Increases in serum levels of prostate-specific antigen (PSA) occur commonly in prostate cancer after radical prostatectomy and are designated "biochemical recurrence." Because the phytochemical sulforaphane has been studied extensively as an anticancer agent, we performed a double-blinded, randomized, placebo-controlled multicenter trial with sulforaphane in 78 patients (mean age, 69 AE 6 years) with increasing PSA levels after radical prostatectomy. Treatment comprised daily oral administration of 60 mg of a stabilized free sulforaphane for 6 months (M0-M6) followed by 2 months without treatment (M6-M8). The study was designed to detect a 0.012 log (ng/mL)/month decrease in the log PSA slope in the sulforaphane group from M0 to M6. The primary endpoint was not reached. For secondary endpoints, median log PSA slopes were consistently lower in sulforaphanetreated men. Mean changes in PSA levels between M6 and M0 were significantly lower in the sulforaphane group (þ0.099 AE 0.341 ng/mL) than in placebo (þ0.620 AE 1.417 ng/mL; P ¼ 0.0433). PSA doubling time was 86% longer in the sulforaphane than in the placebo group (28.9 and 15.5 months, respectively). PSA increases >20% at M6 were significantly greater in the placebo group (71.8%) than in the sulforaphane group (44.4%); P ¼ 0.0163. Compliance and tolerance were very good. Sulforaphane effects were prominent after 3 months of intervention (M3-M6). After treatment, PSA slopes from M6 to M8 remained the same in the 2 arms. Daily administration of free sulforaphane shows promise in managing biochemical recurrences in prostate cancer after radical prostatectomy. Cancer Prev Res; 8(8); 712-9. Ó2015 AACR.
The aim of this work was to demonstrate the impact of ultrasonography in utero to gain a better understanding of the anatomy, growth, anatomical variations and function of the fetal kidney and urinary tract. Three main topics are discussed in this paper based on the authors' personal experience and data from the literature: 1) the technique of ultrasonography in utero, including the main difficulties encountered and limitations of this technique; 2) ultrasonographic study of the morphology, growth and anatomical variations of the fetal kidney. The length of the fetal kidney was found to be the most significant parameter for assessment of its growth. At term, the kidney measures slightly more than 4 cm in length, while the renal pelvis is usually no more than 10 mm thick; 3) current knowledge of the physiology of the fetal urinary apparatus especially the kidney. Excretory function of the kidney begins in the third month of gestation and its main role involves the regulation of the amniotic fluid.
The authors describe the ultrasonographic anatomy and semiology of allowing detection of the main types of fetal uropathies. The results of the author's personal experience in this domain are compared to data from the literature. Differential features of the uropathies are given and the limitations and practical significance of prenatal and postnatal ultrasonography are discussed.
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