, Collins SP. Patient-reported urinary incontinence following stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer. Radiat Oncol 2014; 9:148. [PMID: 24966110 PMCID: PMC4083362 DOI: 10.1186/1748-717x-9-148] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/11/2014] [Indexed: 12/17/2022] Open
Abstract
Purpose Urinary incontinence (UI) following prostate radiotherapy is a rare toxicity that adversely affects a patient’s quality of life. This study sought to evaluate the incidence of UI following stereotactic body radiation therapy (SBRT) for prostate cancer. Methods Between February, 2008 and October, 2010, 204 men with clinically localized prostate cancer were treated definitively with SBRT at Georgetown University Hospital. Patients were treated to 35–36.25 Gray (Gy) in 5 fractions delivered with the CyberKnife (Accuray). UI was assessed via the Expanded Prostate Index Composite (EPIC)-26. Results Baseline UI was common with 4.4%, 1.0% and 3.4% of patients reporting leaking > 1 time per day, frequent dribbling and pad usage, respectively. Three year post treatment, 5.7%, 6.4% and 10.8% of patients reported UI based on leaking > 1 time per day, frequent dribbling and pad usage, respectively. Average EPIC UI summary scores showed an acute transient decline at one month post-SBRT then a second a gradual decline over the next three years. The proportion of men feeling that their UI was a moderate to big problem increased from 1% at baseline to 6.4% at three years post-SBRT. Conclusions Prostate SBRT was well tolerated with UI rates comparable to conventionally fractionated radiotherapy and brachytherapy. More than 90% of men who were pad-free prior to treatment remained pad-free three years following treatment. Less than 10% of men felt post-treatment UI was a moderate to big problem at any time point following treatment. Longer term follow-up is needed to confirm late effects.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sean P Collins
- Department of Radiation Medicine, Georgetown University Hospital, 3800 Reservoir Road, N W, Washington, DC 20007, USA.
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Kiełtyka-Kurc A, Frąckowiak H, Zdun M, Nabzdyk M, Kowalczyk K, Tołkacz M. The arteries on the base of the brain in the camelids (Camelidae). ACTA ACUST UNITED AC 2014. [DOI: 10.1080/11250003.2014.901428] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chen LN, Rubin RS, Othepa E, Cer C, Yun E, Agarwal RP, Collins BT, McGeagh K, Pahira J, Bandi G, Kowalczyk K, Kumar D, Dritschilo A, Collins SP, Bostwick DG, Lynch JH, Suy S. Correlation of HOXD3 promoter hypermethylation with clinical and pathologic features in screening prostate biopsies. Prostate 2014; 74:714-21. [PMID: 24847526 PMCID: PMC4285328 DOI: 10.1002/pros.22790] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Molecular markers that can discriminate indolent cancers from aggressive ones may improve the management of prostate cancer and minimize unnecessary treatment.Aberrant DNA methylation is a common epigenetic event in cancers and HOXD3 promoter hypermethylation (H3PH) has been found in prostate cancer. Our objective was to evaluate the relationship between H3PH and clinicopathologic features in screening prostate biopsies. METHODS Ninety-two patients who underwent a prostate biopsy at our institution between October 2011 and May 2012 were included in this study. The core with the greatest percentage of the highest grade disease was analyzed for H3PH by methylation-specific PCR. Correlational analysis was used to analyze the relationship between H3PH and various clinical parameters. Chi-square analysis was used to compare H3PH status between benign and malignant disease. RESULTS Of the 80 biopsies with HOXD3 methylation status assessable, 66 sets were confirmed to have cancer. In the 14 biopsies with benign disease there was minimal H3PH with the mean percentage of methylation reference (PMR) of 0.7%. In contrast, the HOXD3 promoter was hypermethylated in 16.7% of all cancers and in 50% of high risk tumors with an average PMR of 4.3% (P=0.008). H3PH was significantly correlated with age (P=0.013), Gleason score (P=0.031) and the maximum involvement of the biopsy core (P=0.035). CONCLUSIONS H3PH is associated with clinicopathologic features. The data indicate that H3PH is more common in older higher risk patients. More research is needed to determine the role of this marker in optimizing management strategies in men with newly diagnosed prostate cancer.
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Affiliation(s)
- Leonard N Chen
- Department of Radiation Medicine, Georgetown University HospitalWashington, District of Columbia
| | - Rachel S Rubin
- Department of Urology, Georgetown University HospitalWashington, District of Columbia
| | - Eugide Othepa
- Department of Radiation Medicine, Georgetown University HospitalWashington, District of Columbia
| | - Caroline Cer
- Department of Radiation Medicine, Georgetown University HospitalWashington, District of Columbia
| | - Elizabeth Yun
- Department of Radiation Medicine, Georgetown University HospitalWashington, District of Columbia
| | - Raghunath P Agarwal
- Department of Radiation Medicine, Georgetown University HospitalWashington, District of Columbia
| | - Brian T Collins
- Department of Radiation Medicine, Georgetown University HospitalWashington, District of Columbia
| | - Kevin McGeagh
- Department of Urology, Georgetown University HospitalWashington, District of Columbia
| | - John Pahira
- Department of Urology, Georgetown University HospitalWashington, District of Columbia
| | - Guarav Bandi
- Department of Urology, Georgetown University HospitalWashington, District of Columbia
| | - Keith Kowalczyk
- Department of Urology, Georgetown University HospitalWashington, District of Columbia
| | - Deepak Kumar
- Deptartment of Biological & Environmental Sciences, University of the District of ColumbiaWashington, District of Columbia
| | - Anatoly Dritschilo
- Department of Radiation Medicine, Georgetown University HospitalWashington, District of Columbia
| | - Sean P Collins
- Department of Radiation Medicine, Georgetown University HospitalWashington, District of Columbia
| | | | - John H Lynch
- Department of Urology, Georgetown University HospitalWashington, District of Columbia
| | - Simeng Suy
- Department of Radiation Medicine, Georgetown University HospitalWashington, District of Columbia
- * Simeng Suy, PhD, 3800 Reservoir Rd. NW LL Bles, Washington, DC 20007. E-mail:
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Vora A, Marchalik D, Nissim H, Kowalczyk K, Bandi G, McGeagh K, Lynch J, Venkatesan K, Ghasemian R, Hwang J, Hwang MV. Multi-institutional outcomes and cost effectiveness of using alvimopan to lower gastrointestinal morbidity after cystectomy and urinary diversion. Can J Urol 2014; 21:7222-7227. [PMID: 24775576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Radical cystectomy is associated with significant morbidity and cost, with rates of gastrointestinal complications as high as 30%. Alvimopan is a mu opioid receptor antagonist that has been shown in randomized-control trials to accelerate gastrointestinal recovery in patients undergoing bowel resection with primary anastamosis. We report our experience with gastrointestinal recovery for patients undergoing cystectomy with urinary diversion treated with alvimopan and cost benefit associated. MATERIALS AND METHODS Between January 2008 and October 2012, 80 patients underwent radical cystectomy with urinary diversion at two institutions. Forty-two patients in our study did not receive alvimopan preoperatively. Thirty-eight patients received perioperative alvimopan and were without postoperative nasogastric decompression. Return of bowel function, initiation of diet, and gastrointestinal complications and estimated cost of hospitalization were evaluated. RESULTS Times to first flatus (3.1 days versus 4.7 days, p < 0.01, 95% CI 0.96-2.24) and bowel movement (3.9 days versus 4.9 days, p < 0.01, 95% CI 0.45-1.55) were significantly shorter in those patients who received alvimopan. Additionally, the initiation of clear liquid diet (4.1 days versus 5.5 days, p < 0.01, 95% CI 0.70-2.10), regular diet (5.2 days versus 6.3 days, p < 0.01, 95% CI 0.39-1.81) and hospital discharge (6.1 days versus 7.7 days, p = 0.04, 95% CI 0.01-3.21) were accelerated in the alvimopan cohort. There were no incidences of prolonged ileus in patients who received perioperative alvimopan (0% versus 26.2%, p < 0.01). With an approximate average cost of alvimopan administration $825 per hospitalization, the average cost benefit of administration over control was $1515 per hospitalization. The cost benefit was mainly a result of a shorter inpatient hospitalization and lack of gastrointestinal morbidity which accumulated a majority of the difference. CONCLUSION In our experience, the use of alvimopan perioperatively significantly accelerates the rate of gastrointestinal recovery and hospital discharge, eliminates the need for nasogastric tube decompression, and reduces the incidence of post-operative ileus in patients following radical cystectomy and urinary diversion.
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Affiliation(s)
- Anup Vora
- Georgetown University Hospital and Washington Hospital Center, Washington, DC USA
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Bhattasali O, Chen LN, Woo J, Park JW, Kim JS, Moures R, Yung T, Lei S, Collins BT, Kowalczyk K, Suy S, Dritschilo A, Lynch JH, Collins SP. Patient-reported outcomes following stereotactic body radiation therapy for clinically localized prostate cancer. Radiat Oncol 2014; 9:52. [PMID: 24512837 PMCID: PMC3931491 DOI: 10.1186/1748-717x-9-52] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 02/06/2014] [Indexed: 02/07/2023] Open
Abstract
Background Stereotactic body radiation therapy (SBRT) delivers high doses of radiation to the prostate while minimizing radiation to adjacent normal tissues. Large fraction sizes may increase the risk of functional decrements. Treatment-related bother may be more important to a patient than treatment-related dysfunction. This study reports on patient-reported outcomes following SBRT for clinically localized prostate cancer. Methods Between August 2007 and July 2011, 228 consecutive hormone-naïve patients with clinically localized prostate cancer were treated with 35–36.25 Gy SBRT delivered using the CyberKnife Radiosurgical System (Accuray) in 5 fractions. Quality of life was assessed using the American Urological Association Symptom Score (AUA) and the Expanded Prostate Cancer Index Composite (EPIC)-26. Urinary symptom flare was defined as an AUA score 15 or more with an increase of 5 or more points above baseline 6 months after treatment. Results 228 patients (88 low-, 126 intermediate- and 14 high-risk) at a median age of 69 (44–90) years received SBRT with a minimum follow-up of 24 months. EPIC urinary and bowel summary scores declined transiently at 1 month and experienced a second, more protracted decline between 9 months and 18 months before returning to near baseline 2 years post-SBRT. 14.5% of patients experienced late urinary symptom flare following treatment. Patients who experienced urinary symptom flare had poorer bowel quality of life following SBRT. EPIC scores for urinary bother declined transiently, first at 1 month and again at 12 months, before approaching pre-treatment scores by 2 years. Bowel bother showed a similar pattern, but the second decline was smaller and lasted 9 months to 18 months. EPIC sexual summary and bother scores progressively declined over the 2 years following SBRT without recovery. Conclusions In the first 2 years, the impact of SBRT on urination and defecation was minimal. Transient late increases in urinary and bowel dysfunction and bother were observed. However, urinary and bowel function and bother recovered to near baseline by 2 years post-SBRT. Sexual dysfunction and bother steadily increased following treatment without recovery. SBRT for clinically localized prostate cancer was well tolerated with treatment-related dysfunction and bother comparable to conventionally fractionated radiation therapy or brachytherapy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sean P Collins
- Department of Radiation Medicine, Georgetown University Hospital, 3800 Reservoir Road, N,W,, Washington, D,C 20007, USA.
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Obayomi-Davies O, Chen LN, Bhagat A, Wright HC, Uhm S, Kim JS, Yung TM, Lei S, Batipps GP, Pahira J, McGeagh KG, Collins BT, Kowalczyk K, Bandi G, Kumar D, Suy S, Dritschilo A, Lynch JH, Collins SP. Potency preservation following stereotactic body radiation therapy for prostate cancer. Radiat Oncol 2013; 8:256. [PMID: 24180317 PMCID: PMC4228383 DOI: 10.1186/1748-717x-8-256] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/24/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Erectile dysfunction after prostate radiation therapy remains an ongoing challenge and critical quality of life issue. Given the higher dose of radiation per fraction using stereotactic body radiation therapy (SBRT) there is concern that post-SBRT impotency would be higher than conventional radiation therapy approaches. This study sought to evaluate potency preservation and sexual function following SBRT for prostate cancer. METHODS Between February 2008 and March 2011, 216 men with clinically localized prostate cancer were treated definitively with SBRT monotherapy at Georgetown University Hospital. Potency was defined as the ability to have an erection firm enough for intercourse with or without sexual aids while sexual activity was defined as the ability to have an erection firm enough for masturbation and foreplay. Patients who received androgen deprivation therapy (ADT) were excluded from this study. Ninety-seven hormone-naïve men were identified as being potent at the initiation of therapy and were included in this review. All patients were treated to 35-36.25 Gy in 5 fractions delivered with the CyberKnife Radiosurgical System (Accuray). Prostate specific antigen (PSA) and total testosterone levels were obtained pre-treatment, every 3 months for the first year and every 6 months for the subsequent year. Sexual function was assessed with the Sexual Health Inventory for Men (SHIM), the Expanded Prostate Index Composite (EPIC)-26 and Utilization of Sexual Medication/Device questionnaires at baseline and all follow-up visits. RESULTS Ninety-seven men (43 low-, 50 intermediate- and 4 high-risk) at a median age of 68 years (range, 48-82 years) received SBRT. The median pre-treatment PSA was 5.9 ng/ml and the minimum follow-up was 24 months. The median pre-treatment total serum testosterone level was 11.4 nmol/L (range, 4.4-27.9 nmol/L). The median baseline SHIM was 22 and 36% of patients utilized sexual aids prior to treatment. Although potency rates declined following treatment: 100% (baseline); 68% (6 months); 62% (12 months); 57% (18 months) and 54.4% (24 months), 78% of previously potent patients had erections sufficient for sexual activity at 24 months post-treatment. Overall sexual aid utilization increased from 36% at baseline to 49% at 24 months. Average EPIC sexual scores showed a slow decline over the first two years following treatment: 77.6 (baseline); 68.7 (6 months); 63.2 (12 months); 61.9 (18 months); 59.3 (24 months). All sexual functions including orgasm declined with time. Prior to treatment, 13.4% of men felt their sexual function was a moderate to big problem which increased to 26.7% two years post treatment. Post-treatment testosterone levels gradually decreased with a median value at two year follow-up of 10.7 nmol/L. However, the average EPIC hormonal scores did not illustrate a statistically significant difference two years post-treatment. Review of the radiation doses to the penile bulb in this study, a potential marker of post-treatment sexual function, revealed that the dose was relatively low and at these low doses the percentage of the penile bulb receiving 29.5 Gy did not correlate with the development of ED. CONCLUSIONS Men undergoing SBRT monotherapy for prostate cancer report sexual outcomes comparable to those reported for conventional radiation modalities within the first 24 months after treatment. Longer follow-up is required to confirm the durability of these findings.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sean P Collins
- Department of Radiation Medicine, Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007, USA.
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Vora A, Large T, Aronica J, Haynes S, Harbin A, Marchalik D, Nissim H, Lynch J, Bandi G, McGeagh K, Kowalczyk K, Ghasemian R, Venkatesan K, Verghese M, Hwang J. Predictors of Gleason score upgrading in a large African-American population. Int Urol Nephrol 2013; 45:1257-62. [PMID: 23864415 DOI: 10.1007/s11255-013-0495-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 06/10/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE Gleason score from biopsy specimens is important for prostate cancer (PCa) risk stratification and influences treatment decisions. Gleason score upgrading (GSU) between biopsy and surgical pathology specimens has been reported as high as 50 % and presents a challenge in counseling low-risk patients. While recent studies have investigated predictors of GSU, populations in these studies have been largely Caucasian. We report our analysis of predictors of GSU in a large urban African-American population. METHODS A total of 959 patients with D'Amico low-risk prostate cancer underwent radical prostatectomy at Georgetown University or Washington Hospital Center between January 2005 and July 2012. Race, age, PSA, body mass index (BMI), cancer of the prostate risk assessment (CAPRA) score, and transrectal ultrasound (TRUS) biopsy characteristics (percent of biopsy cores showing adenocarcinoma, highest percent of biopsy core involved with cancer, and measured TRUS prostate volume) were analyzed with both univariate and multivariate analyses to identify significant predictors of GSU while controlling for clinical parameters. RESULTS Of the 959 cases, 288 (30.0 %) were upgraded on final pathologic specimen with approximately 38 % (133/355) of African-American patients experiencing GSU. BMI (P = 0.02), percent positive biopsy cores (P < 0.01) and percent of core involved with cancer (P < 0.01), increasing CAPRA score, and serum PSA were independent predictors of GSU on both uni- and multivariate regression analyses. African Americans had a 73 % increase in the incidence of GSU over other races. CONCLUSION More than a quarter of low-risk prostate cancer patients were upgraded on final pathology in our series. Higher BMI, serum PSA, CAPRA score, percent of cores positive, and percent of cores involved were independent predictors of GSU. Individuals with those clinical parameters may harbor occult high-grade disease and should be carefully counseled on treatment decisions.
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Affiliation(s)
- Anup Vora
- Departments of Urology, Washington Hospital Center and Georgetown University Hospital, 3401 38th ST NW, Suite 915, Washington, DC, 20016, USA,
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Vora A, Large T, Aronica J, Haynes S, Nissim H, Harbin A, Bandi G, McGeagh K, Kowalczyk K, Lynch J, Venkatesan K, Ghasemian R, Verghese M, Hwang J. 348 MULTI-INSTITUTIONAL PREDICTORS OF GLEASON SCORE UPGRADING IN A LARGE AFRICAN-AMERICAN POPULATION. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.1734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Vora A, Rayson R, Harbin A, Bandi G, McGeagh K, Kowalczyk K, Lynch J, Ghasemain R, Venkatesan K, Hwang J, Verghese M. 415 MULTI-INSTITUTIONAL OUTCOMES AND COST EFFECTIVENESS OF USING ALVIMOPAN TO LOWER GI MORBIDITY AFTER CYSTECTOMY AND URINARY DIVERSION. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.1805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chen LN, Suy S, Uhm S, Oermann EK, Ju AW, Chen V, Hanscom HN, Laing S, Kim JS, Lei S, Batipps GP, Kowalczyk K, Bandi G, Pahira J, McGeagh KG, Collins BT, Krishnan P, Dawson NA, Taylor KL, Dritschilo A, Lynch JH, Collins SP. Stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer: the Georgetown University experience. Radiat Oncol 2013; 8:58. [PMID: 23497695 PMCID: PMC3610192 DOI: 10.1186/1748-717x-8-58] [Citation(s) in RCA: 198] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 02/25/2013] [Indexed: 12/13/2022] Open
Abstract
Background Stereotactic body radiation therapy (SBRT) delivers fewer high-dose fractions of radiation which may be radiobiologically favorable to conventional low-dose fractions commonly used for prostate cancer radiotherapy. We report our early experience using SBRT for localized prostate cancer. Methods Patients treated with SBRT from June 2008 to May 2010 at Georgetown University Hospital for localized prostate carcinoma, with or without the use of androgen deprivation therapy (ADT), were included in this retrospective review of data that was prospectively collected in an institutional database. Treatment was delivered using the CyberKnife® with doses of 35 Gy or 36.25 Gy in 5 fractions. Biochemical control was assessed using the Phoenix definition. Toxicities were recorded and scored using the CTCAE v.3. Quality of life was assessed before and after treatment using the Short Form-12 Health Survey (SF-12), the American Urological Association Symptom Score (AUA) and Sexual Health Inventory for Men (SHIM) questionnaires. Late urinary symptom flare was defined as an AUA score ≥ 15 with an increase of ≥ 5 points above baseline six months after the completion of SBRT. Results One hundred patients (37 low-, 55 intermediate- and 8 high-risk according to the D’Amico classification) at a median age of 69 years (range, 48–90 years) received SBRT, with 11 patients receiving ADT. The median pre-treatment prostate-specific antigen (PSA) was 6.2 ng/ml (range, 1.9-31.6 ng/ml) and the median follow-up was 2.3 years (range, 1.4-3.5 years). At 2 years, median PSA decreased to 0.49 ng/ml (range, 0.1-1.9 ng/ml). Benign PSA bounce occurred in 31% of patients. There was one biochemical failure in a high-risk patient, yielding a two-year actuarial biochemical relapse free survival of 99%. The 2-year actuarial incidence rates of GI and GU toxicity ≥ grade 2 were 1% and 31%, respectively. A median baseline AUA symptom score of 8 significantly increased to 11 at 1 month (p = 0.001), however returned to baseline at 3 months (p = 0.60). Twenty one percent of patients experienced a late transient urinary symptom flare in the first two years following treatment. Of patients who were sexually potent prior to treatment, 79% maintained potency at 2 years post-treatment. Conclusions SBRT for clinically localized prostate cancer was well tolerated, with an early biochemical response similar to other radiation therapy treatments. Benign PSA bounces were common. Late GI and GU toxicity rates were comparable to conventionally fractionated radiation therapy and brachytherapy. Late urinary symptom flares were observed but the majority resolved with conservative management. A high percentage of men who were potent prior to treatment remained potent two years following treatment.
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Affiliation(s)
- Leonard N Chen
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC 20007, USA
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Gurka MK, Horne ZD, Chen L, Lei S, Krishnan P, Kowalczyk K, Suy S, Dritschilo A, Lynch JH, Collins SP. Stereotactic body radiation therapy (SBRT) following procedures for benign prostatic hyperplasia (BPH): A report on early toxicity. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.6_suppl.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
165 Background: When treating patients with prostate cancer, hypofractionation with SBRT takes advantage of radiobiologically favorable factors as compared to conventional fractionation. However, this may increase the risk of urinary toxicity, especially in patients with prior procedures for BPH. Herein, we report early urinary toxicity following SBRT in patients with a history of procedures for BPH. Methods: Thirty three patients treated with SBRT for localized prostate cancer from February 2009 to October 2011 at Georgetown University Hospital with history of a prior procedure for BPH were included in this retrospective analysis. Treatment was delivered using the CyberKnife with doses of 35 Gy-36.25 Gy in 5 fractions. Toxicities were scored using the CTCAE v.3. Cystoscopy findings were retrospectively reviewed. Patient-reported urinary symptoms were assessed using the American Urological Association Symptom Score (AUA). Results: The median age was 70 years (range, 64 - 84). The median follow-up time was 18.7 months (range 9.2 – 38.9). Grade 2 or 3 urinary toxicity occurred in 9 patients and there were no grade 4 or 5 toxicities. Hematuria occurred in 12 patients. The median time to onset of hematuria from SBRT was 6 months (range 1 – 30). Grade 1 hematuria occurred in 7 patients, grade 2 in 4 patients and 1 patient experienced grade 3. Cystoscopy was performed in 9 of these patients at a median time of 9 months (range 3-27). Eight had hyperemia or evidence of bleeding from the prostatic urethra and 5 of these patients also had evidence of bleeding from the bladder neck/wall. All patients except one, who died from other causes, are still being followed and hematuria has resolved in 9 of the 12 patients. The median baseline AUA symptom score of 7 increased to 11 at 1 month, however decreased to a median score of 6 at 3 months. The median AUA symptom score increased to 9 at 1 year. Conclusions: A history of prior transurethral resection of prostate may predispose patients to increased urinary toxicity and hematuria following prostate SBRT. Stricter urethra/bladder neck dosimetric criteria or alternative fractionation regimens may be required to decrease urinary toxicity in these patients.
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Affiliation(s)
| | | | | | - Sue Lei
- Georgetown University Hospital, Washington, DC
| | | | | | - Simeng Suy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Anatoly Dritschilo
- Georgetown University Hospital Lombardi Comprehensive Cancer Center, Washington, DC
| | | | - Sean P. Collins
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
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Okoń S, Kowalczyk K, Miazga D. Identification of Ppd-B1 alleles in common wheat cultivars by CAPS marker. Genetika 2012; 48:628-633. [PMID: 22830258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Photoperiod response is a major determinant of the duration of growth stages in common wheat. In common wheat, many genes play a role in determining flowering time, but the Ppd genes located on the homoeologous group 2 play a major role. Of these Ppd-B1 is located on the short arm of 2B. In 107 common wheat cultivars grown in Poland and neighboring countries, the identification of Ppd-B1 alleles using in-del analysis by using a CAPS markers was investigated. 87 cultivars were shown to carry dominant Ppd-B1 alleles. This shows that Ppd-B1 alleles is have been widely used in common wheat breeding programme in these countries. Recessive ppd-B1 alleles were found only in 20 cultivars (12 Polish, 5 former Soviet Union, 2 German, 1 Swedish).
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Affiliation(s)
- S Okoń
- Institute of Plant Genetics, Breeding and Biotechnology, University of Life Sciences in Lublin, Lublin 20-950, Poland.
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Kaplan J, Kowalczyk K, Borza T, Gu X, Nguyen P, Yu HY, Hu J. 947 RADIOTHERAPY FOLLOWING PROSTATECTOMY DOES NOT IMPACT BONE-RELATED EVENTS IN PATIENTS WITH NODE-POSITIVE PROSTATE CANCER. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.1045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kwarciany M, Gasecki D, Rojek A, Nowak R, Kowalczyk K, Boutouyrie P, Nyka W, Laurent S, Narkiewicz K. TIME-DEPENDENT CHANGES IN CAROTID-FEMORAL PULSE WAVE VELOCITY IN PATIENTS AFTER ISCHEMIC STROKE. J Hypertens 2011. [DOI: 10.1097/00004872-201106001-01525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Stepień L, Chen Y, Chełkowski J, Kowalczyk K. Powdery mildew resistance genes in wheat: verification of STS markers. J Appl Genet 2001; 42:413-23. [PMID: 14564018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Five accessions of Aegilops speltoides and 67 European wheat cultivars (winter and spring) originating from the Czech Republic, Germany, Poland, Russia, Slovakia, United Kingdom, and 4 non-European wheat cultivars from Brazil and the USA were examined with molecular Sequence Tagged Site (STS) markers for resistance genes to powdery mildew: Pm 1, Pm 2, Pm 3 and Pm 13. All markers gave clear, repeatable results, although three of them (Pm 1, Pm 2 and Pm 3) appeared as not specific for resistance genes. Comparison of STS analysis results with Pm genes, postulated as the reaction type after inoculation with differential isolates of Erysiphe graminis f.sp. tritici (Blumeria graminis), revealed a high number of disparities. The marker for Pm 13 was not detected in any examined cultivar but was present in five accessions of Aegilops speltoides.
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Affiliation(s)
- L Stepień
- Institute of Plant Genetics, Polish Academy of Sciences, Poznań, Poland
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Abstract
Gel filtration of human thyroid extract with Sephadex G-200 revealed two molecular forms of adenosine deaminase differing in their molecular sizes. The smaller form of adenosine deaminase was purified over 120-fold by precipitation of the protein impurities at pH5.6 and chromatography on DEAE-Sephadex A-50, Sephadex G-100 and adenosine-Sepharose. The purified enzyme was specific towards adenosine. The Michaelis constant was 5.2 X 10(-5) M. The optimum pH was about 7.0 and molecular weight 42000.
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Affiliation(s)
- L Jaroszewicz
- Department of Physical Chemistry, Medical Academy, Białystok, Poland
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