Predictive value of PAK6 and PSMB4 expression in patients with localized prostate cancer treated with dose-escalation radiation therapy and androgen deprivation therapy.

PURPOSE: The present study analyzed the expression by immunochemistry of the novel markers P21-activated protein kinase 6 (PAK6) and proteasome beta-4 subunit (PSMB4) in men with localized prostate cancer (PC) who were treated with dose-escalation radiotherapy (RT) and androgen deprivation therapy. MATERIALS AND METHODS: Between 1996 and 2004, a cohort of 129 patients with PC who underwent diagnostic biopsies pretreatment and 24 to 36 months following RT were enrolled in this study. Suitable archival diagnostic tissue was obtained from 89 patients. Median follow-up was 129 months (48-198). Correlation analysis was done to assess association between PAK6 and PSMB4 expression and clinical outcome. RESULTS: PAK6 and PSMB4 were expressed in the cytoplasm in 62% and 96.7% of diagnostic biopsies, respectively. Increased staining for PAK6 was significantly (P = 0.04) correlated with higher Gleason scores. In the multivariate analysis, the intensity of PSMB4 staining was an independent predictor of local relapse (hazard ratio = 8.6, P = 0.04). CONCLUSIONS: To our knowledge, this is the first description of PAK6 and PSMB4 expression in the diagnostic specimens of men with PC who were treated with RT. If confirmed by further studies, increased expression of these genes could be used to identify patients at a high risk of developing local failure following high-dose RT, thus better tailoring treatments for the individual patient.

Transdermal iontophoresis with verapamil and dexamethasone in the acute phase of peyronie's disease. Our experience.

OBJECTIVES: To evaluate the treatment of Peyronie's disease (PD) with verapamil and dexamethasone iontophoresis. METHODS: Twenty nine patients with PD were treated by means of a Miniphysionize" dispositive 3 sessions a week during 4 consecutive weeks. 5mL of a combination of verapamil(10mg.) and dexamethasone (4mg.) were transdermally administered with a 2.5 mA current during 20 min. The aim is to evaluate treatment efficacy in correcting penile curvature (Kelami test), plaque size (penis ultrasound (US)) improvement of pain and, other parameters like erectile function (EF), intercourse capacity or adverse effects of the treatment, which were evaluated with questionnaires. RESULTS: All patients completed the treatment protocol (12 sessions) and a total number of 348 sessions of iontophoresis were performed. After treatment, 3 patients (10.7%) continued with pain, but it disappeared in 25 of them (89.3%). A decrease of the size of the plaque was observed in 13 patients (44.8%), even disappearance in 4 patients (13.8%). No patient had curvature decrease after treatment. However, EF (IIEF score) and ability for intercourse improved in 3 (10.3%) and 4 patients (13.8%) respectively. CONCLUSION: Verapamil and dexamethasone iontophoresis is a safe and reliable treatment resolving painful erections in the acute phase of PD. However its efficacy in solving penile curvature and erectile dysfunction (ED) is more limited.

Iontoforesis transdérmica con verapamilo y dexametasona para la fase aguda de la Enfermedad de La Peyronie. Nuestra experiencia / Transdermal iontophoresis with verapamil and dexamethasone in the acute phase of peyronie's disease. Our experience

OBJETIVO: Evaluar el resultado del tratamiento de la Enfermedad de Peyronie (EP) mediante iontoforesis de verapamilo y dexametasona. MÉTODOS: Tratamiento de 29 pacientes con EP en 3 sesiones semanales durante cuatro semanas consecutivas mediante un dispositivo Miniphysionizer©. Administrando 5 mL de una combinación de 10mg de verapamilo y 4mg de dexametasona, aplicado transdérmico a través de una corriente de 2.5 mA durante ciclos de 20 min. Se evalúa la eficacia del tratamiento mediante corrección de curvatura peneana (test de Kelami), tamaño de la placa (ecografía peneana), mejoría del dolor y otros parámetros, como, la función eréctil, capacidad de penetración o efectos secundarios del tratamiento, que fueron valorados mediante cuestionarios. RESULTADO: Todos los pacientes completaron el protocolo de tratamiento (12 sesiones) y se efectuaron un total de 348 sesiones de iontoforesis. Tras finalizar el tratamiento completo, 3 pacientes (10.7%) continuaron presentando dolor, mientras que remitió en 25 de ellos (89.3%). En 13 pacientes (44.8%) se observó una disminución del tamaño de la placa, desapareciendo incluso totalmente en 4 pacientes (13.8%). La curvatura no se disminuyó en ninguno de los pacientes tras el tratamiento. Sin embargo, la función eréctil mejoró en 3 pacientes (10.3%) según la puntuación del IIEF, y la capacidad para la penetración mejoró en 4 pacientes (13.8%). CONCLUSIONES: La iontoforesis con verapamilo y dexametasona es un tratamiento seguro y eficaz en la resolución del dolor con las erecciones en la fase aguda de la EP. Sin embargo la eficacia en la resolución de la curvatura y la DE es más limitado (AU)

OBJECTIVES: To evaluate the treatment of Peyronie's disease (PD) with verapamil and dexamethasone iontophoresis. METHODS: Twenty nine patients with PD were treated by means of a Miniphysionizer” dispositive 3 sessions a week during 4 consecutive weeks. 5mL of a combination of verapamil (10mg.) and dexamethasone (4mg.) were transdermally administered with a 2.5 mA current during 20 min. The aim is to evaluate treatment efficacy in correcting penile curvature (Kelami test), plaque size (penis ultrasound (US)) improvement of pain and, other parameters like erectile function (EF), intercourse capacity or adverse effects of the treatment, which were evaluated with questionnaires. RESULTS: All patients completed the treatment protocol (12 sessions) and a total number of 348 sessions of iontophoresis were performed. After treatment, 3 patients (10.7%) continued with pain, but it disappeared in 25 of them (89.3%). A decrease of the size of the plaque was observed in 13 patients (44.8%), even disappearance in 4 patients (13.8%). No patient had curvature decrease after treatment. However, EF (IIEF score) and ability for intercourse improved in 3 (10.3%) and 4 patients (13.8%) respectively. CONCLUSION: Verapamil and dexamethasone iontophoresis is a safe and reliable treatment resolving painful erections in the acute phase of PD. However its efficacy in solving penile curvature and erectile dysfunction (ED) is more limited (AU)