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P S Ray

Publications and source records attributed to P S Ray.

26 records · Page 2Linked to original sources

The results of a five-year early prostate cancer detection intervention. Investigators of the American Cancer Society National Prostate Cancer Detection Project.

BACKGROUND: The American Cancer Society-National Prostate Cancer Detection Project (ACS-NPCDP) is a multidisciplinary evaluation of early prostate cancer detection interventions. This report summarizes the experience of the investigators to date and describes the overall and relative performance of the different detection modalities studied in this project. METHODS: Two thousand nine hundred ninety-nine men aged 55 to 70 years at entry who were not already under evaluation for prostate cancer were recruited to participate in up to 5 annual examinations by prostate specific antigen (PSA), digital rectal examination (DRE), and transrectal ultrasound (TRUS). In the course of 5 years of intervention, ACS-NPCDP investigators have completed 9937 examinations, recommended 1215 biopsies, and detected 203 cancers. RESULTS: Loss to cohort follow-up was greatest in the first year. Overall, TRUS led to twice the number of recommendations for biopsy compared with DRE (8.9% versus 4.4%). Elevated PSA was observed in 13.0% of 9535 measurements performed. The overall cancer detection rate declined significantly during the five years of intervention. Detection was significantly associated with age and symptom status at entry. DRE had lower sensitivity compared with TRUS or PSA, particularly in later years of follow-up. The specificity of TRUS was lower than that for DRE. PSA was elevated in 69.2% of examinations that led to cancer detection, compared with only 10.9% when cancer was not found. PSA level, PSA density, and PSA change were all related to the presence of cancer. Less than 6% of the cancers detected in this study were clinically advanced at the time of diagnosis. CONCLUSIONS: These data quantify the yield of early cancer detection that may be expected when PSA, DRE, and TRUS are used in populations comparable to the men participating in the ACS-NPCDP. Continued follow-up and further research is needed to assess whether men receiving early prostate cancer interventions benefit as a result.

Aged↗

Immunoregulatory markers in rats carrying Dunning R3327 H, G, or MAT-LyLu prostatic adenocarcinoma variants.

The Dunning R3327 tumor represents a system for studying prostate cancer in Copenhagen X Fischer rats. Animals bearing variant sublines (H, G, and MAT-LyLu) differing in growth rate, differentiation, hormone responsiveness, and metastatic ability were assayed for three immunological markers. Spleens were passed through a tissue sieve, and mononuclear cells were obtained by Ficoll-Hypaque centrifugation. These were assayed for leukocytic subsets using monoclonal antibodies. An adherent population was isolated and evaluated using thin-layer chromatography for conversion of radiolabeled arachidonic acid to E series prostaglandins. Finally, sera from these animals were assayed for levels of circulating immune complexes using polyethylene glycol precipitation. Data from 52 rats bearing the various tumors were obtained, correlated with subline aggressiveness, and compared to 15 controls. Each tumor group demonstrated significantly lower helper/suppressor T-cell ratios than controls, probably due to general tumor presence. In addition, the most aggressive R3327 MAT-LyLu variant had significantly increased prostaglandin E synthesis by adherent spleen cells compared to the H or G sublines and significantly increased levels of circulating immune complexes relative to the H subline. G subline values for both prostaglandin E and circulating immune complexes levels were intermediate, suggesting that these markers correlate better with tumor aggressiveness than helper/suppressor T-cell ratios.

Adenocarcinoma↗

Early experience with Walsh technique of radical retropubic prostatectomy.

We analyzed the operative experience and postoperative and late complications of pelvic lymphadenectomy and radical retropubic prostatectomy in 27 consecutive cases in which the modifications of prostatectomy described by Walsh were employed, and compared the results with those of 29 cases performed in the preceding three years when the Campbell technique of prostatectomy was employed. The mean operative time, mean blood loss, and incidences of early postoperative complications and incontinence were less for patients treated with the Walsh technique than with the Campbell technique. After surgery 85 per cent of evaluable patients remained potent with the Walsh technique compared with 16 per cent of patients treated with the Campbell technique. Although other factors besides operative approach may have biased our results, we are persuaded that the innovations of radical retropubic prostatectomy detailed by Walsh constitute important advances in surgical technique, and we now use this procedure in all suitable patients electing treatment by radical prostatectomy for localized prostatic cancer.

Erectile Dysfunction↗

Fixation of proximal humeral fractures with the Polarus nail.

Thirty patients with fractures of the proximal humerus were treated by internal fixation with an intramedullary locked nail. Fourteen of these patients were more than 60 years of age; 23 patients had 2-part fractures (surgical neck fractures) and were operated on within an average of 3 days after injury. At follow-up, 20 (80%) of 25 patients showed satisfactory to excellent functional outcomes, as measured by Constant score. All but 1 fracture progressed to clinical and radiologic union. The good functional results indicate that the Polarus nail is a satisfactory mechanical device that can be used in the treatment of displaced proximal humeral fractures in both the young and the elderly with osteopenic bone.

Adolescent↗