Prostate-specific antigen (PSA) density in the diagnostic algorithm of prostate cancer.

Science.gov (United States)

Nordström, Tobias; Akre, Olof; Aly, Markus; Grönberg, Henrik; Eklund, Martin

2018-04-01

Screening for prostate cancer using prostate-specific antigen (PSA) alone leads to un-necessary biopsying and overdiagnosis. PSA density is easily accessible, but early evidence on its use for biopsy decisions was conflicting and use of PSA density is not commonly recommended in guidelines. We analyzed biopsy outcomes in 5291 men in the population-based STHLM3 study with PSA ≥ 3 ng/ml and ultrasound-guided prostate volume measurements by using percentages and regression models. PSA density was calculated as total PSA (ng/ml) divided by prostate volume (ml). Main endpoint was clinically significant cancer (csPCa) defined as Gleason Score ≥ 7. The median PSA-density was 0.10 ng/ml 2 (IQR 0.075-0.14). PSA-density was associated with the risk of finding csPCa both with and without adjusting for the additional clinical information age, family history, previous biopsies, total PSA and free/total PSA (OR 1.06; 95% CI:1.05-1.07 and OR 1.07, 95% CI 1.06-1.08). Discrimination for csPCa was better when PSA density was added to a model with additional clinical information (AUC 0.75 vs. 0.73, P PSA-density. Omitting prostate biopsy for men with PSA-density ≤0.07 ng/ml 2 would save 19.7% of biopsy procedures, while missing 6.9% of csPCa. PSA-density cutoffs of 0.10 ng/ml 2 and 0.15 ng/ml 2 resulted in detection of 77% (729/947) and 49% (461/947) of Gleason Score ≥7 tumors. PSA-density might inform biopsy decisions, and spare some men from the morbidity associated with a prostate biopsy and diagnosis of low-grade prostate cancer.

Quality PSA for PSA applications

International Nuclear Information System (INIS)

Carska, K.; Rybar, J.

2012-03-01

The safety guideline defines with more precision Nuclear Regulatory Authority of the Slovak Republic requirements of the quality of probabilistic safety assessment (PSA) for PSA application. Term of quality of PSA is explained in detail. Procedure for determining the quality of PSA is provided. The categorization of PSA study according the quality of PSA is suggested. A comprehensive list of PSA applications for nuclear facilities is provided. What technical features of a PSA should be satisfied to support the PSA applications of interest is stated. (authors)

Predictor of response to salvage radiotherapy in patients with PSA recurrence after radical prostatectomy. The usefulness of PSA doubling time

International Nuclear Information System (INIS)

Numata, Kousaku; Azuma, Koji; Hashine, Katsuyoshi; Sumiyoshi, Yoshiteru

2005-01-01

We assessed predictors of response to salvage radiotherapy (sRT) in patients with prostate-specific antigen (PSA) recurrence after radical prostatectomy. A total of 21 patients receiving sRT for PSA recurrence without systemic progression after radical prostatectomy had medical records available for retrospective review. We defined sRT as external beam radiotherapy for patients with a continuous increase in PSA level≥0.2 ng/ml after radical prostatectomy. Response was defined as achievement of a PSA nadir of ≤0.1 ng/ml. Various pre-treatment parameters were evaluated retrospectively. The median follow-up period after sRT was 38 months. Of the 21 patients, 15 were good responders (71%). The only predictive factor was PSA doubling time (PSADT). Age and PSA level at diagnosis, Gleason score and surgical margin status were not significant predictors of response. The median PSADT in responders was 6.2 months versus 1.9 months in non-responders (P=0.019). The patients with a PSADT of ≥5 months were all responders. PSADT appears to be a good predictor of response to sRT. sRT was especially effective when PSADT was ≥5 months. (author)

Comparative evaluation of PSA-Density, percent free PSA and total PSA

OpenAIRE

Ströbel, Greta

2010-01-01

BACKGROUND The objective of this study was to evaluate the prostate specific antigen (PSA) density (PSAD) (the quotient of PSA and prostate volume) compared with the percent free PSA (%fPSA) and total PSA (tPSA) in different total PSA (tPSA) ranges from 2 ng/mL to 20 ng/mL. Possible cut-off levels depending on the tPSA should be established. METHODS In total, 1809 men with no pretreatment of the prostate were enrolled between 1996 and 2004. Total and free PSA were measured with t...

Detection of prostate cancer with complexed PSA and complexed/total PSA ratio - is there any advantage?

OpenAIRE

Strittmatter, F; Stieber, P; Nagel, D; Füllhase, C; Walther, S; Stief, CG; Waidelich, R

2011-01-01

Abstract Objective To evaluate the performance of total PSA (tPSA), the free/total PSA ratio (f/tPSA), complexed PSA (cPSA) and the complexed/total PSA ratio (c/tPSA) in prostate cancer detection. Methods Frozen sera of 442 patients have been analysed for tPSA, free PSA (fPSA) and cPSA. 131 patients had prostate cancer and 311 patients benign prostatic hyperplasia. Results Differences in the distribution of the biomarkers were seen as follows: tPSA, cPSA and c/tPSA were significantly higher i...

Performance of serum prostate-specific antigen isoform [-2]proPSA (p2PSA) and the prostate health index (PHI) in a Chinese hospital-based biopsy population.

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Na, Rong; Ye, Dingwei; Liu, Fang; Chen, Haitao; Qi, Jun; Wu, Yishuo; Zhang, Guiming; Wang, Meilin; Wang, Wenying; Sun, Jielin; Yu, Guopeng; Zhu, Yao; Ren, Shancheng; Zheng, S Lilly; Jiang, Haowen; Sun, Yinghao; Ding, Qiang; Xu, Jianfeng

2014-11-01

The use of serum [-2]proPSA (p2PSA) and its derivative, the prostate health index (PHI), in detecting prostate cancer (PCa) have been consistently shown to have better performance than total prostate-specific antigen (tPSA) in discriminating biopsy outcomes in western countries. However, little is known about their performance in Chinese men. Our objective is to test the performance of p2PSA and PHI and their added value to tPSA in discriminating biopsy outcomes in Chinese men. Consecutive patients who underwent prostate biopsy in three tertiary hospitals in Shanghai, China during 2012-2013 were recruited. Serum tPSA, free PSA (fPSA), and p2PSA were measured centrally using Beckman Coulter's DxI 800 Immunoassay System. The primary outcome is PCa and the secondary outcome is high-grade PCa (Gleason Score of 4 + 3 or worse). Discriminative performance was assessed using the area under the receiver operating characteristic curve (AUC), detection rate and Decision Curve Analysis (DCA). Among 636 patients who underwent prostate biopsy, PHI was a significant predictor of biopsy outcomes, independent of other clinical variables. The AUC in discriminating PCa from non-PCa was consistently higher for PHI than tPSA in the entire cohort (0.88 vs. 0.81) as well as in patients with tPSA at 2-10 ng/ml (0.73 vs. 0.53), at 10.1-20 ng/ml (0.81 vs. 0.58), and at tPSA >20 ng/ml (0.90 vs. 0.80). The differences were statistically significant in all comparisons, P prostate biopsy in China. © 2014 Wiley Periodicals, Inc.

PSA kinetics after prostate brachytherapy: PSA bounce phenomenon and its implications for PSA doubling time

International Nuclear Information System (INIS)

Ciezki, Jay P.; Reddy, Chandana A.; Garcia, Jorge; Angermeier, Kenneth; Ulchaker, James; Mahadevan, Arul; Chehade, Nabil; Altman, Andrew; Klein, Eric A.

2006-01-01

using the bF3 definition and 8.8 months using the bFn+2 definition. However, a significant difference was found in the time to the first rise in PSA after PI for patients with a PSA bounce vs. patients with bF. The median time to the first rise in PSA after nadir for those with a PSA bounce was 15.1 months vs. 30.0 months using the bF3 definition (p = 0.001) and 22.3 months using the bFn+2 definition (p = 0.013). Conclusion: Patients experiencing a PSA bounce are more likely to be younger and will have a better bRFS. The PSADT cannot differentiate a PSA bounce from bF. The time to the initial PSA rise after nadir is an excellent discriminator of bF from PSA bounce. The time of the PSA rise after nadir occurs far sooner for a PSA bounce than for bF. This factor should be considered when assessing a patient with a rising PSA level after PI before a patient is administered salvage therapy

The diagnostic value of PSA, cPSA and bone scintigraphy for early skeletal metastasis of prostate cancer

International Nuclear Information System (INIS)

Xue Zhongguang

2007-01-01

Objective: To evaluate the value of prostate specific antigen (PSA), complexed prostate specific antigen (cPSA) and bone scintigraphic imaging in diagnosis of early skeletal metastasis of prostate cancer. Methods: 152 patients (74 with prostate cancer, 78 with benign prostate disease) and 90 controls were examined for the serum concentrations of PSA and cPSA. At the same time, the 74 patients with PCa were examined with bone scintigraphy. The cPSA/PSA ratio was calculated. Results: Serum PSA, cPSA levels and cPSA/PSA ratio of patients with prostate cancer were significantly higher than those in benign prostate patients and controls. In addition, the serum PSA, cPSA levels and cPSA/PSA ratio in prostate cancer patients with skeletal metastasis were remarkably higher than those in patients without skeletal metastasis, and the differences were significant (P 20 μg/L, cPSA>10 μg/L, cPSA/PSA>0.80, there is a high probability that skeletal metastasis of prostate cancer would be present and bone scintigraphy should be performed. (authors)

Re-examining Prostate-specific Antigen (PSA) Density: Defining the Optimal PSA Range and Patients for Using PSA Density to Predict Prostate Cancer Using Extended Template Biopsy.

Science.gov (United States)

Jue, Joshua S; Barboza, Marcelo Panizzutti; Prakash, Nachiketh S; Venkatramani, Vivek; Sinha, Varsha R; Pavan, Nicola; Nahar, Bruno; Kanabur, Pratik; Ahdoot, Michael; Dong, Yan; Satyanarayana, Ramgopal; Parekh, Dipen J; Punnen, Sanoj

2017-07-01

To compare the predictive accuracy of prostate-specific antigen (PSA) density vs PSA across different PSA ranges and by prior biopsy status in a prospective cohort undergoing prostate biopsy. Men from a prospective trial underwent an extended template biopsy to evaluate for prostate cancer at 26 sites throughout the United States. The area under the receiver operating curve assessed the predictive accuracy of PSA density vs PSA across 3 PSA ranges (10 ng/mL). We also investigated the effect of varying the PSA density cutoffs on the detection of cancer and assessed the performance of PSA density vs PSA in men with or without a prior negative biopsy. Among 1290 patients, 585 (45%) and 284 (22%) men had prostate cancer and significant prostate cancer, respectively. PSA density performed better than PSA in detecting any prostate cancer within a PSA of 4-10 ng/mL (area under the receiver operating characteristic curve [AUC]: 0.70 vs 0.53, P PSA >10 mg/mL (AUC: 0.84 vs 0.65, P PSA density was significantly more predictive than PSA in detecting any prostate cancer in men without (AUC: 0.73 vs 0.67, P PSA increases, PSA density becomes a better marker for predicting prostate cancer compared with PSA alone. Additionally, PSA density performed better than PSA in men with a prior negative biopsy. Copyright © 2017 Elsevier Inc. All rights reserved.

Correlative study of SPECT bone scan, serum tPSA and fPSA/tPSA ratio and the pathological grade of prostate cancer with bone metastasis

International Nuclear Information System (INIS)

Xu Haiqing; Duan Jun

2011-01-01

Objective: To study the rules and characteristics of SPECT bone scan, serum TPSA, fPSA/tPSA ratio and the pathological grade of prostate cancer with bone metastasis. Methods: Nuclear medicine SPECT bone scan as the gold standard, retrospective analysis of the in vitro radioimmunoassay in 107 patients with prostate cancer serum PSA (prostate specific antigen) levels, serum fPSA/tPSA ratio and whole body bone imaging studies and pathological classification. Results: 107 patients with prostate cancer : 49 patients had bone metastases, accounting for 45.8% (49/107), in which groups of different pathological comparison between the incidence of bone metastasis significantly, the lower the degree of differentiation, the more the incidence of bone metastases high; with elevated levels of tPSA, the incidence of bone metastasis increased significantly; serum tPSA 4 - 40 ng/ml, the use of fPSA/tPSA ratio may improve the diagnostic specificity of prostate cancer. Conclusion: Patients with bone metastases of prostate cancer incidence and degree of differentiation of prostate cancer, serum PSA levels and fPSA/tPSA ratio of a certain relationship. The lower degree of differentiation,the higher the incidence of bone metastasis. (authors)

Serum PSA and cure perspective for prostate cancer in males with nonpalpable tumor

Directory of Open Access Journals (Sweden)

Marcos F. Dall'Oglio

2005-10-01

Full Text Available INTRODUCTION: Many studies have shown the association between PSA levels and the subsequent detection of prostate cancer. In the present trial, we have studied the relationship between preoperative PSA levels and clinical outcome following radical prostatectomy in men with clinical stage T1c. MATERIALS AND METHODS: 257 individuals with clinical stage T1c undergoing retropubic radical prostatectomy were selected in the period from 1991 to 2000. Following surgery, biochemical recurrence-free survival curves were constructed according to PSA levels between 0-4; 4.1-10; 10.1-20 and > 20 ng/mL. RESULTS: Of the total of 257 selected patients, 206 (80% had Gleason scores from 2 to 6 and 51 (20%, presented Gleason scores 7 and 8, as defined by the pathological report from prostate biopsy. There was no biochemical recurrence of disease when the PSA was lower than 4, regardless of Gleason score. Biochemical recurrence-free survival according to PSA between 0-4; 4.1-10; 10.1-20 and > 20 was 100%, 87.6%, 79% and 68.8% for Gleason scores 2-6 and 100%; 79.4%; 40% and 100% for Gleason scores 7-8 respectively. When all individuals were grouped, regardless of their Gleason scores, the probability of biochemical recurrence-free survival was 100%, 65.1%, 53.4% and 72.2% according to PSA between 0-4; 4.1-10; 10.1-20 and > 20 ng/mL respectively. CONCLUSION: Non-palpable prostate cancer presents higher chances of cure when the PSA is inferior to 4 ng/mL.

Serum PSA Evaluations during salvage radiotherapy for post-prostatectomy biochemical failures as prognosticators for treatment outcomes

International Nuclear Information System (INIS)

Do, Tri; Dave, Giatri; Parker, Robert; Kagan, A. Robert

2001-01-01

Introduction: Serum prostate specific antigen (PSA) levels have proved to be sensitive markers for the diagnosis of prostate cancer. In addition, PSA levels are useful for detecting and monitoring prostate cancer progression after radiotherapy. Serum PSA evaluations during radiotherapy, however, have not been well documented. In this study, we investigate the prognostic value of PSA evaluations during salvage radiotherapy for prostatectomy failures. Methods: Forty-one patients with biochemical failures after prostatectomy treated with salvage radiotherapy consented to have their serum PSA levels evaluated at 30 Gy and 45 Gy of irradiation. All 41 patients had negative metastatic workup and pathologically uninvolved pelvic lymph nodes at the time of referral for salvage radiotherapy. Radiation therapy was delivered with 10-25 MV photons, with doses of 59.4-66.6 Gy. No patients received hormonal ablation therapy before irradiation. Results: The mean follow-up for all patients was 30.9 months. At last follow-up, 28/41 patients (68.3%) were free from biochemical failure, with 20 of 41 patients (48.8%) expressing undetectable PSA levels. Serum PSA evaluations at 30 Gy did not significantly predict for either biochemical (p=0.0917) or clinical (p=0.106) disease-free outcome. However, serum PSA evaluations at 45 Gy significantly predicted for both biochemical (p=0.0043) and clinical (p=0.0244) disease-free outcomes, with PSA elevations at 45 Gy significantly associated with poor outcomes. On univariate analysis of prognosticators for biochemical failures, the following were significant: an elevation in serum PSA levels at 45 Gy, detectable serum PSA immediately after prostatectomy, Gleason score 7-10, and serum PSA level >1 ng/ml before salvage radiotherapy. Conclusion: Evaluation of serum PSA level at 45 Gy of salvage radiotherapy for biochemical relapses after prostatectomy may serve as a significant prognosticator for both biochemical and clinical disease-free outcomes

Prediction of PSA bounce after permanent prostate brachytherapy for localized prostate cancer

International Nuclear Information System (INIS)

Kanai, Kunimitsu; Nakashima, Jun; Sugawara, Akitomo

2009-01-01

We aimed to calculate the frequency and features of the development of a prostate-specific antigen (PSA) bounce after prostate brachytherapy alone, to correlate the bounce with clinical and dosimetric factors and to identify factors that predict PSA bounce. PSA bounce was evaluated in 86 patients with T1-T2 prostate cancer who underwent radioactive seed implantation using iodine-125 (I-125) without hormonal therapy or external-beam radiation therapy (EBRT) from September 2004 to December 2007. A PSA bounce was defined as a rise of at least 0.4 ng/ml greater than a previous PSA level with a subsequent decline equal to, or less than, the initial nadir. Calculated by the Kaplan-Meier method, the incidence of PSA bounce at a 2-year follow-up was 26%. Median time to the PSA bounce was 15 months. Univariate analysis demonstrated that age, dose received by 90% of the prostate gland (D90), volume of gland receiving 100% of the prescribed dose (V100), and V150 were significantly associated with the PSA bounce, while pretreatment PSA level, Gleason score, pretreatment prostate volume, clinical T stage, and V200 were not. In multivariate analysis, age 67 years or less and D90 more than 180 Gy were identified as independent factors for predicting the PSA bounce (P<0.05). PSA bounce is not a rare phenomenon after prostate brachytherapy. It is more common in younger patients and patients receiving higher doses of radiation. (author)

[Relationship between tumor volume and PSA recurrence after radical prostatectomy].

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Hashimoto, Yasuhiro; Momose, Akishi; Okamoto, Akiko; Yamamoto, Hayato; Hatakeyama, Shingo; Iwabuchi, Ikuya; Yoneyama, Takahiro; Koie, Takuya; Kamimura, Noritaka; Ohyama, Chikara

2010-02-01

We examined whether the tumor volume (TV) is a good predictor of PSA recurrence after radical prostatectomy. Data were collected for 158 patients with clinically localized prostate cancer undergoing radical prostatectomy without neoadjuvant hormonal therapy in our hospital since April 2005 to September 2007. Along with the routine pathological assessment, TV was assessed in all prostatectomy specimens. PSA recurrence was defined as PSA levels of greater than 0.2 ng/ml. The TVs were 1.81+/-1.66 ml (mean +/-SD) ranging from 0.02 to 8.20 ml. The TV in cT1c was 1.77+/-1.64, and 1.89+/-1.72 ml in cT2 (not significant). Significant differences were observed between TV and pT. The TVs in pT2a, pT2b and pT3/4 were 0.54+/-0.54, 1.63+/-1.47 and 2.67+/-1.80 ml, respectively. The median follow-up period was 32.3 months (range from 15 to 45) after radical prostatectomy, and PSA recurrence was observed in 32 cases. Patients with smaller TV (TV TV (TV > or = 1.3 ml, 66.7%) with a significant difference atp TV, pT, Gleason Score (GS), and surgical margins. Significant differences were observed for GS, and surgical margins, but not for TV. Clinically organ-confined disease in Japanese patients with prostate cancer included various cancers from clinically insignificant to locally advanced ones. In our series, TV was not regarded as a predictor of PSA recurrence after radical prostatectomy.

Can Prostate Imaging Reporting and Data System Version 2 reduce unnecessary prostate biopsies in men with PSA levels of 4-10 ng/ml?

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Xu, Ning; Wu, Yu-Peng; Chen, Dong-Ning; Ke, Zhi-Bin; Cai, Hai; Wei, Yong; Zheng, Qing-Shui; Huang, Jin-Bei; Li, Xiao-Dong; Xue, Xue-Yi

2018-05-01

To explore the value of Prostate Imaging Reporting and Data System Version 2 (PI-RADS v2) for predicting prostate biopsy results in patients with prostate specific antigen (PSA) levels of 4-10 ng/ml. We retrospectively reviewed multi-parameter magnetic resonance images from 528 patients with PSA levels of 4-10 ng/ml who underwent transrectal ultrasound-guided prostate biopsies between May 2015 and May 2017. Among them, 137 were diagnosed with prostate cancer (PCa), and we further subdivided them according to pathological results into the significant PCa (S-PCa) and insignificant significant PCa (Ins-PCa) groups (121 cases were defined by surgical pathological specimen and 16 by biopsy). Age, PSA, percent free PSA, PSA density (PSAD), prostate volume (PV), and PI-RADS score were collected. Logistic regression analysis was performed to determine predictors of pathological results. Receiver operating characteristic curves were constructed to analyze the diagnostic value of PI-RADS v2 in PCa. Multivariate analysis indicated that age, PV, percent free PSA, and PI-RADS score were independent predictors of biopsy findings, while only PI-RADS score was an independent predictor of S-PCa (P PSA, and PI-RADS score were 0.570, 0.430, 0.589 and 0.836, respectively. The area under the curve for diagnosing S-PCa with respect to PI-RADS score was 0.732. A PI-RADS score of 3 was the best cutoff for predicting PCa, and 4 was the best cutoff for predicting S-PCa. Thus, 92.8% of patients with PI-RADS scores of 1-2 would have avoided biopsy, but at the cost of missing 2.2% of the potential PCa cases. Similarly, 83.82% of patients with a PI-RADS score ≤ 3 would have avoided biopsy, but at the cost of missing 3.3% of the potential S-PCa cases. PI-RADS v2 could be used to reduce unnecessary prostate biopsies in patients with PSA levels of 4-10 ng/ml.

Improving PSA quality of KSNP PSA model

International Nuclear Information System (INIS)

Yang, Joon Eon; Ha, Jae Joo

2004-01-01

In the RIR (Risk-informed Regulation), PSA (Probabilistic Safety Assessment) plays a major role because it provides overall risk insights for the regulatory body and utility. Therefore, the scope, the level of details and the technical adequacy of PSA, i.e. the quality of PSA is to be ensured for the successful RIR. To improve the quality of Korean PSA, we evaluate the quality of the KSNP (Korean Standard Nuclear Power Plant) internal full-power PSA model based on the 'ASME PRA Standard' and the 'NEI PRA Peer Review Process Guidance.' As a working group, PSA experts of the regulatory body and industry also participated in the evaluation process. It is finally judged that the overall quality of the KSNP PSA is between the ASME Standard Capability Category I and II. We also derive some items to be improved for upgrading the quality of the PSA up to the ASME Standard Capability Category II. In this paper, we show the result of quality evaluation, and the activities to improve the quality of the KSNP PSA model

{sup 68}Ga-PSMA-11 PET/CT in primary staging of prostate cancer: PSA and Gleason score predict the intensity of tracer accumulation in the primary tumour

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Uprimny, Christian; Kroiss, Alexander Stephan; Decristoforo, Clemens; Guggenberg, Elisabeth von; Kendler, Dorota; Scarpa, Lorenza; Di Santo, Gianpaolo; Roig, Llanos Geraldo; Maffey-Steffan, Johanna; Virgolini, Irene Johanna [Medical University Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Fritz, Josef [Medical University Innsbruck, Department of Medical Statistics, Informatics and Health Economics, Innsbruck (Austria); Horninger, Wolfgang [Medical University Innsbruck, Department of Urology, Innsbruck (Austria)

2017-06-15

Prostate cancer (PC) cells typically show increased expression of prostate-specific membrane antigen (PSMA), which can be visualized by {sup 68}Ga-PSMA-11 PET/CT. The aim of this study was to assess the intensity of {sup 68}Ga-PSMA-11 uptake in the primary tumour and metastases in patients with biopsy-proven PC prior to therapy, and to determine whether a correlation exists between the primary tumour-related {sup 68}Ga-PSMA-11 accumulation and the Gleason score (GS) or prostate-specific antigen (PSA) level. Ninety patients with transrectal ultrasound biopsy-proven PC (GS 6-10; median PSA: 9.7 ng/ml) referred for {sup 68}Ga-PSMA-11 PET/CT were retrospectively analysed. PET images were analysed visually and semiquantitatively by measuring the maximum standardized uptake value (SUV{sub max}). The SUV{sub max} of the primary tumour and pathologic lesions suspicious for lymphatic or distant metastases were then compared to the physiologic background activity of normal prostate tissue and gluteal muscle. The SUV{sub max} of the primary tumour was assessed in relation to both PSA level and GS. Eighty-two patients (91.1%) demonstrated pathologic tracer accumulation in the primary tumour that exceeded physiologic tracer uptake in normal prostate tissue (median SUV{sub max}: 12.5 vs. 3.9). Tumours with GS of 6, 7a (3+4) and 7b (4+3) showed significantly lower {sup 68}Ga-PSMA-11 uptake, with median SUV{sub max} of 5.9, 8.3 and 8.2, respectively, compared to patients with GS >7 (median SUV{sub max}: 21.2; p < 0.001). PC patients with PSA ≥10.0 ng/ml exhibited significantly higher uptake than those with PSA levels <10.0 ng/ml (median SUV{sub max}: 17.6 versus 7.7; p < 0.001). In 24 patients (26.7%), 82 lymph nodes with pathologic tracer accumulation consistent with metastases were detected (median SUV{sub max}: 10.6). Eleven patients (12.2%) revealed 55 pathologic osseous lesions suspicious for bone metastases (median SUV{sub max}: 11.6). The GS and PSA level correlated with

PSA, PSA derivatives, proPSA and prostate health index in the diagnosis of prostate cancer

OpenAIRE

Ayyıldız, Sema Nur; Ayyıldız, Ali

2014-01-01

Currently, prostate- specific antigen (PSA) is the most common oncological marker used for prostate cancer screening. However, high levels of PSA in benign prostatic hyperplasia and prostatitis decrease the specificity of PSA as a cancer marker. To increase the specificity of PSA, PSA derivatives and PSA kinetics have been used. However, these new techniques were not able to increase the diagnostic specificity for prostate cancer. Therefore, the search for new molecules and derivatives of PSA...

The significance of the probabilistic safety analysis (PSA) in administrative procedures under nuclear law

International Nuclear Information System (INIS)

Berg, H.P.

1994-01-01

The probabilistic safety analysis (PSA) is a useful tool for safety relevant evaluation of nuclear power plant designed on the basis of deterministic specifications. The PSA yields data identifying reliable or less reliable systems, or frequent or less frequent failure modes to be taken into account for safety engineering. Performance of a PSA in administrative procedures under nuclear law, e.g. licensing, is an obligation laid down in a footnote to criterion 1.1 of the BMI safety criteria catalogue, which has been in force unaltered since 1977. The paper explains the application and achievements of PSA in the phase of reactor development concerned with the conceptual design basis and design features, using as an example the novel PWR. (orig./HP) [de

The percentage of prostate-specific antigen (PSA) isoform [-2]proPSA and the Prostate Health Index improve the diagnostic accuracy for clinically relevant prostate cancer at initial and repeat biopsy compared with total PSA and percentage free PSA in men aged ≤65 years.

Science.gov (United States)

Boegemann, Martin; Stephan, Carsten; Cammann, Henning; Vincendeau, Sébastien; Houlgatte, Alain; Jung, Klaus; Blanchet, Jean-Sebastien; Semjonow, Axel

2016-01-01

To prospectively test the diagnostic accuracy of the percentage of prostate specific antigen (PSA) isoform [-2]proPSA (%p2PSA) and the Prostate Health Index (PHI), and to determine their role for discrimination between significant and insignificant prostate cancer at initial and repeat prostate biopsy in men aged ≤65 years. The diagnostic performance of %p2PSA and PHI were evaluated in a multicentre study. In all, 769 men aged ≤65 years scheduled for initial or repeat prostate biopsy were recruited in four sites based on a total PSA (t-PSA) level of 1.6-8.0 ng/mL World Health Organization (WHO) calibrated (2-10 ng/mL Hybritech-calibrated). Serum samples were measured for the concentration of t-PSA, free PSA (f-PSA) and p2PSA with Beckman Coulter immunoassays on Access-2 or DxI800 instruments. PHI was calculated as (p2PSA/f-PSA × √t-PSA). Uni- and multivariable logistic regression models and an artificial neural network (ANN) were complemented by decision curve analysis (DCA). In univariate analysis %p2PSA and PHI were the best predictors of prostate cancer detection in all patients (area under the curve [AUC] 0.72 and 0.73, respectively), at initial (AUC 0.67 and 0.69) and repeat biopsy (AUC 0.74 and 0.74). t-PSA and %f-PSA performed less accurately for all patients (AUC 0.54 and 0.62). For detection of significant prostate cancer (based on Prostate Cancer Research International Active Surveillance [PRIAS] criteria) the %p2PSA and PHI equally demonstrated best performance (AUC 0.70 and 0.73) compared with t-PSA and %f-PSA (AUC 0.54 and 0.59). In multivariate analysis PHI we added to a base model of age, prostate volume, digital rectal examination, t-PSA and %f-PSA. PHI was strongest in predicting prostate cancer in all patients, at initial and repeat biopsy and for significant prostate cancer (AUC 0.73, 0.68, 0.78 and 0.72, respectively). In DCA for all patients the ANN showed the broadest threshold probability and best net benefit. PHI as single parameter

Alterations in expressed prostate secretion-urine PSA N-glycosylation discriminate prostate cancer from benign prostate hyperplasia.

Science.gov (United States)

Jia, Gaozhen; Dong, Zhenyang; Sun, Chenxia; Wen, Fuping; Wang, Haifeng; Guo, Huaizu; Gao, Xu; Xu, Chuanliang; Xu, Chuanliang; Yang, Chenghua; Sun, Yinghao

2017-09-29

The prostate specific antigen (PSA) test is widely used for early diagnosis of prostate cancer (PCa). However, its limited sensitivity has led to over-diagnosis and over-treatment of PCa. Glycosylation alteration is a common phenomenon in cancer development. Different PSA glycan subforms have been proposed as diagnostic markers to better differentiate PCa from benign prostate hyperplasia (BPH). In this study, we purified PSA from expressed prostate secretions (EPS)-urine samples from 32 BPH and 30 PCa patients and provided detailed PSA glycan profiles in Chinese population. We found that most of the PSA glycans from EPS-urine were complex type biantennary glycans. We observed two major patterns in PSA glycan profiles. Overall there was no distinct separation of PSA glycan profiles between BPH and PCa patients. However, we detected a significant increase of glycan FA2 and FM5A2G2S1 in PCa when compared with BPH patients. Furthermore, we observed that the composition of FA2 glycan increased significantly in advanced PCa with Gleason score ≥8, which potentially could be translated to clinic as a marker for aggressive PCa.

PSA Nadir of <0.5 ng/mL Following Brachytherapy for Early-Stage Prostate Adenocarcinoma is Associated With Freedom From Prostate-Specific Antigen Failure

Energy Technology Data Exchange (ETDEWEB)

Ko, Eric C. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States); Stone, Nelson N. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States); Department of Urology, Mount Sinai Medical Center, New York, NY (United States); Stock, Richard G., E-mail: Richard.Stock@mountsinai.org [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States)

2012-06-01

Purpose: Because limited information exists regarding whether the rate or magnitude of PSA decline following brachytherapy predicts long-term clinical outcomes, we evaluated whether achieving a prostate-specific antigen (PSA) nadir (nPSA) <0.5 ng/mL following brachytherapy is associated with decreased PSA failure and/or distant metastasis. Methods and Materials: We retrospectively analyzed our database of early-stage prostate adenocarcinoma patients who underwent brachytherapy, excluding those receiving androgen-deprivation therapy and those with <2 years follow-up. Median and mean pretreatment PSA were 6 ng/mL and 7.16 ng/mL, respectively. By clinical stage, 775 were low risk ({<=}T2a), 126 were intermediate risk (T2b), and 20 were high risk (>T2b). By Gleason score, 840 were low risk ({<=}6), 71 were intermediate risk (7), and 10 were high risk (>7). Patients were treated with brachytherapy only (I-125, n = 779, or Pd-103, n = 47), or brachytherapy + external-beam radiation therapy (n = 95). Median follow-up was 6.3 years. We noted whether nPSA <0.5 ng/mL was achieved and the time to achieve this nadir and tested for associations with pretreatment risk factors. We also determined whether this PSA endpoint was associated with decreased PSA failure or distant metastasis. Results: Absence of high-risk factors in clinical stage ({<=}T2b), Gleason score ({<=}7), and pretreatment PSA ({<=}20 ng/mL) was significantly associated with achieving nPSA <0.5 ng/mL. By Kaplan-Meier analysis, patients achieving nPSA <0.5 ng/mL had significantly higher long-term freedom from biochemical failure (FFBF) than nonresponders (5-year FFBF: 95.2 {+-} 0.8% vs. 71.5 {+-} 6.7%; p < 0.0005). Among responders, those who achieved nPSA <0.5 ng/mL in {<=}5 years had higher FFBF than those requiring >5 years (5-year FFBF: 96.7 {+-} 0.7% vs. 80.8 {+-} 4.6%; p < 0.0005). On multivariate analysis, patients who achieved nPSA <0.5 ng/mL in {<=}5 years had significantly higher FFBF than other

Clinical performance of serum [-2]proPSA derivatives, %p2PSA and PHI, in the detection and management of prostate cancer.

Science.gov (United States)

Huang, Ya-Qiang; Sun, Tong; Zhong, Wei-De; Wu, Chin-Lee

2014-01-01

Prostate-specific antigen (PSA) has been widely used as a serum marker for prostate cancer (PCa) screening or progression monitoring, which dramatically increased rate of early detection while significantly reduced PCa-specific mortality. However, a number of limitations of PSA have been noticed. Low specificity of PSA may lead to overtreatment in men who presenting with a total PSA (tPSA) level of PHI) and %p2PSA, which were defined as [(p2PSA/fPSA) × √ tPSA] and [(p2PSA/fPSA) × 100] respectively, have been suggested to be increased in PCa and can better distinguish PCa from benign prostatic diseases than tPSA or fPSA. We performed a systematic review of the available scientific evidences to evaluate the potentials of %p2PSA and PHI in clinical application. Mounting evidences suggested that both %p2PSA and PHI possess higher area under the ROC curve (AUC) and better specificity at a high sensitivity for PCa detection when compare with tPSA and %fPSA. It indicated that measurements of %p2PSA and PHI significantly improved the accuracy of PCa detection and diminished unnecessary biopsies. Furthermore, elevations of %p2PSA and PHI are related to more aggressive diseases. %p2PSA and PHI might be helpful in reducing overtreatment on indolent cases or assessing the progression of PCa in men who undergo active surveillance. Further studies are needed before being applied in routine clinical practice.

Stage T1-2 prostate cancer with pretreatment PSA 10 ng/ml or less: radiotherapy or surgery?

International Nuclear Information System (INIS)

Keyser, Douglas; Kupelian, Patrick; Zippe, Craig; Klein, Eric

1996-01-01

Purpose: Presently, patients with pretreatment PSA levels ≤10 ng/ml constitute the majority of cases presenting for definitive treatment. Our aim was to determine whether the type of treatment (radiotherapy versus surgery) affected biochemical failure rates in this group of patients. This study is based on 389 patients treated at a single institution. Material and Methods: The charts of all patients treated with either radiotherapy or prostatectomy alone between 1987 and 1993 were reviewed (n=811). Patients with clinical stage T1 or T2 disease, and a pretreatment PSA level (iPSA) of 10.0 or less were analyzed (n=389). Two hundred forty nine (64%) received radical prostatectomy and 140 (36%) received radiotherapy (median dose 66.6 Gy). Pretreatment patient characteristics including clinical stage, biopsy Gleason score (GS) and iPSA level were not significantly different between the radiation and surgery groups (Table 1). The patients treated with radiation were significantly older (median age 70 years vs. 64 years, p<0.05). A total of 37% of the prostatectomy patients had a positive margin. The median follow-up time was 33 months; 1458 follow-up PSA levels were available for analysis. Biochemical failure was defined as a rise in PSA level of 1.0 ng/ml above the nadir PSA level in radiotherapy cases, or any value above 0.2 ng/ml in the prostatectomy cases. Results: The overall 5 year actuarial biochemical relapse free survival (bRFS) rate was 70%. The 5-year bRFS rates for prostatectomy and radiotherapy were identical (70%) (Fig.1). The significant factors affecting bRFS rates were iPSA level (≤4 vs. 4-10 ng/ml) and Gleason score (≤6 vs. ≥7) (Table 2). The 5-year bRFS rates of patients with iPSA ≤4 vs. iPSA 4-10 ng/ml were 92% vs. 61% respectively, p<0.01. The 5-year clinical relapse free survival was 93%. All clinical failures were preceded by biochemical failure. Patients with positive surgical margins did significantly worse than those with negative

Prebiopsy biparametric MRI: differences of PI-RADS version 2 in patients with different PSA levels.

Science.gov (United States)

Choi, M H; Lee, Y J; Jung, S E; Rha, S E; Byun, J Y

2018-06-09

To validate the diagnostic accuracy of Prostate Imaging-Reporting and Data System (PI-RADS) version 2 in detecting clinically significant prostate cancer (csPCa, Gleason score ≥7) on prebiopsy biparametric MRI (bpMRI) in patients with different prostate-specific antigen (PSA) levels. This retrospective study included 184 patients who underwent prebiopsy bpMRI followed by transrectal ultrasonography-guided biopsy between June 2015 and February 2017. Reader 1 performed a combination of systematic and targeted biopsy with cognitive fusion after reviewing bpMRI and reader 2 reviewed the bpMRIs retrospectively. PI-RADS categories 4 and 5 were considered positive, and the results of the biopsy were considered the reference standard. Diagnostic performance of PI-RADS of bpMRI was evaluated in two PSA groups with a PSA cut-off level of 10 ng/ml and compared to PSA and the PSA density using receiver operating characteristics (ROC) curve analysis. csPCa was diagnosed in 24 of 123 patients (19.5%) and 26 of 61 patients (42.6%) in the low and high PSA groups, respectively. A PI-RADS v2 category by either readers 1 or 2 had a significantly better performance to detect csPCa than PSA in both PSA groups. In the high PSA group, only one csPCa was missed by reader 2, but none by reader 1. In the low PSA group, readers 1 and 2 were unable to detect seven and five of the 24 csPCas, respectively. Prebiopsy bpMRI has good performance for detecting csPCa in the high PSA group but may miss small-volume csPCa in the low PSA group. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Clinical performance of serum [-2]proPSA derivatives, %p2PSA and PHI, in the detection and management of prostate cancer

OpenAIRE

Huang, Ya-Qiang; Sun, Tong; Zhong, Wei-De; Wu, Chin-Lee

2014-01-01

Prostate-specific antigen (PSA) has been widely used as a serum marker for prostate cancer (PCa) screening or progression monitoring, which dramatically increased rate of early detection while significantly reduced PCa-specific mortality. However, a number of limitations of PSA have been noticed. Low specificity of PSA may lead to overtreatment in men who presenting with a total PSA (tPSA) level of < 10 ng/mL. As a type of free PSA (fPSA), [-2]proPSA is differentially expressed in peripheral ...

PSA and Prostate Health Index based prostate cancer screening in a hereditary migration complicated population: implications in precision diagnosis.

Science.gov (United States)

Akizhanova, Mariyam; Iskakova, Elzira E; Kim, Valdemir; Wang, Xiao; Kogay, Roman; Turebayeva, Aiym; Sun, Qinglei; Zheng, Ting; Wu, Shenghui; Miao, Lixia; Xie, Yingqiu

2017-01-01

Precision diagnosis requires specific markers for differential ethnic populations. Prostate-Specific Antigen (PSA) level (threshold of 4ng/ml) has been widely used to screen prostate cancer and as reference of pro-biopsy but false diagnosis frequently occurs. Prostate health Index (PHI) is a new diagnosis marker which combines PSA, free PSA and p2PSA4. Overall the PCa screening database is lacking in Kazakhstani patients. We analyzed the PSA levels and Gleason scores of 222 biopsies collected in 2015 in Almaty area, Kazakhstan approved by institutional ethics board. We found using PSA of 4ng/ml as threshold, only 25.68% of patients have cancer with Gleason score ranged 6-8 and 65.77% of patients have no character of cancer. Moreover, there is no significant correlation between PSA and cancerous (P=0.266) or Gleason grade (P=0.3046) based on pathological biopsy. In addition, PHI is not correlated to prostate cancer (P=0.4301). Our data suggest that false-positive rate is much higher than the correct-positive diagnosis when using PSA as the first screening. Thus in this cohort study, most patients can not get benefit from the PSA screening for precision PCa diagnosis. As Kazakhstani family trees are unique and complicated because of history and migration, the high rate of over diagnosis might be due to the hyperexpression of PSA via heterosis in Eurasian men. Therefore we should be cautious when using pro-biopsy in precision diagnosis for Eurasian prostate cancer patients.

PSA doubling time of prostate carcinoma managed with watchful observation alone

International Nuclear Information System (INIS)

Choo, Richard; DeBoer, Gerrit; Klotz, Lawrence; Danjoux, Cyril; Morton, Gerard C.; Rakovitch, Eileen; Fleshner, Neil; Bunting, Peter; Kapusta, Linda; Hruby, George

2001-01-01

Purpose: To study prostate-specific antigen (PSA) doubling time of untreated, favorable grade, prostate carcinoma. Methods and Materials: A prospective single-arm cohort study has been in progress to assess the feasibility of a watchful observation protocol with selective delayed intervention using clinical, histologic, or PSA progression as treatment indication in untreated, localized, favorable grade prostate adenocarcinoma (T1b-T2bN0 M0, Gleason Score ≤7, and PSA ≤15 ng/mL). Patients are conservatively managed with watchful observation alone, as long as they do not meet the arbitrarily defined disease progression criteria. Patients are followed regularly and undergo blood tests including PSA at each visit. PSA doubling time (Td) is estimated from a linear regression of ln(PSA) on time, assuming a simple exponential growth model. Results: As of March 2000, 134 patients have been on the study for a minimum of 12 months (median, 24; range, 12-52) and have a median frequency of PSA measurement of 7 times (range, 3-15). Median age is 70 years. Median PSA at enrollment is 6.3 (range, 0.5-14.6). The distribution of Td is as follows: 50 years, 27. The median Td is 5.1 years. In 44 patients (33%), Td is greater than 10 years. There was no correlation between Td and patient age, clinical T stage, Gleason score, or initial PSA level. Conclusion: Td of untreated prostate cancer varies widely. In our cohort, 33% have Td >10 years. Td may be a useful tool to guide treatment intervention for patients managed conservatively with watchful observation alone

Preirradiation PSA predicts biochemical disease-free survival in patients treated with postprostatectomy external beam irradiation

International Nuclear Information System (INIS)

Crane, Christopher H.; Rich, Tyvin A.; Read, Paul W.; Sanfilippo, Nicholas J.; Gillenwater, Jay Y.; Kelly, Maria D.

1997-01-01

Purpose: To assess the clinical outcome and prostate-specific antigen (PSA) response and to determine prognostic factors for biochemical disease-free survival in patients treated with external beam radiotherapy following radical prostatectomy without hormonal therapy. Methods and Materials: Forty-eight patients were treated after prostatectomy with radiotherapy between March, 1988 and December, 1993. Seven patients had undetectable PSA ( 2.7. Five-year actuarial biochemical disease-free survival values were 71, 48, and 0%, respectively, for the three groups. Biochemical disease-free survival was not affected by preoperative PSA level, clinical stage, Gleason's score, pathologic stage, surgical margins, presence of undetectable PSA after surgery, surgery to radiation interval, total dose, or presence of clinically suspicious local disease. Based on digital rectal exam, there were no local failures. Conclusion: Biochemical disease-free survival after postprostatectomy radiation is predicted by the PSA at the time of irradiation. Clinical local control is excellent, but distant failure remains a significant problem in this population. The addition of concomitant systemic therapy should be investigated in patients with PSA >2.7

Prognostic significance of race on biochemical control in patients with localized prostate cancer treated with permanent brachytherapy: multivariate and matched-pair analyses

International Nuclear Information System (INIS)

Lee, Lucille N.; Barnswell, Carlton; Torre, Taryn; Fearn, Paul; Kattan, Michael; Potters, Louis

2002-01-01

Purpose: To compare PSA relapse-free survival (PSA-RFS) between African-American (AA) and white American (WA) males treated with permanent prostate brachytherapy (PPB) for clinically localized prostate cancer. Methods and materials: One thousand eighty-one consecutive patients, including 246 African-Americans, underwent PPB with 103 Pd or 125 I, alone or with external beam radiation therapy between September 1992 and September 1999. Computer-generated matching was performed to create two identical cohorts of WA and AA males, based on the use of neoadjuvant androgen ablation (NAAD), pretreatment PSA, and Gleason score. Presenting characteristics were used to define risk groups, as follows: Low risk had PSA ≤10 and Gleason score ≤6, intermediate risk had PSA >10 or Gleason score ≥7, and high risk had PSA >10 and Gleason score ≥7. PSA-RFS was calculated using the Kattan modification of the ASTRO definition, and the log-rank test was used to compare Kaplan-Meier PSA-RFS curves. Univariate and multivariate analyses were performed to determine predictors of PSA-RFS. Results: Overall, univariate analysis revealed that AA males at presentation had lower disease stage (p=0.01), had lower Gleason scores (p=0.017), were younger (p=0.001), and were more likely to receive NAAD (p=0.001) than their WA counterparts. There were no differences in pretreatment PSA, isotope selection, use of external beam radiation therapy, median follow-up, or risk group classification between AA and WA males. Pretreatment PSA and Gleason score were significant predictors of PSA-RFS in multivariate analysis, and race was not significant. There was no significant difference between the 5-year PSA-RFS for AA males (84.0%) and the matched cohort of WA males (81.2%) (p=0.384). Race was not a predictor of 5-year PSA-RFS among patients treated with or without NAAD and within low-, intermediate-, and high-risk groups. Conclusion: Race is not an independent predictor of 5-year PSA-RFS in patients

Low percentage of free prostate-specific antigen (PSA) is a strong predictor of later detection of prostate cancer among Japanese men with serum levels of total PSA of 4.0 ng/mL or less.

Science.gov (United States)

Sasaki, Mitsuharu; Ishidoya, Shigeto; Ito, Akihiro; Saito, Hideo; Yamada, Shigeyuki; Mitsuzuka, Koji; Kaiho, Yasuhiro; Shibuya, Daisuke; Yamaguchi, Takuhiro; Arai, Yoichi

2014-11-01

To investigate the effect of the percentage of free prostate-specific antigen (%fPSA) on future prostate cancer risk. We examined serum total PSA (tPSA) and %fPSA annually in a prostate cancer-screening cohort between July 2001 and June 2011. Men with tPSA >4.0 ng/mL or tPSA of 2.0-4.0 ng/mL with %fPSA ≤12% were screened as positive and were recommended to undergo a biopsy. The study population consisted of 6368 men, aged 40-79 years, who had tPSA ≤4.0 ng/mL at initial screening and who subsequently underwent 1 or more screenings. We calculated the cumulative risk and hazard ratio of prostate cancer stratified by the initial %fPSA groups as quartiles of prostate cancer patients. During a median follow-up of 36 months, 119 men were diagnosed with prostate cancer. The lowest quartile of %fPSA (22.2%). For the subset with an initial tPSA ≤1.0 ng/mL, all men diagnosed with cancer had an initial %fPSA ≤33.3% (median). For the subset with tPSA >1.0 ng/mL, men with %fPSA ≤23.0% (median) had significantly higher risk for cancer than those with %fPSA >23.0% (P men with prostate cancer in whom pathologic findings were available, 79 (69.3%) had a Gleason score ≥3 + 4 = 7. A low %fPSA is a strong predictor of a subsequent diagnosis of prostate cancer among men with tPSA levels ≤4.0 ng/mL. Measurement of %fPSA might enhance the detection of high-grade cancer that warrants aggressive treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Implementation guidelines for seismic PSA

International Nuclear Information System (INIS)

Coman, Ovidiu; Samaddar, Sujit; Hibino, Kenta; )

2014-01-01

The presentation was devoted to development of guidelines for implementation of a seismic PSA. If successful, these guidelines can close an important gap. ASME/ANS PRA standards and the related IAEA Safety Guide (IAEA NS-G-2.13) describe capability requirements for seismic PSA in order to support risk-informed applications. However, practical guidance on how to meet these requirements is limited. Such guidelines could significantly contribute to improving risk-informed safety demonstration, safety management and decision making. Extensions of this effort to further PSA areas, particularly to PSA for other external hazards, can enhance risk-informed applications

Serum complexed and free prostate-specific antigen (PSA) for the diagnosis of the polycystic ovarian syndrome (PCOS).

Science.gov (United States)

Diamandis, Eleftherios P; Stanczyk, Frank Z; Wheeler, Sarah; Mathew, Anu; Stengelin, Martin; Nikolenko, Galina; Glezer, Eli N; Brown, Marshall D; Zheng, Yingye; Chen, Yen-Hao; Wu, Hsiao-Li; Azziz, Ricardo

2017-10-26

Polycystic ovarian syndrome (PCOS) is a common cause of reproductive and metabolic dysfunction. We hypothesized that serum prostate-specific antigen (PSA) may constitute a new biomarker for hyperandrogenism in PCOS. We conducted a cross-sectional study of 45 women with PCOS and 40 controls. Serum from these women was analyzed for androgenic steroids and for complexed PSA (cPSA) and free PSA (fPSA) with a novel fifth- generation assay with a sensitivity of ~10 fg/mL for cPSA and 140 fg/mL for fPSA. cPSA and fPSA levels were about three times higher in PCOS compared to controls. However, in PCOS, cPSA and fPSA did not differ according to waist-to-hip ratio, Ferriman-Gallwey score, or degree of hyperandrogenemia or oligo-ovulation. In PCOS and control women, serum cPSA and fPSA levels were highly correlated with each other, and with free and total testosterone levels, but not with other hormones. Adjusting for age, body mass index (BMI) and race, cPSA was significantly associated with PCOS, with an odds ratio (OR) of 5.67 (95% confidence interval [CI]: 1.86, 22.0). The OR of PCOS for fPSA was 7.04 (95% CI: 1.65, 40.4). A multivariate model that included age, BMI, race and cPSA yielded an area-under-the-receiver-operating-characteristic curve of 0.89. Serum cPSA and fPSA are novel biomarkers for hyperandrogenism in PCOS and may have value for disease diagnosis.

Methodology for seismic PSA of NPPs

International Nuclear Information System (INIS)

Jirsa, P.

1999-09-01

A general methodology is outlined for seismic PSA (probabilistic safety assessment). The main objectives of seismic PSA include: description of the course of an event; understanding the most probable failure sequences; gaining insight into the overall probability of reactor core damage; identification of the main seismic risk contributors; identification of the range of peak ground accelerations contributing significantly to the plant risk; and comparison of the seismic risk with risks from other events. The results of seismic PSA are typically compared with those of internal PSA and of PSA of other external events. If the results of internal and external PSA are available, sensitivity studies and cost benefit analyses are performed prior to any decision regarding corrective actions. If the seismic PSA involves analysis of the containment, useful information can be gained regarding potential seismic damage of the containment. (P.A.)

Clinical significance of combined determination of serum levels of free prostate specific antigen (fPSA) and insulin-like growth factor-1 (IGF-1) in patients with prostatic cancer

International Nuclear Information System (INIS)

Wang Xiaolong; Chen Baixun; Chen Yue

2004-01-01

Objective: To explore the clinical significance of combined determination of serum levels of fPSA and IGF-1 in patients with prostatic cancer. Methods: Serum levels of fPSA (with chemiluminescence) and IGF-1 (with IRMA) were measured in 48 patients with prostatic cancer, 63 patients with benign prostate hyperplasia and 38 controls. Results: Serum levels of fPSA and IGF-1 in the 111 patients were significantly higher than those in controls (P<0.05). The positive rate for prostatic cancer detection with fPSA, IGF-1 and fPSA combined with IGF-1 was 83.3%, 79.2% and 95.8% respectively. Conclusion: Combined measurement of fPSA and IGF-1 was most preferable for screening prostatic cancer

Relationship of chronic histologic prostatic inflammation in biopsy specimens with serum isoform [-2]proPSA (p2PSA), %p2PSA, and prostate health index in men with a total prostate-specific antigen of 4-10 ng/ml and normal digital rectal examination.

Science.gov (United States)

Lazzeri, Massimo; Abrate, Alberto; Lughezzani, Giovanni; Gadda, Giulio Maria; Freschi, Massimo; Mistretta, Francesco; Lista, Giuliana; Fossati, Nicola; Larcher, Alessandro; Kinzikeeva, Ella; Buffi, Nicolòmaria; Dell'Acqua, Vincenzo; Bini, Vittorio; Montorsi, Francesco; Guazzoni, Giorgio

2014-03-01

To investigate the relationship between serum [-2]proPSA (p2PSA) and derivatives with chronic histologic prostatic inflammation (CHPI) in men undergoing prostate biopsy for suspected prostate cancer (PCa). This nested case-control study resulted from an observational prospective trial for the definition of sensibility, specificity, and accuracy of p2PSA, %p2PSA, and Beckman Coulter Prostate Health Index (PHI), in men undergoing prostate biopsy, with a total prostate-specific antigen (PSA) of 4-10 ng/mL and normal digital rectal examination. CHPI was the outcome of interest and defined as the presence of moderate to large infiltration of lymphomononuclear cells with interstitial and/or glandular disruption in absence of PCa. p2PSA, %p2PSA, and PHI were considered the index tests and compared with the established biomarker reference standard tests: tPSA, fPSA, %fPSA. Of 267 patients subjected to prostate biopsy, 73 (27.3%) patients were diagnosed with CHPI. Comparing CHPI with PCa patients, %p2PSA and PHI were found to be significantly lower, whereas fPSA and %fPSA were significantly higher. %p2PSA and PHI were the most accurate predictors of CHPI at biopsy, significantly outperforming tPSA, fPSA, and %fPSA. On the contrary, no significant differences were found in PSA, p2PSA, and derivatives between CHPI and benign prostatic hyperplasia (BPH) patients. Our findings showed that p2PSA, %p2PSA, and PHI values might discriminate PCa from CHPI or BPH, but not CHPI from BPH, in men with a total PSA 4-10 ng/mL and normal digital rectal examination. p2PSA isoform and its derivatives could be useful in clinical decision making to avoid unnecessary biopsies in patients with CHPI and elevated tPSA value. Copyright © 2014 Elsevier Inc. All rights reserved.

PSA Review Handbook

International Nuclear Information System (INIS)

Hallman, Anders; Nyman, Ralph; Knochenhauer, Michael

2004-05-01

The Swedish Nuclear Power Inspectorate (SKI) expresses requirements on the performance of PSAs as well as on PSA activities in general in the the regulatory document 'Regulations Concerning Safety in Certain Nuclear Facilities', SKlFS 1998:1. The follow-up of these activities is part of the inspection tasks of the SKI. In view or this, there is a need for documented guidelines on now to perform these inspections and reviews. The SKI PSA Review Handbook is intended to be a support in the SKI inspection and control of the PSA activities or the licensees. These PSA activities include both the organisation and working procedures of the licensee, the layout and contents of the PSA, and its areas of application. Using the regulation SKIFS 1998:1 as a starting point, the review handbook presents important aspects to be considered when judging whether a licensee fulfils the requirements on PSA activities, including the performance of PSA:s or PSA applications. The handbook shall also be a guidance for the review of PSA:s. However, the intention of the PSA Review Handbook is not to be a handbook for how a PSA is performed. The PSA Review Handbook is applicable to all types or initiating events and all operating conditions, and has been structured in a way, which stresses the integrated characteristics of PSA in the creation of the risk picture of a plant. The PSA Review Handbook has been based on the requirements for PSA of nuclear power plants, as this is the most extensive application. However, the relevant parts of it are also applicable when analysing other nuclear installations. The PSA Review Handbook is published as a research report as its contents are judged to be of general interest, and the SKI welcomes comments to the handbook. An update or the PSA Review Handbook may be required as experience with the use of the handbook is acquired and if general PSA requirements change

Understanding PSA and its derivatives in prediction of tumor volume: Addressing health disparities in prostate cancer risk stratification.

Science.gov (United States)

Chinea, Felix M; Lyapichev, Kirill; Epstein, Jonathan I; Kwon, Deukwoo; Smith, Paul Taylor; Pollack, Alan; Cote, Richard J; Kryvenko, Oleksandr N

2017-03-28

To address health disparities in risk stratification of U.S. Hispanic/Latino men by characterizing influences of prostate weight, body mass index, and race/ethnicity on the correlation of PSA derivatives with Gleason score 6 (Grade Group 1) tumor volume in a diverse cohort. Using published PSA density and PSA mass density cutoff values, men with higher body mass indices and prostate weights were less likely to have a tumor volume PSA derivatives when predicting for tumor volume. In receiver operator characteristic analysis, area under the curve values for all PSA derivatives varied across race/ethnicity with lower optimal cutoff values for Hispanic/Latino (PSA=2.79, PSA density=0.06, PSA mass=0.37, PSA mass density=0.011) and Non-Hispanic Black (PSA=3.75, PSA density=0.07, PSA mass=0.46, PSA mass density=0.008) compared to Non-Hispanic White men (PSA=4.20, PSA density=0.11 PSA mass=0.53, PSA mass density=0.014). We retrospectively analyzed 589 patients with low-risk prostate cancer at radical prostatectomy. Pre-operative PSA, patient height, body weight, and prostate weight were used to calculate all PSA derivatives. Receiver operating characteristic curves were constructed for each PSA derivative per racial/ethnic group to establish optimal cutoff values predicting for tumor volume ≥0.5 cm3. Increasing prostate weight and body mass index negatively influence PSA derivatives for predicting tumor volume. PSA derivatives' ability to predict tumor volume varies significantly across race/ethnicity. Hispanic/Latino and Non-Hispanic Black men have lower optimal cutoff values for all PSA derivatives, which may impact risk assessment for prostate cancer.

Incorporating Level-2 PSA Feature of CONPAS into AIMS-PSA Software

International Nuclear Information System (INIS)

Han, Sang Hoon; Lim, Hogon; Ahn, Kwang Il

2014-01-01

CONPAS (CONtainment Performance Analysis System) utilizes a methodology to treat containment phenomena in detail like APET but in simple way. In mid 2000's, KAERI has developed very fast cut set generator FTREX and PC's OS (Operating system) has changed into Windows 95. Thus, KAERI has developed new Level-1 PSA software, called AIMS-PSA (Advanced Information Management System for PSA) to replace KIRAP. Recently, KAERI has been developing an integrated PSA platform, called OCEANS (On-line Consolidator and Evaluator of All mode risk for Nuclear System), for the risk assessment of all power modes and all hazards. CONPAS for Level-2 PSA was developed in 1990's using the Visual Basic 6.0 compiler which is not supported any more. It needs to be updated for the integrated PSA software framework. This paper describes a study to incorporate the features of CONPAS into AIMS-PSA. The basic idea is to follow the approach of CONPAS, but in the integrated way. Various approaches for Level-2 PSA have been used since WASH-1400. APET approach of NUREG-1150 study would be most comprehensive and complex methodology for containment event tree analysis. CONPAS is the Level-2 PSA software to utilize an approach to treat containment phenomena in detail like APET but in simple way. But, new Level-2 PSA software is required to develop more integrated PSA framework. A modified approach of CONPAS is developed and incorporated in AIMS-PSA software that can handle Level-1 and Level-2 PSA in the integrated way (from the viewpoint of event tree and fault tree). AIMS-PSA combines whole Level-2 PSA model to produce a One Top fault tree and to generate cut sets in the same way as Level-1 PSA. Quantification results of Level-2 PSA such as frequency for each STC can be calculated from the minimal cut sets

PSA predicts development of incident lower urinary tract symptoms: results from the REDUCE study.

Science.gov (United States)

Patel, Devin N; Feng, Tom; Simon, Ross M; Howard, Lauren E; Vidal, Adriana C; Moreira, Daniel M; Castro-Santamaria, Ramiro; Roehrborn, Claus; Andriole, Gerald L; Freedland, Stephen J

2018-05-23

The relationship between baseline prostate-specific antigen (PSA) and development of lower urinary tract symptoms (LUTS) in asymptomatic and mildly symptomatic men is unclear. We sought to determine if PSA predicts incident LUTS in these men. A post-hoc analysis of the 4-year REDUCE study was performed to assess for incident LUTS in 1534 men with mild to no LUTS at baseline. The primary aim was to determine whether PSA independently predicted incident LUTS after adjusting for the key clinical variables of age, prostate size, and baseline International prostate symptom score (IPSS). Incident LUTS was defined as the first report of medical treatment, surgery, or sustained clinically significant symptoms (two IPSS >14). Cox proportional hazards, cumulative incidence curves, and the log-rank test were used to test our hypothesis. A total of 1534 men with baseline IPSS PSA 2.5-4 ng/mL, 589 with PSA 4.1-6 ng/mL, and 610 with PSA 6-10 ng/mL. During the 4-year study, 196 men progressed to incident LUTS (50.5% medical treatment, 9% surgery, and 40.5% new symptoms). As a continuous variable, higher PSA was associated with increased incident LUTS on univariable (HR 1.09, p = 0.019) and multivariable (HR 1.08, p = 0.040) analysis. Likewise, baseline PSA 6-10 ng/mL was associated with increased incident LUTS vs. PSA 2.5-4 ng/mL in adjusted models (HR 1.68, p = 0.016). This association was also observed in men with PSA 4.1-6 ng/mL vs. PSA 2.5-4 ng/mL (HR 1.60, p = 0.032). Men with mild to no LUTS but increased baseline PSA are at increased risk of developing incident LUTS presumed due to benign prostatic hyperplasia.

PSA bounces after neoadjuvant androgen deprivation and external beam radiation: Impact on definitions of failure

International Nuclear Information System (INIS)

Zietman, Anthony L.; Christodouleas, John P.; Shipley, William U.

2005-01-01

Purpose: To determine the characteristics of prostate specific antigen (PSA) bounces after external beam radiation therapy (EBRT) with neoadjuvant androgen deprivation and their impact on definitions of biochemical failure. Methods and Materials: Characteristics of bounce were calculated for all patients treated by EBRT with neoadjuvant androgen deprivation at our institution between 1992 and 1998 (preexclusion analysis). Calculations were repeated for the subgroup that satisfied additional inclusion/exclusion criteria (postexclusion analysis). The percentage of bounces scoring as false positives according to the ASTRO definition of biochemical failure was compared with those for three alternative definitions (Vancouver, Nadir-plus-two, and Nadir-plus-three) using McNemar's tests. Results: Thirty-nine percent (preexclusion cohort) and 56% (postexclusion cohort) of patients demonstrated a PSA bounce. Twenty percent (preexclusion analysis) and 25% (postexclusion analysis) of these bounces scored as biochemical failure according to the ASTRO definition. The Nadir-plus-three definition scored the smallest percentage of bounces as failure, but the difference between this definition and the ASTRO definition reached statistical significance in neither preexclusion nor postexclusion analyses (p ≥ 0.070). Conclusions: A substantial proportion of patients treated by EBRT with neoadjuvant deprivation experienced a PSA bounce. A large percentage of these bounces scored as biochemical failure according to the ASTRO definition. The Nadir-plus-three definition is less vulnerable to this bias

Use of PSA in a regulatory framework

International Nuclear Information System (INIS)

Ross, P.J.

1994-01-01

The paper will briefly describe the use of PSA in the licensing process for the Sizewell 'B' PWR Power Station currently under construction in the U.K. There are two distinct phases in the licensing process - (i) A PSA has been performed to support the application to construct Sizewell 'B'. At that stage the PSA was used as a design tool (along with deterministic design requirements) for Sizewell 'B' and as such lead to a number of significant design changes in the early design process. (ii) A PSA is currently being performed to support the application to operate Sizewell 'B'. The PSA is required to support the claim that the design has included all reasonably practical measures to prevent and mitigate accidents. The comprehensive PSA being produced for the second phase of the licensing process will be described. The way the regulators/designer/analysts have interacted over the years has affected the scope, complexity, detail and bias of the comprehensive PSA. The paper will discuss these issues and highlight some of the more significant ones. The benefits and drawbacks of providing a PSA in a regulatory framework will be discussed. One of the conclusions of the paper is that the use of true ''best-estimates'' in the PSA is difficult to achieve in a regulatory framework where persistent bias to the conservative side is apparent in the designers, analysts and regulators judgements. The usefulness of the PSA is therefore, potentially, compromised by giving misleading outputs or diverting resources to unnecessary areas. (author)

Methodology - PSA Regulatory handbook. Comparisons to a modern PSA study

International Nuclear Information System (INIS)

Bostroem, Urban; Jung, Gunnar; Flodin, Yngve

2003-03-01

The regulatory handbook is applicable to all types of initiating events and all operating conditions. It should be noted that it does not make the traditional subdivision of PSA into internal and external events, level 1 and level 2 PSA, or power operation and shut-down. The reason for this is that this has given the regulatory handbook a more logical structure, and that this approach underlines the integrated character of PSA when it comes to creating the plan risk profile. The regulatory handbook has been structured following the requirements on a PSA for a nuclear power plant, as this is the most demanding application. However, it is applicable also to the analysis of other nuclear installations. The purpose of the comparative review presented in this report has been to, as part of a quality review establish the PSA Handbook, compare (parts of) the handbook and its criteria with a recent PSA analysis, and to identify major discrepancies. Considerable weight has also been allocated to a review of the plant model (Risk Spectrum event trees and fault trees). The results presented in the report are not based on a complete review of the PSA in question (or of the complete PSA Handbook). Following discussions between the SKI and SwedPower, and based on the experience of the SwedPower reviewers, the following issues were chosen to be the main parts of the project: 1) General comparison according to content and transparency - Levels of ambition in PSA Handbook, PSA method description and actual PSA report. 2) Detailed comparison of: Selected component failure data - Assumptions regarding room events - CCI frequencies, realism, identification, categorisation - Taking credit for non-safety classified systems - Event tree modelling - Presentation of results 3) Fault tree model, specifically - Time frame for crediting of battery capacity - Modelling of regulators - Modelling of dependencies for room events - general quality, like how the paper documentation and the logic

Prostate Health Index (Phi) and Prostate Cancer Antigen 3 (PCA3) significantly improve prostate cancer detection at initial biopsy in a total PSA range of 2-10 ng/ml.

Science.gov (United States)

Ferro, Matteo; Bruzzese, Dario; Perdonà, Sisto; Marino, Ada; Mazzarella, Claudia; Perruolo, Giuseppe; D'Esposito, Vittoria; Cosimato, Vincenzo; Buonerba, Carlo; Di Lorenzo, Giuseppe; Musi, Gennaro; De Cobelli, Ottavio; Chun, Felix K; Terracciano, Daniela

2013-01-01

Many efforts to reduce prostate specific antigen (PSA) overdiagnosis and overtreatment have been made. To this aim, Prostate Health Index (Phi) and Prostate Cancer Antigen 3 (PCA3) have been proposed as new more specific biomarkers. We evaluated the ability of phi and PCA3 to identify prostate cancer (PCa) at initial prostate biopsy in men with total PSA range of 2-10 ng/ml. The performance of phi and PCA3 were evaluated in 300 patients undergoing first prostate biopsy. ROC curve analyses tested the accuracy (AUC) of phi and PCA3 in predicting PCa. Decision curve analyses (DCA) were used to compare the clinical benefit of the two biomarkers. We found that the AUC value of phi (0.77) was comparable to those of %p2PSA (0.76) and PCA3 (0.73) with no significant differences in pairwise comparison (%p2PSA vs phi p = 0.673, %p2PSA vs. PCA3 p = 0.417 and phi vs. PCA3 p = 0.247). These three biomarkers significantly outperformed fPSA (AUC = 0.60), % fPSA (AUC = 0.62) and p2PSA (AUC = 0.63). At DCA, phi and PCA3 exhibited a very close net benefit profile until the threshold probability of 25%, then phi index showed higher net benefit than PCA3. Multivariable analysis showed that the addition of phi and PCA3 to the base multivariable model (age, PSA, %fPSA, DRE, prostate volume) increased predictive accuracy, whereas no model improved single biomarker performance. Finally we showed that subjects with active surveillance (AS) compatible cancer had significantly lower phi and PCA3 values (pphi and PCA3 comparably increase the accuracy in predicting the presence of PCa in total PSA range 2-10 ng/ml at initial biopsy, outperforming currently used %fPSA.

PSA in America

International Nuclear Information System (INIS)

Linn, M.A.; Cunningham, M.A.; Johnson, D.H.

1996-01-01

Although the concept of acceptable risk has always been the foundation of the nuclear industry design, the use of formal PSA (or PRA-probabilistic risk assessment) in the U.S. nuclear power industry has followed an unusual path in arriving at its current level of notability. Prior to 1975, probabilistic evaluations were limited to a few specific applications such as the evaluation of man-made (i.e., airplane crashes) and natural (i.e., earthquakes) hazards. In 1975, the industry was introduced to comprehensive PSA by the Reactor Safety Study (WASH-1400). However, the study languished in relative obscurity until the accident at Three Mile Island 2 (TMI-2) in 1979. This event significantly altered the industry's view of severe accidents in the U.S. and worldwide. Investigative committees of TMI-2 recommended that PSA techniques be more widely used to augment the traditional deterministic methods of determining nuclear plant safety. This initiated an unprecedented effort by nuclear regulators and licensees worldwide to significantly improve the state of knowledge of severe accidents at nuclear power plants. In the U.S., use of PSA began to increase as evidenced by its application in the anticipated transient without scram and station blackout rulemakings, generic issue prioritization and resolution, risk-based inspection guidelines, backfit policy, and technical specification improvements. However, broad application of probabilistic techniques to the industry as a whole was initiated in 1986 with the publication of Safety Goals for the Operation of Nuclear Power Plant; Policy Statement. This put PSA front and center in the U.S. regulatory arena by open-quotes establish[ing] goals that broadly define an acceptable level of radiological risk that might be imposed on the public as a result of nuclear power plant operation.close quotes Both qualitative safety goals and quantitative objectives were articulated in this policy statement

Two-year survival rates of anti-TNF-α therapy in psoriatic arthritis (PsA) patients with either polyarticular or oligoarticular PsA.

Science.gov (United States)

Iannone, F; Lopriore, S; Bucci, R; Scioscia, C; Anelli, M G; Notarnicola, A; Lapadula, G

2015-05-01

To evaluate the 2-year drug survival rates of the tumour necrosis factor (TNF)-α blockers adalimumab, etanercept, and infliximab in psoriatic arthritis (PsA) patients with either oligoarticular (oligo-PsA) or polyarticular PsA (poly-PsA). We studied a prospective cohort of 328 PsA patients with peripheral arthritis (213 with poly-PsA and 115 with oligo-PsA), beginning their first ever anti-TNF-α treatment with adalimumab, etanercept, or infliximab. The aim of the study was to evaluate the drug survival rates and possible baseline predictors at 2 years. After 24 months, persistence in therapy with the first anti-TNF-α blocker was not statistically different in the oligo-PsA (70.4%) and poly-PsA (65.7%) subsets. Predictors of drug discontinuation were female sex [hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.00-2.68, p = 0.04] and starting the therapy in years 2003-8 (HR 0.51, 95% CI 0.33-0.80, p = 0.003). In poly-PsA, the persistence of etanercept (68.3%) was significantly higher than that of adalimumab (51.9%, p = 0.01), whereas in oligo-PsA no significant difference was detected. In poly-PsA, the period 2003-8 was a negative predictor (HR 0.36, 95% CI 0.21-0.62, p = 0.0001) whereas in oligo-PsA female gender was a positive predictor of drug discontinuation (HR 2.08, 95% CI 1.02-4.24, p = 0.04). With regard to clinical outcomes, the best responses in terms of European League Against Rheumatism (EULAR) 'good' response or Disease Activity Score (DAS28) remission, crude or adjusted according to the LUND Efficacy indeX (LUNDEX), were seen in patients on etanercept or infliximab. Our study provides some evidence that anti-TNF-α drugs may perform differently in PsA, and that the analysis of clinical disease subsets may improve our knowledge and promote better management of PsA.

NRC regulatory uses of PSA

International Nuclear Information System (INIS)

Murley, T.E.

1991-01-01

The publication in 1975 of WASH-1400, with its new probabilistic safety assessment (PSA) methodology, had the effect of presenting a pair of eyeglasses to a man with poor eyesight. Suddenly, it gave us a view of nuclear safety with a new clarity, and it allowed us to sort out the important safety issues from the unimportant. In the intervening years, PSA insights have permeated the fabric of nearly all our safety judgments. This acceptance can be seen from the following list of broad areas where the Nuclear Regulatory Commission (NRC) staff uses PSA insights and methodology: evaluating the safety significance of operating events and recommending safety improvements where warranted; requesting licensees to systematically look for design vulnerabilities in each operating reactor; evaluating the safety significance of design weaknesses or non-compliances when judging the time frame for necessary improvements; conducting sensitivity analyses to judge where safety improvements are most effective; assessing the relative safety benefits of design features for future reactors. In judging where PSA methodology can be improved to give better safety insights, it is believed that the following areas need more attention: better modeling of cognitive errors; more comprehensive modeling of accident sequences initiated from conditions other than full power; more comprehensive modeling of inter-system loss of coolant accident (ISLOCA) sequences. Although PSA is widely used in the staff's regulatory activities, the NRC deliberately chooses not to include probabilistic prescriptions in regulations or guidance documents. The staff finds the bottom line risk estimates to be one of the least reliable products of a PSA. The reason for this view is that PSA cannot adequately address cognitive errors nor assess the effects of a pervasive poor safety attitude

Prevalence and causes of abnormal PSA recovery.

Science.gov (United States)

Lautenbach, Noémie; Müntener, Michael; Zanoni, Paolo; Saleh, Lanja; Saba, Karim; Umbehr, Martin; Velagapudi, Srividya; Hof, Danielle; Sulser, Tullio; Wild, Peter J; von Eckardstein, Arnold; Poyet, Cédric

2018-01-26

Prostate-specific antigen (PSA) test is of paramount importance as a diagnostic tool for the detection and monitoring of patients with prostate cancer. In the presence of interfering factors such as heterophilic antibodies or anti-PSA antibodies the PSA test can yield significantly falsified results. The prevalence of these factors is unknown. We determined the recovery of PSA concentrations diluting patient samples with a standard serum of known PSA concentration. Based on the frequency distribution of recoveries in a pre-study on 268 samples, samples with recoveries 120% were defined as suspect, re-tested and further characterized to identify the cause of interference. A total of 1158 consecutive serum samples were analyzed. Four samples (0.3%) showed reproducibly disturbed recoveries of 10%, 68%, 166% and 4441%. In three samples heterophilic antibodies were identified as the probable cause, in the fourth anti-PSA-autoantibodies. The very low recovery caused by the latter interference was confirmed in serum, as well as heparin- and EDTA plasma of blood samples obtained 6 months later. Analysis by eight different immunoassays showed recoveries ranging between PSA which however did not show any disturbed PSA recovery. About 0.3% of PSA determinations by the electrochemiluminescence assay (ECLIA) of Roche diagnostics are disturbed by heterophilic or anti-PSA autoantibodies. Although they are rare, these interferences can cause relevant misinterpretations of a PSA test result.

Comparison of clinical and survival characteristics between prostate cancer patients of PSA-based screening and clinical diagnosis in China.

Science.gov (United States)

Xu, Libo; Wang, Jinguo; Guo, Baofeng; Zhang, Haixia; Wang, Kaichen; Wang, Ding; Dai, Chang; Zhang, Ling; Zhao, Xuejian

2018-01-02

Prostate-specific antigen (PSA)-based mass screening remains the most controversial topic in prostate cancer. PSA-based mass screening has not been widely used in China yet. The aim of our study was to evaluate the effect of the PSA-based screening in China. The cohort consisted of 1,012 prostate cancer patients. Data were retrospectively collected and clinical characteristics of the cohorts were investigated. Survival was analyzed for prostatic carcinoma of both PSA screened and clinically diagnosed patients according to clinical characteristics and the National Comprehensive Cancer Network (NCCN) risk classification. Cox Proportional Hazards Model analysis was done for risk predictor identification. The median age was 71 years old. Five-year overall and prostate-cancer-specific survival in prostatic adenocarcinoma patients were 77.52% and 79.65%; 10-year survivals were 62.57% and 68.60%, respectively. Survival was significantly poorer in patients with metastases and non-curative management. T staging and Gleason score by NCCN classification effectively stratified prostatic adenocarcinoma patients into different risk groups. T staging was a significant predictor of survival by COX Proportional Hazard Model. PSA screened patients had a significantly higher percentage diagnosed in early stage. PSA screened prostatic adenocarcinoma patients had a better prognosis in both overall and prostate cancer-specific survivals. This Chinese cohort had a lower overall and prostate cancer survival rate than it is reported in western countries. The incidence of early-stage prostate cancer found in PSA-based mass screening was high and there were significant differences in both overall and prostate cancer-specific survival between the PSA-screened and clinically diagnosed patients.

Prostate Health Index (Phi and Prostate Cancer Antigen 3 (PCA3 significantly improve prostate cancer detection at initial biopsy in a total PSA range of 2-10 ng/ml.

Directory of Open Access Journals (Sweden)

Matteo Ferro

Full Text Available Many efforts to reduce prostate specific antigen (PSA overdiagnosis and overtreatment have been made. To this aim, Prostate Health Index (Phi and Prostate Cancer Antigen 3 (PCA3 have been proposed as new more specific biomarkers. We evaluated the ability of phi and PCA3 to identify prostate cancer (PCa at initial prostate biopsy in men with total PSA range of 2-10 ng/ml. The performance of phi and PCA3 were evaluated in 300 patients undergoing first prostate biopsy. ROC curve analyses tested the accuracy (AUC of phi and PCA3 in predicting PCa. Decision curve analyses (DCA were used to compare the clinical benefit of the two biomarkers. We found that the AUC value of phi (0.77 was comparable to those of %p2PSA (0.76 and PCA3 (0.73 with no significant differences in pairwise comparison (%p2PSA vs phi p = 0.673, %p2PSA vs. PCA3 p = 0.417 and phi vs. PCA3 p = 0.247. These three biomarkers significantly outperformed fPSA (AUC = 0.60, % fPSA (AUC = 0.62 and p2PSA (AUC = 0.63. At DCA, phi and PCA3 exhibited a very close net benefit profile until the threshold probability of 25%, then phi index showed higher net benefit than PCA3. Multivariable analysis showed that the addition of phi and PCA3 to the base multivariable model (age, PSA, %fPSA, DRE, prostate volume increased predictive accuracy, whereas no model improved single biomarker performance. Finally we showed that subjects with active surveillance (AS compatible cancer had significantly lower phi and PCA3 values (p<0.001 and p = 0.01, respectively. In conclusion, both phi and PCA3 comparably increase the accuracy in predicting the presence of PCa in total PSA range 2-10 ng/ml at initial biopsy, outperforming currently used %fPSA.

PSA Update Procedures, an Ultimate Need for Living PSA

International Nuclear Information System (INIS)

Hegedus, D.

1998-01-01

Nuclear facilities by their complex nature, change with time. These changes can be both physical (plant modification, etc.), operational (enhanced procedures, etc.) and organizational. In addition, there are also changes in our understanding of the plant, due to operational experience, data collection, technology enhancements, etc. Therefore, it is imperative that PSA model must be frequently up-dated or modified to reflect these changes. Over the last ten years. these has been a remarkable growth of the use of Probabilistic Safety Assessments (PSAs). The most rapidly growing area of the PSA Applications is their use to support operational decision-making. Many of these applications are characterized by the potential for not only improving the safety level but also for providing guidance on the optimal use of resources and reducing regulatory burden. To enable a wider use of the PSA model as a tool for safety activities it is essential to maintain the model in a controlled state. Moreover, to fulfill requirements for L iving PSA , the PSA model has to be constantly updated and/or monitored to reflect the current plant configuration. It should be noted that the PSA model should not only represent the plant design but should also represent the operational and emergency procedures. To keep the PSA model up-to-date several issues should be clearly defined including: - Responsibility should be divided among the PSA group, - Procedures for implementing changes should be established, and - QA requirements/program should be established to assure documentation and reporting. (author)

PET/CT with (18)F-choline after radical prostatectomy in patients with PSA ≤2 ng/ml. Can PSA velocity and PSA doubling time help in patient selection?

Science.gov (United States)

Chiaravalloti, Agostino; Di Biagio, Daniele; Tavolozza, Mario; Calabria, Ferdinando; Schillaci, Orazio

2016-07-01

To investigate the performance of (18)F-fluorocholine ((18)F-FCH) PET/CT in relation to the prostate-specific antigen (PSA) kinetic indexes, PSA doubling time (PSAdt) and PSA velocity (PSAve), in detecting recurrent prostate cancer (PC) in a selected population of patients treated with radical prostatectomy and with PSA ≤2 ng/ml. The study group comprised 79 patients (mean age 70 ± 7 years, range 58 - 77 years) who had been treated with radical surgery 30 to 90 months previously and with biochemical failure (defined as a measurable serum PSA level) who were evaluated with (18)F-FCH PET/CT. In order to establish the optimal threshold for PSAdt and PSAve, the diagnostic performance of PSA, PSAdt and PSAve were compared by receiver operating characteristic analysis. In the population examined, PSA (mean ± SD) was 1.37 ± 0.44 ng/ml (range 0.21 - 2 ng/ml) before PET/CT examination, PSAdt was 10.04 ± 16.67 months and PSAve was 2.75 ± 3.11 ng/ml per year. (18)F-FCH PET/CT was positive in 44 patients (55 %). PSAve and PSAdt were significantly different between patients with a positive and a negative (18)F-FCH PET/CT scan. Thresholds of 6 months for PSAdt and 1 ng/ml per year for PSAve were selected. For PSAdt ≤6 months the detection rate (DR) was 65 %, and for PSAve >1 ng/ml per year the DR was 67 %. PSA values were not significantly different between patients with a positive and a negative PET/CT scan. The results of our study suggest that (18)F-FCH PET/CT could be considered for the evaluation of patients with biochemical recurrence of PC and with low PSA levels. Fast PSA kinetics could be useful in the selection of these patients.

Putting PSA to work

International Nuclear Information System (INIS)

Gubler, R.; Gomez-Cobo, A.

1998-01-01

The IAEA has, during the last three years, been working intensively on PSA applications. The draft TECDOC prepared during these activities, ''PSA Applications'' is summarized in this paper. Actual events at nuclear facilities provide an important basis to compare PSAs with reality. PSA based operational event analysis therefore can be used to evaluate the importance of operational events from a risk perspective but also can contribute to validating and enhancing PSAs and to continuously check whether or not the PSA models are adequate, appropriate and complete. The work of the IAEA in this area is therefore summarized as well. In a companion paper, titled ''Towards a credible PSA fit for applications'', two specific aspects regarding the quality of the PSA to be used are discussed in detail, namely the Living PSA concept, which ensures that the PSA reflects actual design and operational features and Quality Assurance for PSA. (author)

DIAGNOSTIC AND PROGNOSTIC UTILITY OF SERUM PSA IN BREAST CANCER

Institute of Scientific and Technical Information of China (English)

张淑群; 强水云; 李妙羡; 纪宗正

2004-01-01

Objective To investigate the diagnostic and prognostic value of total and free prostate-specific antigen (PSA) in breast cancer women. Methods Using the microparticle enzyme immunoassay system, we measured the concentrations of these markers in the sera of 85 women with breast cancer and in 30 healthy women.Results Free PSA levels were significantly higher in women with breast cancer than healthy women (P ＜0. 05 ).The percentage of free PSA predominant subjects was 37. 6% in breast cancer patients and 3. 3% in healthy women.In women with breast cancer,total PSA positivity was 23.5% and free PSA positivity was 27. 1%. When compared to negatives,total PSA positive patients had a higher percentage of lymph node involvement tamours ( P ＞0. 05).However, patients with predominant free PSA had a higher percentage of early stage than patients with predominant PSA-ACT. Conclusion This study indicate clinical significance of preoperative measurement of serum total and free PSA in diagnosis and prognosis of women with breast cancer. The expression of KLKs is correlated with carcinogenesis of breast cancer.

Clinical diagnostic value of combined determination of serum tPSA, cPSA and IGF-I levels in patients with prostatic disorders

International Nuclear Information System (INIS)

Zhang Bashan; Zhang Zigang; Lai Fudi

2008-01-01

Objective: To investigate the diagnostic value of combined determination of serum total prostatic specific antigen (tPSA), complex prostatic specific antigen (cPSA) and IGF-I levels in patients with prostatic disorders. Methods: Serum tPSA, cPSA (with CLIA) and IGF-I (with IRMA) levels were determined in 41 patients with prostatic carcinoma, 60 patients with benign prosta- tic hypertrophy (BPH) and 55 controls. Results: The serum tPSA, cPSA and IGF-I levels in patients with prostatic cancer were significantly higher than those in patients with BPH and controls (P<0.01). Taking the cut-off values of 4ng/ml, 3.6ng/ml and 150 for tPSA, cPSA and IGF-I respectively, the combined determination of these three items would yield a sensitivity of 88.6%, specificity of 84.9%, positive predicative value of 83% and negative predicative value of 90.0% for diagnosis of prostatic cancer. Conclusion: Combined determination of tPSA, cPSA and IGF-I would yield better sensitive and accurate diagnostic rate in patients with prostatic cancer, especially in those with laboratory values within the 'grey zone'. (authors)

PSA Model Improvement Using Maintenance Rule Function Mapping

Energy Technology Data Exchange (ETDEWEB)

Seo, Mi Ro [KHNP-CRI, Nuclear Safety Laboratory, Daejeon (Korea, Republic of)

2011-10-15

The Maintenance Rule (MR) program, in nature, is a performance-based program. Therefore, the risk information derived from the Probabilistic Safety Assessment model is introduced into the MR program during the Safety Significance determination and Performance Criteria selection processes. However, this process also facilitates the determination of the vulnerabilities in currently utilized PSA models and offers means of improving them. To find vulnerabilities in an existing PSA model, an initial review determines whether the safety-related MR functions are included in the PSA model. Because safety-related MR functions are related to accident prevention and mitigation, it is generally necessary for them to be included in the PSA model. In the process of determining the safety significance of each functions, quantitative risk importance levels are determined through a process known as PSA model basic event mapping to MR functions. During this process, it is common for some inadequate and overlooked models to be uncovered. In this paper, the PSA model and the MR program of Wolsong Unit 1 were used as references

Vergleichende Einschätzung der diagnostischen Aussagekraft der Kenngrößen freies PSA, Alpha1-Antichymotrypsin-PSA und komplexiertes PSA in der Diagnostik des Prostatakarzinoms

OpenAIRE

Baumgart E; Deger S; Jung K; Lein M; Loening SA; Schnorr D

2001-01-01

Ziel der Studie war die vergleichende Einschätzung der diagnostischen Aussagekraft von Gesamt-PSA (tPSA), freiem PSA (fPSA), alpha1-Antichymotrypsin-PSA (ACT-PSA) und komplexiertem PSA (cPSA) sowie der entsprechenden Quotienten zur Differenzierung zwischen einem Prostatakarzinom (PCa) und einer Benignen Prostatahyperplasie (BPH). Die Bestimmung erfolgte bei insgesamt 324 Männern (PCa: n = 144; BPH: n = 89; Kontrollen: n = 91). Die tPSA- und cPSA-Konzentrationen wurden mit dem Bayer Immuno 1 S...

Prostate Health Index (Phi) and Prostate Cancer Antigen 3 (PCA3) Significantly Improve Prostate Cancer Detection at Initial Biopsy in a Total PSA Range of 2–10 ng/ml

Science.gov (United States)

Perdonà, Sisto; Marino, Ada; Mazzarella, Claudia; Perruolo, Giuseppe; D’Esposito, Vittoria; Cosimato, Vincenzo; Buonerba, Carlo; Di Lorenzo, Giuseppe; Musi, Gennaro; De Cobelli, Ottavio; Chun, Felix K.; Terracciano, Daniela

2013-01-01

Many efforts to reduce prostate specific antigen (PSA) overdiagnosis and overtreatment have been made. To this aim, Prostate Health Index (Phi) and Prostate Cancer Antigen 3 (PCA3) have been proposed as new more specific biomarkers. We evaluated the ability of phi and PCA3 to identify prostate cancer (PCa) at initial prostate biopsy in men with total PSA range of 2–10 ng/ml. The performance of phi and PCA3 were evaluated in 300 patients undergoing first prostate biopsy. ROC curve analyses tested the accuracy (AUC) of phi and PCA3 in predicting PCa. Decision curve analyses (DCA) were used to compare the clinical benefit of the two biomarkers. We found that the AUC value of phi (0.77) was comparable to those of %p2PSA (0.76) and PCA3 (0.73) with no significant differences in pairwise comparison (%p2PSA vs phi p = 0.673, %p2PSA vs. PCA3 p = 0.417 and phi vs. PCA3 p = 0.247). These three biomarkers significantly outperformed fPSA (AUC = 0.60), % fPSA (AUC = 0.62) and p2PSA (AUC = 0.63). At DCA, phi and PCA3 exhibited a very close net benefit profile until the threshold probability of 25%, then phi index showed higher net benefit than PCA3. Multivariable analysis showed that the addition of phi and PCA3 to the base multivariable model (age, PSA, %fPSA, DRE, prostate volume) increased predictive accuracy, whereas no model improved single biomarker performance. Finally we showed that subjects with active surveillance (AS) compatible cancer had significantly lower phi and PCA3 values (p<0.001 and p = 0.01, respectively). In conclusion, both phi and PCA3 comparably increase the accuracy in predicting the presence of PCa in total PSA range 2–10 ng/ml at initial biopsy, outperforming currently used %fPSA. PMID:23861782

PI-RADS version 2 for prediction of pathological downgrading after radical prostatectomy: a preliminary study in patients with biopsy-proven Gleason Score 7 (3+4) prostate cancer

Energy Technology Data Exchange (ETDEWEB)

Woo, Sungmin; Kim, Sang Youn [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Joongyub [Seoul National University College of Medicine, Seoul National University Hospital, Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul (Korea, Republic of); Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine and Kidney Research Institute, Seoul (Korea, Republic of)

2016-10-15

To evaluate PI-RADSv2 for predicting pathological downgrading after radical prostatectomy (RP) in patients with biopsy-proven Gleason score (GS) 7(3+4) PC. A total of 105 patients with biopsy-proven GS 7(3+4) PC who underwent multiparametric prostate MRI followed by RP were included. Two radiologists assigned PI-RADSv2 scores for each patient. Preoperative clinicopathological variables and PI-RADSv2 scores were compared between patients with and without downgrading after RP using the Wilcoxon rank sum test or Fisher's exact test. Logistic regression analyses with Firth's bias correction were performed to assess their association with downgrading. Pathological downgrading was identified in ten (9.5 %) patients. Prostate-specific antigen (PSA), PSA density, percentage of cores with GS 7(3+4), and greatest percentage of core length (GPCL) with GS 7(3+4) were significantly lower in patients with downgrading (p = 0.002-0.037). There was no significant difference in age and clinical stage (p = 0.537-0.755). PI-RADSv2 scores were significantly lower in patients with downgrading (3.8 versus 4.4, p = 0.012). At univariate logistic regression analysis, PSA, PSA density, and PI-RADSv2 scores were significant predictors of downgrading (p = 0.003-0.022). Multivariate analysis revealed only PSA density and PI-RADSv2 scores as independent predictors of downgrading (p = 0.014-0.042). The PI-RADSv2 scoring system was an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4) PC. (orig.)

Extreme conservation of the psaA/psaB intercistronic spacer reveals a translational motif coincident with the evolution of land plants.

Science.gov (United States)

Peredo, Elena L; Les, Donald H; King, Ursula M; Benoit, Lori K

2012-12-01

Although chloroplast transcriptional and translational mechanisms were derived originally from prokaryote endosymbionts, chloroplasts retain comparatively few genes as a consequence of the overall transfer to the nucleus of functions associated formerly with prokaryotic genomes. Various modifications reflect other evolutionary shifts toward eukaryotic regulation such as posttranscriptional transcript cleavage with individually processed cistrons in operons and gene expression regulated by nuclear-encoded sigma factors. We report a notable exception for the psaA-psaB-rps14 operon of land plant (embryophyte) chloroplasts, where the first two cistrons are separated by a spacer region to which no significant role had been attributed. We infer an important function of this region, as indicated by the conservation of identical, structurally significant sequences across embryophytes and their ancestral protist lineages, which diverged some 0.5 billion years ago. The psaA/psaB spacers of embryophytes and their progenitors exhibit few sequence and length variants, with most modeled transcripts resolving the same secondary structure: a loop with projecting Shine-Dalgarno site and well-defined stem that interacts with adjacent coding regions to sequester the psaB start codon. Although many functions of the original endosymbiont have been usurped by nuclear genes or interactions, conserved functional elements of embryophyte psaA/psaB spacers provide compelling evidence that translation of psaB is regulated here by a cis-acting mechanism comparable to those common in prokaryotes. Modeled transcripts also indicate that spacer variants in some plants (e.g., aquatic genus Najas) potentially reflect ecological adaptations to facilitate temperature-regulated translation of psaB.

Influence of PSA, PSA velocity and PSA doubling time on contrast-enhanced 18F-choline PET/CT detection rate in patients with rising PSA after radical prostatectomy

International Nuclear Information System (INIS)

Schillaci, Orazio; Calabria, Ferdinando; Tavolozza, Mario; Caracciolo, Cristiana Ragano; Orlacchio, Antonio; Danieli, Roberta; Simonetti, Giovanni; Agro, Enrico Finazzi; Miano, Roberto

2012-01-01

To evaluate the accuracy of contrast-enhanced 18 F-choline PET/CT in restaging patients with prostate cancer after radical prostatectomy in relation to PSA, PSA velocity (PSAve) and PSA doubling time (PSAdt). PET/CT was performed in 49 patients (age range 58-87 years) with rising PSA (mean 4.13 ng/ml) who were divided in four groups according to PSA level: ≤1 ng/ml, 1 to ≤2 ng/ml, 2 to ≤4 ng/ml, and >4 ng/ml. PSAve and PSAdt were measured. PET and CT scans were interpreted separately and then together. PET/CT diagnosed relapse in 33 of the 49 patients (67%). The detection rates were 20%, 55%, 80% and 87% in the PSA groups ≤1, 1 to ≤2, 2 to ≤4 and >4 ng/ml, respectively. PET/CT was positive in 7 of 18 patients (38.9%) with a PSA ≤2 ng/ml, and in 26 of 31 (83.9%) with a PSA >2 ng/ml. PET/CT was positive in 7 of 25 patients (84%) with PSAdt ≤6 months, and in 12 of 24 patients (50%) with PSAdt >6 months, and was positive in 26 of 30 patients (86%) with a PSAve >2 ng/ml per year, and in 7 of 19 patients (36.8%) with PSAve ≤2 ng/ml per year. PET alone was positive in 31 of 49 patients (63.3%), and of these 31 patients, CT was negative in 14 but diagnosed bone lesions in 2 patients in whom PET alone was negative. CT with the administration of intravenous contrast medium did not provide any further information. Detection rate of 18 F-choline imaging is closely related to PSA and PSA kinetics. In particular, 18 F-choline PET/CT is recommended in patients with PSA >2 ng/ml, PSAdt ≤6 months and PSAve >2 ng/ml per year. CT is useful for detecting bone metastases that are not 18 F-choline-avid. The use of intravenous contrast agent seems unnecessary. (orig.)

Predictive value of PSA velocity over early clinical and pathological parameters in patients with localized prostate cancer who undergo radical retropubic prostatectomy

Directory of Open Access Journals (Sweden)

Martinez Carlos A.L.

2004-01-01

Full Text Available OBJECTIVES: To analyze the behavior of the prostate specific antigen velocity (PSAV in localized prostate adenocarcinoma. MATERIALS AND METHODS: We conducted a retrospective study of 500 men who had localized prostate adenocarcinoma, who underwent radical retropubic prostatectomy between January 1986 and December 1999. The PSAV was calculated for each patient and subsequently, the values were correlated with 5 groups: age, initial PSA value, clinical stage, tumor volume and Gleason score. RESULTS: The behavior of PSAV presented statistic significance with an increment between 1.3 ng/mL and 9.6 ng/mL, ranging from 38.6% and 59.8% when compared with the initial PSA value (p < 0.0001, clinical stage (p = 0.0002, tumor volume (p < 0.0001 and Gleason score (p = 0.0009. CONCLUSION: PSAV up to 2.5 ng/mL/year is associated with factors of good prognosis, such as initial PSA below 10 mg/mL, clinical stage T1, tumor volume below 20% and Gleason score lower than 7.

Prediction of extraprostatic extension by prostate specific antigen velocity, endorectal MRI, and biopsy Gleason score in clinically localized prostate cancer

International Nuclear Information System (INIS)

Nishimoto, Koshiro; Nakashima, Jun; Hashiguchi, Akinori; Kikuchi, Eiji; Miyajima, Akira; Nakagawa, Ken; Ohigashi, Takashi; Oya, Mototsugu; Murai, Masaru

2008-01-01

The objective of this study was to investigate the clinical value of prostate specific antigen velocity (PSAV) in predicting the extraprostatic extension of clinically localized prostate cancer. One hundred and three patients who underwent radical prostatectomy for clinically localized prostate cancer were included in the analysis. The correlation between preoperative parameters, including PSA-based parameters, clinical stage, and histological biopsy findings, and the pathological findings were analyzed. Logistic regression analysis was performed to identify a significant set of independent predictors for the local extent of the disease. Sixty-four (60.2%) patients had organ confined prostate cancer and 39 (39.8%) patients had extraprostatic cancer. The biopsy Gleason score, PSA, PSA density, PSA density of the transition zone, and PSAV were significantly higher in the patients with extraprostatic cancer than in those with organ confined cancer. Multivariate logistic regression analysis indicated that the biopsy Gleason score, endorectal magnetic resonance imaging findings, and PSAV were significant predictors of extraprostatic cancer (P<0.01). Probability curves for extraprostatic cancer were generated using these three preoperative parameters. The combination of PSAV, endorectal magnetic resonance imaging findings, and biopsy Gleason score can provide additional information for selecting appropriate candidates for radical prostatectomy. (author)

Issues reporting PSA in prostate cancer

International Nuclear Information System (INIS)

Lange, Paul H.

1996-01-01

The National Cancer Institute Prostate; Lung; Colon; Ovarian Cancer Screening (PLCO) project is a multi-center trial developed to investigate the effectiveness of DRE and PSA testing in the early detection and outcome of patients with prostate cancer. Accordingly, the Prostate Cancer Intervention versus Observation Trial (PIVOT) has been launched and is a randomized trial comparing radical prostatectomy versus expectant management for ALCaP. PSA: Initially PSA was thought to be of little value for diagnosis because 20% of men undergoing radical prostatectomy have 'normal' PSA and patients with apparently only symptomatic BPH have 'elevated' levels as follows: 4-10 ng/ml (Tandem-R) - 20%, >10 ng/ml -3%. Yet, PSA has looked attractive as a diagnostic tool in many studies; for example, when PSA was used in a screening approach as the first test which then drove further evaluation (Catalona, Brawer). It was shown that the positive predictive value for PSA's between 4 and 10 is approximately 20% and > 10 approximately 55%. The value of serial PSA's (velocity) is unknown but is under intense study: one major issue is determination of what represents a significant rise (details to be presented). Studies have also revealed that a DRE and PSA are important for optimal results. About 18% of clinically detectable cancers are only DRE positive while about 25 - 30% are only PSA positive. When both a DRE and PSA are used together, very few clinically apparent cancers are missed (3-5%). Recent ROC curves suggest that 4 ng/ml is reasonable. Recently, PSA values for men without apparent cancer were stratified by age, and taking the 2SD, age specific reference values were generated as follows: age 40-49 (0-2.5 ng/ml), 50-59 (0-3.5), 60-69 (0-4.5), 70-70 (0-6.5). Finally, there is the issue about different PSA assays regarding the compatabilities/reliability of the upper limit of normal and serial values. Much of the confusion is because there is no international PSA standard and

Prostate-Specific Antigen (PSA) Bounce After Dose-Escalated External Beam Radiation Therapy Is an Independent Predictor of PSA Recurrence, Metastasis, and Survival in Prostate Adenocarcinoma Patients.

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Romesser, Paul B; Pei, Xin; Shi, Weiji; Zhang, Zhigang; Kollmeier, Marisa; McBride, Sean M; Zelefsky, Michael J

2018-01-01

To evaluate the difference in prostate-specific antigen (PSA) recurrence-free, distant metastasis-free, overall, and cancer-specific survival between PSA bounce (PSA-B) and non-bounce patients treated with dose-escalated external beam radiation therapy (DE-EBRT). During 1990-2010, 1898 prostate adenocarcinoma patients were treated with DE-EBRT to ≥75 Gy with ≥5 years follow-up. Patients receiving neoadjuvant/concurrent androgen-deprivation therapy (n=1035) or with fewer than 4 PSA values obtained 6 months or more after post-EBRT completion (n=87) were excluded. The evaluable 776 patients were treated (median, 81.0 Gy). Prostate-specific antigen bounce was defined as a ≥0.2-ng/mL increase above the interval PSA nadir, followed by a decrease to nadir or below. Prostate-specific antigen relapse was defined as post-radiation therapy PSA nadir + 2 ng/mL. Median follow-up was 9.2 years (interquartile range, 6.9-11.3 years). One hundred twenty-three patients (15.9%) experienced PSA-B after DE-EBRT at a median of 24.6 months (interquartile range, 16.1-38.5 months). On multivariate analysis, younger age (P=.001), lower Gleason score (P=.0003), and higher radiation therapy dose (P=.0002) independently predicted PSA-B. Prostate-specific antigen bounce was independently associated with decreased risk for PSA relapse (hazard ratio [HR] 0.53; 95% confidence interval [CI] 0.33-0.85; P=.008), distant metastatic disease (HR 0.34; 95% CI 0.12-0.94; P=.04), and all-cause mortality (HR 0.53; 95% CI 0.29-0.96; P=.04) on multivariate Cox analysis. Because all 50 prostate cancer-specific deaths in patients without PSA-B were in the non-bounce cohort, competing-risks analysis was not applicable. A nonparametric competing-risks test demonstrated that patients with PSA-B had superior cancer-specific survival compared with patients without PSA-B (P=.004). Patients treated with dose-escalated radiation therapy for prostate adenocarcinoma who experience posttreatment PSA-B have

Influence of PSA, PSA velocity and PSA doubling time on contrast-enhanced {sup 18}F-choline PET/CT detection rate in patients with rising PSA after radical prostatectomy

Energy Technology Data Exchange (ETDEWEB)

Schillaci, Orazio [University ' ' Tor Vergata' ' , Department of Biopathology and Diagnostic Imaging, Interventional, Rome (Italy); IRCCS Neuromed, Department of Nuclear Medicine and Molecular Imaging, Pozzilli (Italy); Calabria, Ferdinando [IRCCS Neuromed, Department of Nuclear Medicine and Molecular Imaging, Pozzilli (Italy); Tavolozza, Mario; Caracciolo, Cristiana Ragano; Orlacchio, Antonio; Danieli, Roberta; Simonetti, Giovanni [University ' ' Tor Vergata' ' , Department of Biopathology and Diagnostic Imaging, Interventional, Rome (Italy); Agro, Enrico Finazzi; Miano, Roberto [University Hospital ' ' Tor Vergata' ' , Department of Urology, Rome (Italy)

2012-04-15

To evaluate the accuracy of contrast-enhanced {sup 18}F-choline PET/CT in restaging patients with prostate cancer after radical prostatectomy in relation to PSA, PSA velocity (PSAve) and PSA doubling time (PSAdt). PET/CT was performed in 49 patients (age range 58-87 years) with rising PSA (mean 4.13 ng/ml) who were divided in four groups according to PSA level: {<=}1 ng/ml, 1 to {<=}2 ng/ml, 2 to {<=}4 ng/ml, and >4 ng/ml. PSAve and PSAdt were measured. PET and CT scans were interpreted separately and then together. PET/CT diagnosed relapse in 33 of the 49 patients (67%). The detection rates were 20%, 55%, 80% and 87% in the PSA groups {<=}1, 1 to {<=}2, 2 to {<=}4 and >4 ng/ml, respectively. PET/CT was positive in 7 of 18 patients (38.9%) with a PSA {<=}2 ng/ml, and in 26 of 31 (83.9%) with a PSA >2 ng/ml. PET/CT was positive in 7 of 25 patients (84%) with PSAdt {<=}6 months, and in 12 of 24 patients (50%) with PSAdt >6 months, and was positive in 26 of 30 patients (86%) with a PSAve >2 ng/ml per year, and in 7 of 19 patients (36.8%) with PSAve {<=}2 ng/ml per year. PET alone was positive in 31 of 49 patients (63.3%), and of these 31 patients, CT was negative in 14 but diagnosed bone lesions in 2 patients in whom PET alone was negative. CT with the administration of intravenous contrast medium did not provide any further information. Detection rate of {sup 18}F-choline imaging is closely related to PSA and PSA kinetics. In particular, {sup 18}F-choline PET/CT is recommended in patients with PSA >2 ng/ml, PSAdt {<=}6 months and PSAve >2 ng/ml per year. CT is useful for detecting bone metastases that are not {sup 18}F-choline-avid. The use of intravenous contrast agent seems unnecessary. (orig.)

Living PSA

International Nuclear Information System (INIS)

Evans, M.G.K.

1997-01-01

The aim of this presentation is to gain an understanding of the requirements for a PSA to be considered a Living PSA. The presentation is divided into the following topics: Definition; Planning/Documentation; Task Performance; Maintenance; Management. 4 figs

Prognostic Significance of 5-Year PSA Value for Predicting Prostate Cancer Recurrence After Brachytherapy Alone and Combined With Hormonal Therapy and/or External Beam Radiotherapy

International Nuclear Information System (INIS)

Stock, Richard G.; Klein, Thomas J.; Cesaretti, Jamie A.; Stone, Nelson N.

2009-01-01

Purpose: To analyze the prognosis and outcomes of patients who remain free of biochemical failure during the first 5 years after treatment. Methods and Materials: Between 1991 and 2002, 742 patients with prostate cancer were treated with brachytherapy alone (n = 306), brachytherapy and hormonal therapy (n = 212), or combined implantation and external beam radiotherapy (with or without hormonal therapy; n = 224). These patients were free of biochemical failure (American Society for Therapeutic Radiology and Oncology [ASTRO] definition) during the first 5 post-treatment years and had a documented 5-year prostate-specific antigen (PSA) value. The median follow-up was 6.93 years. Results: The actuarial 10-year freedom from PSA failure rate was 97% using the ASTRO definition and 95% using the Phoenix definition. The median 5-year PSA level was 0.03 ng/mL (range, 0-3.6). The 5-year PSA value was ≤0.01 in 47.7%, >0.01-0.10 in 31.1%, >0.10-0.2 in 10.2%, >0.2-0.5 in 7.82%, and >0.5 in 3.10%. The 5-year PSA value had prognostic significance, with a PSA value of ≤0.2 ng/mL (n = 661) corresponding to a 10-year freedom from PSA failure rate of 99% with the ASTRO definition and 98% with the Phoenix definition vs. 86% (ASTRO definition) and 81% (Phoenix definition) for a PSA value ≥0.2 ng/mL (n = 81; p < .0001). The treatment regimen had no effect on biochemical failure. None of the 742 patients in this study developed metastatic disease or died of prostate cancer. Conclusion: The results of this study have shown that the prognosis for patients treated with brachytherapy and who remain biochemically free of disease for ≥5 years is excellent and none developed metastatic disease during the first 10 years after treatment. The 5-year PSA value is prognostic, and patients with a PSA value <0.2 ng/mL are unlikely to develop subsequent biochemical relapse.

Survey of Dynamic PSA Methodologies

International Nuclear Information System (INIS)

Lee, Hansul; Kim, Hyeonmin; Heo, Gyunyoung; Kim, Taewan

2015-01-01

Event Tree(ET)/Fault Tree(FT) are significant methodology in Probabilistic Safety Assessment(PSA) for Nuclear Power Plants(NPPs). ET/FT methodology has the advantage for users to be able to easily learn and model. It enables better communication between engineers engaged in the same field. However, conventional methodologies are difficult to cope with the dynamic behavior (e.g. operation mode changes or sequence-dependent failure) and integrated situation of mechanical failure and human errors. Meanwhile, new possibilities are coming for the improved PSA by virtue of the dramatic development on digital hardware, software, information technology, and data analysis.. More specifically, the computing environment has been greatly improved with being compared to the past, so we are able to conduct risk analysis with the large amount of data actually available. One method which can take the technological advantages aforementioned should be the dynamic PSA such that conventional ET/FT can have time- and condition-dependent behaviors in accident scenarios. In this paper, we investigated the various enabling techniques for the dynamic PSA. Even though its history and academic achievement was great, it seems less interesting from industrial and regulatory viewpoint. Authors expect this can contribute to better understanding of dynamic PSA in terms of algorithm, practice, and applicability. In paper, the overview for the dynamic PSA was conducted. Most of methodologies share similar concepts. Among them, DDET seems a backbone for most of methodologies since it can be applied to large problems. The common characteristics sharing the concept of DDET are as follows: • Both deterministic and stochastic approaches • Improves the identification of PSA success criteria • Helps to limit detrimental effects of sequence binning (normally adopted in PSA) • Helps to avoid defining non-optimal success criteria that may distort the risk • Framework for comprehensively considering

Survey of Dynamic PSA Methodologies

Energy Technology Data Exchange (ETDEWEB)

Lee, Hansul; Kim, Hyeonmin; Heo, Gyunyoung [Kyung Hee University, Yongin (Korea, Republic of); Kim, Taewan [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

2015-05-15

Event Tree(ET)/Fault Tree(FT) are significant methodology in Probabilistic Safety Assessment(PSA) for Nuclear Power Plants(NPPs). ET/FT methodology has the advantage for users to be able to easily learn and model. It enables better communication between engineers engaged in the same field. However, conventional methodologies are difficult to cope with the dynamic behavior (e.g. operation mode changes or sequence-dependent failure) and integrated situation of mechanical failure and human errors. Meanwhile, new possibilities are coming for the improved PSA by virtue of the dramatic development on digital hardware, software, information technology, and data analysis.. More specifically, the computing environment has been greatly improved with being compared to the past, so we are able to conduct risk analysis with the large amount of data actually available. One method which can take the technological advantages aforementioned should be the dynamic PSA such that conventional ET/FT can have time- and condition-dependent behaviors in accident scenarios. In this paper, we investigated the various enabling techniques for the dynamic PSA. Even though its history and academic achievement was great, it seems less interesting from industrial and regulatory viewpoint. Authors expect this can contribute to better understanding of dynamic PSA in terms of algorithm, practice, and applicability. In paper, the overview for the dynamic PSA was conducted. Most of methodologies share similar concepts. Among them, DDET seems a backbone for most of methodologies since it can be applied to large problems. The common characteristics sharing the concept of DDET are as follows: • Both deterministic and stochastic approaches • Improves the identification of PSA success criteria • Helps to limit detrimental effects of sequence binning (normally adopted in PSA) • Helps to avoid defining non-optimal success criteria that may distort the risk • Framework for comprehensively considering

The clinical study of serum PSA and fPSA assayed by CLIA in diagnosing prostate disease

International Nuclear Information System (INIS)

Xiong Jiang; Qian Xiaoyu; Ji Hong; Yang Su; Ding Ying; Zhu Ruisen; Chen Zhong

2003-01-01

The purpose of this study is to evaluate the clinical value of PSA (prostate specific antigen) and fPSA(free prostate specific antigen) in differentiating prostate disease. CLIA was used to quantitatively assay PSA, fPSA and fPSA/PSA in 30 cases of normal controls, 32 cases of prostate cancer patients and 76 cases of BPH patients. The result showed that if liminal value of PSA was set at 4 ng/mL, the diagnostic sensitivity and specificity of prostate cancer were 100% and 50.6% respectively. Meanwhile, if liminal value of fPSA/PSA set at 16% was added, the diagnostic sensitivity and specificity of prostate cancer were 100% and 85.3% respectively. It was concluded that the combining assay of PSA and fPSA could increase the diagnostic specificity of prostate cancer in a certain degree

Can PSA Reflex Algorithm be a valid alternative to other PSA-based prostate cancer screening strategies?

Science.gov (United States)

Caldarelli, G; Troiano, G; Rosadini, D; Nante, N

2017-01-01

The available laboratory tests for the differential diagnosis of prostate cancer, are represented by the total PSA, the free PSA, and the free/total PSA ratio. In Italy most of doctors tend to request both total and free PSA for their patients even in cases where the total PSA doesn't justify the further request of free PSA, with a consequent growth of the costs for the National Health System. The aim of our study was to predict the saving in Euro (due to reagents) and reduction in free PSA tests, applying the "PSA Reflex" algorithm. We calculated the number of total PSA and free PSA exams performed in 2014 in the Hospital of Grosseto and, simulating the application of the "PSA Reflex" algorithm in the same year, we calculated the decrease in the number of free PSA requests and we tried to predict the Euro savings in reagents, obtained from this reduction. In 2014 in the Hospital of Grosseto 25,955 total PSA tests have been performed: 3,631 (14%) resulted greater than 10 ng / ml; 7,686 (29.6%) between 2 and 10 ng / ml; 14,638 (56.4%) lower than 2 ng / ml. The performed free PSA tests were 16904. Simulating the use of "PSA Reflex" algorithm, the free PSA tests would be performed only in cases with total PSA values between 2 and 10 ng / mL with a saving of 54.5% of free PSA exams and of 8,971 euros, only for reagents. Our study showed that the "PSA Reflex" algorithm is a valid alternative leading to a reduction of the costs. The estimated intralaboratory savings, due to the reagents, seem to be modest, however, they are followed by the additional savings due to the other diagnostic processes for prostate cancers.

Effectiveness of early adalimumab therapy in psoriatic arthritis patients from Reuma.pt - EARLY PsA.

Science.gov (United States)

Santos, Helena; Eusébio, Mónica; Borges, Joana; Gonçalves, Diana; Ávila-Ribeiro, Pedro; Faria, Daniela Santos; Lopes, Carina; Rovisco, João; Águeda, Ana; Nero, Patrícia; Valente, Paula; Cravo, Ana Rita; Santos, Maria José

2017-01-01

Objective To compare outcomes in psoriatic arthritis (PsA) patients initiating adalimumab (ADA), with short- and long-term disease duration and to evaluate the potential effect of concomitant conventional synthetic disease-modifying antirheumatic drugs (csDMARD) or glucocorticoids. Methods Analyses included adult PsA patients registered in the Rheumatic Diseases Portuguese Register (Reuma.pt) between June 2008-June 2016 who received ADA for ≥3 months. Psoriatic Arthritis Response Criteria (PsARC) response, tender and swollen joint count, inflammatory parameters, patient (PtGA) and physician global assessment (PhGA), Disease Activity Score-28 joints (DAS28), and Health Assessment Questionnaire Disability Index (HAQ-DI) were compared between patients with PsA) and those with ≥5 years of disease duration (late PsA). Time to achieving PsARC response was estimated using the Kaplan-Meier method. Results Of 135 PsA patients treated with ADA, 126 had information on disease duration (earlyPsA, n=41). PsARC response was achieved by 72.9% of the patients (88.0% early PsA vs 62.2% late PsA; P=0.022) after 3 months and by 85.4% after 24 months (100% early PsA vs 75.9% late PsA; P=0.044). Early PsA patients achieved significantly less painful joints (2.7 vs 6.7, p=0.006), lower mean C-reactive protein (0.5 mg/dL vs 1.3 mg/dL; P=0.011), and PhGA (18.3 vs 28.1; P=0.020) at 3 months. In the long term, early PsA patients also had fewer swollen joints (0.3 vs 1.7; P=0.030) and lower PhGA (6.3 vs 21.9; PPsA, respectively. Early PsA patients obtained PsARC response more rapidly than late PsA (3.8 and 7.4 months, respectively; P=0.008). Concomitant csDMARDs showed clinical benefit (2-year PsARC response, 88.3% vs 60.0%; P=0.044). Concomitant glucocorticoids had no effect on PsARC response over 2 years of follow-up. Persistence on ADA was similar in both groups. Conclusion Early PsA patients had a greater chance of improvement after ADA therapy and better functional outcome, and

Clinical outcomes and nadir prostate-specific antigen (PSA) according to initial PSA levels in primary androgen deprivation therapy for metastatic prostate cancer.

Science.gov (United States)

Kitagawa, Yasuhide; Ueno, Satoru; Izumi, Kouji; Kadono, Yoshifumi; Mizokami, Atsushi; Hinotsu, Shiro; Akaza, Hideyuki; Namiki, Mikio

2016-03-01

To investigate the clinical outcomes of metastatic prostate cancer patients and the relationship between nadir prostate-specific antigen (PSA) levels and different types of primary androgen deprivation therapy (PADT). This study utilized data from the Japan Study Group of Prostate Cancer registry, which is a large, multicenter, population-based database. A total of 2982 patients treated with PADT were enrolled. Kaplan-Meier analysis was used to compare progression-free survival (PFS) and overall survival (OS) in patients treated using combined androgen blockade (CAB) and non-CAB therapies. The relationships between nadir PSA levels and PADT type according to initial serum PSA levels were also investigated. Among the 2982 enrolled patients, 2101 (70.5 %) were treated with CAB. Although CAB-treated patients had worse clinical characteristics, their probability of PFS and OS was higher compared with those treated with a non-CAB therapy. These results were due to a survival benefit with CAB in patients with an initial PSA level of 500-1000 ng/mL. Nadir PSA levels were significantly lower in CAB patients than in non-CAB patients with comparable initial serum PSA levels. A small survival benefit for CAB in metastatic prostate cancer was demonstrated in a Japanese large-scale prospective cohort study. The clinical significance of nadir PSA levels following PADT was evident, but the predictive impact of PSA nadir on OS was different between CAB and non-CAB therapy.

Minimal percentage of dose received by 90% of the urethra (%UD90) is the most significant predictor of PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy) for prostate cancer.

Science.gov (United States)

Tanaka, Nobumichi; Asakawa, Isao; Fujimoto, Kiyohide; Anai, Satoshi; Hirayama, Akihide; Hasegawa, Masatoshi; Konishi, Noboru; Hirao, Yoshihiko

2012-09-14

To clarify the significant clinicopathological and postdosimetric parameters to predict PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy) for prostate cancer. We studied 200 consecutive patients who received LDR-brachytherapy between July 2004 and November 2008. Of them, 137 patients did not receive neoadjuvant or adjuvant androgen deprivation therapy. One hundred and forty-two patients were treated with LDR-brachytherapy alone, and 58 were treated with LDR-brachytherapy in combination with external beam radiation therapy. The cut-off value of PSA bounce was 0.1 ng/mL. The incidence, time, height, and duration of PSA bounce were investigated. Clinicopathological and postdosimetric parameters were evaluated to elucidate independent factors to predict PSA bounce in hormone-naïve patients who underwent LDR-brachytherapy alone. Fifty patients (25%) showed PSA bounce and 10 patients (5%) showed PSA failure. The median time, height, and duration of PSA bounce were 17 months, 0.29 ng/mL, and 7.0 months, respectively. In 103 hormone-naïve patients treated with LDR-brachytherapy alone, and univariate Cox proportional regression hazard model indicated that age and minimal percentage of the dose received by 30% and 90% of the urethra were independent predictors of PSA bounce. With a multivariate Cox proportional regression hazard model, minimal percentage of the dose received by 90% of the urethra was the most significant parameter of PSA bounce. Minimal percentage of the dose received by 90% of the urethra was the most significant predictor of PSA bounce in hormone-naïve patients treated with LDR-brachytherapy alone.

Molecular Form Differences Between Prostate-Specific Antigen (PSA) Standards Create Quantitative Discordances in PSA ELISA Measurements

Science.gov (United States)

McJimpsey, Erica L.

2016-02-01

The prostate-specific antigen (PSA) assays currently employed for the detection of prostate cancer (PCa) lack the specificity needed to differentiate PCa from benign prostatic hyperplasia and have high false positive rates. The PSA calibrants used to create calibration curves in these assays are typically purified from seminal plasma and contain many molecular forms (intact PSA and cleaved subforms). The purpose of this study was to determine if the composition of the PSA molecular forms found in these PSA standards contribute to the lack of PSA test reliability. To this end, seminal plasma purified PSA standards from different commercial sources were investigated by western blot (WB) and in multiple research grade PSA ELISAs. The WB results revealed that all of the PSA standards contained different mass concentrations of intact and cleaved molecular forms. Increased mass concentrations of intact PSA yielded higher immunoassay absorbance values, even between lots from the same manufacturer. Standardization of seminal plasma derived PSA calibrant molecular form mass concentrations and purification methods will assist in closing the gaps in PCa testing measurements that require the use of PSA values, such as the % free PSA and Prostate Health Index by increasing the accuracy of the calibration curves.

The relationship between serum PSA, six sex hormones and the benign or malignant prostate diseases

International Nuclear Information System (INIS)

Xu Yancun

2008-01-01

In order to study clinical significance of serum prostate-specific antigen (PSA), free prostate specific antigen (PSA), f/tPSA and six sex hormones in prostate diseases, the serum levels of PSA, fPSA, f/tPSA, T, P, E 2 , PRL, LH and FSH in 72 cases of hyperplasia of prostate patients and 40 patients with prostate cancer were determined by RIA. The results showed that the serum levels of T, E 2 , PRL, LH, FSH in the BPH Group were significantly lower than those of in Pca group, the serum level of P in Pca group were significantly lower than those in BPH group; the levels of fPSA and f/tPSA ratio in BPH Group were significantly higher than those in Pca group. The results suggest that benign and malignant prostate disease (BPH and Pca) was related with the hormone imbalance. The serum total PSA and fPSA can be regarded as important indicators in the diagnosis of BPH and Pea. The combined determination of PSA, fPSA and f/tPSA may improve the diagnostic accuracy of Pca. (authors)

Evaluation of total PSA assay on vitros ECi and correlation with Kryptor-PSA assay.

Science.gov (United States)

Cassinat, B; Wacquet, M; Toubert, M E; Rain, J D; Schlageter, M H

2001-01-01

An increasing number of multiparametric immuno-analysers for PSA assays are available. As different immuno-assays may vary in their analytical quality and their accuracy for the follow-up of patients, expertise is necessary for each new assay. The PSA assay on the Vitros-ECi analyser has been evaluated and compared with the PSA assay from the Kryptor analyser. Variation coefficients were 0.91 to 1.98% for within-run assays, and 4.2% to 5.4% for interassay (PSA levels = 0.8 microgram/L to 33.6 micrograms/L). Dilution tests showed 93 to 136% recovery until 70 micrograms/L PSA. Functional sensitivity was estimated at 0.03 microgram/L. Equimolarity of the test was confirmed. Correlation of PSA levels measured with Vitros-ECi and Kryptor analysers displayed a correlation coefficient r2 of 0.9716. The half-lives and doubling times of PSA were similar using both methods. Vitros-ECi PSA assay meets the major criteria for the management of prostate cancer patients.

Post treatment PSA nadirs support continuing dose escalation study in patients with pretreatment PSA levels >10 ng/ml, but not in those with PSA <10 NG/ML

International Nuclear Information System (INIS)

Herold, D.H.; Hanlon, A.L.; Movsas, B.; Hanks, G.E.

1996-01-01

Purpose: We have recently shown that ICRU reporting point radiation doses above 71 Gy are not associated with improved bNED survival in prostate cancer patients with pretreatment PSA level 20 ng/ml we found a strong correlation between dose and nadir values < 1.0 ng/ml (p=.003) as well as for nadir's < 0.5 ng/ml (p=.04). This dose/nadir effect held at several dose levels, but 74 Gy for nadir values < 1.0 ng/ml and 72 Gy for nadir's < 0.5 ng/ml remained the most significant. 32% of these patients achieved a nadir < 1.0ng/ml and 15% < 0.5ng/ml. Conclusions: This analysis provides strong additional support that patients with pretreatment PSA values of < 10 ng/ml do not benefit from dose escalation beyond an ICRU reporting point dose of 71 Gy. For patients with pretreatment PSA's of 10-19.9 ng/ml there is no dose/nadir response evaluated at a nadir of 1.0 ng/ml; however, there is a borderline effect observed at a nadir of 0.5 ng/ml. Patients with pretreatment PSA's of 20 ng/ml or greater clearly benefit from higher doses as evaluated by PSA nadirs of 1.0 ng/ml, and 0.5 ng/ml. These studies support the continued investigation of dose escalation in treating patients with PSA levels over 10 ng/ml, they do not support continued investigation of dose escalation beyond 71 Gy in patients with pretreatment PSA levels < 10 ng/ml. The failure to demonstrate any dose response for the low PSA group and the finding of only a borderline effect for the intermediate PSA group may be influenced by the relatively small number of patients in our series treated to doses < 70 Gy and the fact that none of our patients were treated to doses below 65.98 Gy. The lower limit of acceptible dose has yet to be defined

SERIAL PERCENT-FREE PSA IN COMBINATION WITH PSA FOR POPULATION-BASED EARLY DETECTION OF PROSTATE CANCER

Science.gov (United States)

Ankerst, Donna Pauler; Gelfond, Jonathan; Goros, Martin; Herrera, Jesus; Strobl, Andreas; Thompson, Ian M.; Hernandez, Javier; Leach, Robin J.

2016-01-01

PURPOSE To characterize the diagnostic properties of serial percent-free prostate-specific antigen (PSA) in relation to PSA in a multi-ethnic, multi-racial cohort of healthy men. MATERIALS AND METHODS 6,982 percent-free PSA and PSA measures were obtained from participants in a 12 year+ Texas screening study comprising 1625 men who never underwent biopsy, 497 who underwent one or more biopsies negative for prostate cancer, and 61 diagnosed with prostate cancer. Area underneath the receiver-operating-characteristic-curve (AUC) for percent-free PSA, and the proportion of patients with fluctuating values across multiple visits were determined according to two thresholds (under 15% versus 25%) were evaluated. The proportion of cancer cases where percent-free PSA indicated a positive test before PSA > 4 ng/mL did and the number of negative biopsies that would have been spared by percent-free PSA testing negative were computed. RESULTS Percent-free PSA fluctuated around its threshold of PSA tested positive earlier than PSA in 71.4% (34.2%) of cancer cases, and among men with multiple negative biopsies and a PSA > 4 ng/mL, percent-free PSA would have tested negative in 31.6% (65.8%) instances. CONCLUSIONS Percent-free PSA should accompany PSA testing in order to potentially spare unnecessary biopsies or detect cancer earlier. When near the threshold, both tests should be repeated due to commonly observed fluctuation. PMID:26979652

Probability of an Abnormal Screening PSA Result Based on Age, Race, and PSA Threshold

Science.gov (United States)

Espaldon, Roxanne; Kirby, Katharine A.; Fung, Kathy Z.; Hoffman, Richard M.; Powell, Adam A.; Freedland, Stephen J.; Walter, Louise C.

2014-01-01

Objective To determine the distribution of screening PSA values in older men and how different PSA thresholds affect the proportion of white, black, and Latino men who would have an abnormal screening result across advancing age groups. Methods We used linked national VA and Medicare data to determine the value of the first screening PSA test (ng/mL) of 327,284 men age 65+ who underwent PSA screening in the VA healthcare system in 2003. We calculated the proportion of men with an abnormal PSA result based on age, race, and common PSA thresholds. Results Among men age 65+, 8.4% had a PSA >4.0ng/mL. The percentage of men with a PSA >4.0ng/mL increased with age and was highest in black men (13.8%) versus white (8.0%) or Latino men (10.0%) (PPSA >4.0ng/mL ranged from 5.1% of Latino men age 65–69 to 27.4% of black men age 85+. Raising the PSA threshold from >4.0ng/mL to >10.0ng/mL, reclassified the greatest percentage of black men age 85+ (18.3% absolute change) and the lowest percentage of Latino men age 65–69 (4.8% absolute change) as being under the biopsy threshold (PPSA threshold together affect the pre-test probability of an abnormal screening PSA result. Based on screening PSA distributions, stopping screening among men whose PSA 10ng/ml has the greatest effect on reducing the number of older black men who will face biopsy decisions after screening. PMID:24439009

Molecular Form Differences Between Prostate-Specific Antigen (PSA) Standards Create Quantitative Discordances in PSA ELISA Measurements

Science.gov (United States)

McJimpsey, Erica L.

2016-01-01

The prostate-specific antigen (PSA) assays currently employed for the detection of prostate cancer (PCa) lack the specificity needed to differentiate PCa from benign prostatic hyperplasia and have high false positive rates. The PSA calibrants used to create calibration curves in these assays are typically purified from seminal plasma and contain many molecular forms (intact PSA and cleaved subforms). The purpose of this study was to determine if the composition of the PSA molecular forms found in these PSA standards contribute to the lack of PSA test reliability. To this end, seminal plasma purified PSA standards from different commercial sources were investigated by western blot (WB) and in multiple research grade PSA ELISAs. The WB results revealed that all of the PSA standards contained different mass concentrations of intact and cleaved molecular forms. Increased mass concentrations of intact PSA yielded higher immunoassay absorbance values, even between lots from the same manufacturer. Standardization of seminal plasma derived PSA calibrant molecular form mass concentrations and purification methods will assist in closing the gaps in PCa testing measurements that require the use of PSA values, such as the % free PSA and Prostate Health Index by increasing the accuracy of the calibration curves. PMID:26911983

Primary Gleason pattern in biopsy Gleason score 7 is predictive of adverse histopathological features and biochemical failure following radical prostatectomy

DEFF Research Database (Denmark)

Berg, Kasper Drimer; Røder, Martin Andreas; Brasso, Klaus

2014-01-01

+3. No difference in age, PSA, percentage of biopsies with cancer, clinical tumour stage or volume on transrectal ultrasonography was found. Primary Gleason pattern 4 was associated with worse pathological stage (p = 0.049). On multivariate analysis, primary Gleason pattern 4 (p ... (p analysis, Gleason score 3+4 had a significantly lower biochemical failure rate compared with Gleason score 4+3 (p = 0.0035). PSA (p 4 (p = 0.001) and percentage of biopsies...

A framework for a quality assurance programme for PSA

International Nuclear Information System (INIS)

1999-08-01

Reviews organized by the IAEA of probabilistic safety assessments (PSAs) of nuclear facilities have, in the past years, shown significant progress in the technical methods and data used for these studies. The IAEA has made a considerable effort to support the development of technical capabilities for PSA in Member States and in writing technical procedures for carrying out PSAs. However, the reviews have also shown significant deficiencies in quality assurance (QA) for PSAs, ranging from no QA at all to inappropriate, inefficient or unbalanced QA. As a PSA represents a very complex model which describes the risk associated with a nuclear facility, an appropriate and efficient QA programme is crucial to obtain a quality PSA. Historically, in the first integral PSAs, many of the PSA elements were handled by independent groups. These elements were finally integrated and put together in the overall model. Many of the interfaces between the elements or tasks were handled as appropriate by exchanging information in oral or written form. Since WASH-1400, the first integral PSA, the process of constructing the PSA model has been further developed. PSA elements previously considered separately can now be handled together with the capable software developed in recent years. Software has made interface control and data transfer easier to perform, but also permits the development of more detailed and complex models. Previously, QA for PSA projects was organized in an ad hoc manner and was sometimes very limited. In recent years, increasingly comprehensive QA programmes have been developed and implemented for PSA projects. Today, a comprehensive, effective and performance-oriented QA is considered to be essential for a reliable and credible PSA. This report describes the framework for developing an adequate QA programme for PSA studies. The framework is based on and is in accordance with the related QA guidelines of the IAEA for safety in nuclear power plants and other nuclear

Effects of increasing the PSA cutoff to perform additional biomarker tests before prostate biopsy.

Science.gov (United States)

Nordström, Tobias; Adolfsson, Jan; Grönberg, Henrik; Eklund, Martin

2017-10-03

Multi-step testing might enhance performance of the prostate cancer diagnostic pipeline. Using PSA >1 ng/ml for first-line risk stratification and the Stockholm 3 Model (S3M) blood-test >10% risk of Gleason Score > 7 prostate cancer to inform biopsy decisions has been suggested. We aimed to determine the effects of changing the PSA cutoff to perform reflex testing with S3M and the subsequent S3M cutoff to recommend prostate biopsy while maintaining the sensitivity to detect Gleason Score ≥ 7 prostate cancer. We used data from the prospective, population-based, paired, diagnostic Stockholm 3 (STHLM3) study with participants invited by date of birth from the Swedish Population Register during 2012-2014. All participants underwent testing with PSA and S3M (a combination of plasma protein biomarkers [PSA, free PSA, intact PSA, hK2, MSMB, MIC1], genetic polymorphisms, and clinical variables [age, family, history, previous prostate biopsy, prostate exam]). Of 47,688 men in the STHLM3 main study, we used data from 3133 men with S3M >10% and prostate biopsy data. Logistic regression models were used to calculate prostate cancer detection rates and proportion saved biopsies. 44.2%, 62.5% and 67.9% of the participants had PSA PSA cut-off for additional work-up from 1 ng/ml to 1.5 ng/ml would thus save 18.3% of the performed tests, 4.9% of the biopsies and 1.3% (10/765) of Gleason Grade ≥ 7 cancers would be un-detected. By lowering the S3M cutoff to recommend biopsy, sensitivity to high-grade prostate cancer can be restored, to the cost of increasing the number of performed biopsies modestly. The sensitivity to detect prostate cancer can be maintained when using different PSA cutoffs to perform additional testing. Biomarker cut-offs have implications on number of tests and prostate biopsies performed. A PSA cutoff of 1.5 ng/ml to perform additional testing such as the S3M test might be considered. ISRCTN84445406 .

Impact of total PSA, PSA doubling time and PSA velocity on detection rates of 11C-Choline positron emission tomography in recurrent prostate cancer

NARCIS (Netherlands)

Rybalov, Maxim; Breeuwsma, Anthonius J.; Leliveld, Anna M.; Pruim, Jan; Dierckx, Rudi A.; de Jong, Igle J.

PURPOSE: To evaluate the effect of total PSA (tPSA) and PSA kinetics on the detection rates of (11)C-Choline PET in patients with biochemical recurrence (BCR) after radical prostatectomy (RP) or external beam radiotherapy (EBRT). METHODS: We included 185 patients with BCR after RP (PSA >0.2 ng/ml)

Clinical impact of body mass index on prostate biopsy in patients with intermediate PSA levels

International Nuclear Information System (INIS)

Sekita, Nobuyuki; Chin, Kensei; Fujimura, Masaaki; Mikami, Kazuo; Suzuki, Hiroyoshi; Kamijima, Shuichi

2008-01-01

From April 2005 to September 2007, 480 patients underwent transrectal prostate biopsy at our institution. The clinical data including age, serum prostate specific antigen (PSA) level, prostate volume and body mass index (BMI) were obtained, and the cancer detection rates and pathological findings were evaluated in 305 cases with a PSA concentration of 4.0 to 10.0 ng/ml. Prostate volume was calculated from magnetic resonance imaging (MRI) findings. The 305 patients were categorized according to their BMI into three groups (normal, less than 22 kg/m 2 ; overweight, 22-25 kg/m 2 ; and obese, more than 25 kg/m 2 ). Cancer detection rates and histopathologic findings were compared between the groups. Multivariate logistic regression analysis was also performed. Prostate cancer was detected in 127 patients. No significant differences in BMI were observed between biopsy-positive and biopsy-negative cases (p=0.965), and the detection rates of prostate cancer observed in the three groups were not significantly different. There was a significant association between BMI and the findings of high Gleason score (more than 4+3) (p=0.048). BMI was not a contributory factor of prostate cancer detection for cases with intermediate PSA levels; however, patients with high BMI may have high-grade malignancy features. (author)

NPP Krsko Living PSA Concept

International Nuclear Information System (INIS)

Vrbanic, I.; Spiler, J.

2000-01-01

NPP Krsko developed PSA model of internal and external initiators within the frame of the Individual Plant Examination (IPE) project. Within this project PSA model was used to examine the existing plant design features. In order to continue with use of this PSA model upon the completion of IPE in various risk-informed applications in support of plant operation and evaluations of design changes, an appropriate living PSA concept needed to be defined. The Living PSA concept is in NPP Krsko considered as being a set of activities pursued in order to update existing PSA model in a manner that it appropriately represents the plant design, operation practice and history. Only a PSA model which is being updated in this manner can serve as a platform for plant-specific risk informed applications. The NPP Krsko living PSA concept is based on the following major ponts. First, the baseline PSA model is defined, which is to be maintained and updated and which is to be reference point for any risk-informed application. Second, issues having a potential for impact on baseline PSA model are identified and procedure and responsibilities for their permanent monitoring and evaluation are established. Third, manner is defined in which consequential changes to baseline PSA model are implemented and controlled, together with associated responsibilities. Finally, the process is defined by which the existing version of baseline PSA model is superseded by a new one. Each time a new version of baseline PSA model is released, it would be re-quantified and the results evaluated and interpreted. By documenting these re-quantifications and evaluations of results in a sequence, the track is being kept of changes in long-term averaged risk perspective, represented by long-term averaged frequencies of core damage and pre-defined release categories. These major topics of NPP Krsko living PSA concept are presented and discussed in the paper. (author)

Antigenic determinants of prostate-specific antigen (PSA) and development of assays specific for different forms of PSA.

OpenAIRE

Nilsson, O.; Peter, A.; Andersson, I.; Nilsson, K.; Grundstr?m, B.; Karlsson, B.

1997-01-01

Monoclonal antibodies were raised against prostate-specific antigen (PSA) by immunization with purified free PSA, i.e. not in complex with any protease inhibitor (F-PSA) and PSA in complex with alpha1-anti-chymotrypsin (PSA-ACT). Epitope mapping of PSA using the established monoclonal antibody revealed a complex pattern of independent and partly overlapping antigenic domains in the PSA molecule. Four independent antigenic domains and at least three partly overlapping domains were exposed both...

Early diagnostic role of PSA combined miR-155 detection in prostate cancer.

Science.gov (United States)

Guo, T; Wang, X-X; Fu, H; Tang, Y-C; Meng, B-Q; Chen, C-H

2018-03-01

As a kind of malignant tumor in the male genitourinary system, prostate cancer exhibits significantly increased occurrence. Prostate-specific antigen (PSA) expression can be seen in the prostate cancer, prostatitis, and other diseases, therefore, lack of diagnostic specificity. The miR-155 expression is abnormally increased in the tumors. Therefore, this study aims to explore the clinical significance of PSA combined miR-155 detection in the early diagnosis of prostate cancer. A total of 86 patients diagnosed with prostate cancer were enrolled in this study. PSA and miR-155 gene expression in tumor tissue were detected by using Real-time PCR. The serum levels of PSA were measured by using enzyme-linked immunosorbent assay (ELISA). The correlation of PSA and miR-155 expression with age, body mass index (BMI), tumor volume, tumor-node-metastasis (TNM) stage, lymph node metastasis (LNM), and other clinicopathological features were analyzed, respectively. Serum PSA expression and PSA gene in tumor tissue were significantly higher compared to that in adjacent tissues (pPSA gene and protein increased significantly with the clinical stage of TNM and decreased following the increase of grade (pPSA and miR-155 expressions were positively correlated with TNM stage, tumor volume, and LNM, and negatively correlated with grade (pPSA and miR-155 were closely related to the clinicopathological features of prostate cancer. Combined detection is helpful for the early diagnosis of prostate cancer.

Prostate health index (phi) and prostate cancer antigen 3 (PCA3) significantly improve diagnostic accuracy in patients undergoing prostate biopsy.

Science.gov (United States)

Perdonà, Sisto; Bruzzese, Dario; Ferro, Matteo; Autorino, Riccardo; Marino, Ada; Mazzarella, Claudia; Perruolo, Giuseppe; Longo, Michele; Spinelli, Rosa; Di Lorenzo, Giuseppe; Oliva, Andrea; De Sio, Marco; Damiano, Rocco; Altieri, Vincenzo; Terracciano, Daniela

2013-02-15

Prostate health index (phi) and prostate cancer antigen 3 (PCA3) have been recently proposed as novel biomarkers for prostate cancer (PCa). We assessed the diagnostic performance of these biomarkers, alone or in combination, in men undergoing first prostate biopsy for suspicion of PCa. One hundred sixty male subjects were enrolled in this prospective observational study. PSA molecular forms, phi index (Beckman coulter immunoassay), PCA3 score (Progensa PCA3 assay), and other established biomarkers (tPSA, fPSA, and %fPSA) were assessed before patients underwent a 18-core first prostate biopsy. The discriminating ability between PCa-negative and PCa-positive biopsies of Beckman coulter phi and PCA3 score and other used biomarkers were determined. One hundred sixty patients met inclusion criteria. %p2PSA (p2PSA/fPSA × 100), phi and PCA3 were significantly higher in patients with PCa compared to PCa-negative group (median values: 1.92 vs. 1.55, 49.97 vs. 36.84, and 50 vs. 32, respectively, P ≤ 0.001). ROC curve analysis showed that %p2PSA, phi, and PCA3 are good indicator of malignancy (AUCs = 0.68, 0.71, and 0.66, respectively). A multivariable logistic regression model consisting of both the phi index and PCA3 score allowed to reach an overall diagnostic accuracy of 0.77. Decision curve analysis revealed that this "combined" marker achieved the highest net benefit over the examined range of the threshold probability. phi and PCA3 showed no significant difference in the ability to predict PCa diagnosis in men undergoing first prostate biopsy. However, diagnostic performance is significantly improved by combining phi and PCA3. Copyright © 2012 Wiley Periodicals, Inc.

Development of PSA workstation KIRAP

Energy Technology Data Exchange (ETDEWEB)

Kim, Tae Un; Han, Sang Hoon; Kim, Kil You; Yang, Jun Eon; Jeong, Won Dae; Chang, Seung Cheol; Sung, Tae Yong; Kang, Dae Il; Park, Jin Hee; Lee, Yoon Hwan; Hwang, Mi Jeong

1997-01-01

Advanced Research Group of Korea Atomic Energy Research Institute has been developing the Probabilistic Safety Assessment(PSA) workstation KIRAP from 1992. This report describes the recent development activities of PSA workstation KIRAP. The first is to develop and improve the methodologies for PSA quantification, that are the incorporation of fault tree modularization technique, the improvement of cut set generation method, the development of rule-based recovery, the development of methodology to solve a fault tree which has the logical loops and to handle a fault tree which has several initiators. These methodologies are incorporated in the PSA quantification software KIRAP-CUT. The second is to convert PSA modeling softwares for Windows, which have been used on the DOS environment since 1987. The developed softwares are the fault tree editor KWTREE, the event tree editor CONPAS, and Data manager KWDBMAN for event data and common cause failure (CCF) data. With the development of PSA workstation, it makes PSA modeling and PSA quantification and automation easier and faster. (author). 8 refs.

Development of PSA workstation KIRAP

International Nuclear Information System (INIS)

Kim, Tae Un; Han, Sang Hoon; Kim, Kil You; Yang, Jun Eon; Jeong, Won Dae; Chang, Seung Cheol; Sung, Tae Yong; Kang, Dae Il; Park, Jin Hee; Lee, Yoon Hwan; Hwang, Mi Jeong.

1997-01-01

Advanced Research Group of Korea Atomic Energy Research Institute has been developing the Probabilistic Safety Assessment(PSA) workstation KIRAP from 1992. This report describes the recent development activities of PSA workstation KIRAP. The first is to develop and improve the methodologies for PSA quantification, that are the incorporation of fault tree modularization technique, the improvement of cut set generation method, the development of rule-based recovery, the development of methodology to solve a fault tree which has the logical loops and to handle a fault tree which has several initiators. These methodologies are incorporated in the PSA quantification software KIRAP-CUT. The second is to convert PSA modeling softwares for Windows, which have been used on the DOS environment since 1987. The developed softwares are the fault tree editor KWTREE, the event tree editor CONPAS, and Data manager KWDBMAN for event data and common cause failure (CCF) data. With the development of PSA workstation, it makes PSA modeling and PSA quantification and automation easier and faster. (author). 8 refs

PSA levels as a predictor of 68Ga PSMA PET/CT positivity in patients with prostate cancer?

Science.gov (United States)

Soydal, Cigdem; Urun, Yuksel; Suer, Evren; Nak, Demet; Ozkan, Elgin; Kucuk, Ozlem N

2018-05-10

The aim of this study is to evaluate predictive factors of 68Gallium (68Ga) Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography (PET)/Computed Tomography (CT) positivity. Relationships between serum Prostate Specific Antigen (PSA), Lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) levels, Gleason Score (GS) and positivity of 68Ga PSMA PET in patients who underwent 68Ga PSMA PET/CT for restaging for PCa were evaluated retrospectively. One hundred and four (median age: 67; range: 51-88) patients were included in this study. Of these patients, PSMA PET was positive in 75 (72%) patients. Mean serum PSA levels for PET negative and positive groups were 0.76±1.00 and 180.85±324.93 ng/ml (pPSA cut-off and 92% and 90%, respectively, for the 2 ng/ml PSA cut-off values. The positivity rates for patients with PSA levels PSA recurrence. Patients with higher GS and early PSA recurrence could benefit from 68Ga PSMA PET/CT.

Proteolytic Activity of Prostate-Specific Antigen (PSA) towards Protein Substrates and Effect of Peptides Stimulating PSA Activity

Science.gov (United States)

Mattsson, Johanna M.; Ravela, Suvi; Hekim, Can; Jonsson, Magnus; Malm, Johan; Närvänen, Ale; Stenman, Ulf-Håkan; Koistinen, Hannu

2014-01-01

Prostate-specific antigen (PSA or kallikrein-related peptidase-3, KLK3) exerts chymotrypsin-like proteolytic activity. The main biological function of PSA is the liquefaction of the clot formed after ejaculation by cleavage of semenogelins I and II in seminal fluid. PSA also cleaves several other substrates, which may explain its putative functions in prostate cancer and its antiangiogenic activity. We compared the proteolytic efficiency of PSA towards several protein and peptide substrates and studied the effect of peptides stimulating the activity of PSA with these substrates. An endothelial cell tube formation model was used to analyze the effect of PSA-degraded protein fragments on angiogenesis. We showed that PSA degrades semenogelins I and II much more efficiently than other previously identified protein substrates, e.g., fibronectin, galectin-3 and IGFBP-3. We identified nidogen-1 as a new substrate for PSA. Peptides B2 and C4 that stimulate the activity of PSA towards small peptide substrates also enhanced the proteolytic activity of PSA towards protein substrates. Nidogen-1, galectin-3 or their fragments produced by PSA did not have any effect on endothelial cell tube formation. Although PSA cleaves several other protein substrates, in addition to semenogelins, the physiological importance of this activity remains speculative. The PSA levels in prostate are very high, but several other highly active proteases, such as hK2 and trypsin, are also expressed in the prostate and may cleave protein substrates that are weakly cleaved by PSA. PMID:25237904

Experiences of Uncertainty in Men With an Elevated PSA.

Science.gov (United States)

Biddle, Caitlin; Brasel, Alicia; Underwood, Willie; Orom, Heather

2015-05-15

A significant proportion of men, ages 50 to 70 years, have, and continue to receive prostate specific antigen (PSA) tests to screen for prostate cancer (PCa). Approximately 70% of men with an elevated PSA level will not subsequently be diagnosed with PCa. Semistructured interviews were conducted with 13 men with an elevated PSA level who had not been diagnosed with PCa. Uncertainty was prominent in men's reactions to the PSA results, stemming from unanswered questions about the PSA test, PCa risk, and confusion about their management plan. Uncertainty was exacerbated or reduced depending on whether health care providers communicated in lay and empathetic ways, and provided opportunities for question asking. To manage uncertainty, men engaged in information and health care seeking, self-monitoring, and defensive cognition. Results inform strategies for meeting informational needs of men with an elevated PSA and confirm the primary importance of physician communication behavior for open information exchange and uncertainty reduction. © The Author(s) 2015.

Repeat prostate-specific antigen (PSA) test before prostate biopsy: a 20% decrease in PSA values is associated with a reduced risk of cancer and particularly of high-grade cancer.

Science.gov (United States)

De Nunzio, Cosimo; Lombardo, Riccardo; Nacchia, Antonio; Tema, Giorgia; Tubaro, Andrea

2018-07-01

To analyse the impact of repeating a prostate-specific antigen (PSA) level assessment on prostate biopsy decision in a cohort of men undergoing prostate biopsy. From 2015 onwards, we consecutively enrolled, at a single institution in Italy, men undergoing 12-core transrectal ultrasonography-guided prostate needle biopsy. Indication for prostate biopsy was a PSA level of ≥4 ng/mL. Demographic, clinical, and histopathological data were collected. The PSA level was tested at enrolment (PSA 1 ) and 4 weeks later on the day before biopsy (PSA 2 ). Variations in PSA level were defined as: stable PSA 2 within a 10% variation, stable PSA 2 within a 20% variation, PSA 2 decreased by ≥10%, PSA 2 decreased by ≥20%, PSA 2 increased by ≥10%, PSA 2 increased by ≥20%, and PSA 2 PSA within 20% variation had a higher risk of prostate cancer (odds ratio [OR] 1.80, P PSA2 decreased by ≥20% had a lower risk of prostate cancer (OR 0.37, P PSA2 increased by ≥10% had an increased risk of high-grade prostate cancer (OR 1.93, P PSA returned to normal values (PSA levels significantly reduced the risk of high-grade prostate cancer. Further multicentre studies should validate our present results. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

Proteolytic activity of prostate-specific antigen (PSA towards protein substrates and effect of peptides stimulating PSA activity.

Directory of Open Access Journals (Sweden)

Johanna M Mattsson

Full Text Available Prostate-specific antigen (PSA or kallikrein-related peptidase-3, KLK3 exerts chymotrypsin-like proteolytic activity. The main biological function of PSA is the liquefaction of the clot formed after ejaculation by cleavage of semenogelins I and II in seminal fluid. PSA also cleaves several other substrates, which may explain its putative functions in prostate cancer and its antiangiogenic activity. We compared the proteolytic efficiency of PSA towards several protein and peptide substrates and studied the effect of peptides stimulating the activity of PSA with these substrates. An endothelial cell tube formation model was used to analyze the effect of PSA-degraded protein fragments on angiogenesis. We showed that PSA degrades semenogelins I and II much more efficiently than other previously identified protein substrates, e.g., fibronectin, galectin-3 and IGFBP-3. We identified nidogen-1 as a new substrate for PSA. Peptides B2 and C4 that stimulate the activity of PSA towards small peptide substrates also enhanced the proteolytic activity of PSA towards protein substrates. Nidogen-1, galectin-3 or their fragments produced by PSA did not have any effect on endothelial cell tube formation. Although PSA cleaves several other protein substrates, in addition to semenogelins, the physiological importance of this activity remains speculative. The PSA levels in prostate are very high, but several other highly active proteases, such as hK2 and trypsin, are also expressed in the prostate and may cleave protein substrates that are weakly cleaved by PSA.

Use of PSA in the development of SMRs

International Nuclear Information System (INIS)

Maioli, A.; Finnicum, D.J.; Lichtenstein, R.H.; Harsche, S.Y.

2012-01-01

This paper reviews the potential new scenarios where PSA (probabilistic safety assessment) may be of significant support to design and operation of SMRs (Small Modular Reactors); it reviews Westinghouse's experience and lessons learned in this endeavour and will discuss related challenges and what the PSA community is currently developing to address them. (authors)

PSA kinetics following primary focal cryotherapy (hemiablation) in organ-confined prostate cancer patients.

Science.gov (United States)

Kongnyuy, Michael; Islam, Shahidul; Mbah, Alfred K; Halpern, Daniel M; Werneburg, Glenn T; Kosinski, Kaitlin E; Chen, Connie; Habibian, David J; Schiff, Jeffrey T; Corcoran, Anthony T; Katz, Aaron E

2018-02-01

We aim to evaluate prostate-specific antigen (PSA) trends in post-primary focal cryotherapy (PFC) patients. This was an institutional review board-approved retrospective study of PFC patients from 2010 to 2015. Patients with at least one post-PFC PSA were included in the study. Biochemical recurrence (BCR) was determined using the Phoenix criteria. PSA bounce was also assessed. We analyzed rates of change of PSA over time of post-PFC between BCR and no BCR groups. PSA-derived variables were analyzed as potential predictors of BCR. A total of 104 PFC patients were included in our analysis. Median (range) age and follow-up time were 66 (48-82) years and 19 (6.3-38.6) months, respectively. Four (3.8%) patients experienced PSA bounce. The median percent drop in first post-PFC PSA of 80.0% was not associated with BCR (p = 0.256) and may indicate elimination of the index lesion. The rate of increase of PSA in BCR patients was significantly higher compared to patients who did not recur (median PSA velocity (PSAV): 0.15 vs 0.04 ng/ml/month, p = 0.001). Similar to PSAV (HR 9.570, 95% CI 3.725-24.592, p PSA nadir ≥ 2 ng/ml [HR (hazard ratio) 1.251, 95% CI 1.100-1.422, p = 0.001] was independently associated with BCR. A significant drop in post-PFC PSA may indicate elimination of the index lesion. Patients who are likely to recur biochemically have a significantly higher PSAV compared to those who do not recur. Nadir PSA of less than 2 ng/ml may be considered the new normal PSA in focal cryotherapy (hemiablation) follow-up.

Prostate-Specific Antigen (PSA) Test

Science.gov (United States)

... Cancer Prostate Cancer Screening Research Prostate-Specific Antigen (PSA) Test On This Page What is the PSA ... parts of the body before being detected. The PSA test may give false-positive or false-negative ...

PSA Level 2:Scope And Method Of PSA Level 2 For Nuclear Power Plant

International Nuclear Information System (INIS)

Widodo, Surip; Antariksawan, Anhar R.

2001-01-01

A study of scope and method of PSA Level 2 had been conducted. The background of the study is the need to gain the capability to well perform PSA Level 2 for nuclear facilities. This study is a literature survey. The scope of PSA Level 2 consists of generating plant damage states, accident progression analysis, and grouping source terms. Concerning accident progression analysis, several methods are used, among others event tree method, named accident progression event tree (APET) or containment event tree (CET), and fault tree method. The end result of PSA Level 2 is release end states which is grouped into release bins. The results will be used for PSA Level 3

Impact of radiation dose on achieving nadir PSA levels after 3-dimensional conformal radiotherapy for patients with localized prostate cancer

International Nuclear Information System (INIS)

Zelefsky, Michael J.; Leibel, Steven A.; Kelson, Suzanne; Fuks, Zvi

1996-01-01

independent predictor for a nadir PSA level of ≤1.0 (p<0.001) followed by pre-treatment PSA levels ≤10 ng/ml (p<0.001) and stage (p=0.01), while the Gleason score had no significant impact. Conclusion: Nadir PSA levels of ≤ 1.0 ng/ml after radiotherapy for localized prostate cancer is the strongest predictor of PSA relapse-free survival. Higher radiation doses are associated with an increased likelihood of achieving post-treatment nadir PSA levels of ≤1.0 ng/ml. Further follow-up is needed to determine whether higher doses will also translate into improved long-term outcome for these patients

Qualification of calculation aids for PSA

International Nuclear Information System (INIS)

Goetz, K.; Hennigs, W.; Kirstein, B.M.; Reinhardt, C.

1998-01-01

In Germany Probabilistic Safety Analysis (PSA) are part of the evaluation of a nuclear power plants safety. The German PSA guide stipulates that the used software must enable a PSA according to the state of the art. This software must be qualified to assure that its features, mathematic methods and its performance enable a PSA like this. In this research work specifications and requirements are developed, which allow the testing of software. A procedure was developed to qualify PSA software according to the PSA guide and the experiences of users of PSA. Setting up a procedure, a tool for a systematic and uniform examination was crated. Additionally the options, mathematic fundamentals and performance of PSA-programs were analyzed. According to this all programs that were analyzed are capable to sovle their original task, that is the calculation of the safety of high available system based on high available components. Against that the requirements of modern PSA, e.g. to handle less available functions, HRA and fire analyses, based on the use of modern software and the implementation of new developments in the field of PSA are not supported adequately by all programs. (orig.) [de

Time from first detectable PSA following radical prostatectomy to biochemical recurrence: A competing risk analysis

Science.gov (United States)

de Boo, Leonora; Pintilie, Melania; Yip, Paul; Baniel, Jack; Fleshner, Neil; Margel, David

2015-01-01

Introduction: In this study, we estimated the time from first detectable prostate-specific antigen (PSA) following radical prostatectomy (RP) to commonly used definitions of biochemical recurrence (BCR). We also identified the predictors of time to BCR. Methods: We identified subjects who underwent a RP and had an undetectable PSA after surgery followed by at least 1 detectable PSA between 2000 and 2011. The primary outcome was time to BCR (PSA ≥0.2 and successive PSA ≥0.2) and prediction of the rate of PSA rise. Outcomes were calculated using a competing risk analysis, with univariable and multivariable Fine and Grey models. We employed a mixed effect model to test clinical predictors that are associated with the rate of PSA rise. Results: The cohort included 376 patients. The median follow-up from surgery was 60.5 months (interquartile range [IQR] 40.8–91.5) and from detectable PSA was 18 months (IQR 11–32). Only 45.74% (n = 172) had PSA values ≥0.2 ng/mL, while 15.16% (n = 57) reached the PSA level of ≥0.4 ng/mL and rising. On multivariable analysis, the values of the first detectable PSA and pathologic Gleason grade 8 or higher were consistently independent predictors of time to BCR. In the mixed effect model rate, the PSA rise was associated with time from surgery to first detectable PSA, Gleason score, and prostate volume. The main limitation of this study is the large proportion of patients that received treatment without reaching BCR. It is plausible that shorter estimated median times would occur at a centre that does not use salvage therapy at such an early state. Conclusion: The time from first detectable PSA to BCR may be lengthy. Our analyses of the predictors of the rate of PSA rise can help determine a personalized approach for patients with a detectable PSA after surgery. PMID:25624961

Generation of monoclonal antibodies against prostate specific antigen (PSA) for the detection of PSA and its purification

International Nuclear Information System (INIS)

Acevedo Castro, Boris Ernesto

2012-01-01

The prostate cancer in Cuba is a problem of health (2672 diagnosed cases and 2769 deaths in 2007). Various diagnostic methods have been implemented for the detection and management of this disease, emphasizing among them (PSA) prostate-specific antigen serological determination. At this work was generated and characterized a panel of 11 antibodies (AcMs) monoclonal IgG1 detected with high affinity described major epitopes of the PSA, both in solution and attached to the test plate. From the panel obtained AcMs was the standardization of an essay type ELISA for the detection of serum total PSA (associated and free) equimolar, based on antibody monoclonal CB-PSA.4 in the coating and the CB-PSA.9 coupled with biotin as liner, with a detection limit of 0.15 ng/mL. Similarly, standardized system for detection in serum free PSA, based on the AcMs CB-PSA.4 (coating) and CB-PSA.2 coupled with biotin (liner), with a detection limit of 0.5 ng/mL. Finally, with the purpose of using PSA as standard in trials type ELISA, developed a simple method of inmunopurificación based on the AcM, CB-PSA.2, which was obtained the PSA with a purity exceeding 90%. Immunoassay Centre on the basis of the AcMs panel and the results of this study, developed and recorded two diagnostic systems for the detection of PSA in human serum. (author)

Model engineering in a modular PSA

International Nuclear Information System (INIS)

Friedlhuber, Thomas

2014-01-01

For the purpose of PSA (Probabilistic Safety Analysis) for complex industrial systems, often PSA models in the form of fault and event trees are developed to model the risk of unwanted situations (hazards). While the recent decades, PSA models have gained high acceptance and have been developed massively. This lead to an increase in model sizes and complexity. Today, PSA models are often difficult to understand and maintain. This manuscript presents the concept of a modular PSA. A modular PSA tries to cope with the increased complexity by the techniques of modularization and instantiation. Modularization targets to treat a model by smaller pieces (the 'modules') to regain control over models. Instantiation aims to configure a generic model to different contexts. Both try to reduce model complexity. A modular PSA proposes new functionality to manage PSA models. Current model management is rather limited and not efficient. This manuscript shows new methods to manage the evolutions (versions) and deviations (variants) of PSA models in a modular PSA. The concepts of version and variant management are presented in this thesis. In this context, a model comparison and fusion of PSA models is precised. Model comparison provides important feedback to model engineers and model fusion kind of combines the work from different model engineers (concurrent model engineering). Apart from model management, methods to understand the content of PSA models are presented. The methods focus to highlight the dependencies between modules rather than their contents. Dependencies are automatically derived from a model structure. They express relations between model objects (for example a fault tree may have dependencies to basic events). To visualize those dependencies (for example in form of a model cartography) can constitute a crucial aid to model engineers for understanding complex interrelations in PSA models. Within the scope of this thesis, a software named 'Andromeda' has been

Development of a PSA information management system

International Nuclear Information System (INIS)

Ho, Seok; Dong Kyu, Kim; Sun Koo, Kang

2007-01-01

In general, Probabilistic Safety Agreement (PSA) is a very complicated work that uses and generates a lot of resources such as reports, procedures, drawings, assumptions, calculation sheets, PSA model, and so on. In many PSAs, however, the data, materials and knowledge considered and generated during performing PSA are scattered in many documents so that overall structure of PSA and information relationship between documents and models cannot easily be understood. To organize and manage all documents related to PSA, to capture knowledge of analysts, and finally to improve the quality of PSA, a PSA information management system (PIMS) was developed. The PIMS can manage all the documents of a PSA in a database and connect the causal relation between one information to another in the scattered documents via link. The PIMS can manage all the assumptions and technical basis used in PSA, and it can keep the record of the design changes the revision of PSA model. It can also control the review results of PSA models. The link of the PIMS can explicitly describe and reveal the expertise of the PSA analysts, and it enables the users to capture the knowledge and to understand the structure and contents of a PSA with ease. We are planning to apply the PIMS to the PSA of Shin Kori Units 1 and 2 as feasibility study and then to all the PSAs of the nuclear power plants in Korea. The PIMS is expected to contribute to enhancing the quality and confidence of PSA and reducing the efforts and costs of maintenance and update of PSA. (authors)

Development of a PSA information management system

Energy Technology Data Exchange (ETDEWEB)

Ho, Seok; Dong Kyu, Kim; Sun Koo, Kang [Korea Power Engineering Company, Inc (Korea, Republic of)

2007-07-01

In general, Probabilistic Safety Agreement (PSA) is a very complicated work that uses and generates a lot of resources such as reports, procedures, drawings, assumptions, calculation sheets, PSA model, and so on. In many PSAs, however, the data, materials and knowledge considered and generated during performing PSA are scattered in many documents so that overall structure of PSA and information relationship between documents and models cannot easily be understood. To organize and manage all documents related to PSA, to capture knowledge of analysts, and finally to improve the quality of PSA, a PSA information management system (PIMS) was developed. The PIMS can manage all the documents of a PSA in a database and connect the causal relation between one information to another in the scattered documents via link. The PIMS can manage all the assumptions and technical basis used in PSA, and it can keep the record of the design changes the revision of PSA model. It can also control the review results of PSA models. The link of the PIMS can explicitly describe and reveal the expertise of the PSA analysts, and it enables the users to capture the knowledge and to understand the structure and contents of a PSA with ease. We are planning to apply the PIMS to the PSA of Shin Kori Units 1 and 2 as feasibility study and then to all the PSAs of the nuclear power plants in Korea. The PIMS is expected to contribute to enhancing the quality and confidence of PSA and reducing the efforts and costs of maintenance and update of PSA. (authors)

Proceedings of the 10th Korea-Japan joint workshop on PSA. For Asian PSA network

International Nuclear Information System (INIS)

Yang, Joon-Eon; Homma, Toshimitsu

2009-12-01

The tenth Korea-Japan Joint Workshop on Probabilistic Safety Assessment (PSA) was held in the Jeju island of Korea, on May 18-20, 2009 organized by Korea Atomic Energy Research Institute (KAERI). The purpose of the workshop was to provide a forum for presentation and discussions on experiences and technical achievements related to PSA, risk-informed and performance-based approach, and other relevant issues in both countries. Since the first Korea-Japan Joint Workshop on PSA started in 1992, the workshops have provided an important and timely opportunity for exchange and discussion of the relevant information to all PSA practitioners and users of risk information in the industry, research, academia and regulatory arena. This was the tenth anniversary of the Joint Workshop with the main theme of 'For Asian PSA Network' and participants included those from China, Taiwan and the United States of America besides Korea and Japan. Two keynote speeches were presented by the former chairmen of this workshop, Prof. Chang-Sun Kang of Seoul National University and Prof. emeritus Shunsuke Kondo of Tokyo University. We had two special lectures, 70 papers presented by experts at 10 technical sessions related PSA, the special session on the status of PSA in Korea, Japan, China and Taiwan and panel discussion on their cooperation in PSA. This report provides the summary of each session, and all the presentation materials presented in the 10th Korea-Japan Joint Workshop on PSA. (author)

Long-term longitudinal changes in baseline PSA distribution and estimated prevalence of prostate cancer in male Japanese participants of population-based PSA screening.

Science.gov (United States)

Oki, Ryo; Ito, Kazuto; Suzuki, Rie; Fujizuka, Yuji; Arai, Seiji; Miyazawa, Yoshiyuki; Sekine, Yoshitaka; Koike, Hidekazu; Matsui, Hiroshi; Shibata, Yasuhiro; Suzuki, Kazuhiro

2018-04-26

Japan has experienced a drastic increase in the incidence of prostate cancer (PC). To assess changes in the risk for PC, we investigated baseline prostate specific antigen (PSA) levels in first-time screened men, across a 25-year period. In total, 72,654 men, aged 50-79, underwent first-time PSA screening in Gunma prefecture between 1992 and 2016. Changes in the distribution of PSA levels were investigated, including the percentage of men with a PSA above cut-off values and linear regression analyses comparing log 10 PSA with age. The 'ultimate incidence' of PC and clinically significant PC (CSPC) were estimated using the PC risk calculator. Changes in the age-standardized incidence rate (AIR) during this period were analyzed. The calculated coefficients of linear regression for age versus log 10 PSA fluctuated during the 25-year period, but no trend was observed. In addition, the percentage of men with a PSA above cut-off values varied in each 5-year period, with no specific trend. The 'risk calculator (RC)-based AIR' of PC and CSPC were stable between 1992 and 2016. Therefore, the baseline risk for developing PC has remained unchanged in the past 25 years, in Japan. The drastic increase in the incidence of PC, beginning around 2000, may be primarily due to increased PSA screening in the country. © 2018 UICC.

Treatment strategy for metastatic prostate cancer with extremely high PSA level: reconsidering the value of vintage therapy.

Science.gov (United States)

Yamada, Yasutaka; Sakamoto, Shinichi; Amiya, Yoshiyasu; Sasaki, Makoto; Shima, Takayuki; Komiya, Akira; Suzuki, Noriyuki; Akakura, Koichiro; Ichikawa, Tomohiko; Nakatsu, Hiroomi

2018-05-04

The prognostic significance of initial prostate-specific antigen (PSA) level for metastatic prostate cancer remains uncertain. We investigated the differences in prognosis and response to hormonal therapies of metastatic prostate cancer patients according to initial PSA levels. We analyzed 184 patients diagnosed with metastatic prostate cancer and divided them into three PSA level groups as follows: low (PSA progression-free survival (PFS) for first-line ADT and overall survival (OS) within each of the three groups. Furthermore, we analyzed response to antiandrogen withdrawal (AW) and alternative antiandrogen (AA) therapies after development of castration-resistant prostate cancer (CRPC). No significant differences in OS were observed among the three groups (P = 0.654). Patients with high PSA levels had significantly short PFS for first-line ADT (P = 0.037). Conversely, patients in the high PSA level group had significantly longer PFS when treated with AW than those in the low PSA level group (P = 0.047). Furthermore, patients with high PSA levels had significantly longer PFS when provided with AA therapy (P = 0.049). PSA responders to AW and AA therapies had significantly longer survival after CRPC development than nonresponders (P = 0.011 and P PSA level predicted favorable response to vintage sequential ADT and AW. The current data suggest a novel aspect of extremely high PSA value as a favorable prognostic marker after development of CRPC.

Assessment of Atorvastatin Effectiveness on Serum PSA Level in Hypercholesterolemic Males

Directory of Open Access Journals (Sweden)

Darya Khosropanah

2011-12-01

Full Text Available The previous large retrospective studies demonstrated that treatment with Statins reduces both the incidence of prostate cancer by 50% and serum Prostate Specific Antigen (PSA level up to 40%. However the main problem in those studies was the absence of control groups of men with hypercholesterolemia without Statin treatment. We performed a small prospective controlled clinical trial to assess the influence of the treatment with Atorvastatin on serum PSA in men with hypercholesterolemia referred to our educational and treatment center from October 2007 to March 2008. In this study, among the newly diagnosed males with hypercholesterolemia (LDL > 130 mg/dl, 40 patients with LDL more than 190 mg/dl were selected as a case group and were treated with Atorvastatin (20 mg/day. Among the same population and in the same period, another 40 patients with LDL between 130 and 190 mg/dl were selected as first control group and were treated only with low fat diet. Another 40 patients with normal serum cholesterol and without any treatment were selected as second control group. The lipid profile and serum PSA level of patients of all groups were tested at the first and third months after the therapy. After completion of data, the mean serum lipids and PSA level were measured in both visits and compared with each other by paired t-test. Also the mean PSA change in two visits between three groups was compared by ANOVA and Tukey HSD test. There was not any significant difference in mean baseline PSA between hypercholesterolemic and normocholesterolemic patients (P=0.547. In case group, mean PSA and LDL was reduced by 14.1% (P=0.0001 and 30% (P=0.0001 respectively by second visit. In first control group, mean PSA was not changed significantly (P=0.337, whereas mean LDL in this group was reduced by 9.6% (P= 0.0001. Similarly in the second control group mean PSA was not changed significantly (P=0.309 by second visit. In addition, mean change of PSA in case group

Development of a PSA information database system

International Nuclear Information System (INIS)

Kim, Seung Hwan

2005-01-01

The need to develop the PSA information database for performing a PSA has been growing rapidly. For example, performing a PSA requires a lot of data to analyze, to evaluate the risk, to trace the process of results and to verify the results. PSA information database is a system that stores all PSA related information into the database and file system with cross links to jump to the physical documents whenever they are needed. Korea Atomic Energy Research Institute is developing a PSA information database system, AIMS (Advanced Information Management System for PSA). The objective is to integrate and computerize all the distributed information of a PSA into a system and to enhance the accessibility to PSA information for all PSA related activities. This paper describes how we implemented such a database centered application in the view of two areas, database design and data (document) service

African-American (AA) men with local-regional prostate cancer (PC) present with higher prostate specific antigen (PSA) levels than whites: results of RTOG 94-12

International Nuclear Information System (INIS)

Vijayakumar, S.; Winter, K.; Sause, W.; Gallagher, M.J.; Perez, C.; Bondy, M.

1996-01-01

Purpose/Objective: To use pretreatment serum PSA levels as an 20), gleason score (2-5,6-7,7-10), race (whites and AAs), and two interactions viz (a) PSA by race (p=0.0012) and (b) PSA by total gleason score (p=0.0001). When race was replaced by educational status, or income, or both, the fits (0.8246,0.8197, and 0.7815, respectively) were not as good as the fit with race in the model. Conclusion: The findings of this nation-wide prospective registration study with a high percentage of AA patient participation confirms previous, smaller, geographically-limited studies (1,2,3) results that AA patients with non-metastatic PC present with a higher mean PSA values than whites. The multivariate findings imply that, for each level of total gleason score, there is a higher percentage of whites with PSA levels 20. Education and/or income as surrogates of sociological status could not completely explain the racial differences. Other reasons for health-care barriers among AAs need to be identified

Percentage of free prostate-specific antigen (PSA) is a useful method in deciding to perform prostate biopsy with higher core numbers in patients with low PSA cut-off values.

Science.gov (United States)

Yilmaz, Hasan; Ciftci, Seyfettin; Yavuz, Ufuk; Ustuner, Murat; Saribacak, Ali; Dillioglugil, Ozdal

2015-06-01

The aim of this study was to evaluate the predictive role of percentage of free prostate-specific antigen (%fPSA) cut-points in prostate cancer (PCa) detection in patients with total PSA (tPSA) levels between 2.5 ng/mL and 10.0 ng/mL. In total, 1321 consecutive initial transrectal ultrasound (TRUS)-guided 12-core biopsies performed between 2005 and 2011 were evaluated retrospectively. Benign pathologies, high-grade prostatic intraepithelial neoplasia, and atypical small acinary proliferations were categorized as noncancerous (benign), and prostate adenocarcinomas were categorized as cancerous (malignant). The patients were categorized according to: Catalona's published %fPSA categories ( 25%); digital rectal examination (DRE) results [benign (negative) or suspicious of malignancy (positive)]. There was a significant relationship between the %fPSA cut-points and detection of PCa in DRE-negative patients. The presence of a 10% cut-point increased the probability of PCa threefold. The %fPSA was significantly more related to PCa than the tPSA value in receiver operating characteristic (ROC) curve analyses (p = 0.001). Based on our findings, a lower %fPSA, especially <10%, is an important parameter when deciding whether to perform a biopsy on patients with a tPSA between 2.5 ng/mL and 10 ng/mL. Copyright © 2015. Published by Elsevier Taiwan.

The treatment of nonpalpable PSA-detected adenocarcinoma of the prostate with 3-dimensional conformal radiation therapy

International Nuclear Information System (INIS)

Horwitz, Eric M.; Hanlon, Alexandra L.; Pinover, Wayne H.; Hanks, Gerald E.

1998-01-01

Purpose: We reviewed our institution's experience treating patients with nonpalpable PSA-detected prostate cancer with three-dimensional conformal radiation therapy (3DCRT) to determine prognostic factors that predict for biochemical-free survival (bNED) control and present the bNED control rates. Methods and Materials: Between May 1, 1990 and November 30, 1994, 160 patients with nonpalpable PSA-detected prostate cancer received 3DCRT at Fox Chase Cancer Center (median total dose 73 Gy; range: 67-78 Gy). bNED failure was defined as three consecutive increases in posttreatment PSA after achieving a nadir. bNED failure was recorded as the time midway between the nadir and the first consecutive rising PSA. Five-year actuarial rates of bNED control were calculated for pretreatment PSA (0-9.9 vs. 10-19.9 vs. ≥ 20 ng/ml), Gleason score (2-6 vs. 7-10), treatment field size (prostate vs. small pelvis), age ( 73 Gy) using Kaplan-Meier methods and compared using the Log rank test. The Cox model was used to multivariately establish independent predictors based on significant univariate factors. Median follow-up was 39 months (range: 2-84 months). Results: The 5-year actuarial rate of bNED control was 86% for the entire group of patients. The Cox Proportional Hazards model demonstrated that pretreatment PSA was an independent predictor of bNED control. Treatment field size was marginally predictive. There was no difference in bNED control when patients were stratified by the number of lobes positive for disease. Statistically different rates of bNED control were seen when the patients with nonpalpable disease were univariately compared to T2b and T2c patients. Three patients experienced Grade 3-4 genitourinary (GU) toxicity and 3 patients experienced Grade 3-4 gastrointestinal (GI) toxicity. Conclusions: Patients with nonpalpable PSA-detected prostate cancer can be effectively treated with 3DCRT with minimal morbidity and high rates of bNED control at 5 years. Pretreatment

PSA applications. Good practices and documentation

International Nuclear Information System (INIS)

Dewailly, J.; Magne, L.

1997-10-01

In this paper, it is shown what the condensed documentation of the main strategic choices and technical assumptions related to a PSA could contain: how to select the internal and external initiating events, how the detail the plant configuration and the general organization of the plant and operating staff, how to highlight the assumptions related to physical models, etc. The proposals in this documentation are based on the R and D D's experience with PSA (construction of PSA models, use of PSA models for operation or maintenance, PSA tools). This document also presents different types of rules or recommendations related to PSA modelling for various applications involved in nuclear power plant operating. Finally, the paper stresses the main difficulties encountered (appropriate use of uncertainties, communication of PSA results to non-specialist users) and it also outlines some prospects for the future. (author)

[PSA interest and prostatitis: literature review].

Science.gov (United States)

Bruyère, F; Amine Lakmichi, M

2013-12-01

Prostatitis is easily diagnosed but sometimes associated with PSA measurement. An increased PSA in an asymptomatic patient may be associated with antibiotic use to eliminate the inflammatory part and to confirm prostate biopsy. It seems interesting to confirm or infirm these attitudes with a systematic review of the literature We performed a literature review using the words [prostatitis], [acute prostatitis], [prostate specific antigen], [PSA], in the MEDLINE, Pubmed and AMBASE database searching for articles in French or English published in the past 20 years. PSA is not always increased during an acute prostatitis episode. An increased PSA in an asymptomatic man does not seem to be systematically correlated to prostate inflammation. Analyzing the studies, it seems inaccurate to measure PSA value during a febrile urinary infection episode in men. Systematic use of antibiotic to decrease PSA and not performing prostate biopsy is not relevant and may induce resistance to antibiotic and doesn't induce a reduction risk of having prostate biopsy. PSA is unnecessary in case of febrile urinary tract infection in men. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Applicability of living PSA in NPP modernization

International Nuclear Information System (INIS)

Himanen, R.

1999-01-01

Recently the utility Teollisuuden Voima Oy (TVO) has modernized the Olkiluoto 1 and 2 nuclear units and increased the net electric power by 18 per cent. Level 2 PSA was performed during the modernization project and the living level 1 PSA was used to support the design of the plant modifications. The plant specific living PSA model was a powerful tool when evaluating modernization alternatives. Successive support of safety management with the PSA model requires, that both the utility and the Regulatory Body understand capability and limitations of the model in details. TVO has prepared an internal procedure that presents in detail the practices and responsibilities concerning living PSA. The procedure is based on general guidelines and requirements on probabilistic safety analysis of nuclear power plants in Finland, released by the Regulatory Body. Living PSA requires that also the procedure for the use of living PSA is living. The recently published USNRC Regulatory Guides on PSA will be taken into account in the next version of the TVO PSA procedure. The PSA Peer Review Certification Process is one way to evaluate the quality of PSA in general, but also to detect the weaknesses of the PSA. However, the Certification Process cover only limited scope of PSA omitting e.g. all other external events except internal floods. This paper gives an overview on the scope of living PSA for Olkiluoto 1 and 2, and presents some examples on the real use of PSA concerning the modernization of the plant. Definition of quantitative dependability requirements for renovated systems is possible, but on the other hand, proving of these targets is in some cases extremely difficult, because of lacking dependability data. The problems are mainly concerned in systems with of programmable logic control. (au)

Performance indicators at Embalse NPP: PSA and safety system indicators based on PSA models

International Nuclear Information System (INIS)

Fornero, D.A.

2001-01-01

Several indicators have been implemented at Embalse NPP. The objective was selecting some representative parameters to evaluate the performance of both the plant and the personnel activities, important for safety. A first set of indicators was defined in accordance with plant technical staff criteria. A complementary set of them was addressed later based on WANO guidance. This report presents the set of indicators used at Embalse NPP, centering the description to related to safety systems performance indicators (SSPI). Some considerations are done about the calculation methods, the need for aligning and updating their values following Embalse Probabilistic Safety Assessment (PSA) development, and some pros and cons of using the PSA model for getting systems indicators. Owing to the fact that PSA ownership by utilities is also a subject of the meeting, some characteristics of the organization of the PSA Project are described at the beginning of the report. At Embalse NPP a Level 1 PSA has been developed under the responsibility of its own plant and with an important contribution from the IAEA. PSA was developed at the site, conducting this to a study strongly interactive with the station staff. (author)

Towards a PSA harmonization French-Belgian comparison of the level 1 PSA for two similar PWR types

International Nuclear Information System (INIS)

Dupuy, P.; Corenwinder, F.; Lanore, J.M.; Gryffroy, D.; Gelder, P. de; Hulsmans, M.

2002-06-01

In the framework of the cooperation between French and Belgian regulatory authorities, a PSA (Probabilistic Safety Assessment) comparison exercise has been carried out for several years. This comparison deals with two PSA level 1 studies for internal events, performed for both power and shutdown states: the French PSA of the 900 MWe-series PWR, and the Belgian PSA of the Tihange 1 PWR, which both concern PWRs with a similar Framatome design. The purpose of this paper is to describe the PSA comparison methodology and to present, in a qualitative way, an overview of the insights obtained up to now. It also shows that such an 'a posteriori' benchmark exercise turns out to be a step towards PSA harmonization, and gives more confidence in the results of plant specific PSA when used for applications like precursor analysis or evaluations of importance to safety. (authors)

Status and use of PSA in Sweden

International Nuclear Information System (INIS)

Knochenhauer, M.

1996-05-01

The performance and use of PSA:s in Sweden goes back about two decades. During all of this time, the field of PSA has been developing intensively, both internationally and within Sweden. The latest years have been characterised by an increased use of PSA models and results, and by major extensions of existing PSA models. The aim of this document is to describe PSA in Sweden with respect to development, scope and maturity, as well as to the contents of the analyses and the use of results. PSA activities will be described from the point of view of both the authorities and the utilities. The report gives an overview of the development within the area of PSA in Sweden both its history and current trends. The aim has been to include a reasonable amount of detail, both on the methods and results in PSA:s performed and on the numerous supporting research programs dealing with various aspects of PSA. 39 refs 39 refs

Status and use of PSA in Sweden

Energy Technology Data Exchange (ETDEWEB)

Knochenhauer, M

1996-05-01

The performance and use of PSA:s in Sweden goes back about two decades. During all of this time, the field of PSA has been developing intensively, both internationally and within Sweden. The latest years have been characterised by an increased use of PSA models and results, and by major extensions of existing PSA models. The aim of this document is to describe PSA in Sweden with respect to development, scope and maturity, as well as to the contents of the analyses and the use of results. PSA activities will be described from the point of view of both the authorities and the utilities. The report gives an overview of the development within the area of PSA in Sweden both its history and current trends. The aim has been to include a reasonable amount of detail, both on the methods and results in PSA:s performed and on the numerous supporting research programs dealing with various aspects of PSA. 39 refs 39 refs.

The inverse relationship between prostate-specific antigen (PSA) and obesity.

Science.gov (United States)

Aref, Adel; Vincent, Andrew D; O'Callaghan, Michael; Martin, Sean; Sutherland, Peter; Hoy, Andrew; Butler, Lisa M; Wittert, Gary

2018-06-25

Obese men have lower serum prostate-specific antigen (PSA) than comparably aged lean men, but the underlying mechanism remains unclear. The aim of this study was to determine the effect of obesity on PSA and the potential contributing mechanisms. A cohort of 1195 men aged 35 years and over at recruitment, with demographic, anthropometric (body mass index (BMI), waist circumference (WC)) and serum hormone (serum testosterone (T), estradiol (E2)), PSA and hematology assessments obtained over two waves was assessed. Men with a history of prostate cancer or missing PSA were excluded, leaving 970 men for the final analysis. Mixed-effects regressions and mediation analyses adjusting for hormonal and volumetric factors explore the potential mechanisms relating obesity to PSA. After adjusting for age, PSA levels were lower in men with greater WC (p=0.001). In a multivariable model including WC, age, E2/T and PlasV as predictors, no statistically significant associations were observed between with PSA and either WC (p=0.36) or PlasV (p=0.49), while strong associations were observed with both E2/T (pPSA (p=0.31), while when E2/T is a mediator; the ACME explained roughly 0.5 of the effect (pPSA levels in obese men, as compared to normal weight men, can be explained both by hormonal changes (elevated E2/T ratio) and haemodilution. Hormonal factors therefore represent a substantial but underappreciated mediating pathway.

Early detection of prostate cancer in Syria using T.PSA and F.PSA

International Nuclear Information System (INIS)

Adel, M.; Abu Daher, D.

2009-12-01

The aim of the current study is performing an initial prostate cancer screening test using PSA and F PSA tumour markers. A total of 3000 men in 40-75 years of age were participated in this study. Demographic and clinical data for subjects were collected by the programme staff. Total PSA and free PSA assays were determined using the ImunoTech total and free PSA assay kits, based on IRMA technique (kindly provided by the International Atomic Energy Agency). Criteria for participating in this study included : 1) men of age 50-75 (men of age as low as 40 were included in case of positive family history). 2) No previous history of prostate cancer. The following parameters were followed to refer the suspicious cases to a specialized hospital specific tests: 1)PSA>3 ng/ml . 2)High PSA value according to the participant age group. 3) Low F/TPSA ratio. In the hospital the following tests were performed:1) Complete clinical exam including DRE.2)TRUS in some cases.3) Biopsy for highly suspicious cases. 4)The low suspicious cases were retested in six months. Out of 338 cases referred to a specialized hospital, 264 cases were shown prostatic benign prostatic hyperplasia (BPH),while 36 cases proved to be prostatic cancer. However, the contact was lost in 36 cases because of changing the phone number or travelling outside the country . The detection rate of prostate cancer among all participating cases in this study was 1.2%, while this ratio was 10.7% among the referred cases. F/TPSA ratio has shown a good ability to discriminate between prostate cancer and benign prostatic hyperplasia. (author)

PSA results and trends for Spain's NPPs

International Nuclear Information System (INIS)

Carretero, J.A.

1993-01-01

The Spain regulatory authority CSN demanded performance of PSA for all Spain nuclear power plants. The specific data analysis carried out as a part of the PSA has contributed to the realistic view on the results which could be achieved by the PSA. The main characteristics of the PSA in Spain and PSA trends in the development are presented in the paper

Variability of assay methods for total and free PSA after WHO standardization.

Science.gov (United States)

Foj, L; Filella, X; Alcover, J; Augé, J M; Escudero, J M; Molina, R

2014-03-01

The variability of total PSA (tPSA) and free PSA (fPSA) results among commercial assays has been suggested to be decreased by calibration to World Health Organization (WHO) reference materials. To characterize the current situation, it is necessary to know its impact in the critical cutoffs used in clinical practice. In the present study, we tested 167 samples with tPSA concentrations of 0 to 20 μg/L using seven PSA and six fPSA commercial assays, including Access, ARCHITECT i2000, ADVIA Centaur XP, IMMULITE 2000, Elecsys, and Lumipulse G1200, in which we only measured tPSA. tPSA and fPSA were measured in Access using the Hybritech and WHO calibrators. Passing-Bablok analysis was performed for PSA, and percentage of fPSA with the Hybritech-calibrated access comparison assay. For tPSA, relative differences were more than 10 % at 0.2 μg/L for ARCHITECT i2000, and at a critical concentration of 3, 4, and 10 μg/L, the relative difference was exceeded by ADVIA Centaur XP and WHO-calibrated Access. For percent fPSA, at a critical concentration of 10 %, the 10 % relative difference limit was exceeded by IMMULITE 2000 assay. At a critical concentration of 20 and 25 %, ADVIA Centaur XP, ARCHITECT i2000, and IMMULITE 2000 assays exceeded the 10 % relative difference limit. We have shown significant discordances between assays included in this study despite advances in standardization conducted in the last years. Further harmonization efforts are required in order to obtain a complete clinical concordance.

Diagnostic value of serum free PSA and the ratio of free to total PSA in the diagnosis of prostate cancer

International Nuclear Information System (INIS)

Qiu Ningyan; Zhang Jingxin; Wu Jinchang; Gong Yiming; Li Huiping

2005-01-01

In order to evaluate the value of free prostate specific antigen (FPSA) and F/T PSA ratio in differential diagnosis of benign prostate hyperplasia (BPH) from prostate cancer (PC), serum FPSA and TPSA levels were measured in 85 patients with PC, 97 BPH and 89 healthy volunteers by chemiluminescence enzyme immunoassay (CLEIA), and the ratio of F/T PSA was calculated. The results showed that serum FPSA and TPSA levels were increased in healthy volunteers of 41-88 years old and were significantly higher in healthy volunteers of 61-88 years old than that in 20-40 gear old (P 10.0 μg/L were 65.0%, 30.9% and 4.1%, respectively, while they were 5.9%, 20.0% and 74.1% in PC patients (P<0.01). When the TPSA value was between 4.0-10.0 μg/L and the ratio of F/T PSA was at 0.10 and below, the probability of PC was larger(88.9%). But the ratio of F/T PSA was at 0.25 and above, the probability of PC was smaller(6.20%). Serum FPSA and TPSA both increased with age in healthy volunteers of 41-88 years old and were positively correlated with age. There were about 30.9% of BPH and 20.0% of PC patients with overlapping of TPSA level. Our conclusion is that the F/T PSA ratio can significantly enhance the specificity for PC diagnosis, especially when the TPSA is within the diagnostic gray zone. (authors)

Propensity Score Analysis: An Alternative Statistical Approach for HRD Researchers

Science.gov (United States)

Keiffer, Greggory L.; Lane, Forrest C.

2016-01-01

Purpose: This paper aims to introduce matching in propensity score analysis (PSA) as an alternative statistical approach for researchers looking to make causal inferences using intact groups. Design/methodology/approach: An illustrative example demonstrated the varying results of analysis of variance, analysis of covariance and PSA on a heuristic…

Immediate treatment with bicalutamide 150mg as adjuvant therapy significantly reduces the risk of PSA progression in early prostate cancer

DEFF Research Database (Denmark)

See, W; Iversen, P; Wirth, M

2003-01-01

To evaluate the effect of bicalutamide ('Casodex') 150mg (in addition to standard care), on the risk of prostate-specific antigen (PSA) progression, in patients with early prostate cancer.......To evaluate the effect of bicalutamide ('Casodex') 150mg (in addition to standard care), on the risk of prostate-specific antigen (PSA) progression, in patients with early prostate cancer....

UV/EB curable psa's

International Nuclear Information System (INIS)

Glotfelter, C.A.

1995-01-01

The author describe both water-based and 100% solids UV/EB curable PSA's (Pressure Sensitive Adhesives) and their properties. A new acrylate monomer, ethoxylated nonyl phenol acrylate, has great utility in the formulation of water-based PSA's

State of living PSA and further development

International Nuclear Information System (INIS)

1999-01-01

In October 1985 OECD-Principal Working Group (PWG 5) - Risk Assessment has initiated the Task Force 7 'Use of PSA in Nuclear Power Plant Management' to explore and report on the principles, characteristics, requirements and status of PSA oriented safety management. During this study, it became apparent that the utilisation of PSA techniques in nuclear plant safety management requires the development of supporting programmes to ensure that PSA models are being updated to reflect plant changes, and to direct their use towards the evaluation and determination of plant changes. These requirements also influence the software and hardware characteristics necessary to support the programme. This overall process is known as Living PSA. In this context OECD-PWG 5 has arranged international workshops on Living PSA application to support this development, to facilitate exchange of international experience and to summarise the state-of-the-art of L-PSA methodology. These activities were accompanied by following Task Groups of OECD-PWG 5 and the work results were published in state-of-the-art reports. According to the increasing development of Living PSA in the international field and its capacity to support plant safety management in a broad sense, OECD PWG 5 continues its work in setting up the Task Group 96-1 'State of Living PSA and Further Development' to clarify specific aspects of Living PSA. This report summarises the state of Living PSA in the international field based on the four Living PSA Workshops from 1988 to 1994 (Chapter 2) and the state of Reliability Data Collection based on the results of Task Group 12 'Reliability Data Collection and Analysis to Support PSA' and the two Data-Workshops from 1995 and 1998 (Chapter 3). The specific items of further development of Living PSA application as mentioned above are treated in Chapter 4. Chapter 5 gives a summary of the current state of Living PSA as well as outlook and recommendations of further development

THE DISCRIMINATIVE ABILITY OF PERCENT FREE PSA IN ...

African Journals Online (AJOL)

Blood samples were collected from all patients, and total PSA, free PSA and % free PSA were calculated in all specimens. Total PSA was measured using the Imx ... Un prélèvement de sang a été réalisé chez tous les patients avec un dosage du PSA total et de la fraction libre de PSA. Le PSA total a été mesuré par un kit ...

An analysis of pretreatment characteristics and the risk of PSA failure by race and ethnicity in prostate cancer patients treated with definitive radiotherapy

International Nuclear Information System (INIS)

Coleman, Cardella W.; Lewis, Pamalar P.; Kroll, Stewart M.; Roach, Mack

1997-01-01

Purpose/Objective: This study was performed to: (1) determine the pretreatment characteristics of racially and ethnically diverse men who were treated with definitive radiotherapy for prostate cancer and; (2) to assess whether race or ethnicity is an independent prognostic factor for biochemical failure using the serum PSA (prostate specific antigen) as a marker of disease free status. Materials and Methods: Between 1987 and 1995, 505 men, (including 487 with pretreatment PSA determined), were treated with radiotherapy for adenocarcinoma of the prostate in the Department of Radiation Oncology at the UCSF or its affiliated hospitals and form the basis of this analysis. These patients were referred from local VA, County, HMO and private facilities in the Northern California Bay Area and represent a diverse group by race, ethnicity and social economic status. PSA failure was defined as a PSA >1.0 ng/ml or rises of ≥ 0.5 ng/ml in 1 year. Results: The median PSA for all patients was 11.5 ng/ml and the mean was 20.8 ng/ml. The mean Gleason score was 5.95, and was similar among treatment groups. Twenty percent of the patients were T1, 56% were T2 and 24% were T3/4. The maximum dose at depth (Dmax) was 71.5 in 42% of the patients. Seventy two men (14%) received neoadjuvant +/- adjuvant hormonal therapy combined with radiotherapy. With a median follow-up exceeding 2 years, 47% of the patients are disease free at 4 years. Major pretreatment characteristics by race or ethnicity are summarized below: On univariate analysis, the relative risk of PSA failure in Blacks compared to Whites was 1.04 (95% confidence interval, 0.72- 1.52, p = 0.82) and in others compared to Whites was 1.12 (95% confidence interval, 0.55 - 2.28, p = 0.77). On multivariate analysis, neither race nor ethnicity were independently significant predictors of outcome. For example, the relative risk of PSA failure in Blacks was 0.88 (95% confidence interval, 0.59 - 1.32, p = 0.53). Factors that influenced

Insulin promotes cell migration by regulating PSA-NCAM

Energy Technology Data Exchange (ETDEWEB)

Monzo, Hector J.; Coppieters, Natacha [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Park, Thomas I.H. [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Pharmacology, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Dieriks, Birger V.; Faull, Richard L.M. [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Dragunow, Mike [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Pharmacology, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Curtis, Maurice A., E-mail: m.curtis@auckland.ac.nz [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand)

2017-06-01

Cellular interactions with the extracellular environment are modulated by cell surface polysialic acid (PSA) carried by the neural cell adhesion molecule (NCAM). PSA-NCAM is involved in cellular processes such as differentiation, plasticity, and migration, and is elevated in Alzheimer's disease as well as in metastatic tumour cells. Our previous work demonstrated that insulin enhances the abundance of cell surface PSA by inhibiting PSA-NCAM endocytosis. In the present study we have identified a mechanism for insulin-dependent inhibition of PSA-NCAM turnover affecting cell migration. Insulin enhanced the phosphorylation of the focal adhesion kinase leading to dissociation of αv-integrin/PSA-NCAM clusters, and promoted cell migration. Our results show that αv-integrin plays a key role in the PSA-NCAM turnover process. αv-integrin knockdown stopped PSA-NCAM from being endocytosed, and αv-integrin/PSA-NCAM clusters co-labelled intracellularly with Rab5, altogether indicating a role for αv-integrin as a carrier for PSA-NCAM during internalisation. Furthermore, inhibition of p-FAK caused dissociation of αv-integrin/PSA-NCAM clusters and counteracted the insulin-induced accumulation of PSA at the cell surface and cell migration was impaired. Our data reveal a functional association between the insulin/p-FAK-dependent regulation of PSA-NCAM turnover and cell migration through the extracellular matrix. Most importantly, they identify a novel mechanism for insulin-stimulated cell migration. - Highlights: • Insulin modulates PSA-NCAM turnover through upregulation of p-FAK. • P-FAK modulates αv-integrin/PSA-NCAM clustering. • αv-integrin acts as a carrier for PSA-NCAM endocytosis. • Cell migration is promoted by cell surface PSA. • Insulin promotes PSA-dependent migration in vitro.

Insulin promotes cell migration by regulating PSA-NCAM

International Nuclear Information System (INIS)

Monzo, Hector J.; Coppieters, Natacha; Park, Thomas I.H.; Dieriks, Birger V.; Faull, Richard L.M.; Dragunow, Mike; Curtis, Maurice A.

2017-01-01

Cellular interactions with the extracellular environment are modulated by cell surface polysialic acid (PSA) carried by the neural cell adhesion molecule (NCAM). PSA-NCAM is involved in cellular processes such as differentiation, plasticity, and migration, and is elevated in Alzheimer's disease as well as in metastatic tumour cells. Our previous work demonstrated that insulin enhances the abundance of cell surface PSA by inhibiting PSA-NCAM endocytosis. In the present study we have identified a mechanism for insulin-dependent inhibition of PSA-NCAM turnover affecting cell migration. Insulin enhanced the phosphorylation of the focal adhesion kinase leading to dissociation of αv-integrin/PSA-NCAM clusters, and promoted cell migration. Our results show that αv-integrin plays a key role in the PSA-NCAM turnover process. αv-integrin knockdown stopped PSA-NCAM from being endocytosed, and αv-integrin/PSA-NCAM clusters co-labelled intracellularly with Rab5, altogether indicating a role for αv-integrin as a carrier for PSA-NCAM during internalisation. Furthermore, inhibition of p-FAK caused dissociation of αv-integrin/PSA-NCAM clusters and counteracted the insulin-induced accumulation of PSA at the cell surface and cell migration was impaired. Our data reveal a functional association between the insulin/p-FAK-dependent regulation of PSA-NCAM turnover and cell migration through the extracellular matrix. Most importantly, they identify a novel mechanism for insulin-stimulated cell migration. - Highlights: • Insulin modulates PSA-NCAM turnover through upregulation of p-FAK. • P-FAK modulates αv-integrin/PSA-NCAM clustering. • αv-integrin acts as a carrier for PSA-NCAM endocytosis. • Cell migration is promoted by cell surface PSA. • Insulin promotes PSA-dependent migration in vitro.

Management and organisational factors in PSA; Organisations- und Management-Faktoren in der PSA

Energy Technology Data Exchange (ETDEWEB)

Balfanz, H.P. [TUEV Nord e.V., Hamburg (Germany)

1999-04-01

The constraints of PSA are increasingly considered with increasing application of PSA for the safety management of nuclear power plants (see US-NRC, 'Risk Informed Regulation', NRC-1). There is a vivid international discourse about the applicability of the variables of plant management and organisation in PSAs, which has lead to a great variety of research activities into this matter (see PSAM 4). This paper here summarizes the current state of progress of research work and discusses the applicability of results. The studies for comparative assessment of methodology and results were performed by the TUeV Nord under the roof of the BMU/BfS-sponsored project SR 2260, ''Further development of probabilistic methods for nuclear power plant safety assessment. (orig./CB) [German] Mit zunehmender Anwendung der PSA (Probabilistische Sicherheitsanalyse) im Sicherheitsmanagement von KKW (vergl. US-NRC, Einfuehrung des Konzepts 'Risk Informed Regulation' NRC-1) gewinnt die Beachtung der Grenzen der PSA zusaetzliche Bedeutung. International ist eine intensive Diskussion ueber die Moeglichkeiten einer Einbindung der Einflussgroesse von Organisation und Management in der PSA zu verzeichnen und wird belegt durch vielfaeltige Forschungs- und Entwicklungsarbeiten (vergl. PSAM 4). Dieser Beitrag setzt sich in erster Linie mit diesem Entwicklungsstand auseinander und diskutiert seinen Anwendungsstand fuer die PSA. Die hierzu vom TUeV Nord durchgefuehrten Arbeiten basieren auf dem BMU/BfS-Vorhaben SR 2260, 'Weiterentwicklung probabilistischer Methoden zur Sicherheitsbeurteilung von KKW'. (orig.)

Using pre-treatment PSA and Gleason score to predict for extra capsular extension among patients with clinically staged organ confined prostate cancer

Energy Technology Data Exchange (ETDEWEB)

Chen, Anita; Roach, Mack; Diaz, Aidnag; Marquez, Carol; Chinn, Dan; Coleman, Lori; Presti, Joseph; Carroll, Peter

1995-07-01

Purpose/Objectives: The patients most suitable for a radical prostatectomy (RP) are those with organ confined disease. At least(1(3)) of patients with clinically staged organ confined disease will be found to have extra capsular extension (ECE) following RP. The purpose of this study is to assess the predictive value of an equation for predicting the risk of ECE based on the pre-treatment prostatic specific antigen (PSA) and Gleason score (GS) in patients with clinical stage T1/T2 prostate cancer. Materials and Methods: Two hundred and twenty-two patients who underwent RP at either the San Francisco VAMC or UCSF between 1988 and 1994 were eligible for this analysis. Patients were considered eligible if the pathological stage, pre-operative PSA and GS were available. Among these patients the median pre-operative PSA was 9 ng/ml (range 0 - 195 ng/ml), and the median pre-operative GS was 6 (range 2-10). The empirically derived equations tested were [1.5 x PSA + (GS - 3) x 10] (Roach, J. Urol., 150: 1923-1924, 1993) as well as a recent modification of this equation of [PSA + (GS - 3.5) x 10]. For these equations, the range of calculated risk was limited to 0 - 100%. Results: The results of using these two equations are shown graphically. Using the modified equation, with a calculated risk (CR) of {<=}25% and an average calculated risk (ACR) of 15.4%, the observed incidence (OI) of ECE was 17.2%. Among the patients with a CR of 26 to 50% and an ACR of 36.1%, the OI of ECE was 38.4%. Among the patients with a CR of 51 to 75% and an ACR of 60.4%, the OI of ECE was 62.7%. Finally, among the patients with a CR of 76 to 100% and an ACR of 77.3%, the OI of ECE was 85.7%. Transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI) reports were available in 72 patients. Correlation with TRUS demonstrated a sensitivity and specificity of 52.4% and 56.1% respectively. Correlation with MRI showed a sensitivity of 57.9% and a specificity of 45.5%. The use of either MRI or

External Events PSA for the Paks NPP

International Nuclear Information System (INIS)

Bareith, Attila; Karsa, Zoltan; Siklossy, Tamas; Vida, Zoltan

2014-01-01

Initially, probabilistic safety assessment of external events was limited to the analysis of earthquakes for the Paks Nuclear Power Plant in Hungary. The level 1 seismic PSA was completed in 2002 showing a significant contribution of seismic failures to core damage risk. Although other external events of natural origin had previously been screened out from detailed plant PSA mostly on the basis of event frequencies, a review of recent experience on extreme weather phenomena made during the periodic safety review of the plant led to the initiation of PSA for external events other than earthquakes in 2009. In the meantime, the accident of the Fukushima Dai-ichi Nuclear Power Plant confirmed further the importance of such an analysis. The external event PSA for the Paks plant followed the commonly known steps: selection and screening of external hazards, hazard assessment for screened-in external events, analysis of plant response and fragility, PSA model development, and risk quantification and interpretation of results. As a result of event selection and screening the following weather related external hazards were subject to detailed analysis: extreme wind, extreme rainfall (precipitation), extreme snow, extremely high and extremely low temperatures, lightning, frost and ice formation. The analysis proved to be a significant challenge due to scarcity of data, lack of knowledge, as well as limitations of existing PSA methodologies. This paper presents an overview of the external events PSA performed for the Paks NPP. Important methodological aspects are summarised. Key analysis findings and unresolved issues that need further elaboration are highlighted. Development of external events PSA for the Paks NPP was completed by the end of 2012. The analysis followed the commonly known steps: selection and screening of external hazards, hazard assessment for screened-in external events, analysis of plant response and fragility, PSA model development, and risk

A multi-institutional analysis comparing adjuvant and salvage radiation therapy for high-risk prostate cancer patients with undetectable PSA after prostatectomy

International Nuclear Information System (INIS)

Budiharto, Tom; Perneel, Christiaan; Haustermans, Karin; Junius, Sara; Tombal, Bertrand; Scalliet, Pierre; Renard, Laurette; Lerut, Evelyne; Vekemans, Kris; Joniau, Steven; Poppel, Hendrik Van

2010-01-01

Background and purpose: In men with adverse pathology at the time of radical prostatectomy (RP), the most appropriate timing to administer radiotherapy (RT) remains a subject for debate. To determine whether salvage radiotherapy (SRT) upon early prostate-specific antigen (PSA) relapse is equivalent to immediate adjuvant radiotherapy (ART) post RP. Material and methods: 130 patients receiving ART and 89 receiving SRT were identified. All had an undetectable PSA after RP. Homogeneous subgroups were built based on the status (±) of lymphatic invasion (LVI) and surgical margins (SM), to allow a comparison of ART and SRT. Biochemical disease-free survival (bDFS) was calculated from the date of surgery and from the end of RT. The multivariate analysis was performed using the Cox Proportional hazard model. Results: In the SM-/LVI- and SM+/LVI- groups, SRT was a significant predictor of a decreased bDFS from the date of surgery, while in the SM+/LVI+ group, there was a trend towards significance. From the end of RT, SRT was also a significant predictor of a decreased bDFS in three patient groups: SM-/LVI-, SM+/LVI- and SM+/LVI+. Gleason score >7 showed to be another factor on multivariate analysis associated with decreased bDFS in the SM-/LVI- group, from the date of surgery and end of RT. Preoperative PSA was a significant predictor in the SM-/LVI- group from the date of RP only. Conclusions: Immediate ART post RP for patients with high risk features in the prostatectomy specimen significantly reduces bDFS after RP compared with early SRT upon PSA relapse.

[Clinical evaluation of TANDEM PSA in Japanese cases and comparison with other methods].

Science.gov (United States)

Kuriyama, M; Yamamoto, N; Shinoda, I; Kawada, Y; Akimoto, S; Shimazaki, J

1995-01-01

Clinical evaluation of TANDEM PSA which is the most frequently used prostate specific antigen (PSA) assay method in the world and a comparison with other methods were performed in Japanese cases in a cooperative research fashion. The minimum detectable level of the method was found to be 0.50 ng of PSA in one ml of serum and 1.9 ng/ml was regarded as the upper normal value in Japanese males. The distribution of serum PSA showed a significant difference between the benign prostate hypertrophy (BPH) cases and patients with stage C or D prostate cancer. The sero-diagnosis prostate cancer at an early stage with the TANDEM PSA was difficult. The correlation to other methods of PSA detection was very high. Furthermore, the clinical use of the method in following-up the clinical course of prostate cancer patients was very useful. These findings suggested that the PSA detection using TANDEM PSA is applicable even in Japanese cases although the upper cut-off level is decreased.

State of the art of probabilistic safety analysis (PSA) in the FRG, and principles of a PSA-guideline

International Nuclear Information System (INIS)

Balfanz, H.P.

1987-01-01

Contents of the articles: Survey of PSA performed during licensing procedures of an NPP; German Nuclear Standards' requirements on the reliability of safety systems; PSA-guideline for NPP: Principles and suggestions; Motivation and tasks of PSA; Aspects of the methodology of safety analyses; Structure of event tree and fault tree analyses; Extent of safety analyses; Performance and limits of PSA. (orig./HSCH)

Experience from the comparison of two PSA-studies

International Nuclear Information System (INIS)

Holmberg, J.; Pulkkinen, U.

2001-03-01

Two probabilistic safety assessments (PSA) made for nearly identical reactors units (Forsmark 3 and Oskarshamn 3) have been compared. Two different analysis teams made the PSAs, and the analyses became quite different. The goal of the study is to identify, clarify and explain differences between PSA-studies. The purpose is to understand limitations and uncertainties in PSA, to explain reasons for differences between PSA-studies, and to give recommendations for comparison of PSA-studies and for improving the PSA-methodology. The reviews have been made by reading PSA-documentation, using the computer model and interviewing persons involved in the projects. The method and findings have been discussed within the project group. Both the PSA-project and various parts in the PSA-model have been reviewed. A major finding was that the two projects had different purpose and thus had different resources, scope and even methods in their study. The study shows that comparison of PSA results from different plants is normally not meaningful. It takes a very deep knowledge of the PSA studies to make a comparison of the results and usually one has to ensure that the compared studies have the same scope and are based on the same analysis methods. Harmonisation of the PSA-methodology is recommended in the presentation of results, presentation of methods, scope main limitation and assumption, and definitions for end states, initiating events and common cause failures. This would facilitate the comparison of the studies. Methods for validation of PSA for different application areas should be developed. The developed PSA review standards can be applied for a general validation of a study. The most important way to evaluate the real feasibility of PSA can take place only with practical applications. The PSA-documentation and models can be developed to facilitate the communication between PSA-experts and users. In any application consultation with the PSA-expert is however needed. Many

Blackpool: More evidence on PSA

International Nuclear Information System (INIS)

Cullingford, M.

1985-01-01

PSA is spreading widely throughout the world, with 30 IAEA Member States having active programmes in this area. The main reason for its popularity is that it offers insights critical in the safety decision-making process available from no other method. It allows power plant designers, regulators, and operators to discriminate between issues important to safety and those which are trivial. Although it is beneficial to perform a PSA to utilize the potential products available from such a study, it is especially important to realize that the PSA process itself is a valuable experience. The main points such as potential users of PSA, safety evaluations, treatment of uncertainties as well as future trends are briefly discussed in this paper

Development of PSA audit guideline and regulatory PSA model for SMART

International Nuclear Information System (INIS)

Cho, Namchul; Lee, Chang-Ju; Kim, I.S.

2012-01-01

SMART is under development for dual purposes of power generation and seawater desalination in Korea. It is an integral reactor type with a thermal power output of 330 MW and employs advanced design features such as a passive system for the removal of residual heat and also the setting of all the components of the primary system inside the reactor pressure vessel. It is essential to develop new probabilistic safety assessment (PSA) validation guidance for SMART. For the purpose of regulatory verification to the risk level of SMART, the insights and key issues on the PSA are identified with referring some worldwide safety guides as well as its design characteristics. Regulatory PSA model under the development for the design confirmation and its preliminary result are also described. (authors)

ASAMPSA-E guidance for level 2 PSA Volume 2. Implementing external Events modelling in Level 2 PSA

International Nuclear Information System (INIS)

Cazzoli, E.; Vitazkova, J.; Loeffler, H.; Burgazzi, L.

2016-01-01

The objective of the present document is to provide guidance on the implementation of external events into an 'extended' L2 PSA. It has to be noted that L2 PSA addresses issues beginning with fuel degradation and ending with the release of radionuclides into the environment. Therefore, the present document may touch upon, but does not evaluate explicitly issues that involve events or phenomena which occur before the fuel begins to degrade. Following the accident at Fukushima Dai-ichi, the nuclear safety community has realized that much attention should be given to the areas of operator interventions and accidents that may develop at the same time in more than one unit if they are initiated by one or more common external events. For this reason and to fulfill the PSA end-users' wish list (as reflected by an ASAMPSA-E survey), the attention is mostly focused on interface between L1 and L2 PSA, fragility analysis, human response analysis and some consideration is given to L2 PSA modeling of severe accidents for multiple unit sites, even though it is premature to provide extensive guidance in this area. The following recommendations, mentioned in various sections within this document, are summarized here: 1. Vulnerability/fragility analyses should be performed with respect to all external hazards and all structures, systems and components potentially affected that could be relevant to L2 PSA, 2. Importance should be given to the assessment of human performance following extreme external events; for extreme circumstances with high stress level, low confidence is justified for SAM human interventions and for such conditions, human interventions could be analyzed as sensitivity cases only in L2 PSA, 3. Results presentation should include assessment of total risk measures compared with risk targets able to assess all contributions to the risk and to judge properly the safety, 4. Total risk measures shall be associated to appropriate information on all

Murine polyomavirus virus-like particles carrying full-length human PSA protect BALB/c mice from outgrowth of a PSA expressing tumor.

Directory of Open Access Journals (Sweden)

Mathilda Eriksson

Full Text Available Virus-like particles (VLPs consist of capsid proteins from viruses and have been shown to be usable as carriers of protein and peptide antigens for immune therapy. In this study, we have produced and assayed murine polyomavirus (MPyV VLPs carrying the entire human Prostate Specific Antigen (PSA (PSA-MPyVLPs for their potential use for immune therapy in a mouse model system. BALB/c mice immunized with PSA-MPyVLPs were only marginally protected against outgrowth of a PSA-expressing tumor. To improve protection, PSA-MPyVLPs were co-injected with adjuvant CpG, either alone or loaded onto murine dendritic cells (DCs. Immunization with PSA-MPyVLPs loaded onto DCs in the presence of CpG was shown to efficiently protect mice from tumor outgrowth. In addition, cellular and humoral immune responses after immunization were examined. PSA-specific CD4(+ and CD8(+ cells were demonstrated, but no PSA-specific IgG antibodies. Vaccination with DCs loaded with PSA-MPyVLPs induced an eight-fold lower titre of anti-VLP antibodies than vaccination with PSA-MPyVLPs alone. In conclusion, immunization of BALB/c mice with PSA-MPyVLPs, loaded onto DCs and co-injected with CpG, induces an efficient PSA-specific tumor protective immune response, including both CD4(+ and CD8(+ cells with a low induction of anti-VLP antibodies.

Murine Polyomavirus Virus-Like Particles Carrying Full-Length Human PSA Protect BALB/c Mice from Outgrowth of a PSA Expressing Tumor

Science.gov (United States)

Eriksson, Mathilda; Andreasson, Kalle; Weidmann, Joachim; Lundberg, Kajsa; Tegerstedt, Karin

2011-01-01

Virus-like particles (VLPs) consist of capsid proteins from viruses and have been shown to be usable as carriers of protein and peptide antigens for immune therapy. In this study, we have produced and assayed murine polyomavirus (MPyV) VLPs carrying the entire human Prostate Specific Antigen (PSA) (PSA-MPyVLPs) for their potential use for immune therapy in a mouse model system. BALB/c mice immunized with PSA-MPyVLPs were only marginally protected against outgrowth of a PSA-expressing tumor. To improve protection, PSA-MPyVLPs were co-injected with adjuvant CpG, either alone or loaded onto murine dendritic cells (DCs). Immunization with PSA-MPyVLPs loaded onto DCs in the presence of CpG was shown to efficiently protect mice from tumor outgrowth. In addition, cellular and humoral immune responses after immunization were examined. PSA-specific CD4+ and CD8+ cells were demonstrated, but no PSA-specific IgG antibodies. Vaccination with DCs loaded with PSA-MPyVLPs induced an eight-fold lower titre of anti-VLP antibodies than vaccination with PSA-MPyVLPs alone. In conclusion, immunization of BALB/c mice with PSA-MPyVLPs, loaded onto DCs and co-injected with CpG, induces an efficient PSA-specific tumor protective immune response, including both CD4+ and CD8+ cells with a low induction of anti-VLP antibodies. PMID:21858228

A PSA study for the SMART basic design

International Nuclear Information System (INIS)

Han, Sang Hoon; Kim, H. C.; Yang, S. H.; Lee, D. J.

2002-03-01

SMART (System-Integrated Modular Advanced Reactor) is under development that is an advanced integral type small and medium category nuclear power reactor with the rated thermal power of 330 MW. A Probabilistic Safety Analysis (PSA) for the SMART basic design has been performed to evaluate the safety and optimize the design. Currently, the basic design is done and the detailed design is not available for the SMART, we made several assumptions about the system design before performing the PSA. The scope of the PSA was limited to the Level-1 internal full power PSA. The level-2 and 3 PSA, the external PSA, and the low power/shutdown PSA will be performed in the final design stage

PSA methodology

International Nuclear Information System (INIS)

Magne, L.

1996-01-01

The purpose of this text is first to ask a certain number of questions on the methods related to PSAs. Notably we will explore the positioning of the French methodological approach - as applied in the EPS 1300 1 and EPS 900 2 PSAs - compared to other approaches (Part One). This reflection leads to more general reflection: what contents, for what PSA? This is why, in Part Two, we will try to offer a framework for definition of the criteria a PSA should satisfy to meet the clearly identified needs. Finally, Part Three will quickly summarize the questions approached in the first two parts, as an introduction to the debate. 15 refs

Improvement of PSA Models Using Monitoring and Prognostics

Energy Technology Data Exchange (ETDEWEB)

Heo, Gyun Young; Chang, Yoon Suk; Kim, Hyun Dae [Kyung Hee University, Yongin (Korea, Republic of)

2014-08-15

Probabilistic Safety Assessment (PSA) has performed a significant role for quantitative decision-making by finding design and operational vulnerability and evaluating cost-benefit in improving such weak points. Especially, it has been widely used as the core methodology for Risk-Informed Applications (RIAs). Even though the nature of PSA seeks realistic results, there are still 'conservative' aspects. The sources for the conservatism come from the assumption of safety analysis and the estimation of failure frequency. Surveillance, Diagnosis, and Prognosis (SDP) utilizing massive database and information technology is worthwhile to be highlighted in terms of the capability of alleviating the conservatism in the conventional PSA. This paper provides enabling techniques to concretize the method to provide time- and condition-dependent risk by integrating a conventional PSA model with condition monitoring and prognostics techniques. We will discuss how to integrate the results with frequency of initiating events (IEs) and failure probability of basic events (BEs). Two illustrative examples will be introduced: how the failure probability of a passive system can be evaluated under different plant conditions and how the IE frequency for Steam Generator Tube Rupture (SGTR) can be updated in terms of operating time. We expect that the proposed PSA model can take a role of annunciator to show the variation of Core Damage Frequency (CDF) in terms of time and operational conditions.

Seismic Level 2 PSA

International Nuclear Information System (INIS)

Dirksen, Gerben; Pellissetti, Manuel; Duncan-Whiteman, Paul

2014-01-01

For most external events, the calculation of the core damage frequency (CDF) in Level 1 PSA is sufficient to be able to show that the contribution of the event to the plant risk is negligible. However, it is not sufficient to compare the CDF due to the external event to the total plant CDF; instead the Level 1 PSA result for the event should be compared to the large early release frequency (LERF), or alternatively arguments should be given why the CDF from the external event will not contribute mostly to LERF. For seismic events in particular, it can often not be easily excluded that sequences leading to core damage would not also result in LERF. Since the confinement function is one of the most essential functions for Level 2 PSA, special care must be taken of the containment penetrations. For example systems with containment penetrations that are normally closed during operation or are designed to withstand more than the maximum containment pressure are normally screened out in the Level 2 PSA for the containment isolation function, however the possibility of LOCA in such systems due to an earthquake may nevertheless lead to containment bypass. Additionally, the functionality of passive features may be compromised in case of a beyond design earthquake. In the present paper, we present crucial ingredients of a methodology for a Level 2 seismic PSA. This methodology consists of the following steps: Extension of the seismic equipment list (SEL) to include Level 2 PSA relevant systems (e.g. containment isolation system, features for core melt stabilization, hydrogen mitigation systems), Determination of the systems within the existing SEL with increased demands in case of severe accidents, Determination of essential components for which a dedicated fragility analysis needs to be performed. (author)

The open PSA standard as a framework for migration of probabilistic models. Experiences with the KKB PSA

International Nuclear Information System (INIS)

Becker, G.; Hussels, U.; Epstein, S.; Rauzy, A.; Schubert, B.

2008-01-01

In its present state, the open PSA standard is helpful to determine capabilities of PSA approaches, which have been taken into account by those who formulated it. As soon, as tools come up, which can automatically bring a given PSA into the standard form, the data will be accessible by other software tools, which either are supplementary to the original one, or they may act in the context of quality control. Taking into account, that a PSA model represents a value of some two to ten person years (dependent on level of completeness and level of detail), it is important to have the data in a transparent way, which does not depend on proprietary formats, and can thus be used for more purposes than those, which are implemented in given PSA codes. (orig.)

NADiA® ProsVue™ PSA Slope Is an Independent Prognostic Marker for Identifying Men at Reduced Risk for Clinical Recurrence of Prostate Cancer after Radical Prostatectomy

Science.gov (United States)

Moul, Judd W.; Lilja, Hans; Semmes, O. John; Lance, Raymond S.; Vessella, Robert L.; Fleisher, Martin; Mazzola, Clarisse; Sarno, Mark J.; Stevens, Barbara; Klem, Robert E.; McDermed, Jonathan E.; Triebell, Melissa T.; Adams, Thomas H.

2015-01-01

Objectives To validate the hypothesis that men displaying serum PSA slopes ≤2.0 pg/mL/month postprostatectomy, measured with a new immuno-PCR diagnostic test (NADiA® ProsVue™) were at a reduced risk of clinical recurrence as determined by positive biopsy, imaging or death due to prostate cancer. Methods From 4 clinical sites, we selected a cohort of 304 men followed up to 17.6 years postprostatectomy for clinical recurrence. We assessed the prognostic value of a PSA slope cutpoint of 2.0 pg/mL/month against established risk factors to identify men at very low risk of clinical recurrence using uni- and multivariate Cox proportional hazards regression and Kaplan-Meier analysis. Results The univariate HR (95% CI) of a PSA slope >2.0 pg/mL/month was 18.3 (10.6–31.8), compared to a slope ≤2.0 pg/mL/month (P free survival was 4.8 years versus >10 years in the 2 groups (P <0.0001). Multivariate HR for PSA slope with the covariates of preprostatectomy PSA, pathologic stage and Gleason score was 9.8 (5.4–17.8), an 89.8% risk reduction, for men with PSA slopes ≤2.0 pg/mL/month (P <0.0001). Gleason Score (<7 vs. ≥7) was the only other significant predictor (HR 5.4, 2.1–13.8, P = 0.0004). Conclusions Clinical recurrence following radical prostatectomy is often difficult to predict since established factors do not reliably stratify risk. We demonstrate that a NADiA ProsVue slope ≤2.0 pg/mL/month postprostatectomy is prognostic for reduced risk of prostate cancer recurrence and adds predictive power to established risk factors. PMID:23107099

Correlation of serum androgens and pituitary hormone levels with serum PSA less than 2.5 ng/ml.

Science.gov (United States)

Sofikerim, Mustafa; Oruç, Ozgür; Eskicorapci, Sadettin; Guliyev, Fuat; Ozen, Haluk

2007-07-27

The aim of this clinical study was to determine whether there is a relationship between total serum testosterone, free testosterone, FSH (Follicle-Stimulating Hormone), LH (Luteinizing Hormone) and serum prostate specific antigen (PSA) levels. We postulated that such a correlation existed then the use of hormone specific reference ranges might enhance the usefullness of PSA concentrations 40 years of age visiting our urology outpatient clinics. PSA was correlated to age (r = 0.23, p = 0.019), but there none between serum testosterone and age. No significant correlation was noted between testosterone or free testosterone and serum PSA levels, and none between serum FSH or LH and PSA. In age specific reference groups (41-49; 50-59; 60-69 years), we found no significant correlation between PSA and hormone concentrations. In this population of eugonadal men with serum PSA values less than 2.5 ng/ml, serum androgens and pituitary hormones do not appear to correlate with serum PSA.

Association of PSA, free-PSA and testosteron levels in serum of patients with benign prostate hyperplasia (BPH) and prostate cancer

International Nuclear Information System (INIS)

Wiwin Mailana; Kristina Dwi P; Sri Insani WW; Puji Widayati

2015-01-01

Prostate cancer screening can be done by measuring the concentration levels of PSA, free-PSA and testosterone in serum that examined with radioimmunoassay (RIA). A total of 30 patients of 45-81 years old had enrolled in this study and were taken their venous blood. The aim of research is to know the relationship between PSA and testosterone free-PSA with BPH and prostate cancer. Results showed that there was no correlation between age with BPH and prostate cancer (p = 0.06), but there is a relationship between PSA with BPH and prostate cancer (p = 0.002), the relationship between free-PSA with BPH and prostate cancer (p = 0.001). No correlation was found between PSA ratio with BPH and prostate cancer as well as the absence of a relationship between testosterone with BPH and prostate cancer (p = 0.924). (author)

Comparative Study of Blood-Based Biomarkers, α2,3-Sialic Acid PSA and PHI, for High-Risk Prostate Cancer Detection.

Science.gov (United States)

Ferrer-Batallé, Montserrat; Llop, Esther; Ramírez, Manel; Aleixandre, Rosa Núria; Saez, Marc; Comet, Josep; de Llorens, Rafael; Peracaula, Rosa

2017-04-17

Prostate Specific Antigen (PSA) is the most commonly used serum marker for prostate cancer (PCa), although it is not specific and sensitive enough to allow the differential diagnosis of the more aggressive tumors. For that, new diagnostic methods are being developed, such as PCA-3, PSA isoforms that have resulted in the 4K score or the Prostate Health Index (PHI), and PSA glycoforms. In the present study, we have compared the PHI with our recently developed PSA glycoform assay, based on the determination of the α2,3-sialic acid percentage of serum PSA (% α2,3-SA), in a cohort of 79 patients, which include 50 PCa of different grades and 29 benign prostate hyperplasia (BPH) patients. The % α2,3-SA could distinguish high-risk PCa patients from the rest of patients better than the PHI (area under the curve (AUC) of 0.971 vs. 0.840), although the PHI correlated better with the Gleason score than the % α2,3-SA. The combination of both markers increased the AUC up to 0.985 resulting in 100% sensitivity and 94.7% specificity to differentiate high-risk PCa from the other low and intermediate-risk PCa and BPH patients. These results suggest that both serum markers complement each other and offer an improved diagnostic tool to identify high-risk PCa, which is an important requirement for guiding treatment decisions.

Review process of PSA level 2 of KBR - Concept and Experience

International Nuclear Information System (INIS)

Andernacht, M.; Glaser, H.; Sonnenkalb, M.

2013-01-01

In Germany, a periodic safety review (PSR) has to be performed every ten years by the utility. In the past, a PSR only included a plant-specific probabilistic safety analysis (PSA) Level 1 study. Since a revised version of the German PSA guideline has been released in 2005, these plant-specific PSAs have to include a PSA Level 2, too. For the NPP Brokdorf (KBR) PSA Level 2 project, an agreement was reached between all parties involved that the study will be performed not as a part of the PSR process, but supplementary to it. This paper will focus on conclusions and findings from an ongoing parallel review process of the first full scope PSA Level 2 performed by the utility for KBR, a typical German PWR-1300. The responsible authority 'Ministerium fuer Soziales, Gesundheit, Familie, Jugend und Senioren des Landes Schleswig- Holstein' (MSGF) initiated this parallel review process in agreement with the utility KBR and the E.ON Kernkraft in 2006. The project will be completed soon. Such a review process allows that essential steps of the PSA will be reviewed and commented before the PSA Level 2 will be finished. So the benefit from this parallel review process is a significant enhancement of the quality and completeness of the PSA Level 2 study as the majority of the recommendations given by the review team has been taken over by the utility and the developer of the PSA, the AREVA NP company. Further, a common understanding and agreement will be reached at the end between all parties involved on the major topics of the PSA Level 2 study. The paper is followed by the slides of the presentation. (authors)

Review process of PSA Level 2 of KBR. Concept and experience

International Nuclear Information System (INIS)

Andernacht, Martin; Glaser, Hendrik; Sonnenkalb, Martin

2009-01-01

In Germany, a periodic safety review (PSR) has to be performed every 10 years by the utility. In the past, a PSR only included a plant-specific probabilistic safety analysis (PSA) Level 1 study. For the NPP Brokdorf (KBR) PSA Level 2 project, an agreement was reached between all parties involved that the study will be performed not as a part of the PSR process, but supplementary to it. Since a revised version of the German PSA guideline has been released in 2005, these plant-specific PSAs have to include a PSA Level 2, too. This paper will focus on conclusions and findings from a ongoing parallel review process of the first full scope PSA Level 2 performed by the utility for KBR, a typical German PWR-1300. The responsible authority 'Ministerium fuer Soziales, Gesundheit, Familie, Jugend und Senioren des Landes Schleswig-Holstein (MSGF)' (Ministry of Social Affairs, Health, Family, Youth and Senior Citizens of Schleswig-Holstein) initiated this parallel review process in agreement with the utility KBR and the E.ON Kernkraft in 2006. The project will be completed soon. Such a review process allows that essential steps of the PSA will be reviewed and commented before the PSA Level 2 will be finished. So the benefit from this parallel review process is a significant enhancement of the quality and completeness of the PSA Level 2 study as the majority of the recommendations given by the review team has been taken over by the utility and the developer of the PSA, the Areva NP company. Further, a common understanding and agreement will be reached at the end between all parties involved on the major topics of the PSA Level 2 study. (orig.)

PSA - a tool for the nuclear safety

International Nuclear Information System (INIS)

Himanen, R.

1992-01-01

The PSA-model for BWR-type reactors of Finnish power company, Teollisuuden Voima Oy (TVO) was finished in year 1989. This basic PSA model included all safety systems, normal operating systems and auxiliary systems. Today TVO is working to enlarge the PSA to level 2 (environmental effects, for the fires, for the floodings and the outages). The TVO's experiences has been showed the PSA an useful tool for the developing the safety of BWR's (orig.)

Year of treatment as independent predictor of relapse-free survival in patients with localized prostate cancer treated with definitive radiotherapy in the PSA era

International Nuclear Information System (INIS)

Kupelian, Patrick; Thames, Howard; Levy, Larry; Horwitz, Eric; Martinez, Alvaro; Michalski, Jeff; Pisansky, Thomas; Sandler, Howard; Shipley, William; Zelefsky, Michael; Zietman, Anthony; Kuban, Deborah

2005-01-01

Purpose: To study the use of the year of therapy as an independent predictor of outcomes, serving as a proxy for time-related changes in therapy and tumor factors in the treatment of prostate cancer. Accounting for these changes would facilitate the retrospective comparison of outcomes for patients treated in different periods. Methods and Materials: Nine institutions combined data on 4,537 patients with Stages T1 and T2 adenocarcinoma of the prostate who had a pretherapy prostate-specific antigen (PSA) level and biopsy Gleason score, and who had received ≥60 Gy external beam radiotherapy without neoadjuvant androgen deprivation or planned adjuvant androgen deprivation. All patients were treated between 1986 and 1995. Two groups were defined: those treated before 1993 (Yr ≤92) vs. 1993 and after (Yr ≥93). Patients treated before 1993 had their follow-up truncated to make the follow-up time similar to that for patients treated in 1993 and after. Therefore, the median follow-up time was 6.0 years for both groups (Yr ≤92 and Yr ≥93). Two separate biochemical failure endpoints were used. Definition A consisted of the American Society for Therapeutic Radiology Oncology endpoint (three PSA rises backdated, local failure, distant failure, or hormonal therapy). Definition B consisted of PSA level greater than the current nadir plus two, local failure, distant failure, or hormonal therapy administered. Multivariate analyses for factors affecting PSA disease-free survival (PSA-DFS) rates using both endpoints were performed for all cases using the following variables: T stage (T1b, T1c, T2a vs. T2b, T2c), pretreatment PSA (continuous variable), biopsy Gleason score (continuous variable), radiation dose (continuous variable), and year of treatment (continuous variable). The year variable (defined as the current year minus 1960) ranged from 26 to 35. To evaluate the effect of radiation dose, the multivariate analyses were repeated with the 3,897 cases who had received

Evaluation of serum PSA after cyproterone compound treatment compared with oral contraceptive pill in hirsute polycystic ovary syndrome patients

OpenAIRE

R. Taheripanah; M. Sepahvandi; A. Entezari; Z. Amiri; E. Neisani Samani

2010-01-01

Objective: To evaluate the effect of oral contraceptive on the serum free prostatic specific antigen (PSA) in women with polycystic ovary syndrome (PCOD) compared with cyproterone compound. Materials and methods: In this randomized clinical trial, 60 hirsute PCOD patients that referred to Imam Hossein hospital were enrolled. Baseline Ferriman–Gallway score (FG), body mass index (BMI), free PSA, 17-hydroxy progesterone (17-OHP), free testosterone, and dehydroepiandrestandione sulfate (DHEAS...

Generation of monoclonal antibodies against prostate specific antigen (PSA) for the detection of PSA and its purification; Generación de anticuerpos monoclonales contra el antígeno específico de próstata (PSA) para la detección del PSA y su purificación

Energy Technology Data Exchange (ETDEWEB)

Acevedo Castro, Boris Ernesto [Centro de Ingeniería Genética y Biotecnología, CIGB, La Habana (Cuba)

2012-07-01

The prostate cancer in Cuba is a problem of health (2672 diagnosed cases and 2769 deaths in 2007). Various diagnostic methods have been implemented for the detection and management of this disease, emphasizing among them (PSA) prostate-specific antigen serological determination. At this work was generated and characterized a panel of 11 antibodies (AcMs) monoclonal IgG1 detected with high affinity described major epitopes of the PSA, both in solution and attached to the test plate. From the panel obtained AcMs was the standardization of an essay type ELISA for the detection of serum total PSA (associated and free) equimolar, based on antibody monoclonal CB-PSA.4 in the coating and the CB-PSA.9 coupled with biotin as liner, with a detection limit of 0.15 ng/mL. Similarly, standardized system for detection in serum free PSA, based on the AcMs CB-PSA.4 (coating) and CB-PSA.2 coupled with biotin (liner), with a detection limit of 0.5 ng/mL. Finally, with the purpose of using PSA as standard in trials type ELISA, developed a simple method of inmunopurificación based on the AcM, CB-PSA.2, which was obtained the PSA with a purity exceeding 90%. Immunoassay Centre on the basis of the AcMs panel and the results of this study, developed and recorded two diagnostic systems for the detection of PSA in human serum. (author)

PSA methodology

Energy Technology Data Exchange (ETDEWEB)

Magne, L

1997-12-31

The purpose of this text is first to ask a certain number of questions on the methods related to PSAs. Notably we will explore the positioning of the French methodological approach - as applied in the EPS 1300{sup 1} and EPS 900{sup 2} PSAs - compared to other approaches (Part One). This reflection leads to more general reflection: what contents, for what PSA? This is why, in Part Two, we will try to offer a framework for definition of the criteria a PSA should satisfy to meet the clearly identified needs. Finally, Part Three will quickly summarize the questions approached in the first two parts, as an introduction to the debate. 15 refs.

Purification of PSA from human semen

International Nuclear Information System (INIS)

Venkatesh, M.

1997-01-01

Full text: 1. Human seminal plasma collected from many volunteers are pooled and passed through a column of phenyl sepharose equilibrated with 1.25 M ammonium sulphate. Elution is carried out with 1.25 M ammonium sulphate initially, to remove the bulk non-adsorbing proteins. Gradient elution of the absorbed proteins with 0.01 M Tris-HCl, 0.25 M NaCl, pH 7.0 buffer gives a sharp peak containing PSA. At each stage, PSA has to be identified by an independent method such as immunodiffusion or an immunoassay. 2. The absorbed protein peak containing PSA is then lyophilised, redissolved in Tris-HCl buffer and chromatographed in a Superdex-75 or Sephadex-75 column. The absorbed proteins elute out as multiple peaks and PSA is eluted as a sharp peak.At each stage, PSA has to be identified by an independent method such as immunodiffusion or an immunoassay. 3. Step 2 is repeated for better purity. 4. The PSA peak is lyophilised, dissolved in Tris-HCl buffer without NaCl and further purified on an ion exchange column (either anion or cation exchange columns such as DEAE Sephadex or CM-Sephadex or Mono Q). Gradient elution using Tris-HCl buffer without NaCl and Tris-HCl buffer with 0.25 M NaCl resulted in a sharp pure PSA peak (homogenous, sharp single band on SDS-PAGE). This procedure is based on that reported by Wang et al., Oncology, 39,1,1982

PSA-Stratified Performance of 18F- and 68Ga-PSMA PET in Patients with Biochemical Recurrence of Prostate Cancer.

Science.gov (United States)

Dietlein, Felix; Kobe, Carsten; Neubauer, Stephan; Schmidt, Matthias; Stockter, Simone; Fischer, Thomas; Schomäcker, Klaus; Heidenreich, Axel; Zlatopolskiy, Boris D; Neumaier, Bernd; Drzezga, Alexander; Dietlein, Markus

2017-06-01

Several studies outlined the sensitivity of 68 Ga-labeled PET tracers against the prostate-specific membrane antigen (PSMA) for localization of relapsed prostate cancer in patients with renewed increase in the prostate-specific antigen (PSA), commonly referred to as biochemical recurrence. Labeling of PSMA tracers with 18 F offers numerous advantages, including improved image resolution, longer half-life, and increased production yields. The aim of this study was to assess the PSA-stratified performance of the 18 F-labeled PSMA tracer 18 F-DCFPyL and the 68 Ga-labeled reference 68 Ga-PSMA-HBED-CC. Methods: We examined 191 consecutive patients with biochemical recurrence according to standard acquisition protocols using 18 F-DCFPyL ( n = 62, 269.8 MBq, PET scan at 120 min after injection) or 68 Ga-PSMA-HBED-CC ( n = 129, 158.9 MBq, 60 min after injection). We determined PSA-stratified sensitivity rates for both tracers and corrected our calculations for Gleason scores using iterative matched-pair analyses. As an orthogonal validation, we directly compared tracer distribution patterns in a separate cohort of 25 patients, sequentially examined with both tracers. Results: After prostatectomy ( n = 106), the sensitivity of both tracers was significantly associated with absolute PSA levels ( P = 4.3 × 10 -3 ). Sensitivity increased abruptly, when PSA values exceeded 0.5 μg/L ( P = 2.4 × 10 -5 ). For a PSA less than 3.5 μg/L, most relapses were diagnosed at a still limited stage ( P = 3.4 × 10 -6 ). For a PSA of 0.5-3.5 μg/L, PSA-stratified sensitivity was 88% (15/17) for 18 F-DCFPyL and 66% (23/35) for 68 Ga-PSMA-HBED-CC. This significant difference was preserved in the Gleason-matched-pair analysis. Outside of this range, sensitivity was comparably low (PSA PSA > 3.5 μg/L). After radiotherapy ( n = 85), tracer sensitivity was largely PSA-independent. In the 25 patients examined with both tracers, distribution patterns of 18 F-DCFPyL and 68 Ga-PSMA-HBED-CC were

Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial.

Science.gov (United States)

Martin, Richard M; Donovan, Jenny L; Turner, Emma L; Metcalfe, Chris; Young, Grace J; Walsh, Eleanor I; Lane, J Athene; Noble, Sian; Oliver, Steven E; Evans, Simon; Sterne, Jonathan A C; Holding, Peter; Ben-Shlomo, Yoav; Brindle, Peter; Williams, Naomi J; Hill, Elizabeth M; Ng, Siaw Yein; Toole, Jessica; Tazewell, Marta K; Hughes, Laura J; Davies, Charlotte F; Thorn, Joanna C; Down, Elizabeth; Davey Smith, George; Neal, David E; Hamdy, Freddie C

2018-03-06

Prostate cancer screening remains controversial because potential mortality or quality-of-life benefits may be outweighed by harms from overdetection and overtreatment. To evaluate the effect of a single prostate-specific antigen (PSA) screening intervention and standardized diagnostic pathway on prostate cancer-specific mortality. The Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) included 419 582 men aged 50 to 69 years and was conducted at 573 primary care practices across the United Kingdom. Randomization and recruitment of the practices occurred between 2001 and 2009; patient follow-up ended on March 31, 2016. An invitation to attend a PSA testing clinic and receive a single PSA test vs standard (unscreened) practice. Primary outcome: prostate cancer-specific mortality at a median follow-up of 10 years. Prespecified secondary outcomes: diagnostic cancer stage and Gleason grade (range, 2-10; higher scores indicate a poorer prognosis) of prostate cancers identified, all-cause mortality, and an instrumental variable analysis estimating the causal effect of attending the PSA screening clinic. Among 415 357 randomized men (mean [SD] age, 59.0 [5.6] years), 189 386 in the intervention group and 219 439 in the control group were included in the analysis (n = 408 825; 98%). In the intervention group, 75 707 (40%) attended the PSA testing clinic and 67 313 (36%) underwent PSA testing. Of 64 436 with a valid PSA test result, 6857 (11%) had a PSA level between 3 ng/mL and 19.9 ng/mL, of whom 5850 (85%) had a prostate biopsy. After a median follow-up of 10 years, 549 (0.30 per 1000 person-years) died of prostate cancer in the intervention group vs 647 (0.31 per 1000 person-years) in the control group (rate difference, -0.013 per 1000 person-years [95% CI, -0.047 to 0.022]; rate ratio [RR], 0.96 [95% CI, 0.85 to 1.08]; P = .50). The number diagnosed with prostate cancer was higher in the intervention group (n = 8054; 4

Pattern of Prostate-Specific Antigen (PSA) Failure Dictates the Probability of a Positive Bone Scan in Patients With an Increasing PSA After Radical Prostatectomy

Science.gov (United States)

Dotan, Zohar A.; Bianco, Fernando J.; Rabbani, Farhang; Eastham, James A.; Fearn, Paul; Scher, Howard I.; Kelly, Kevin W.; Chen, Hui-Ni; Schöder, Heiko; Hricak, Hedvig; Scardino, Peter T.; Kattan, Michael W.

2007-01-01

Purpose Physicians often order periodic bone scans (BS) to check for metastases in patients with an increasing prostate-specific antigen (PSA; biochemical recurrence [BCR]) after radical prostatectomy (RP), but most scans are negative. We studied patient characteristics to build a predictive model for a positive scan. Patients and Methods From our prostate cancer database we identified all patients with detectable PSA after RP. We analyzed the following features at the time of each bone scan for association with a positive BS: preoperative PSA, time to BCR, pathologic findings of the RP, PSA before the BS (trigger PSA), PSA kinetics (PSA doubling time, PSA slope, and PSA velocity), and time from BCR to BS. The results were incorporated into a predictive model. Results There were 414 BS performed in 239 patients with BCR and no history of androgen deprivation therapy. Only 60 (14.5%) were positive for metastases. In univariate analysis, preoperative PSA (P = .04), seminal vesicle invasion (P = .02), PSA velocity (P < .001), and trigger PSA (P < .001) predicted a positive BS. In multivariate analysis, only PSA slope (odds ratio [OR], 2.71; P = .03), PSA velocity (OR, 0.93; P = .003), and trigger PSA (OR, 1.022; P < .001) predicted a positive BS. A nomogram for predicting the bone scan result was constructed with an overfit-corrected concordance index of 0.93. Conclusion Trigger PSA, PSA velocity, and slope were associated with a positive BS. A highly discriminating nomogram can be used to select patients according to their risk for a positive scan. Omitting scans in low-risk patients could reduce substantially the number of scans ordered. PMID:15774789

PSA, subjective probability and decision making

International Nuclear Information System (INIS)

Clarotti, C.A.

1989-01-01

PSA is the natural way to making decisions in face of uncertainty relative to potentially dangerous plants; subjective probability, subjective utility and Bayes statistics are the ideal tools for carrying out a PSA. This paper reports that in order to support this statement the various stages of the PSA procedure are examined in detail and step by step the superiority of Bayes techniques with respect to sampling theory machinery is proven

Seismic PSA of nuclear power plants a case study

International Nuclear Information System (INIS)

Hari Prasad, M.; Dubey, P.N.; Reddy, G.R.; Saraf, R.K.; Ghosh, A.K.

2006-07-01

Seismic Probabilistic Safety Assessment (Seismic PSA) analysis is an external event PSA analysis. The objective of seismic PSA for the plants is to examine the existence of plant vulnerabilities against postulated earthquakes by numerically assessing the plant safety and to take appropriate measures to enhance the plant safety. Seismic PSA analysis integrates the seismic hazard analysis, seismic response analysis, seismic fragility analysis and system reliability/ accident sequence analysis. In general, the plant consists of normally operating and emergency standby systems and components. The failure during an earthquake (induced directly by excessive inertial stresses or indirectly following the failure of some other item) of an operating component will lead to a change in the state of the plant. In that case, various scenarios can follow depending on the initiating event and the status of other sub-systems. The analysis represents these possible chronological sequences by an event tree. The event trees and the associated fault trees model the sub-systems down to the level of individual components. The procedure has been applied for a typical Indian nuclear power plant. From the internal event PSA level I analysis significant contribution to the Core Damage Frequency (CDF) was found due to the Fire Water System. Hence, this system was selected to establish the procedure of seismic PSA. In this report the different elements that go into seismic PSA analysis have been discussed. Hazard curves have been developed for the site. Fragility curve for the seismically induced failure of Class IV power has been developed. The fragility curve for fire-water piping system has been generated. Event tree for Class IV power supply has been developed and the dominating accident sequences were identified. CDF has been estimated from these dominating accident sequences by convoluting hazard curves of initiating event and fragility curves of the safety systems. (author)

Radical prostatectomy and positive surgical margins: tumor volume and Gleason score predicts cancer outcome

International Nuclear Information System (INIS)

La Roca, Ricardo L.R. Felts de; Fonseca, Francisco Paula da; Cunha, Isabela Werneck da; Bezerra, Stephania Martins

2013-01-01

Introduction: positive surgical margins (PSMs) are common adverse factors to predict the outcome of a patient submitted to radical prostatectomy (PR). However, not all of these men will follow with biochemical (BCR) or clinical (CR) recurrence. Relationship between PSMs with these recurrent events has to be correlated with other clinicopathological findings in order to recognize more aggressive tumors in order to recommend complementary treatment to these selected patients. Materials and methods: we retrospectively reviewed the outcome of 228 patients submitted to open retropubic RP between March 1991 and June 2008, where 161 had and 67 did not have PSMs. Minimum follow-up time was considered 2 years after surgery. BCR was considered when PSA ≥ 0.2 ng/ml. CR was determined when clinical evidence of tumor appeared. Chi-square test was used to correlate clinical and pathologic variables with PSMs. The estimated 5-year risk of BCR and CR in presence of PSMs was determined using the Kaplan-Meier method and compared to log-rank tests. Results: from the total of 228 patients, 161 (71%) had PSMs, while 67 (29%) had negative surgical margins (NSMs). Prostatic circumferential margin was the most common (43.4%) site. Univariate analysis showed statistically significant (p < 0.001) associations between the presence of PSMs and BCR, but not with CR (p = 0.06). Among 161 patients with PSMs, 61 (37.8%) presented BCR, while 100 (62.8%) did not. Predicting progression-free survival for 5 years, BCR was correlated with pathological stage; Gleason score; pre-treatment PSA; tumor volume in specimen; capsular and perineural invasion; presence and number of PSMs. RC correlated only with angiolymphatic invasion and Gleason score. Considering univariate analyses the clinicopathological factors predicting BCR for 5 years, results statistically significant links with prostate weight; pre-treatment PSA; Gleason score; pathological stage; tumor volume; PSMs; capsular and perineural

Radical prostatectomy and positive surgical margins: tumor volume and Gleason score predicts cancer outcome

Energy Technology Data Exchange (ETDEWEB)

La Roca, Ricardo L.R. Felts de, E-mail: Ricardo@delarocaurologia.com.br [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil); Fonseca, Francisco Paula da, E-mail: fpf@uol.com.br [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Divisao de Urologia. Dept. de Cirurgia Pelvica; Cunha, Isabela Werneck da; Bezerra, Stephania Martins, E-mail: iwerneck@gmail.com, E-mail: stephaniab@gmail.com [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Patologia

2013-07-01

Introduction: positive surgical margins (PSMs) are common adverse factors to predict the outcome of a patient submitted to radical prostatectomy (PR). However, not all of these men will follow with biochemical (BCR) or clinical (CR) recurrence. Relationship between PSMs with these recurrent events has to be correlated with other clinicopathological findings in order to recognize more aggressive tumors in order to recommend complementary treatment to these selected patients. Materials and methods: we retrospectively reviewed the outcome of 228 patients submitted to open retropubic RP between March 1991 and June 2008, where 161 had and 67 did not have PSMs. Minimum follow-up time was considered 2 years after surgery. BCR was considered when PSA {>=} 0.2 ng/ml. CR was determined when clinical evidence of tumor appeared. Chi-square test was used to correlate clinical and pathologic variables with PSMs. The estimated 5-year risk of BCR and CR in presence of PSMs was determined using the Kaplan-Meier method and compared to log-rank tests. Results: from the total of 228 patients, 161 (71%) had PSMs, while 67 (29%) had negative surgical margins (NSMs). Prostatic circumferential margin was the most common (43.4%) site. Univariate analysis showed statistically significant (p < 0.001) associations between the presence of PSMs and BCR, but not with CR (p = 0.06). Among 161 patients with PSMs, 61 (37.8%) presented BCR, while 100 (62.8%) did not. Predicting progression-free survival for 5 years, BCR was correlated with pathological stage; Gleason score; pre-treatment PSA; tumor volume in specimen; capsular and perineural invasion; presence and number of PSMs. RC correlated only with angiolymphatic invasion and Gleason score. Considering univariate analyses the clinicopathological factors predicting BCR for 5 years, results statistically significant links with prostate weight; pre-treatment PSA; Gleason score; pathological stage; tumor volume; PSMs; capsular and perineural

Comparison of SKIFS 2004:1 and Tillsynshandbok PSA against the ASME PRA Standard and European requirements on PSA

International Nuclear Information System (INIS)

Hellstroem, Per

2005-04-01

Requirements on PSA for risk informed applications are expressed in different international documents. The ASME PRA standard published in spring 2002 is one such document, PSA requirements are also expressed in the European Utility Requirements (EUR) for new reactors. The Swedish PSA requirements are provided in the Swedish regulators (SKI) statutes SKIFS 2004:1. SKI also has a review handbook for PSA activities (SKI report 2003:48). The review handbook is a support during review of the utilities PSA activities and the PSAs themselves. The review handbook expresses SKIs expectations by providing so called important aspects for both the PSA work and the PSAs, A comparison of SKIFS requirements and the important aspects in the Review handbook, on one side, and the requirements on PSA in EUR and ASME on the other side, is presented. The comparison shows a large difference in the level of detail in the different documents, where ASME is most detailed and specific. This is expected since the SKI review handbook not is a 'PSA guide' in the same way as the ASME PRA standard. A direct comparison of the ASME PRA standard requirements with the important aspects in the review handbook cannot answer the question which ASME capacity level that is achieved by a PSA meeting all important aspects. The conclusion is that it is not likely to achieve capacity level 2 and 3, since very few ASME level 3 attributes are explicitly expressed as important aspects, though many are expressed in general terms. The review handbook important aspects that are most similar to the ASME capacity level 1 attributes are initiating events, sequence analysis, and system analysis while less similarity is found for analysis of operator actions data analysis, quantification and containment analysis (level 2). Less similarity is found for capacity level 2 and 3. However, the number of additional ASME attributes on capacity level 2 and 3 are few. There are also important aspects in the review handbook that

Improved Monte Carlo Method for PSA Uncertainty Analysis

International Nuclear Information System (INIS)

Choi, Jongsoo

2016-01-01

The treatment of uncertainty is an important issue for regulatory decisions. Uncertainties exist from knowledge limitations. A probabilistic approach has exposed some of these limitations and provided a framework to assess their significance and assist in developing a strategy to accommodate them in the regulatory process. The uncertainty analysis (UA) is usually based on the Monte Carlo method. This paper proposes a Monte Carlo UA approach to calculate the mean risk metrics accounting for the SOKC between basic events (including CCFs) using efficient random number generators and to meet Capability Category III of the ASME/ANS PRA standard. Audit calculation is needed in PSA regulatory reviews of uncertainty analysis results submitted for licensing. The proposed Monte Carlo UA approach provides a high degree of confidence in PSA reviews. All PSA needs accounting for the SOKC between event probabilities to meet the ASME/ANS PRA standard

Improved Monte Carlo Method for PSA Uncertainty Analysis

Energy Technology Data Exchange (ETDEWEB)

Choi, Jongsoo [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2016-10-15

The treatment of uncertainty is an important issue for regulatory decisions. Uncertainties exist from knowledge limitations. A probabilistic approach has exposed some of these limitations and provided a framework to assess their significance and assist in developing a strategy to accommodate them in the regulatory process. The uncertainty analysis (UA) is usually based on the Monte Carlo method. This paper proposes a Monte Carlo UA approach to calculate the mean risk metrics accounting for the SOKC between basic events (including CCFs) using efficient random number generators and to meet Capability Category III of the ASME/ANS PRA standard. Audit calculation is needed in PSA regulatory reviews of uncertainty analysis results submitted for licensing. The proposed Monte Carlo UA approach provides a high degree of confidence in PSA reviews. All PSA needs accounting for the SOKC between event probabilities to meet the ASME/ANS PRA standard.

Pre-radiotherapy PSA progression is a negative prognostic factor in prostate cancer patients using 5-alpha-reductase inhibitors

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Taussky, Daniel; Lambert, Carole; Bahary, Jean-Paul; Beauchemin, Marie-Claude; Barkati, Maroie; Menard, Cynthia; Delouya, Guila [Hopital Notre-Dame, Department of Radiation Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, QC (Canada); CRCHUM-Centre de Recherche du Centre Hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Piotte, Julie [Hopital Notre-Dame, Department of Radiation Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Zorn, Kevin C.; Zanaty, Marc [Centre Hospitalier de l' Universite de Montreal, Section of Urology, Department of Surgery, Montreal, QC (Canada); Krishnan, Vimal [Centre Hospitalier de l' Universite de Montreal, Department of Pathology, Montreal, Quebec (Canada)

2018-01-15

To investigate the impact of 5-alpha-reductase inhibitor (5-ARI) use on radiotherapy outcomes for localized prostate cancer. We included 203 patients on a 5-ARI from our institutional database comprising over 2500 patients who had been treated with either external beam radiotherapy (EBRT) or brachytherapy for localized prostate cancer. Patients received a 5-ARI for urinary symptoms or active surveillance. Cancer progressions at the time of definitive treatment were analyzed according to the following criteria: (a) progression of Gleason score or increase in cancer volume on biopsy, (b) first biopsy positive for cancer after being treated for urinary symptoms with a 5-ARI, and (c) prostate-specific antigen (PSA) progression with or without a previous cancer diagnosis. Biochemical failure (BF) was defined by the Phoenix definition. Log-rank test was used for survival analysis. At a median follow-up of 38.2 months (standard deviation 22.2 months), 10 (4.9%) patients experienced BF. Concerning prostate cancer progression criteria, 52% of men demonstrated none, 37% showed only one criterion, and 11% showed two. Using univariate analysis, PSA progression (p = 0.004) and appearance of a positive biopsy (p < 0.001) were significant predictive factors for BF, while Gleason progression (p = 0.3) was not. In multivariate analysis adjusted for cancer aggressiveness, rising PSA (hazard ratio, HR, 5.7; 95% confidence interval, CI, 1.1-28.8; p = 0.04) and the number of cancer progression factors (HR 2.9, 95% CI 1.2-7.0, p = 0.02) remained adverse risk factors. PSA progression experienced during 5-ARI treatment before radiotherapy is predictive of worse biochemical outcome. Such details should be considered when counseling men prior to radiation therapy. (orig.) [German] Untersuchung des Einflusses einer Behandlung mit einem 5-Alpha-Reduktaseinhibitor (5-ARI) auf das Ergebnis der Strahlentherapie beim lokalisierten Prostatakarzinom. In die Studie eingeschlossen wurden 203

Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

International Nuclear Information System (INIS)

Gupta, Nakul; Patel, Anish; Ensor, Joe; Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael; Matin, Surena; Gupta, Sanjay

2017-01-01

PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

Energy Technology Data Exchange (ETDEWEB)

Gupta, Nakul [Houston Methodist Hospital (United States); Patel, Anish [The University of Texas Southwestern Medical Center (United States); Ensor, Joe [Houston Methodist Research Institute, The Houston Methodist Cancer Center (United States); Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States); Matin, Surena [The University of Texas MD Anderson Cancer Center, Department of Urology (United States); Gupta, Sanjay, E-mail: sgupta@mdanderson.org [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States)

2017-02-15

PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

PROSTATE CANCER SCREENING: PSA TEST AWARENESS AMONG ADULT MALES.

Science.gov (United States)

Obana, Michael; O'Lawrence, Henry

2015-01-01

The overall purpose of this study was to determine whether visits to the doctor in the last 12 months, education level, and annual household income for adult males increased the awareness of prostate-specific antigen (PSA) tests. The effect of these factors for the knowledge of PSA exams was performed using statistical analysis. A retrospective secondary database was utilized for this study using the questionnaire in the California Health Interview Survey from 2009. Based on this survey, annual visits to the doctor, higher educational levels attained, and greater take-home pay were statistically significant and the results of the study were equivalent to those hypothesized. This also reflects the consideration of marketing PSA blood test screenings to those adult males who are poor, uneducated, and do not see the doctor on a consistent basis.

PSA-based evaluation and rating of operational events

International Nuclear Information System (INIS)

Gomez Cobo, A.

1997-01-01

The presentation discusses the PSA-based evaluation and rating of operational events, including the following: historical background, procedures for event evaluation using PSA, use of PSA for event rating, current activities

Updating the Psoriatic Arthritis (PsA) Core Domain Set: A Report from the PsA Workshop at OMERACT 2016.

Science.gov (United States)

Orbai, Ana-Maria; de Wit, Maarten; Mease, Philip J; Callis Duffin, Kristina; Elmamoun, Musaab; Tillett, William; Campbell, Willemina; FitzGerald, Oliver; Gladman, Dafna D; Goel, Niti; Gossec, Laure; Hoejgaard, Pil; Leung, Ying Ying; Lindsay, Chris; Strand, Vibeke; van der Heijde, Désirée M; Shea, Bev; Christensen, Robin; Coates, Laura; Eder, Lihi; McHugh, Neil; Kalyoncu, Umut; Steinkoenig, Ingrid; Ogdie, Alexis

2017-10-01

To include the patient perspective in accordance with the Outcome Measures in Rheumatology (OMERACT) Filter 2.0 in the updated Psoriatic Arthritis (PsA) Core Domain Set for randomized controlled trials (RCT) and longitudinal observational studies (LOS). At OMERACT 2016, research conducted to update the PsA Core Domain Set was presented and discussed in breakout groups. The updated PsA Core Domain Set was voted on and endorsed by OMERACT participants. We conducted a systematic literature review of domains measured in PsA RCT and LOS, and identified 24 domains. We conducted 24 focus groups with 130 patients from 7 countries representing 5 continents to identify patient domains. We achieved consensus through 2 rounds of separate surveys with 50 patients and 75 physicians, and a nominal group technique meeting with 12 patients and 12 physicians. We conducted a workshop and breakout groups at OMERACT 2016 in which findings were presented and discussed. The updated PsA Core Domain Set endorsed with 90% agreement by OMERACT 2016 participants included musculoskeletal disease activity, skin disease activity, fatigue, pain, patient's global assessment, physical function, health-related quality of life, and systemic inflammation, which were recommended for all RCT and LOS. These were important, but not required in all RCT and LOS: economic cost, emotional well-being, participation, and structural damage. Independence, sleep, stiffness, and treatment burden were on the research agenda. The updated PsA Core Domain Set was endorsed at OMERACT 2016. Next steps for the PsA working group include evaluation of PsA outcome measures and development of a PsA Core Outcome Measurement Set.

Level 2 PSA methodology and severe accident management

International Nuclear Information System (INIS)

1997-01-01

The objective of the work was to review current Level 2-PSA (Probabilistic Safety Assessment) methodologies and practices and to investigate how Level 2-PSA can support severe accident management programmes, i.e. the development, implementation, training and optimisation of accident management strategies and measures. For the most part, the presented material reflects the state in 1996. Current Level 2 PSA results and methodologies are reviewed and evaluated with respect to plant type specific and generic insights. Approaches and practices for using PSA results in the regulatory context and for supporting severe accident management programmes by input from level 2 PSAs are examined. The work is based on information contained in: PSA procedure guides, PSA review guides and regulatory guides for the use of PSA results in risk informed decision making; plant specific PSAs and PSA related literature exemplifying specific procedures, methods, analytical models, relevant input data and important results, use of computer codes and results of code calculations. The PSAs are evaluated with respect to results and insights. In the conclusion section, the present state of risk informed decision making, in particular in the level 2 domain, is described and substantiated by relevant examples

Low Power Shutdown PSA for CANDU Type Plants

Energy Technology Data Exchange (ETDEWEB)

Bae, Yeon Kyoung; Kim, Myung Su [KHNP CRI, Daejeon (Korea, Republic of)

2016-10-15

KHNP also have concentrated on full power PSA. Some recently constructed OPR1000 type plants and APR1400 type plants have performed the low power and shutdown (LPSD) PSA. The purpose of LPSD PSA is to identify the main contributors on the accident sequences of core damage and to find the measure of safety improvement. After the Fukushima accident, Korean regulatory agency required the shutdown severe accident management guidelines (SSAMG) development for safety enhancement. For the reliability of SSAMG, KHNP should develop the LPSD PSA. Especially, the LPSD PSA for CANDU type plant had developed for the first time in Korea. This paper illustrates how the LPSD PSA for CANDU type developed and the core damage frequency (CDF) is different with that of full power PSA. KHNP performed LPSD PSA to develop the SSAMG after the Fukushima accidents. The results show that risk at the specific operation mode during outage is higher than that of full power operation. Also, the results indicated that recovery failure of class 4 power at the POS 5A, 5B contribute dominantly to the total CDF from importances analysis. LPSD PSA results such as CDF with initiating events and POSs, risk results with plant damage state, and containment failure probability and frequency with POSs can be used by inputs for developing the SSAMG.

Significance of periacinar cleftings as supporting criteria in diagnosis of prostatic adenocarcinoma Gleason score-a 7 (3+4 and Gleason score-a 7 (4+3 and their relationship with parameters of predictive value

Directory of Open Access Journals (Sweden)

Mijović Milica

2014-01-01

Full Text Available Diagnosis of different pathohystological diseases of prostate in the most cases is based on common benignant and malignant characteristics. The presence of periacinar cleftings (PC is an additional criterion favouring prostatic adenocarcinoma. According to the presence and extent of PC, analysed on high power field (400x, glands were classified into 3 groups: group 1-glands without PC or with PC affecting ≤50% of gland circumference; group 2-glands with PC affecting >50% gland circumference in 50% gland circumference in ≥50% examined glands. The aim of our study was to determine the importance of presence of PC in prostatic adenocarcinoma (ADCP of Gleason score 7(3+4 and 7(4+3 and establish the existence of differences in their appearance at ADCP with first and second dominant histological grade 3 and 4 in each different relationship based on correlation analysis of PC and parameters of the predictive value (preoperative value of serum prostate specific antigen, tumor volume, clinical stage and degree of focal neuroendocrine differentiation. The study included 33 ADCP of Gleason score 7, 26 (78.79% ADCP 7(3+4 and 7 (21.21% ADCP 7(4+3. In ADCP Gleason 7(3+4 periacinar cleftings are more common in tumors that are smaller, better differentiated (produce more PSA, which is diagnosed in less advanced clinical stages and showing a less degree of focal neuroendocrine differentiation. In ADCP Gleason 7(4+3 periacinar cleftings are more common in tumors which produce less value of serum PSA (poorly differentiated and in tumors that are diagnosed in advanced clinical stages. Periacinar cleftings are common findings in prostatic adenocarcinoma Gleason score 7(4+3 which are considerd as tumors with worse prognosis. Because of all we can rank PC among the important additional criteria for the diagnosis of adenocarcinoma of the prostate.

Comparison of prostate cancer gene 3 score, prostate health index and percentage free prostate-specific antigen for differentiating histological inflammation from prostate cancer and other non-neoplastic alterations of the prostate at initial biopsy.

Science.gov (United States)

De Luca, Stefano; Passera, Roberto; Bollito, Enrico; Manfredi, Matteo; Scarpa, Roberto Mario; Sottile, Antonino; Randone, Donato Franco; Porpiglia, Francesco

2014-12-01

To determine if prostate cancer gene 3 (PCA3) score, Prostate Health Index (PHI), and percent free prostate-specific antigen (%fPSA) may be used to differentiate prostatitis from prostate cancer (PCa), benign prostatic hyperplasia (BPH) and high-grade prostate intraepithelial neoplasia (HG-PIN) in patients with elevated PSA and negative digital rectal examination (DRE). in the present prospective study, 274 patients, undergoing PCA3 score, PHI and %fPSA assessments before initial biopsy, were enrolled. Three multivariate logistic regression models were used to test PCA3 score, PHI and %fPSA as risk factors for prostatitis vs. PCa, vs. BPH, and vs. HG-PIN. All the analyses were performed for the whole patient cohort and for the 'gray zone' of PSA (4-10 ng/ml) cohort (188 individuals). The determinants for prostatitis vs. PCa were PCA3 score, PHI and %fPSA (Odds Ratio [OR]=0.97, 0.96 and 0.94, respectively). Unit increase of PHI was the only risk factor for prostatitis vs. BPH (OR=1.06), and unit increase of PCA3 score for HG-PIN vs. prostatitis (OR=0.98). In the 'gray zone' PSA cohort, the determinants for prostatitis vs. PCa were PCA3 score, PHI and %fPSA (OR=0.96, 0.94 and 0.92, respectively), PCA3 score and PHI for prostatitis vs. BPH (OR=0.96 and 1.08, respectively), and PCA3 score for prostatitis vs. HG-PIN (OR=0.97). The clinical benefit of using PCA3 score and PHI to estimate prostatitis vs. PCa was comparable; even %fPSA had good diagnostic performance, being a faster and cheaper marker. PHI was the only determinant for prostatitis vs. BPH, while PCA3 score for prostatitis vs. HG-PIN. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Radiometric assays for the measurement of PSA

International Nuclear Information System (INIS)

Venkatesh, M.

1997-01-01

Prostate Specific Antigen, a serine protease enzyme, of M.W. ∼ 26-33 kDa, is widely considered to be a very useful marker for prostate cancer. It satisfies nearly all the requirements of an ideal 'Tumour Marker' and has hence attracted a lot of attention in the past decade. PSA is present in multiple forms in serum, with an appreciable fraction bound to the protease inhibitor α-1-antichymotrypsin (ACT) and to a small extent to other proteins such as α-2-macroglobulin (AMG) leaving the rest in the free form. The total PSA levels have been reported to have 80% sensitivity and 60% specificity towards the detection of prostate cancer. The lack of specificity occurs mainly due to the high levels of t-PSA in benign prostatic hypertrophy(BPH) apart from the cancer. The concept of free PSA has been introduced in the recent past and the ratio of free/total PSA levels have been shown to be advantageous in the differential diagnosis of BPH from prostate cancer. The f/t ratio is considered to be particularly useful in the grey zones of decision making (t-PSA levels 4-20 ng/mL). The need for the development of assays for total and free PSA is felt due to: a. the high incidence of prostate cancers being detected currently; b. the high cost of tests (higher for free PSA assay, and the cost becomes an important parameter when a patient has to be regularly monitored after therapy) that is not affordable for many patients; c. the potential for research in the area of prostate cancer management where the PSA (total and free) assays will be of great help

PSA response signatures - a powerful new prognostic indicator after radiation for prostate cancer?

International Nuclear Information System (INIS)

Denham, James W.; Lamb, David S.; Joseph, David; Matthews, John; Atkinson, Chris; Spry, Nigel A.; Duchesne, Gillian; Ebert, Martin; Steigler, Allison; D'Este, Catherine

2009-01-01

Background: We sought to determine whether inter-patient variations in pattern of PSA changes after radiation exist and, if so, are they prognostically significant. Methods: In the Trans-Tasman Radiation Oncology Group (TROG) 96.01 randomized controlled trial, patients with T2b,c,3,4 N0 prostate cancer (PC) were randomised to 0, 3 or 6 months maximal androgen deprivation prior to 66 Gy to the prostate and seminal vesicles (XRT). Patterns of anatomical site of failure were one of the trial endpoints. Serial serum PSA's were mandated at all follow-up visits. Pattern recognition software was developed to characterize PSA response 'signatures' (PRS) after therapy in individual patients. Results: By 2000, 270 eligible patients were randomised to radiation alone. Individual patient PSA values were observed to descend after radiation according to one of two characteristic 'signatures': single exponential (PRS Type 1), non-exponential (PRS Type 2). Compared to PRS Type 1, men with PRS Type 2 (50% of the group) had lower PSA nadir (nPSA) levels (p < .0001), longer doubling times on relapse (p = .006) and significantly lower rates of local (hazard ratio [HR]: 0.47, 95% confidence interval [0.30-0.75], p = .0014) and distant failure (HR: 0.25[0.13-0.46], p < .0001), death due to PC (HR: 0.20[0.10-0.42], p < .0001) and death due to any cause (HR: 0.37 [0.23-0.60], p < .0001). PRS retained its powerful prognostic significance in Cox models that incorporated all key pre-treatment covariates and nPSA. Conclusions: PRS reflect the presence of tumor phenotypes that vary substantially in their clinical behavior and response to XRT. Molecular characterization is now necessary

Relation of prostatic specific antigen, bone scan and Gleason score in prostate cancer Nuclear Medicine Center IPEN - INEN, 1993-1995

International Nuclear Information System (INIS)

Mendoza Perez, German E.

2006-01-01

Objectives: To establish the relationship of serum prostate specific antigen (PSA), Gleason score and bone scan, to determine bone metastases in prostate cancer patients (PC). Material and Methods: A retrospective cases and series study was performed in patients with prostate cancer derived to the Centre of Nuclear Medicine IPEN-INEN from 1993 to 1995. 165 patients were included. Frequency charts were done for every study variable, quantitative variables were expressed by mean ± SD; for qualitative variables percentages were used. To confirm relations a Chi-square (χ2) test was applied. Sensitivity, specificity, positive predictive value and negative predictive value for a 20 ng/mL cut off point of PSA and a Gleason score of 8 were carried out using contingency charts. Diagnostic performance of this tests were performed applying R.O.C. curve. Results: Mean age was 71.27 ± 7.6 years. Bone metastases were found in 84 (50.9%) patients. For a 20 ng/mL PSA, sensitivity was of 0.92, specificity of 0.47, PPV of 0.64 and NPV of 0.84; for a Gleason score of 8, sensitivity was 0.59, specificity 0.69, PPV O.67 and NPV 0.62. The probability to have a positive bone scan with a Gleason score of 8 is up to 10% for ≤ 4 ng/mL PSA; 15% for ≤ 10 ng/mL PSA, and 20% if PSA level is ≤ 20 ng/mL. Conclusions: We conclude, for the studied population, that it is necessary to perform a bone scan in all recently diagnosed prostate cancer patients, independently of PSA levels and Gleason score, in order to determine if bone metastases are present. (author)

Early Prediction of Therapy Response to Abiraterone Acetate Using PSA Subforms in Patients with Castration Resistant Prostate Cancer

Directory of Open Access Journals (Sweden)

Katrin Schlack

2016-09-01

Full Text Available The purpose of this study was to evaluate the prognostic ability of early changes of total prostate specific antigen (tPSA, free PSA (fPSA, [−2]proPSA and the Prostate Health Index (PHI following initiation of Abiraterone-therapy in men with castration resistant prostate cancer (mCRPC. In 25 patients, PSA-subforms were analyzed before and at 8–12 weeks under therapy as prognosticators of progression-free-survival (PFS and overall survival (OS. Comparing patients with a PFS < vs. ≥12 months by using Mann–Whitney–Wilcoxon Tests, the relative-median-change of tPSA (−0.1% vs. −86.8%; p = 0.02, fPSA (12.1% vs. −55.3%; p = 0.03 and [−2]proPSA (8.1% vs. −59.3%; p = 0.05 differed significantly. For men with ≤ vs. >15 months of OS there was a non-significant trend for a difference in the relative-median-change of fPSA (17.0% vs. −46.3%; p = 0.06. In Kaplan–Meier analyses, declining fPSA and [−2]proPSA were associated with a longer median PFS (13 months, 95% confidence interval (CI: 9.6–16.4 vs. 10 months, 95% CI: 3.5–16.5; p = 0.11, respectively. Correspondingly, decreasing fPSA and [−2]proPSA values indicated an OS of 32 months (95% CI: not reached (NR compared to 21 months in men with rising values (95% CI: 7.7–34.3; p = 0.14, respectively. We concluded that the addition of fPSA- and [−2]proPSA-changes to tPSA-information might be further studied as potential markers of early Abiraterone response in mCRPC patients.

Status of the PSA use in the Czech regulatory process

International Nuclear Information System (INIS)

Dusek, J.

1994-01-01

A review of previous probabilistic safety assessment (PSA) activities initiated by regulatory body and preparation of the preliminary PSA study and final PSA study (released in January 1994) for the nuclear power plant Dukovany with WWER-440 type 213 reactor is described. A brief information about the NPP Temelin (with WWER-1000) PSA Study, shutdown and PSA risk monitor current activities for the NPP Dukovany, next PSA activities in 1994 and about planned PSA activities in future is attached. (author). 21 refs

Workshop on PSA for New and Advanced Reactors

International Nuclear Information System (INIS)

2012-01-01

This workshop was organized by the NEA Working Group on Risk Assessment (WGRISK). The key objective of the workshop was to share the current state-of-the art on the PSA (Probabilistic Safety Assessment) applied for new reactors and advanced reactors. Fifty experts from 13 countries and one international organization (IAEA) participated in the present workshop, and 35 technical papers were presented. The main topics of interest, discussed during the workshop, included the followings: regulatory aspects, risk-informed methods, technical aspects of the PSA for new and advanced reactors, hazards of PSA (internal and external), severe accident/source term/Level 2 PSA, and consequence analysis/Level 3 PSA. Among the technical aspects of the PSA, the assessment of the reliability of passive safety systems appears to be a recurrent issue

Development of multipurpose regulatory PSA model

International Nuclear Information System (INIS)

Lee, Chang Ju; Sung, Key Yong; Kim, Hho Jung; Yang, Joon Eon; Ha, Jae Joo

2004-01-01

Generally, risk information for nuclear facilities comes from the results of Probabilistic safety assessment (PSA). PSA is a systematic tool to ensure the safety of nuclear facilities, since it is based on thorough and consistent application of probability models. In particular, the PSA has been widely utilized for risk-informed regulation (RIR), including various licensee-initiated risk-informed applications (RIA). In any regulatory decision, the main goal is to make a sound safety decision based on technically defensible information. Also, due to the increased public requests for giving a safety guarantee, the regulator should provide the visible means of safety. The use of PSA by the regulator can give the answer on this problem. Therefore, in order to study the applicability of risk information for regulatory safety management, it is a demanding task to prepare a well-established regulatory PSA model and tool. In 2002, KINS and KAERI together made a research cooperation to form a working group to develop the regulatory PSA model - so-called MPAS model. The MPAS stands for multipurpose probabilistic analysis of safety. For instance, a role of the MPAS model is to give some risk insights in the preparation of various regulatory programs. Another role of this model is to provide an independent risk information to the regulator during regulatory decision-making, not depending on the licensee's information

The optimal timing to perform 18F/11C-choline PET/CT in patients with suspicion of relapse of prostate cancer: trigger PSA versus PSA velocity and PSA doubling time.

Science.gov (United States)

Calabria, Ferdinando; Rubello, Domenico; Schillaci, Orazio

2014-12-09

In the present short communication we considered the main publications focused on trigger prostate-specific antigen (PSA) and PSA kinetics that systematically compared 18F to 11C-choline PET/CT in order to establish the optimal time to perform choline PET/CT in relation to the trigger values and velocity, as well as doubling time of PSA serum levels.

Review of APR+ Level 2 PSA

International Nuclear Information System (INIS)

Lehner, J.R.; Mubayi, V.; Pratt, W.T.

2012-01-01

Brookhaven National Laboratory (BNL) assisted the Korea Institute of Nuclear Safety (KINS) in reviewing the Level 2 Probabilistic Safety Assessment (PSA) of the APR+ Advanced Pressurized Water Reactor (PWR) prepared by the Korea Hydro and Nuclear Power Co., Ltd (KHNP) and KEPCO Engineering and Construction Co., Inc. (KEPCO-E and C). The work described in this report involves a review of the APR+ Level 2 PSA submittal (Ref. 1). The PSA and, therefore, the review is limited to consideration of accidents initiated by internal events. As part of the review process, the review team also developed three sets of Requests for Additional Information (RAIs). These RAIs were provided to KHNP and KEPCO-E and C for their evaluation and response. This final detailed report documents the review findings for each technical element of the PSA and includes consideration of all of the RAIs made by the reviewers as well as the associated responses. This final report was preceded by an interim report (Ref. 2) that focused on identifying important issues regarding the PSA. In addition, a final meeting on the project was held at BNL on November 21-22, 2011, where BNL and KINS reviewers discussed their preliminary review findings with KHNP and KEPCO-E and C staffs. Additional information obtained during this final meeting was also used to inform the review findings of this final report. The review focused not only on the robustness of the APR+ design to withstand severe accidents, but also on the capability and acceptability of the Level 2 PSA in terms of level of detail and completeness. The Korean nuclear regulatory authorities will decide whether the PSA is acceptable and the BNL review team is providing its comments for KINS consideration. Section 2.0 provides the basis for the BNL review. Section 3.0 presents the review of each technical element of the PSA. Conclusions and a summary are presented in Section 4.0. Section 5.0 contains the references.

Neurochemical Characterization of PSA-NCAM+ Cells in the Human Brain and Phenotypic Quantification in Alzheimer's Disease Entorhinal Cortex.

Science.gov (United States)

Murray, Helen C; Swanson, Molly E V; Dieriks, B Victor; Turner, Clinton; Faull, Richard L M; Curtis, Maurice A

2018-02-21

Polysialylated neural cell adhesion molecule (PSA-NCAM) is widely expressed in the adult human brain and facilitates structural remodeling of cells through steric inhibition of intercellular NCAM adhesion. We previously showed that PSA-NCAM immunoreactivity is decreased in the entorhinal cortex in Alzheimer's disease (AD). Based on available evidence, we hypothesized that a loss of PSA-NCAM + interneurons may underlie this reduction. PSA-NCAM expression by interneurons has previously been described in the human medial prefrontal cortex. Here we used postmortem human brain tissue to provide further evidence of PSA-NCAM + interneurons throughout the human hippocampal formation and additional cortical regions. Furthermore, PSA-NCAM + cell populations were assessed in the entorhinal cortex of normal and AD cases using fluorescent double labeling and manual cell counting. We found a significant decrease in the number of PSA-NCAM + cells per mm 2 in layer II and V of the entorhinal cortex, supporting our previous description of reduced PSA-NCAM immunoreactivity. Additionally, we found a significant decrease in the proportion of PSA-NCAM + cells that co-labeled with NeuN and parvalbumin, but no change in the proportion that co-labeled with calbindin or calretinin. These results demonstrate that PSA-NCAM is expressed by a variety of interneuron populations throughout the brain. Furthermore, that loss of PSA-NCAM expression by NeuN + cells predominantly contributes to the reduced PSA-NCAM immunoreactivity in the AD entorhinal cortex. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

Clinical and Patient-reported Outcomes in Patients with Psoriatic Arthritis (PsA) by Body Surface Area Affected by Psoriasis: Results from the Corrona PsA/Spondyloarthritis Registry.

Science.gov (United States)

Mease, Philip J; Karki, Chitra; Palmer, Jacqueline B; Etzel, Carol J; Kavanaugh, Arthur; Ritchlin, Christopher T; Malley, Wendi; Herrera, Vivian; Tran, Melody; Greenberg, Jeffrey D

2017-08-01

Psoriatic arthritis (PsA) is commonly comorbid with psoriasis; the extent of skin lesions is a major contributor to psoriatic disease severity/burden. We evaluated whether extent of skin involvement with psoriasis [body surface area (BSA) > 3% vs ≤ 3%] affects overall clinical and patient-reported outcomes (PRO) in patients with PsA. Using the Corrona PsA/Spondyloarthritis Registry, patient characteristics, disease activity, and PRO at registry enrollment were assessed for patients with PsA aged ≥ 18 years with BSA > 3% versus ≤ 3%. Regression models were used to evaluate associations of BSA level with outcome [modified minimal disease activity (MDA), Health Assessment Questionnaire (HAQ) score, patient-reported pain and fatigue, and the Work Productivity and Activity Impairment questionnaire score]. Adjustments were made for age, sex, race, body mass index, disease duration, and history of biologics, disease-modifying antirheumatic drug, and prednisone use. This analysis included 1240 patients with PsA with known BSA level (n = 451, BSA > 3%; n = 789, BSA ≤ 3%). After adjusting for potential confounding variables, patients with BSA > 3% versus ≤ 3% had greater patient-reported pain and fatigue and higher HAQ scores (p = 2.33 × 10 -8 , p = 0.002, and p = 1.21 × 10 -7 , respectively), were 1.7× more likely not to be in modified MDA (95% CI 1.21-2.41, p = 0.002), and were 2.1× more likely to have overall work impairment (1.37-3.21, p = 0.0001). These Corrona Registry data show that substantial skin involvement (BSA > 3%) is associated with greater PsA disease burden, underscoring the importance of assessing and effectively managing psoriasis in patients with PsA because this may be a contributing factor in PsA severity.

IAEA work with guides for PSA quality

International Nuclear Information System (INIS)

Hellstroem, Per

2004-09-01

IAEA has a project on development of a TECDOC 'PSA Quality for Various Applications'. The project develops the guidance document in stages with intermediate meetings with exchange of ideas, thoughts and experience. Draft versions are being produced successively. The objective with the project is to use attributes to describe the quality of different elements of a PSA (Analysis of initiating events, accident progression, system, data, human reliability, etc) making the PSA suitable for application in various risk informed activities. Two of the meetings in this project took place in February 2004 and in July 2004. The February meeting discussed different aspects of PSA quality in relation to applications and a draft of the TECDOC was reviewed. The meeting made recommendations for preparation of a final document and set priorities for further work in the area. The July meeting elaborated the document further in a small working group and a new draft version was prepared. A final version is expected to be published during 2005. The project has come to the conclusion that it is a limited number of PSA element attributes that are specific for a certain application. Most of the attributes concern plant specificity, realism and level of detail in a general manner, how plant specific is the model, how realistic and how detailed? Many attributes have the characteristic that they are good to have, but not necessarily needed to do the job. This last statement is valid both for a baseline PSA and a PSA application. The IAEA project has identified a limited number of attributes that are necessary to describe characteristics needed for specific applications. The PSA scope needed for a specific application is not covered by the project/document, even though it is obvious that different applications will need different scope or approaches to handle scope limitations. The guidance on performing a PSA available today is old. It is a need to review these guides and update with regard

Elevated Serum PSA is Associated With Human Herpesvirus 8 Infection and Increased Circulating Cytokine Levels in Men From Tobago.

Science.gov (United States)

Henning, Jill D; Karamchandani, Jaideep M; Bonachea, Luis A; Bunker, Clareann H; Patrick, Alan L; Jenkins, Frank J

2017-05-01

Serum-prostate specific antigen (PSA) levels have been used for many years as a biomarker for prostate cancer. This usage is under scrutiny due to the fact that elevated PSA levels can be caused by other conditions such as benign prostatic hyperplasia and infections of or injury to the prostate. As a result, the identification of specific pathogens capable of increasing serum levels of PSA is important. A potential candidate responsible for elevated PSA is human herpesvirus 8 (HHV-8). We have reported previously that HHV-8 is capable of infecting and establishing a latent infection in the prostate. In this current study we test the hypothesis that HHV-8 infection is associated with elevated PSA levels. Circulating cytokine levels between men with elevated PSA and controls are also compared. HHV-8 serostatus was determined among men with elevated serum PSA (≥4 ng/ml; n = 168, no prostate cancer on biopsy) and age-matched controls (PSA PSA and 85 controls). Men with an elevated serum PSA were significantly more likely to be HHV-8 seropositive (42.9%) than the age-matched cancer-free men (22.2%; OR 2.51; 95%CI 1.48-4.29, P = 00001). Comparison of circulating cytokine levels between men with elevated serum PSA and controls indicated that elevated serum PSA is associated with a pro-inflammatory response with a mixed Th1/Th2 response while HHV-8 infection was associated with significantly higher levels of IL12p70, IL-10, and IL-13 indicating a Th2 immune response. We found a significant association between HHV-8 infection and increased levels of serum PSA. In an age of patient-centered medicine, men with an elevated serum PSA should be considered for HHV-8 serology testing to determine if HHV-8 is responsible for the elevated PSA. Prostate 77: 617-624, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Method comparison for determination of the tumor markers AFP, CEA, PSA and free PSA between Immulite 2000 XPI and Dimension Vista 1500.

Science.gov (United States)

Zur, Berndt; Holdenrieder, Stefan; Walgenbach-Brünagel, Gisela; Albers, Eike; Stoffel-Wagner, Birgit

2012-01-01

For the Luminescent Oxygen Channeling Immunoassay (LOCI) technology as established for Dimension Vista 1500, assays have been developed for the serum tumor markers AFP, CEA, PSA and free PSA. We performed a method analysis for these parameters using the Immulite 2000 XPI. Determination of within-day and total imprecision of the methods was carried out according to CLSI guidelines with three serum pools. In addition, parallel measurements were performed with both systems in 1,871 routine serum samples and correlations were calculated. Calculated total imprecision of the three serum pools for AFP was 3.8 - 4.3%, for CEA 3.3 - 4.3%, for tPSA 3.6 - 4.0% and for fPSA it was 3.5 - 8.2%. Correlations of these markers across the entire value range were very good with the following correlation coefficients: 0.997 for AFP, 0.996 for CEA, 0.971 for tPSA and 0.988 for fPSA. While values for AFP and tPSA from both methods were comparable (slopes 1.02 and 1.01), lower values were measured for CEA and fPSA with the Dimension Vista (slopes 0.83 and 0.91). For AFP, a sample cluster with considerably higher values than with Dimension Vista was observed in the lower measurement range (CEA, tPSA and fPSA, as developed with the LOCI technology for the Dimension Vista, show good comparability with results obtained from the Immulite 2000 XPI. However, lower measurement ranges for CEA and fPSA as well as individual divergences, especially with AFP, must be taken into consideration in the event of method changeover.

The Planetary Science Archive (PSA): Exploration and discovery of scientific datasets from ESA's planetary missions

Science.gov (United States)

Vallat, C.; Besse, S.; Barbarisi, I.; Arviset, C.; De Marchi, G.; Barthelemy, M.; Coia, D.; Costa, M.; Docasal, R.; Fraga, D.; Heather, D. J.; Lim, T.; Macfarlane, A.; Martinez, S.; Rios, C.; Vallejo, F.; Said, J.

2017-09-01

The Planetary Science Archive (PSA) is the European Space Agency's (ESA) repository of science data from all planetary science and exploration missions. The PSA provides access to scientific datasets through various interfaces at http://psa.esa.int. All datasets are scientifically peer-reviewed by independent scientists, and are compliant with the Planetary Data System (PDS) standards. The PSA has started to implement a number of significant improvements, mostly driven by the evolution of the PDS standards, and the growing need for better interfaces and advanced applications to support science exploitation.

Characteristics Studies of 125I- and total PSA antibody's Binding with prostate specific antigen (PSA) in Human Uterus Tumors

International Nuclear Information System (INIS)

Al-Mudaffar, S.; Al-Salihi, J.

2005-01-01

Two groups of uterus tumors (benign and malignant) postmenopausal patients were used to investigate the presence of prostate specific antigen (PSA). Preliminary experiments were performed to follow the binding of '1 25 I-anti total PSA antibody with PSA in uterus tissues homogenates of the two groups with their corresponding antigen and found to be (8.8,7.1%) for benign and malignant tumors, respectively. An Immuno Radio Metric Assay (IRMA) procedure was developed for measuring PSA in benign and malignant uterus tumors homogenates. The optimum conditions of the binding of 125 I-anti total PSA antibody with PSA were as follows: PSA concentration (150,200 μg protein),tracer antibody concentration (125,250 μg protein), p H (7.6,7.2), temp (15,25?C) and time (1.5 hrs) for postmenopausal benign and malignant uterus tumors tissue homogenates, respectively. The use of different concentrations of Na + and Mg 2+ ions were shown to cause an increase in the binding at concentration of (125,75 mΜ) of Na 1+ ions (75,225 mΜ) of Mg 2+ ions for benign and malignant uterus tumors homogenates, respectively, while the use of different concentrations of urea and polyethylene glycol (PEG) Caused a decrease in the binding with the increase in the concentration of each of urea and PEG in the both cases

The clinical value of serum PSA and PAP determinations in prostate cancer patients

International Nuclear Information System (INIS)

Zeng Lei; Yu Renbo; Du Guowei; Pang Baozhong

2001-01-01

Objective: To investigate the clinical value of serum PSA and PAP determinations in diagnosis of prostate cancer patients. Methods: The serum PSA and PAP levels of 98 prostate cancer patients, 45 prostate benign disease patients and 40 normal subjects were tested by IRMA. Results: The serum PSA and PAP levels of prostate cancer patients were significantly higher than those in prostate benign disease patients and normal controls (P < 0.01). The diagnostic sensitivity and specificity of serum PSA for prostate cancer were 93.9% and 93.3% respectively. The diagnostic sensitivity and specificity of serum PAP for prostate cancer were 71.4% and 91.1% respectively. Conclusion: The determination of serum PSA and PAP was of high clinical value for diagnosis of early prostate cancer. It could be used as an important reference parameter for the clinical staging, follow-up of treatment result and prediction of prognosis

Guideline level-3 PSA

International Nuclear Information System (INIS)

Roelofsen, P.M.; Van der Steen, J.

1993-09-01

For several applications of radioactive materials calculations must be executed to determine the radiation risk for the population. A guideline for the risk calculation method of two main sources: nuclear power plants, and other intended and unintended activities with radioactive materials, is given. The standards, recommendations and regulations in this report concern mainly the analysis of the radiological (external) consequences of nuclear power plant accidents, classified as level-3 PSA (Probabilistic Safety Analysis). Level-3 PSA falls within the scales 5-7 of the International Nuclear Event Scale (INES). The standards, etc., focus on the risks for groups of people and the so-called maximum individual risk. In chapter two the standards and regulations are formulated for each part of level-3 PSA: the source term spectrum, atmospheric distribution and deposition, exposure to radiation doses and calculation of radiation doses, dose-response relationships, measures to reduce the effect of radiation doses, design basis accidents, and finally uncertainty analysis. In chapter four, modelled descriptions are given of the standards and regulations, which could or should be used in a calculation program in case of level-3 PSA. In chapter three the practical execution of a probabilistic consequences analysis, the collection of input data and the presentation of the results are dealt with. 2 figs., 14 tabs., 64 refs

Improvement of Prostate Cancer Diagnosis by Detecting PSA Glycosylation-Specific Changes.

Science.gov (United States)

Llop, Esther; Ferrer-Batallé, Montserrat; Barrabés, Sílvia; Guerrero, Pedro Enrique; Ramírez, Manel; Saldova, Radka; Rudd, Pauline M; Aleixandre, Rosa N; Comet, Josep; de Llorens, Rafael; Peracaula, Rosa

2016-01-01

New markers based on PSA isoforms have recently been developed to improve prostate cancer (PCa) diagnosis. However, novel approaches are still required to differentiate aggressive from non-aggressive PCa to improve decision making for patients. PSA glycoforms have been shown to be differentially expressed in PCa. In particular, changes in the extent of core fucosylation and sialylation of PSA N-glycans in PCa patients compared to healthy controls or BPH patients have been reported. The objective of this study was to determine these specific glycan structures in serum PSA to analyze their potential value as markers for discriminating between BPH and PCa of different aggressiveness. In the present work, we have established two methodologies to analyze the core fucosylation and the sialic acid linkage of PSA N-glycans in serum samples from BPH (29) and PCa (44) patients with different degrees of aggressiveness. We detected a significant decrease in the core fucose and an increase in the α2,3-sialic acid percentage of PSA in high-risk PCa that differentiated BPH and low-risk PCa from high-risk PCa patients. In particular, a cut-off value of 0.86 of the PSA core fucose ratio, could distinguish high-risk PCa patients from BPH with 90% sensitivity and 95% specificity, with an AUC of 0.94. In the case of the α2,3-sialic acid percentage of PSA, the cut-off value of 30% discriminated between high-risk PCa and the group of BPH, low-, and intermediate-risk PCa with a sensitivity and specificity of 85.7% and 95.5%, respectively, with an AUC of 0.97. The latter marker exhibited high performance in differentiating between aggressive and non-aggressive PCa and has the potential for translational application in the clinic.

Perineural invasion and Gleason 7-10 tumors predict increased failure in prostate cancer patients with pretreatment PSA <10 ng/ml treated with conformal external beam radiation therapy

International Nuclear Information System (INIS)

Anderson, Penny R.; Hanlon, Alexandra L.; Patchefsky, Arthur; Al-Saleem, Tahseen; Hanks, Gerald E.

1998-01-01

Purpose: It has been well established that prostate cancer patients with pretreatment PSA<10 ng/ml enjoy excellent bNED control when treated with definitive external beam radiation therapy. This report identifies predictors of failure for patients with pretreatment PSA <10 ng/ml. These predictors are then used to define favorable and unfavorable prognostic subgroups of patients for which bNED control is compared. Methods and Materials: Between 3/87 and 11/94, 266 patients with T1-T3NXM0 prostate cancer and pretreatment PSA values <10 ng/ml were treated with definitive external beam radiation therapy. Median central axis dose and median follow-up for the entire group was 72 Gy (63-79 Gy) and 48 months (2-120 months). Predictors of bNED control were evaluated univariately using Kaplan-Meier methodology and the log-rank test and multivariately using Cox proportional hazards modeling. Covariates considered were pretreatment PSA, palpation stage, Gleason score, presence of perineual invasion (PNI) and central axis dose. Independent predictors based on multivariate results were then used to stratify the patients into two prognostic groups for which bNED control was compared. bNED failure is defined as PSA ≥ 1.5 ng/ml and rising on two consecutive determinations. Results: Univariate analysis according to pretreatment and treatment factors for bNED control demonstrates a statistically significant improvement in 5-year bNED control for patients with Gleason score 2-6 vs. 7-10, patients without evidence of perineural invasion (PNI) vs. those with PNI, and patients with palpation stage T1/T2AB vs. T2C/T3. Multivariate analysis demonstrates that Gleason score (p = 0.0496), PNI (p = 0.0008) and palpation stage (p = 0.0153) are significant independent predictors of bNED control. Based on these factors, patients are stratified into a more favorable prognosis group (Gleason 2-6, no PNI, and stage T1/T2AB, n = 172) and a less favorable prognosis group (Gleason 7-10 or PNI or T2C

[Prostate specific antigen--PSA and histopathological findings of endometrium in women with fibrocystic breast disease].

Science.gov (United States)

Radowicki, Stanisław; Kunicki, Michał

2010-02-01

The aim of the study was to evaluate the relationship between serum free and total PSA and histopathological findings in women with fibrocystic mastopathy. 176 women with fibrocystic breast disease, aged 18 to 45 years.--Group I: comprised 114 patients with cysts 10 mm in diameter. The control group consisted of 46 healthy women aged 18 - 45 years who had no breast pathology Total PSA (PSA-T) and free PSA (PSA-Free) were measured by an ultra-sensitive fluoroimmunometric DELFIA assay (Prostatus PSA Free/Total Wallac, Turku, Finland). The detection limit for PSA was 0.01 ng/ml. Endometrial samples have been obtained with Pipelle probe between 22 and 24 days of the menstrual cycle. In the control group secretory endometrium was more frequently detected than in the mastopathy group (chi2 = 11,15, p = 0.01). Proliferatory (chi2 = 8.27, p = 0.004) and presecretory endometrium (chi2 = 4.61, p = 0.03) were more frequently detected in the mastopathy group than in controls. We did not find statistically significant relationship between the mean PSA concentrations between the groups in relation to histopathological findings. No relationships between free and total PSA measured in the follicular phase of the menstrual cycle and endometrial findings were detected in our study. Further research is required to evaluate the relationship between PSA and endometrial findings.

PSA-operations synergism for the advanced test reactor shutdown operations PSA

International Nuclear Information System (INIS)

Atkinson, S.A.

1996-01-01

The Advanced Test Reactor (ATR) Probabilistic Safety Assessment (PSA) for shutdown operations, cask handling, and canal draining is a successful example of the importance of good PSA-operations synergism for achieving a realistic and accepted assessment of the risks and for achieving desired risk reduction and safety improvement in a best and cost-effective manner. The implementation of the agreed-upon upgrades and improvements resulted in the reductions of the estimated mean frequency for core or canal irradiated fuel uncovery events, a total reduction in risk by a factor of nearly 1000 to a very low and acceptable risk level for potentially severe events

Evaluation of serum PSA after cyproterone compound treatment compared with oral contraceptive pill in hirsute polycystic ovary syndrome patients

Directory of Open Access Journals (Sweden)

R. Taheripanah

2010-07-01

Conclusion: Serum free PSA and free testosterone and FG score were decreased after treatment with OCP and cyproterone compound but there was no preference between the two groups of anti-androgen treatment.

A Preliminary Fire PSA on PGSFR

International Nuclear Information System (INIS)

Kim, Kilyoo; Han, Sanghoon; Lee, KwiLim

2017-01-01

A Prototype Generation IV Sodium Fast Reactor (PGSFR) is under design with defense in depth concept with active, passive, and inherent safety features to acquire a design approval for PGSFR from Korean regulatory authority by around 2017. A preliminary fire PSA on PGSFR is done in 2016 and a final fire PSA of PGSFR will be done in 2017. The characteristics of the preliminary fire PSA on PGSFR are described in this paper. Since PGSFR is very safe reactor, it is not bad approach to use a conservative assumption in the preliminary PSA. In addition, several drawings including cable routing are not yet issued, a conservative calculation for CDF is performed. As shown in Table 2, the CDF caused by the fire in the control room takes 89% portion of total CDF. Thus, a detailed fire modeling for control room is necessary for the final fire PSA on PGSFR. Also, the increased ignition frequency due to sodium leak would be derived by considering the sodium piping complexity in the final fire PSA on PGSFR. The 4th column of Table 2 is derived the 3rd column by multiplying the factor (592/1177). The 5th column is the ignition frequency caused by the sodium leak. The 6th column is derived by summing the 4th column and the 5th column. The 7th column is the CDF portion of each fire area. The control room (fire area F-A404A) is the most important area since the control room fire takes 89% portion of total CDF.

Regulatory requirements on PSA level 2: Review, aspects and applications

International Nuclear Information System (INIS)

Husarcek, J.

2003-01-01

The general requirements concerning utility obligations, probabilistic safety criteria (CDF should not exceed 1.0E-4/reactor year and LERF should not exceed 1.0E-5/reactor year), documentation and results, living PSA requirements and major steps in level 2 PSA are presented. PSA developments in Slovakia, collection and assembly of information, plant damage states, containment performance and failure modes, severe accident progression analyses, containment failure modes and source terms as a part of performed level 2 PSA are discussed. The PSA applications in design and operation evaluation, support to plant upgrade and modifications are also described. At the end, the following conclusion is made: more extensive PSA application needs to foster the exchange of experience and communication between PSA specialists, non-PSA engineers, designers, and the regulatory body staff responsible for safety assessment, inspection and enforcement

An approach to develop a PSA workstation in KAERI

International Nuclear Information System (INIS)

Kim, T. W.; Han, S. H.; Park, C. K.

1995-01-01

This paper describes three kinds of efforts for the development of PSA workstation in KAERI; Development of a PSA tool, KIRAP, Reliability Database Development, Living PSA tool development. Korea has 9 nuclear power plants (NPPs) in operation and 9 NPPs under design or construction. For the NPPs recently constructed or designed, the probabilistic safety assessments (PSAs) have been performed by the Government requirements. For these PSAs, the MSDOS version of KIRAP has been used. For the consistent data management and the easiness of information handling needed in PSA, APSA workstation, KIRAP-Win is under development under Windows environment. For the reliability database on component failure rate, human error rate, and common cause failure rate, data used in international PSA or reliability data handbook are collected and processed to use in Korean new plants' PSAs. Finally, an effort for the development of a living PSA tool in KAERI based on dynamic PSA concept is described

A methodology for PSA model validation

International Nuclear Information System (INIS)

Unwin, S.D.

1995-09-01

This document reports Phase 2 of work undertaken by Science Applications International Corporation (SAIC) in support of the Atomic Energy Control Board's Probabilistic Safety Assessment (PSA) review. A methodology is presented for the systematic review and evaluation of a PSA model. These methods are intended to support consideration of the following question: To within the scope and depth of modeling resolution of a PSA study, is the resultant model a complete and accurate representation of the subject plant? This question was identified as a key PSA validation issue in SAIC's Phase 1 project. The validation methods are based on a model transformation process devised to enhance the transparency of the modeling assumptions. Through conversion to a 'success-oriented' framework, a closer correspondence to plant design and operational specifications is achieved. This can both enhance the scrutability of the model by plant personnel, and provide an alternative perspective on the model that may assist in the identification of deficiencies. The model transformation process is defined and applied to fault trees documented in the Darlington Probabilistic Safety Evaluation. A tentative real-time process is outlined for implementation and documentation of a PSA review based on the proposed methods. (author). 11 refs., 9 tabs., 30 refs

Development and perspectives of PSA in Cuba

International Nuclear Information System (INIS)

1996-01-01

During the last decade the GDA/PSA has carried out the pre-operational PSA task for the Juragua Nuclear Power Plant. Since 1991 the work has been accomplished in the frames of the IAEA Technical Assistance Project CUB/9/008. The paper describes the stages of this study, (concluding with the Final Report of the pre-operational Level 1 PSA Rev. O), its assumptions, limitations and the main results and concluding remarks

PSA applications

International Nuclear Information System (INIS)

Dubreuil Chambardel, A.

1996-01-01

The IAEA now defines three types of PSA applications: Validation of design and of operation procedures; optimization of plant operation; and regulatory applications. The applications of PSA are manifold: only a few are dealt with here (precursor analysis is dealt with in session 3, topic 4). For each of them, we will do the utmost to demonstrate the main difficulties encountered, EDF's viewpoint on the matter, and the points remaining to be solved. In what follows, unless explicitly stated otherwise, we have made every effort to represent the different applications as they are practiced by all concerned in the international community, and to describe the inherent difficulties the international community has encountered with these applications with all objectivity. It goes without saying that the comments below are simply those of the ESF department, and are submitted here for discussion by the experts. 13 refs

PSA applications

Energy Technology Data Exchange (ETDEWEB)

Dubreuil Chambardel, A

1997-12-31

The IAEA now defines three types of PSA applications: Validation of design and of operation procedures; optimization of plant operation; and regulatory applications. The applications of PSA are manifold: only a few are dealt with here (precursor analysis is dealt with in session 3, topic 4). For each of them, we will do the utmost to demonstrate the main difficulties encountered, EDF`s viewpoint on the matter, and the points remaining to be solved. In what follows, unless explicitly stated otherwise, we have made every effort to represent the different applications as they are practiced by all concerned in the international community, and to describe the inherent difficulties the international community has encountered with these applications with all objectivity. It goes without saying that the comments below are simply those of the ESF department, and are submitted here for discussion by the experts. 13 refs.

PSA testing anxiety, psychological morbidity, and PSA utility in the management of prostate cancer.

OpenAIRE

Micsunescu, Anamaria Elia

2017-01-01

Anecdotal reports from urologists and medical oncologists have suggested that patients with prostate cancer (PCa) often present with anxiety related to ongoing monitoring of their PSA levels as part of their disease management. The purpose of the current study, therefore, was to determine the prevalence and severity of prostate specific antigen (PSA) testing anxiety in a population of patients with either localised or metastatic PCa living in Australia. Other aspects of psychological morbidit...

Tools for PSA reviews

International Nuclear Information System (INIS)

Linden, J. von

1998-01-01

It is desirable to have a uniform and competent procedure for the review of PSAs which are performed within the framework of the Periodic Safety Review of German Nuclear Power Plants. Guidelines for the review process should therefore be evaluated within task A. 1 of project SR 2096. The basis for this work is the experience and knowledge within GRS derived from PSA-related work and from several review projects as well as the German PSA Guide with its appendices. Furthermore, the review processes in the USA, Switzerland and Sweden and the Guidelines for the International Peer Review Service (IPERS Guidelines) were utilized. As a result, recommendations are given for the review process, with individual recommendations concerning the organization of the review, task allocation between the reviewers, interface problems, assessment criteria, the scope and depth of the review as well as the supporting documents. An additional result are checklists for the technical elements of the PSA, which are listed to facilicate the review work. It is not the intention of this report to work out complete review guidelines. Its aims is rather more to give recommondations and support for the review in addition to what can be derived from the existing documents that should be used for the review. The recommendations reflect the view of GRS and go beyond the statements given in the German PSA Guide (Leitfaden Probabilistische Sicherheitsanalyse /PSUe97/) in some points. (orig.) [de

[Use of [-2] pro PSA and phi index for early detection of prostate cancer: a prospective of 452 patients].

Science.gov (United States)

Houlgatte, A; Vincendeau, S; Desfemmes, F; Ramirez, J; Benoist, N; Bensalah, K; Durand, X

2012-05-01

Early detection of prostate cancer (Pca) is a real challenge to reduce morbidity and mortality while avoiding over-diagnosis and over-treatment. The prostate specific antigen (PSA) is characterized by its imperfections justifying the evaluation of new serum or urinary specific markers allowing a better selection of patients at risk of developing aggressive Pca. To compare the value of -2pro PSA and phi index to total and free PSA. Serum sampled from 452 patients from two university centers were used to determine levels of PSA before performing biopsies. The patients were included in this study based on the PSA serum concentration between 1.6 ng/mL and 8 ng/mL according to the WHO international standard. All biopsies were performed according to a standardized protocol consisting of 12 cores or more. Sera were analyzed centrally in one of the two institutions with on a single analyzer. Sera from 243 prostate cancer and 208 negative biopsies patients have been taken into account. Sera were analyzed blinded for total PSA, free PSA and [-2] proPSA using Access(®) immunoassay method from Beckman Coulter. The Prostate Health Index (phi) was calculated using the formula phi=([-2] proPSA/fPSA)×sqrt (PSA). The median value of the phi index is significantly (P>0.0001) higher for patients with cancer (phi=65.8) compared to patients with negative biopsies (phi=40.6). At a given sensitivity, the phi index significantly increases the specificity of detection of prostate cancer compared to other markers. The phi index currently appears as the best predictor of prostate cancer for patients with a total PSA between 1.6 and 8 ng/mL according to the WHO standard. The improvement in specificity of the phi index over tPSA could reduce significantly the numbers of unnecessary biopsies. Whether this new biomarker could be an indicator of aggressive prostate cancer remains to be confirmed. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Final guidance document for extended Level 2 PSA Volume 1. Summary report for external hazards implementation in extended L2 PSA, validation of SAMG strategy and complement of ASAMPSA2 L2PSA guidance

International Nuclear Information System (INIS)

Loeffler, H.; Raimond, E.

2016-01-01

The present document is a summary of the deliverables produced within the ASAMPSA-E project for extended L2 PSA. These deliverables are: D30.7 vol. 2, 'Implementing external Events modelling in Level 2 PSA': D30.7 vol. 3: 'Verification and improvement of SAM strategy: D30.7 vol. 4: 'Consideration of shutdown states, spent fuel pools and recent R and D results'. Among many others, the following summary statements are provided: Analyses of external events: - No need for new methodology, - It is necessary to develop L1 PSA first and then clearly defined boundary conditions for the L2 PSA must be generated, - The remaining challenge is how to address adverse environmental conditions due to external hazards. Multi units: - No practical methodology exists to treat the problem, - A new methodology is necessary to be developed first for the L1 PSA. This should, from the beginning, take into account the specific needs of L2 PSA so that the boundary conditions for subsequent level 2 analysis can be generated adequately. SAM strategies verification and improvement: - L2 PSA methodology can usefully by applied and experience exists for internal initiating events L2 PSA, - How to address adverse environmental conditions due to external hazards - needs for new methodology or examples of experience, - How to model the decision process when there is a conflict of interest - needs for new methodology or examples of experience. For L2 PSA in shutdown states with open RPV, some new technical issues (fission product release, thermal load to structures above RPV) have to be addressed. Spent fuel pool issues have been developed, in particular: - Heat load from the melting spent fuel to structures above (e.g. to the containment roof) is a severe challenge for the plant and for the present-day, methodology is missing. Recent R and D achievements with relevance for L2 PSA: - Basic research has been continued in the radiochemistry (iodine and ruthenium chemistry) field, but the existing

Prostate-specific antigen cancer volume: a significant prognostic factor in prostate cancer patients at intermediate risk of failing radiotherapy

International Nuclear Information System (INIS)

Lankford, Scott P.; Pollack, Alan; Zagars, Gunar K.

1997-01-01

Purpose: Although the pretreatment serum prostate-specific antigen level (PSAL) is the single-most significant predictor of local and biochemical control in prostate cancer patients treated with radiotherapy, it is relatively insensitive for patients with a PSAL in the intermediate range (4-20 ng/ml). PSA density (PSAD) has been shown to be slightly more predictive of outcome than PSAL for this intermediate risk group; however, this improvement is small and of little use clinically. PSA cancer volume (PSACV), an estimate of cancer volume based on PSA, has recently been described and has been purported to be more significant t than PSAL in predicting early biochemical failure after radiotherapy. We report a detailed comparison between this new prognostic factor, PSAL, and PSAD. Methods and Materials: The records of 356 patients treated with definitive external beam radiotherapy for regionally localized (T1-4,Nx,M0) adenocarcinoma of the prostate were reviewed. Each patient had a PSAL, biopsy Gleason score, and pretreatment prostate volume by transrectal ultrasonography. The median PSAL was 9.3 ng/ml and 66% had Gleason scores in the 2-6 range. The median radiation dose was 66.0 Gy and the median follow-up for those living was 27 months. PSACV was calculated using a formula which takes into account PSAL, pretreatment prostate ultrasound volume, and Gleason score. The median PSACV was 1.43 cc. Biochemical failure was defined as increases in two consecutive follow-up PSA levels, one increase by a factor > 1.5, or an absolute increase of > 1 ng/ml. Local failure was defined as a cancer-positive prostate biopsy, obtained for evidence of tumor progression. Results: The distributions of PSACV and PSAL were similar and, when normalized by log transformation, were highly correlated (p < 0.0001, linear regression). There was a statistically significant relationship between PSACV and several potential prognostic factors including PSAL, PSAD, stage, Gleason score, and

One Approach to the Fire PSA Uncertainty Analysis

International Nuclear Information System (INIS)

Simic, Z.; Mikulicic, V.; Vukovic, I.

2002-01-01

Experienced practical events and findings from the number of fire probabilistic safety assessment (PSA) studies show that fire has high relative importance for nuclear power plant safety. Fire PSA is a very challenging phenomenon and a number of issues are still in the area of research and development. This has a major impact on the conservatism of fire PSA findings. One way to reduce the level of conservatism is to conduct uncertainty analysis. At the top-level, uncertainty of the fire PSA can be separated in to three segments. The first segment is related to fire initiating events frequencies. The second uncertainty segment is connected to the uncertainty of fire damage. Finally, there is uncertainty related to the PSA model, which propagates this fire-initiated damage to the core damage or other analyzed risk. This paper discusses all three segments of uncertainty. Some recent experience with fire PSA study uncertainty analysis, usage of fire analysis code COMPBRN IIIe, and uncertainty evaluation importance to the final result is presented.(author)

PSA in operator training

International Nuclear Information System (INIS)

Nos, V.; Faig, J.; Plesa, P.; Delgado, J. L.

2000-01-01

The systematic approach to training is internationally accepted as the best method to achieve and maintain the qualification and competence of power plant personnel and to guarantee the quality of their training. Following the recommendations and guidelines of international organisations competent in the field, TECNATOM SA has developed projects based on the systematic approach to training for all Spanish nuclear power plants. One of the latest projects was the systematic approach to training developed for the operation personnel of ASCO Nuclear Power Plant. In this case, certain results of the Probabilistic Safety Analysis (PSA) which complement the systematic safety and reliability criteria of the systematic approach to training process have been incorporated in the traditional processes of work and task analysis and training plan design. This incorporation provides the training manager with additional criteria based not only on safety aspects obtained through the statistical treatment of considerations of skilled technical personnel (operators, operation chief supervisors, etc), but also on the independent criterion of the PSA. The inclusion of this approach basically affects all systematics in two of its stages: During the selection process of operating practices in SMR or SGI, the possible scenarios have been associated with all those situations where human actions which lead to an initiating event or human actions to mitigate an initiating event, may take place, as defined in the PSA. During the scenario development process, the instruments involved in the performance of human actions which originate or mitigate an event taking place have been identified. This pakes it possible to reconcile the scenario event sequence with the sequence considered in the PSA study, as the most likely to provoke a more serious accident. The incorporation of these PSA results contributes to the strengthening of safety aspects in training in an objective way, and confirms that

Upgrade of internal events PSA model using the AESJ level-1 PSA standard for operating state

International Nuclear Information System (INIS)

Sato, Teruyoshi; Yoneyama, Mitsuru; Hirokawa, Naoki; Sato, Chikahiro; Sato, Eisuke; Tomizawa, Shigeatsu

2009-01-01

In 2003, the Atomic Energy Society of Japan (AESJ) started to develop the Level-1 Probabilistic Safety Assessment (PSA) standard of internal events for operating state (AESJ standard). The AESJ standard has been finished to be asked for public comment. Using the AESJ standard (draft version), the authors have upgraded the PSA model for Tokyo Electric Power Company (TEPCO) BWR-5 plant not only to reflect latest knowledge but also to ensure high quality of PSA model (not yet peer-reviewed) for the purpose of better operation and maintenance management of TEPCO BWR plants. For example, the categorization of structures, systems and components (SSCs) will be performed to improve nuclear reactor safety using information of risk importance. (author)

Evaluation of PCA3 and multiparametric MRI’s: collective benefits before deciding initial prostate biopsy for patients with PSA level between 3-10ng/mL

Directory of Open Access Journals (Sweden)

Sezgin Okcelik

2016-06-01

Full Text Available ABSTRACT Objective To analyze the contribution of multiparametric MRI and PCA3 assay, pre- decision of initial biopsy in PSA level between 3-10 ng/mL patients with normal digital rectal examination(DRE. Materials and Methods PSA level 3-10 ng/mL ,patients, with normal DRE results and no previous prostate biopsy history, were included in this study. Each patient underwent multiparametric MRI one week before biopsy. Urine sample taking for PCA3 examination preceded the biopsy. Systematic and targeted biopsies were conducted. Patients with high PSA levels were seperated into two groups as: high PCA3 scored and low PCA3 scored. Then each group was divided into two sub-groups as: MRI lesion positive and negative. Tumor incidence, positive predictive values(PPV and negative predictive values(NPV were calculated. Results 53 patients were included between February 2013 and March 2014.Mean age 61.22 ± 1.06. Mean PSA value 5.13 ± 0.19 ng / mL. Mean PCA3 score 98.01 ± 23.13 and mean prostate size was 48.96 ± 2.67 grams. Fourty nine patients had both PCA3 score and multiparametric MRI. The PCA3’s PPV value was 58.33%. If multiparametric MRI lesions are added to high PCA3 scores , the PPV appears to elevate to 91.66%. NPV of PCA3 was 96%. NPV was 95% when there was no lesion in the multiparametric MRI with low PCA3 scores. Sensitivity was 91.66% , specificity was 95% respectively. Conclusion Adding multimetric MRI can also support biopsy decision for patients with high PCA3 value. When PCA3 value is low, patients can be survailled without any need to take a MRI.

Development of seismic PSA methodology at JAERI

International Nuclear Information System (INIS)

Muramatsu, K.; Ebisawa, K.; Matsumoto, K.; Oikawa, T.; Kondo, M.

1995-01-01

The Japan Atomic Energy Research Institute (JAERI) is developing a methodology for seismic probabilistic safety assessment (PSA) of nuclear power plants, aiming at providing a set of procedures, computer codes and data suitable for performing seismic PSA in Japan. In order to demonstrate the usefulness of JAERI's methodology and to obtain better understanding on the controlling factors of the results of seismic PSAs, a seismic PSA for a BWR is in progress. In the course of this PSA, various improvements were made on the methodology. In the area of the hazard analysis, the application of the current method to the model plant site is being carried out. In the area of response analysis, the response factor method was modified to consider the non-linear response effect of the building. As for the capacity evaluation of components, since capacity data for PSA in Japan are very scarce, capacities of selected components used in Japan were evaluated. In the systems analysis, the improvement of the SECOM2 code was made to perform importance analysis and sensitivity analysis for the effect of correlation of responses and correlation of capacities. This paper summarizes the recent progress of the seismic PSA research at JAERI with emphasis on the evaluation of component capacity and the methodology improvement of systems reliability analysis. (author)

Results of level 1 PSA in Trillo 1 NPP

International Nuclear Information System (INIS)

Gomez, F.; Lopez, C.

1998-01-01

In July 1991, C. N. Trillo I was requested by the Spanish Regulatory Body (CSN) to perform a PSA that should include: - Level 1 PSA at power - Internal flooding analysis - Level 2 PSA including containment capacity analysis. - External event analyses (fires, external flooding, seismic events and other external events) - Risk analysis for off power conditions (shutdown and low power) - Risk analysis due to other sources of radioactivity In 1992 the Project Plan was issued and the PSA team for the performance of Level 1 PSA was established. Before finishing the Project, it was decided to develop a Phase B to take into account some important modifications that had been accomplished in the Plant and that, probably, could affect the results. Level 1 PSA was finished in March 1998. Both the results of the study and the main conclusions derived from the importance, uncertainty and sensibility analysis performed are presented in this paper. These results de not include the internal flooding analysis conclusions and correspond to PSA revision 0 that is currently being evaluated by the Spanish Regulatory Body. (Author)

Perspectives of Living PSA in NPP Krsko

International Nuclear Information System (INIS)

Vrbanic, I.; Kastelan, M.

1996-01-01

Nuclear power plant Krsko has completed the Level 1/Level 2 Probabilistic Safety Analysis (PSA) for internal initiating events and is in the process of completing the same for the external initiators. The analysis completed up to now has provided a valuable insight into a plant risk profile. In NPP Krsko there is a plan to use the PSA model as a permanent tool for the risk based applications and incorporate it into a decision making process. In order to achieve this there is a need to permanently maintain the PSA model in a manner that it reflects both the plan configuration/design at a time point and the operational experience up to the time point. All the activities aimed toward keeping the PSA model up-to-dated in this sense are usually referred to as a Living PSA (LPSA) program. NPP Krsko is in the process of defining and proceduralizing a LPSA program that would be plant specific and based on known world practices. Further, in order to be suitable for risk based applications the PSA model must be flexible in a sense that modifications to the base case model may be done easily and requantifications performed quickly as to evaluate various conditions imposed by real or hypothetical situations. NPP Krsko PSA model has been based on licensing type software. The requirements specified above dictate the transfer of the overall model to an application oriented software of newer generation with larger capabilities. The transfer becomes a part of a mentioned ongoing effort aimed at establishing LPSA model and concept. The paper present this effort and the perspectives of LPSA concept and risk based applications in NPP Krsko. (author)

Key Characteristics of Combined Accident including TLOFW accident for PSA Modeling

Energy Technology Data Exchange (ETDEWEB)

Kim, Bo Gyung; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of); Yoon, Ho Joon [Khalifa University of Science, Technology and Research, Abu Dhabi (United Arab Emirates)

2015-05-15

The conventional PSA techniques cannot adequately evaluate all events. The conventional PSA models usually focus on single internal events such as DBAs, the external hazards such as fire, seismic. However, the Fukushima accident of Japan in 2011 reveals that very rare event is necessary to be considered in the PSA model to prevent the radioactive release to environment caused by poor treatment based on lack of the information, and to improve the emergency operation procedure. Especially, the results from PSA can be used to decision making for regulators. Moreover, designers can consider the weakness of plant safety based on the quantified results and understand accident sequence based on human actions and system availability. This study is for PSA modeling of combined accidents including total loss of feedwater (TLOFW) accident. The TLOFW accident is a representative accident involving the failure of cooling through secondary side. If the amount of heat transfer is not enough due to the failure of secondary side, the heat will be accumulated to the primary side by continuous core decay heat. Transients with loss of feedwater include total loss of feedwater accident, loss of condenser vacuum accident, and closure of all MSIVs. When residual heat removal by the secondary side is terminated, the safety injection into the RCS with direct primary depressurization would provide alternative heat removal. This operation is called feed and bleed (F and B) operation. Combined accidents including TLOFW accident are very rare event and partially considered in conventional PSA model. Since the necessity of F and B operation is related to plant conditions, the PSA modeling for combined accidents including TLOFW accident is necessary to identify the design and operational vulnerabilities.The PSA is significant to assess the risk of NPPs, and to identify the design and operational vulnerabilities. Even though the combined accident is very rare event, the consequence of combined

Regulatory review of probabilistic safety assessment (PSA) Level 2

International Nuclear Information System (INIS)

2001-07-01

Probabilistic safety assessment (PSA) is increasingly being used as part of the decision making process to assess the level of safety of nuclear power plants. The methodologies in use are maturing and the insights gained from the PSAs are being used along with those from deterministic analysis. Many regulatory authorities consider the current state of the art in PSA to be sufficiently well developed for results to be used centrally in the regulatory decision making process-referred to as risk informed regulation. For these applications to be successful, it will be necessary for the regulatory authority to have a high degree of confidence in the PSA. However, at the 1994 IAEA Technical Committee Meeting on Use of PSA in the Regulatory Process and at the OECD Nuclear Energy Agency Committee for Nuclear Regulatory Activities (CNRA) 'Special Issues' meeting in 1997 on Review Procedures and Criteria for Different Regulatory Applications of PSA, it was recognized that formal regulatory review guidance for PSA did not exist. The senior regulators noted that there was a need to produce some international guidance for reviewing PSAs to establish an agreed basis for assessing whether important technological and methodological issues in PSAs are treated adequately and to verify that conclusions reached are appropriate. In 1997, the IAEA and OECD Nuclear Energy Agency agreed to produce, in cooperation, guidance on Regulatory Review of PSA. This led to the publication of IAEA-TECDOC-1135 on the Regulatory Review of Probabilistic Safety Assessment (PSA) Level 1, which gives advice for the review of Level 1 PSA for initiating events occurring at power plants. This TECDOC extends the coverage to address the regulatory review of Level 2 PSA.These publications are intended to provide guidance to regulatory authorities on how to review the PSA for a nuclear power plant to gain confidence that it has been carried out to an acceptable level of quality so that it can be used as the

Regulatory review of probabilistic safety assessment (PSA) level 1

International Nuclear Information System (INIS)

2000-02-01

Probabilistic safety assessment (PSA) is increasingly being used as part of the decision making process to assess the level of safety of nuclear power plants. The methodologies in use are maturing and the insights gained from the PSAs are being used along with those from the deterministic analysis. Many regulatory authorities consider that the current state of the art in PSA (especially Level 1 PSA) is sufficiently well developed that it can be used centrally in the regulatory decision making process - referred to as 'risk informed regulation'. For these applications to be successful, it will be necessary for regulatory authorities to have a high degree of confidence in PSA. However, at the IAEA Technical Committee Meeting on Use of PSA in the Regulatory Process in 1994 and at the OECD Nuclear Energy Agency Committee for Nuclear Regulatory Activities (CNRA) 'Special Issues' Meeting in 1997 on Review Procedures and Criteria for Different Regulatory Applications of PSA, it was recognized that formal regulatory review guidance for PSA did not exist. The senior regulators noted that there was a need to produce some international guidance for reviewing PSAs to establish an agreed basis for assessing whether important technological and methodological issues in PSAs are treated adequately and to verify that conclusions reached are appropriate. In 1997 the IAEA and OECD Nuclear Energy Agency agreed to produce in co-operation a technical document on the regulatory review of PSA. This publication is intended to provide guidance to regulatory authorities on how to review the PSA for a nuclear power plant to gain confidence that it has been carried out to an acceptable standard so that it can be used as the basis for taking risk informed decisions within a regulatory decision making process. The document gives guidance on how to set about reviewing a PSA and on the technical issues that need to be addressed. This publication gives guidance for the review of Level 1 PSA for

Applications of probabilistic safety assessment (PSA) for nuclear power plants

International Nuclear Information System (INIS)

2001-02-01

This report, which compiles information on a comprehensive set of PSA applications in the areas of NPP design, operation, and accident mitigation and management, is the culmination of an IAEA project on PSA Applications and Tools to Improve NPP Safety. In this regard, the Technical Committee Meeting (TCM) held in Madrid in February 1998 allowed participants to review and provide very valuable comments for this report. Several important facts related to PSA and its applications were highlighted during this TCM: living PSAs are the basis for the risk informed approach to decision making; development and use of safety/risk monitors as tools for configuration management is spreading fast; the different uses of PSA to support NPP testing and maintenance planning and optimization are amongst the most widespread PSA applications; plant specific PSAs are being used to support the safety upgrading programmes of plants built to earlier standards; not all countries have a regulatory framework for the use of the probabilistic approach in decision making. Some countries are still far from 'risk-informed' regulation, and this means that there is still considerable work ahead, both for regulators and utilities, to clarify approaches, to establish a framework and to reach a common understanding in relation to the use of PSA in decision making. This report is based on the premise that the use of PSA can provide useful information for the decision maker. This report is intended to provide an overview of current PSA applications. Section 2 addresses the PSA application process, outlines the general requirements for PSA tools and provides a discussion on PSA aspects such as PSA level, scope and level of detail, which have to be considered when planning/performing PSA applications. Section 3 discusses the technical aspects of individual applications and is divided into three parts. Section 3.1 is dedicated to the design related PSA applications. The second part of Section 3 considers

Prostate health index and prostate cancer gene 3 score but not percent-free Prostate Specific Antigen have a predictive role in differentiating histological prostatitis from PCa and other nonneoplastic lesions (BPH and HG-PIN) at repeat biopsy.

Science.gov (United States)

De Luca, Stefano; Passera, Roberto; Fiori, Cristian; Bollito, Enrico; Cappia, Susanna; Mario Scarpa, Roberto; Sottile, Antonino; Franco Randone, Donato; Porpiglia, Francesco

2015-10-01

To determine if prostate health index (PHI), prostate cancer antigen gene 3 (PCA3) score, and percentage of free prostate-specific antigen (%fPSA) may be used to differentiate asymptomatic acute and chronic prostatitis from prostate cancer (PCa), benign prostatic hyperplasia (BPH), and high-grade prostate intraepithelial neoplasia (HG-PIN) in patients with elevated PSA levels and negative findings on digital rectal examination at repeat biopsy (re-Bx). In this prospective study, 252 patients were enrolled, undergoing PHI, PCA3 score, and %fPSA assessments before re-Bx. We used 3 multivariate logistic regression models to test the PHI, PCA3 score, and %fPSA as risk factors for prostatitis vs. PCa, vs. BPH, and vs. HG-PIN. All the analyses were performed for the whole patient cohort and for the "gray zone" of PSA (4-10ng/ml) cohort (171 individuals). Of the 252 patients, 43 (17.1%) had diagnosis of PCa. The median PHI was significantly different between men with a negative biopsy and those with a positive biopsy (34.9 vs. 48.1, Pprostatitis and PCa was moderate, although it extended to a good range of threshold probabilities (40%-100%), whereas that from using %fPSA was negligible: this pattern was reported for the whole population as for the "gray zone" PSA cohort. In front of a good diagnostic performance of all the 3 biomarkers in distinguishing negative biopsy vs. positive biopsy, the clinical benefit of using the PCA3 score and PHI to estimate prostatitis vs. PCa was comparable. PHI was the only determinant for prostatitis vs. BPH, whereas no biomarkers could differentiate prostate inflammation from HG-PIN. Copyright © 2015 Elsevier Inc. All rights reserved.

PSA in design of passive/active safety reactors

International Nuclear Information System (INIS)

Sato, T.; Tanabe, A.; Kondo, S.

1995-01-01

PSAs in the design of advanced reactors are applied mainly in level 1 PSA areas. However, even in level 1 PSA, there are certain areas where special care must be taken depending on plant design concepts. This paper identifies these areas both for passive and active safety reactor concepts. For example, 'long-term PSA' and shutdown PSA are very important for a passive safety reactor concept from the standpoint of effectiveness of a grace period and passive safety systems. External events are also important for an active safety reactor concept. These kinds of special PSAs are difficult to conduct precisely in a conceptual design stage. This paper shows methods of conducting these kinds of special PSAs simply and conveniently and the use of acquired insights for the design of advanced reactors. This paper also clarifies the meaning or definition of a grace period from the standpoint of PSA

PSA data base, comparison of the German and French approach

International Nuclear Information System (INIS)

Kreuser, A.; Tirira, J.

2001-01-01

The results of probabilistic safety assessments (PSA) of nuclear power plants strongly depend on the reliability data used. This report describes coarsely the general process to generate reliability data for components and resumes the differences between the German and French approaches. As has been shown in former studies which compared international PSA data, PSA data are closely related to the model definitions of the PSA. Therefore single PSA data cannot be compared directly without regard e.g. to the corresponding fault trees. These findings are confirmed by this study. The comparison of German and French methods shows a lot of differences concerning various details of the data generation process. Some differences between single reliability data should be eliminated when taking into account the complete fault tree analysis. But there are some other differences which have a direct impact on the obtained results of a PSA. In view of the all differences between both approaches concerning the definition of data and the data collection process, it is not possible to compare directly German and French PSA data. However, the database differences give no indication on the influence on the PSA results. Therefore, it is a need to perform a common IPSN/GRS assessment on how the different databases impact the PSA results. (orig.)

Summary report for the second TUV-workshop proceedings on living PSA application

International Nuclear Information System (INIS)

1991-01-01

This workshop on living PSA Application was organized to support the OECD/NEA CSNI-Principal Working Group No.5 on Risk Assessment for an international exchange of experience on living PSA application. The first session was devoted to Living PSA Applications and the second session to Tools for Living PSA. Living PSA Applications: Reasons for performing PSA (regulatory requirement, targets; corporate requirement, targets; safety related activity prioritization; other); Logistic of Living PSA Management (Corporate management involvement, Decision making levels and guidance, Plant level involvement, Required personnel commitment, Frequency and extent of re-quantification of PSA, Types of safety/risk parameters to be monitored, Quality assurance on maintaining Living PSA); Examples of Application (Experiences of application, State of Living PSA/e.g. all accident sequences involved, Details of component level involvement). Tools for Living PSA: Data Collection Systems and Codes (Source and type of data collected, Probabilistic parameter quantification, Interface to basic event data, Data code systems). An executive summary of the workshop is given

A preliminary investigation of PSA validation methods

Energy Technology Data Exchange (ETDEWEB)

Unwin, S D [Science Applications International Corp., (United States)

1995-09-01

This document has been prepared to support the initial phase of the Atomic Energy Control Board`s program to review and evaluate Probabilistic Safety Assessment (PSA) studies conducted by nuclear generating station designers and licensees. The document provides (1) a review of current and prospective applications of PSA technology in the Canadian nuclear power industry; (2) an assessment of existing practices and techniques for the review or risk and hazard identification studies in the international nuclear power sector and other technological sectors; and (3) proposed analytical framework in which to develop systematic techniques for the scrutiny and evaluation of a PSA model. These frameworks are based on consideration of the mathematical structure of a PSA model and are intended to facilitate the development of methods to evaluate a model relative to intended end-uses. (author). 34 refs., 10 tabs., 3 figs.

A preliminary investigation of PSA validation methods

International Nuclear Information System (INIS)

Unwin, S.D.

1995-09-01

This document has been prepared to support the initial phase of the Atomic Energy Control Board's program to review and evaluate Probabilistic Safety Assessment (PSA) studies conducted by nuclear generating station designers and licensees. The document provides (1) a review of current and prospective applications of PSA technology in the Canadian nuclear power industry; (2) an assessment of existing practices and techniques for the review or risk and hazard identification studies in the international nuclear power sector and other technological sectors; and (3) proposed analytical framework in which to develop systematic techniques for the scrutiny and evaluation of a PSA model. These frameworks are based on consideration of the mathematical structure of a PSA model and are intended to facilitate the development of methods to evaluate a model relative to intended end-uses. (author). 34 refs., 10 tabs., 3 figs

The role of PSA in safety management

International Nuclear Information System (INIS)

Szikszai, T.

1997-01-01

The presentation discusses the following issues: defence in depth principle (the role of the barriers, how does PSA represents the barriers?); the safety management and nuclear power plants; the probabilistic and deterministic approaches; the PSA applications and safety management

Comparison and lessons learned from plant specific PSA of German NPP

International Nuclear Information System (INIS)

Balfanz, Hans-Peter; Berg, H.P.

2000-01-01

PSA are launched in frame of Periodic Safety Reviews (PSR) in Germany. The aims are to identify overall safety level and relative weak points. Some backfitting measures have been realized for older plants to remove relative weak points and to bring these plants to the state of the art. In this field PSA is well accepted today and is seen as a valuable tool supplementing the deterministic analysis. Main application of PSA within PSR is planned to become mandatory as part of the revision of the German Atomic Energy Act. According to the German PSA Guideline plant specific PSA level 1+ were performed for all 19 In comparison with international practice German PSA are very detailed. Otherwise they do not handle all external events, non-power states and accident management measures as discussed before. The New PSA guideline will cover these aspects and therefore analysts have to take them into account in further PSA. Moreover gathering of plant specific data is needed. The development in this field is driven by the utilities (for instance in frame of their so-called ZEDB project). Public discussion about quantitative risk of industrial hazards is quite limited in Germany and PSA results have only few impacts to this respect. Independent from this PSA for NPP is understood as a diverse tool in supporting the deterministic licensing and supervision process. Risk based decision making as well as informed regulation are just only of the beginning. State of PSA of NPP in Germany, comparison of PSA result of different NPP, German PSA guideline and state of discussion of further development and recommendation of further development of PSA of NPP are discussed in this paper in more detail. (S.Y.)

Comparison and lessons learned from plant specific PSA of German NPP

Energy Technology Data Exchange (ETDEWEB)

Balfanz, Hans-Peter [TUEV Nord, Hamburg (Germany); Berg, H.P.

2000-07-01

PSA are launched in frame of Periodic Safety Reviews (PSR) in Germany. The aims are to identify overall safety level and relative weak points. Some backfitting measures have been realized for older plants to remove relative weak points and to bring these plants to the state of the art. In this field PSA is well accepted today and is seen as a valuable tool supplementing the deterministic analysis. Main application of PSA within PSR is planned to become mandatory as part of the revision of the German Atomic Energy Act. According to the German PSA Guideline plant specific PSA level 1+ were performed for all 19 In comparison with international practice German PSA are very detailed. Otherwise they do not handle all external events, non-power states and accident management measures as discussed before. The New PSA guideline will cover these aspects and therefore analysts have to take them into account in further PSA. Moreover gathering of plant specific data is needed. The development in this field is driven by the utilities (for instance in frame of their so-called ZEDB project). Public discussion about quantitative risk of industrial hazards is quite limited in Germany and PSA results have only few impacts to this respect. Independent from this PSA for NPP is understood as a diverse tool in supporting the deterministic licensing and supervision process. Risk based decision making as well as informed regulation are just only of the beginning. State of PSA of NPP in Germany, comparison of PSA result of different NPP, German PSA guideline and state of discussion of further development and recommendation of further development of PSA of NPP are discussed in this paper in more detail. (S.Y.)

Image Guided Hypofractionated Radiotherapy by Helical Tomotherapy for Prostate Carcinoma: Toxicity and Impact on Nadir PSA

Directory of Open Access Journals (Sweden)

Salvina Barra

2014-01-01

Full Text Available Aim. To evaluate the toxicity of a hypofractionated schedule for primary radiotherapy (RT of prostate cancer as well as the value of the nadir PSA (nPSA and time to nadir PSA (tnPSA as surrogate efficacy of treatment. Material and Methods. Eighty patients underwent hypofractionated schedule by Helical Tomotherapy (HT. A dose of 70.2 Gy was administered in 27 daily fractions of 2.6 Gy. Acute and late toxicities were graded on the RTOG/EORTC scales. The nPSA and the tnPSA for patients treated with exclusive RT were compared to an equal cohort of 20 patients treated with conventional fractionation and standard conformal radiotherapy. Results. Most of patients (83% did not develop acute gastrointestinal (GI toxicity and 50% did not present genitourinary (GU toxicity. After a median follow-up of 36 months only grade 1 of GU and GI was reported in 6 and 3 patients as late toxicity. Average tnPSA was 30 months. The median value of nPSA after exclusive RT with HT was 0.28 ng/mL and was significantly lower than the median nPSA (0.67 ng/mL of the conventionally treated cohort (P=0.02. Conclusions. Hypofractionated RT schedule with HT for prostate cancer treatment reports very low toxicity and reaches a low level of nPSA that might correlate with good outcomes.

The OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) is reliable and sensitive to change: results from an OMERACT workshop

DEFF Research Database (Denmark)

Bøyesen, Pernille; McQueen, Fiona M; Gandjbakhch, Frédérique

2011-01-01

The aim of this multireader exercise was to assess the reliability and sensitivity to change of the psoriatic arthritis magnetic resonance imaging score (PsAMRIS) in PsA patients followed for 1 year.......The aim of this multireader exercise was to assess the reliability and sensitivity to change of the psoriatic arthritis magnetic resonance imaging score (PsAMRIS) in PsA patients followed for 1 year....

Lessons learned form IRSN review of Flamanville 3 Level PSA

International Nuclear Information System (INIS)

Georgescu, G.; Corenwinder, F.

2012-01-01

In the frame of the construction and licensing of Flamanville 3 NPP the PSA (Probabilistic Safety Assessment)plays an important role for the EPR Project assessment. The PSA was used for early design verification of EPR Reactor, several design improvement being defined based on these PSA insights and following the discussions with the French and German safety authorities. IRSN, as the French Safety Authority (ASN) technical support organization, performs the review of the PSA developed by the plant operator (EDF). The paper presents the main issues regarding the using of 'design PSA', identified by IRSN following the review of the internal events Level 1 PSA transmitted by EDF in the frame of the anticipated instruction of the application for operating license of the Flamanville 3 reactor. (authors)

Examination of risk significant configuration during low power and shutdown with ORION and PSA

Energy Technology Data Exchange (ETDEWEB)

Park, Chul Kyu; Oh, Seung Jong [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

2015-10-15

This paper suggests an approach to calculate the increased CDF corresponding to Orange and Red states in ORION program and analyzed the result of calculation. This approach is expected to be useful for checking the adequacy of the LPSD PSA. And also, the result of this calculation can provide the information about which SSCs for certain SF are more sensitive to risk in particular POS. Defense-in-depth is a safety philosophy in which multiple lines of defense and conservative design and evaluation methods are applied to ensure the safety of the public. Based on this philosophy EPRI developed Outage Risk Assessment and Management (ORAM) program as a qualitative assessment to better manage the risk during low power and shutdown event after the Vogtle loss of vital AC power and RHR event in 1990. Each risk level of RED, ORANGE color status caused by the degradation of each key safety function might be different depend on the importance of each key safety function. However we can't know how much different. If we know the quantitative information about the risk level represented by color, we can take and prepare concrete actions to reduce the risk level of the plant with rescheduling maintenance, strengthen surveillance for important safety function, and developing outage management strategy. The probabilistic safety analysis for low power and shutdown period can provide risk information with quantitative value related on the degradation of redundancy and diversity level for the safety functions during outage. In this study, we calculated the increased Core Damage frequency (CDF) of each RED and ORANGE states in ORION program caused by the degradation of each key safety function by modifying LPSD PSA model. The result of calculation and analysis could be effective to check adequacy and find improvement for these two methods.

A Joint Report on PSA for New and Advanced Reactors

International Nuclear Information System (INIS)

2013-01-01

This report addresses the application of Probabilistic Safety Assessment (PSA) to new and advanced nuclear reactors. As far as advanced reactors are concerned, the objectives were to characterize the ability of current PSA technology to address key questions regarding the development, acceptance and licensing of advanced reactor designs, to characterize the potential value of advanced PSA methods and tools for application to advanced reactors, and to develop recommendations for any needed developments regarding PSA for these reactors. As far as the design and commissioning of new nuclear power plants is concerned, the objectives were to identify and characterize current practices regarding the role of PSA, to identify key technical issues regarding PSA, lessons learned and issues requiring further work; to develop recommendations regarding the use of PSA, and to identify future international cooperative work on the identified issues. In order to reach these objectives, questionnaires had been sent to participating countries and organisations

Enhanced detection sensitivity of prostate-specific antigen via PSA-conjugated gold nanoparticles based on localized surface plasmon resonance: GNP-coated anti-PSA/LSPR as a novel approach for the identification of prostate anomalies.

Science.gov (United States)

Jazayeri, M H; Amani, H; Pourfatollah, A A; Avan, A; Ferns, G A; Pazoki-Toroudi, H

2016-10-01

Prostate-specific antigen (PSA) is used to screen for prostate disease, although it has several limitations in its application as an organ-specific or cancer-specific marker. Furthermore, a highly specific/sensitive and/or label-free identification of PSA still remains a challenge in the diagnosis of prostate anomalies. We aimed to develop a gold nanoparticle (GNP)-conjugated anti-PSA antibody-based localized surface plasmon resonance (LSPR) as a novel approach to detect prostatic disease. A total of 25 nm colloidal gold particles were prepared followed by conjugation with anti-PSA pAb (GNPs-PSA pAb). LSPR was used to monitor the absorption changes of the aggregation of the particles. The size, shape and stability of the GNP-anti-PSA were evaluated by dynamic light scattering transmission electron microscopy (TEM) and zetasizer. The GNPs-conjugated PSA-pAb was successfully synthesized and subsequently characterized using ultraviolet absorption spectroscopy and TEM to determine the size distribution, crystallinity and stability of the particles (for example, stability of GNP: 443 mV). To increase the stability of the particles, we pegylated GNPs using an N-(3-dimethylaminopropyl)-N*-ethylcarbodiimide hydrochloride (EDC)/N-hydroxylsuccinimide (NHS) linker (for example, stability of GNP after pegylation: 272 mV). We found a significant increase in the absorbance and intensity of the particles with extinction peak at 545/2 nm, which was shifted by ~1 nm after conjugation. To illustrate the potential of the GNPs-PSA pAb to bind specifically to PSA, LSPR was used. We found that the extinction peak shifted 3 nm for a solution of 100 nM unlabeled antigen. In summary, we have established a novel approach for improving the efficacy/sensitivity of PSA in the assessment of prostate disease, supporting further investigation on the diagnostic value of GNP-conjugated anti-PSA/LSPR for the detection of prostate cancer.

The influence of stress, depression, and anxiety on PSA screening rates in a nationally representative sample.

Science.gov (United States)

Kotwal, Ashwin A; Schumm, Phil; Mohile, Supriya G; Dale, William

2012-12-01

Prostate-specific antigen (PSA) testing for prostate cancer is controversial, with concerning rates of both overscreening and underscreening. The reasons for the observed rates of screening are unknown, and few studies have examined the relationship of psychological health to PSA screening rates. Understanding this relationship can help guide interventions to improve informed decision-making for screening. A nationally representative sample of men 57-85 years old without prostate cancer (N = 1169) from the National Social life, Health and Aging Project was analyzed. The independent relationship of validated psychological health scales measuring stress, anxiety, and depression to PSA testing rates was assessed using multivariable logistic regression analyses. PSA screening rates were significantly lower for men with higher perceived stress [odds ratio (OR) = 0.76, P = 0.006], but not for higher depressive symptoms (OR = 0.89, P = 0.22) when accounting for stress. Anxiety influences PSA screening through an interaction with number of doctor visits (P = 0.02). Among the men who visited the doctor once those with higher anxiety were less likely to be screened (OR = 0.65, P = 0.04). Conversely, those who visited the doctor 10+ times with higher anxiety were more likely to be screened (OR = 1.71, P = 0.04). Perceived stress significantly lowers PSA screening likelihood, and it seems to partly mediate the negative relationship of depression with screening likelihood. Anxiety affects PSA screening rates differently for men with different numbers of doctor visits. Interventions to influence PSA screening rates should recognize the role of the patients' psychological state to improve their likelihood of making informed decisions and improve screening appropriateness.

Quality of the current low power and shutdown PSA practice

International Nuclear Information System (INIS)

Jang, Seung Cheol; Park, Jin Hee; Lim, Ho Gon; Kim, Tae Woon

2004-01-01

A probabilistic safety assessment (PSA) for the low-power and shutdown (LPSD) modes in a Korea standard nuclear power plant (KSNP) has been performed for the purpose of estimating the LPSD risk and identifying the vulnerabilities of LPSD operations. Both the operational experience and PSA results indicate that the risks from LPSD operations could be comparable with those from power operations. However, the application of the LPSD risk insights to risk-informed decision making has been slow to be adopted in practice. It is largely due to the question of whether the current LPSD PSA practice is appropriate for application to risk-informed decision making or not. Such a question has to do with the quality of the current LPSD PSA practice. In this paper, we have performed self-assessment of the KSNP LPSD PSA quality based on the ANS Standard (draft as of 13 Sep. 2002). The aims of the work are to find the LPSD PSA technical areas insufficient for application to risk-informed decision making and to efficiently allocate the limited research resources to improve the LPSD PSA model quality. Many useful findings regarding the current LPSD PSA quality are presented in this paper

Development of the IPRO-zone for fire PSA and its applications

International Nuclear Information System (INIS)

Kang, D. I.; Han, S. H.

2012-01-01

A PSA analyst has been manually determining fire-induced component failure modes and modeling them into the PSA logics. These can be difficult and time-consuming tasks as they need much information and many events are to be modeled. KAERI has been developing the IPRO-ZONE (interface program for constructing zone effect table) to facilitate fire PSA works for identifying and modeling fire-induced component failure modes, and to construct a one top fire event PSA model. With the output of the IPRO-ZONE, the AIMS-PSA, and internal event one top PSA model, one top fire events PSA model is automatically constructed. The outputs of the IPRO-ZONE include information on fire zones/fire scenarios, fire propagation areas, equipment failure modes affected by a fire, internal PSA basic events corresponding to fire-induced equipment failure modes, and fire events to be modeled. This paper introduces the IPRO-ZONE, and its application results to fire PSA of Ulchin Unit 3 and SMART(System-integrated Modular Advanced Reactor). (authors)

Development of the IPRO-zone for fire PSA and its applications

Energy Technology Data Exchange (ETDEWEB)

Kang, D. I.; Han, S. H. [Integrated Safety Assessment Div., Korea Atomic Energy Research Inst. KAERI, 1045 Daedeokdaero (150 Deokjin-Dong), Yuseong-Gu, Daejon, 305-353 (Korea, Republic of)

2012-07-01

A PSA analyst has been manually determining fire-induced component failure modes and modeling them into the PSA logics. These can be difficult and time-consuming tasks as they need much information and many events are to be modeled. KAERI has been developing the IPRO-ZONE (interface program for constructing zone effect table) to facilitate fire PSA works for identifying and modeling fire-induced component failure modes, and to construct a one top fire event PSA model. With the output of the IPRO-ZONE, the AIMS-PSA, and internal event one top PSA model, one top fire events PSA model is automatically constructed. The outputs of the IPRO-ZONE include information on fire zones/fire scenarios, fire propagation areas, equipment failure modes affected by a fire, internal PSA basic events corresponding to fire-induced equipment failure modes, and fire events to be modeled. This paper introduces the IPRO-ZONE, and its application results to fire PSA of Ulchin Unit 3 and SMART(System-integrated Modular Advanced Reactor). (authors)

Development of a Base Model for the New Fire PSA Training

International Nuclear Information System (INIS)

Kim, Kilyoo; Kang, Daeil; Kim, Wee Kyong; Do, Kyu Sik

2013-01-01

US NRC/EPRI issued a new fire PSA method represented by NUREG/CR 6850, and have been training many operators and inspectors to widely spread the new method. However, there is a limitation in time and efficiency for many foreigners, who generally have communication problem, to participate in the EPRI/NRC training to learn the new method. Since it is about time to introduce the new fire PSA method as a regulatory requirement for the fire protection in Korea, a simple and easy-understandable base model for the fire PSA training is required, and KAERI-KINS is jointly preparing the base model for the new fire PSA training. This paper describes how the base model is developed. Using an imaginary simple NPP, a base model of fire PSA following the new fire PSA method was developed in two ways from the internal PSA model. Since we have the base model and know the process of making the fire PSA model, the training for the new fire PSA method can be in detail performed in Korea

Analytic expressions for the construction of a fire event PSA model

International Nuclear Information System (INIS)

Kang, Dae Il; Kim, Kil Yoo; Kim, Dong San; Hwang, Mee Jeong; Yang, Joon Eon

2016-01-01

In this study, the changing process of an internal event PSA model to a fire event PSA model is analytically presented and discussed. Many fire PSA models have fire induced initiating event fault trees not shown in an internal event PSA model. Fire-induced initiating fault tree models are developed for addressing multiple initiating event issues. A single fire event within a fire compartment or fire scenario can cause multiple initiating events. As an example, a fire in a turbine building area can cause a loss of the main feed-water and loss of off-site power initiating events. Up to now, there has been no analytic study on the construction of a fire event PSA model using an internal event PSA model with fault trees of initiating events. In this paper, the changing process of an internal event PSA model to a fire event PSA model was analytically presented and discussed. This study results show that additional cutsets can be obtained if the fault trees of initiating events for a fire event PSA model are not exactly developed.

Analytic expressions for the construction of a fire event PSA model

Energy Technology Data Exchange (ETDEWEB)

Kang, Dae Il; Kim, Kil Yoo; Kim, Dong San; Hwang, Mee Jeong; Yang, Joon Eon [KAERI, Daejeon (Korea, Republic of)

2016-05-15

In this study, the changing process of an internal event PSA model to a fire event PSA model is analytically presented and discussed. Many fire PSA models have fire induced initiating event fault trees not shown in an internal event PSA model. Fire-induced initiating fault tree models are developed for addressing multiple initiating event issues. A single fire event within a fire compartment or fire scenario can cause multiple initiating events. As an example, a fire in a turbine building area can cause a loss of the main feed-water and loss of off-site power initiating events. Up to now, there has been no analytic study on the construction of a fire event PSA model using an internal event PSA model with fault trees of initiating events. In this paper, the changing process of an internal event PSA model to a fire event PSA model was analytically presented and discussed. This study results show that additional cutsets can be obtained if the fault trees of initiating events for a fire event PSA model are not exactly developed.

Serum PSA levels in the Indian population: Is it different?

Science.gov (United States)

Agrawal, Amit; Karan, Shailesh Chandra

2017-04-01

Serum prostate-specific antigen (PSA) is an important tumour, marker which is widely used to trigger trans-rectal ultrasound (TRUS)-guided prostate biopsy. However, the PSA levels vary with race and ethnicity. Therefore, there is a need to have an Indian reference range. All adult male patients meeting the inclusion and exclusion criteria were enrolled in this study. They were subjected to assessment of serum total PSA, digital rectal examination and trans-abdominal ultrasound. If any one or more of these were found abnormal, then a TRUS-guided 12-core prostate biopsy was done. Patients who were detected to have prostatic cancer were excluded from the final analysis. The data so obtained was grouped among the following three age groups: 40-49, 50-59 and 60-70 years, and the age-specific PSA values, prostatic volume and PSA density were found. A total of 1772 patients were analysed. The mean serum total PSA was 1.76 ng/ml with a standard deviation of 2.566 ng/ml. Group-wise age distribution of the mean serum total PSA was 1.22, 1.97 and 2.08 ng/ml in 40-49, 50-59 and 60-70 years age groups. The mean total PSA and the age-specific PSA range tend to be lower in the Indians than the Western population.

Safety Goal, Multi-unit Risk and PSA Uncertainty

Energy Technology Data Exchange (ETDEWEB)

Yang, Joon-Eon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-10-15

The safety goal is an answer of each country to the question 'How safe is safe enough?'. Table 1 shows some examples of the safety goal. However, many countries including Korea do not have the official safety goal for NPPs up to now since the establishment of safety goal is not just a technical issue but a very complex socio-technical issue. In establishing the safety goal for nuclear facilities, we have to consider various factors including not only technical aspects but also social, cultural ones. Recently, Korea is trying to establish the official safety goal. In this paper, we will review the relationship between the safety goal and Probabilistic Safety Assessment (PSA). We will also address some important technical issues to be considered in establishing the safety goal for NPPs from PSA point of view, i.e. a multi-unit risk issue and the uncertainty of PSA. In this paper, we reviewed some issues related to the safety goal and PSA. We believe that the safety goal is to be established in Korea considering the multi-unit risk. In addition, the relationship between the safety goal and PSA should be also defined clearly since PSA is the only way to answer to the question 'How safe is safe enough?'.

[Rates of total and free PSA prescriptions in France (2012-2014)].

Science.gov (United States)

Tuppin, Philippe; Leboucher, Claire; Peyre-Lanquar, Gabrielle; Lamy, Pierre-Jean; Gabach, Pierre; Rébillard, Xavier

2017-10-01

In 2010, the French Haute Autorité de santé (National Health Authority) confirmed the limited value of prostate cancer (PCa) screening by total prostate-specific antigen (PSA) assay. This study was designed to determine the modalities of ordering total PSA or free PSA assays (in the absence of PCa) according to various parameters and the corresponding sums reimbursed. Men aged 40 years and older covered by the national health insurance general scheme (73% of the French population) between 2012 and 2014 were selected. Data were derived from the Système national d'information inter-régimes de l'assurance maladie (Sniiram) (National health insurance information system) database. In 2014, 27% of the 11.6 million men 40 years and older underwent at least one total PSA assay and 5.6% underwent at least one free PSA assay, with marked variations according to the presence or absence of treated lower urinary tract symptoms (LUTS) (53% and 15% vs 24% and 5%) and from one administrative department to another. The peak total PSA assay rate was observed between the ages of 65 and 74 years: 64% of men with LUTS, 46% without LUTS. Between 2012 and 2014, men in whom at least one PSA assay had been performed underwent a mean of 1.8 total PSA assays and 1.7 free PSA assays, with means of 2.3 and 2, respectively, in the presence of LUTS. General practice specialists ordered 91% of the PSA tests reimbursed in 2014 (92% for total PSA and 87% for free PSA) and urologists ordered 4% of reimbursed tests. The total sum reimbursed was €28.5 million, comprising €8.7 million for free PSA. An average of 10 laboratory tests was performed at the same time as the PSA assay in the absence of treated LUTS. Total PSA and free PSA assays are performed in a large number of men, although the value of these tests as first-line test before biopsy remains controversial. These PSA assays are associated with many other laboratory tests looking for possible abnormalities, especially in younger

Report 5: Guidance document. Implementation of biological infestation hazards in extended PSA

International Nuclear Information System (INIS)

Hasnaoui, C.; Georgescu, G.; Joel, P.; Sperbeck, S.; Kollasko, H.; Kumar, M.

2016-01-01

This report covers the assessment of biological hazards with PSA. It provides an overview of the available data and available practices in modelling this type of hazard. First researches in the national and international literature regarding PSA for external and internal hazards shows that probabilistic analyses were very rarely carried out in order to quantify the risk induced by biological hazards. Nevertheless, Section 3 provides some data from some countries. History has shown that this hazard can happened and can be highly safety significant. Screening out this event must be done with great care. The overall analysis approach for Level 1 PSA for internal events can be used for the biological hazards with some care to take into impact the nature of the hazard as it impacts many systems at different times and duration. A proposed detailed methodology is described in Section 4. Still some open issues remain: the methodology must also consider event combination of biological infestation with other external hazards wind or flooding or rainfall and multi-units impact. These aspects present still a lot of challenges to PSA developers. The ASAMPSA-E report recommends that further emphasis shall be put on these two aspects of PSA modelling: multi-units site impact and hazards combinations. (authors)

Prostate-Specific Antigen (PSA) Test: MedlinePlus Lab Test Information

Science.gov (United States)

... medlineplus.gov/labtests/prostatespecificantigenpsatest.html Prostate-Specific Antigen (PSA) Test To use the sharing features on this ... enable JavaScript. What is a prostate-specific antigen (PSA) test? A prostate-specific antigen (PSA) test measures ...

Real-life experience of using conventional disease-modifying anti-rheumatic drugs (DMARDs) in psoriatic arthritis (PsA). Retrospective analysis of the efficacy of methotrexate, sulfasalazine, and leflunomide in PsA in comparison to spondyloarthritides other than PsA and literature review of the use of conventional DMARDs in PsA

Science.gov (United States)

Roussou, Euthalia; Bouraoui, Aicha

2017-01-01

Objective With the aim of assessing the response to treatment with conventional disease-modifying anti-rheumatic drugs (DMARDs) used in patients with psoriatic arthritis (PsA), data on methotrexate, sulfasalazine (SSZ), and leflunomide were analyzed from baseline and subsequent follow-up (FU) questionnaires completed by patients with either PsA or other spondyloarthritides (SpAs). Material and Methods A single-center real-life retrospective analysis was performed by obtaining clinical data via questionnaires administered before and after treatment. The indices used were erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), wellbeing (WB), and treatment effect (TxE). The indices measured at baseline were compared with those measured on one occasion in a FU visit at least 1 year later. Results A total of 73 patients, 51 with PsA (mean age 49.8±12.8 years; male-to-female ratio [M:F]=18:33) and 22 with other SpAs (mean age 50.6±16 years; M:F=2:20), were studied. BASDAI, BASFI, and WB displayed consistent improvements during FU assessments in both PsA patients and controls in comparison to baseline values. SSZ exhibited better efficacy as confirmed by TxE in both PsA patients and controls. ESR and CRP displayed no differences in either the PsA or the SpA group between the cases before and after treatment. Conclusion Real-life retrospective analysis of three DMARDs used in PsA (and SpAs other than PsA) demonstrated that all three DMARDs that were used brought about improvements in BASDAI, BASFI, TxE, and WB. However, the greatest improvements at FU were seen with SSZ use in both PsA and control cohorts. PMID:28293446

Risk score predicts high-grade prostate cancer in DNA-methylation positive, histopathologically negative biopsies.

Science.gov (United States)

Van Neste, Leander; Partin, Alan W; Stewart, Grant D; Epstein, Jonathan I; Harrison, David J; Van Criekinge, Wim

2016-09-01

Prostate cancer (PCa) diagnosis is challenging because efforts for effective, timely treatment of men with significant cancer typically result in over-diagnosis and repeat biopsies. The presence or absence of epigenetic aberrations, more specifically DNA-methylation of GSTP1, RASSF1, and APC in histopathologically negative prostate core biopsies has resulted in an increased negative predictive value (NPV) of ∼90% and thus could lead to a reduction of unnecessary repeat biopsies. Here, it is investigated whether, in methylation-positive men, DNA-methylation intensities could help to identify those men harboring high-grade (Gleason score ≥7) PCa, resulting in an improved positive predictive value. Two cohorts, consisting of men with histopathologically negative index biopsies, followed by a positive or negative repeat biopsy, were combined. EpiScore, a methylation intensity algorithm was developed in methylation-positive men, using area under the curve of the receiver operating characteristic as metric for performance. Next, a risk score was developed combining EpiScore with traditional clinical risk factors to further improve the identification of high-grade (Gleason Score ≥7) cancer. Compared to other risk factors, detection of DNA-methylation in histopathologically negative biopsies was the most significant and important predictor of high-grade cancer, resulting in a NPV of 96%. In methylation-positive men, EpiScore was significantly higher for those with high-grade cancer detected upon repeat biopsy, compared to those with either no or low-grade cancer. The risk score resulted in further improvement of patient risk stratification and was a significantly better predictor compared to currently used metrics as PSA and the prostate cancer prevention trial (PCPT) risk calculator (RC). A decision curve analysis indicated strong clinical utility for the risk score as decision-making tool for repeat biopsy. Low DNA-methylation levels in PCa-negative biopsies led

Impact of PSA density of transition zone as a potential parameter in reducing the number of unnecessary prostate biopsies in patients with psa levels between 2.6 and 10.0 ng/mL.

Science.gov (United States)

Castro, Hugo A Socrates; Iared, Wagner; Santos, José Eduardo Mourão; Solha, Raphael Sandes; Shigueoka, David Carlos; Ajzen, Sergio Aron

2018-04-10

To assess the accuracy of prostate-specific antigen (PSA) adjusted for the transition zone volume (PSATZ) in predicting prostate cancer by comparing the ability of several PSA parameters in predicting prostate cancer in men with intermediate PSA levels of 2.6 - 10.0 ng/mL and its ability to reduce unnecessary biopsies. This study included 656 patients referred for prostate biopsy who had a serum PSA of 2.6 - 10.0 ng/mL. Total prostate and transition zone volumes were measured by transrectal ultrasound using the prolate ellipsoid method. The clinical values of PSA, free-to-total (F/T) ratio, PSA density (PSAD) and PSATZ for the detection of prostate cancer were calculated and statistical comparisons between biopsy-positive (cancer) and biopsy-negative (benign) were conducted. Cancer was detected in 172 patients (26.2%). Mean PSA, PSATZ, PSAD and F/T ratio were 7.5 ng/mL, 0.68 ng/mL/cc. 0.25 ng/mL/cc and 0.14 in patients with prostate cancer and 6.29 ng/mL, 0.30 ng/mL/cc, 0.16 ng/mL/cc and 0.22 in patients with benign biopsies, respectively. ROC curves analysis demonstrated that PSATZ had a higher area under curve (0,838) than F/T ratio (0,806) (PPSA. Compared to other PSA related parameters, it was better in differentiating between prostate cancer and benign prostatic enlargement. Also, PSATZ could reduce a significant number of unnecessary biopsies. Copyright® by the International Brazilian Journal of Urology.

Development of the SKI Handbook for reviewing PSA after the review of the of a PSA level 2 study; Utveckling av SKIs Tillsynshandbok foer PSA utifraan granskningen av en PSA Nivaa-2 studie

Energy Technology Data Exchange (ETDEWEB)

Lindholm, Ilona; Sairanen, Risto [VTT Processes, Helsinki (Finland)

2003-02-01

A review of the Oskarshamn 2 Level 2 PSA has been conducted by VTT Processes. One objective of the review was validation and development of Tillsynshandbok PSA applying it to Oskarshamn 2 PSA Level 2 study. The review was based on the PSA Level 2 documentation: the main report, the supporting reports on containment success criteria and release calculations with the MAAP4 code, and five phenomenological reports for selected specific questions. The main result of the phenomenological analyses is that none of the phenomena considered contributes to the conditional failure probability of the Oskarshamn 2 containment in severe accidents. The project was conducted as a set of separate studies and the project quality assurance has also focused on one part at the time. As such, the quality assurance is adequate. A high level QA ensuring that all separate studies and analysis steps use same assumptions seems to be missing. Results from the phenomenology reports are not always transferred to accident analyses and vice versa. There is no specific discussion of uncertainty or sensitivity analyses. In general, the number of sensitivity analyses could be larger. Such should have been provided for sequences or phenomena that could result in early or unmitigated release. Examples are pressure vessel failure at high pressure, the effect of larger hydrogen production, and the key assumptions used for steam explosion and direct containment heating. Suggestions for additional sensitivity studies have been given in discussion of phenomenological reports. The project documentation is generally good. Missing information is usually associated with transfer of results from one study to another. It can be assumed that the information exists also in this cases but has not been documented in the reports above. Documentation of the containment event trees and the assumptions used for them could be more detailed, maybe similar to the approach used in the Appendix of this report. More effort

Presence of PSA auto-antibodies in men with prostate abnormalities (prostate cancer/benign prostatic hyperplasia/prostatitis).

Science.gov (United States)

Lokant, M T; Naz, R K

2015-04-01

Prostate-specific antigen (PSA), produced by the prostate, liquefies post-ejaculate semen. PSA is detected in semen and blood. Increased circulating PSA levels indicate prostate abnormality [prostate cancer (PC), benign prostatic hyperplasia (BPH), prostatitis (PTIS)], with variance among individuals. As the prostate has been proposed as an immune organ, we hypothesise that variation in PSA levels among men may be due to presence of auto-antibodies against PSA. Sera from healthy men (n = 28) and men having prostatitis (n = 25), BPH (n = 30) or PC (n = 29) were tested for PSA antibody presence using enzyme-linked immunosorbent assay (ELISA) values converted to standard deviation (SD) units, and Western blotting. Taking ≥2 SD units as cut-off for positive immunoreactivity, 0% of normal men, 0% with prostatitis, 33% with BPH and 3.45% with PC demonstrated PSA antibodies. One-way analysis of variance (anova) performed on the mean absorbance values and SD units of each group showed BPH as significantly different (P prostatitis. All others were nonsignificant (P prostate abnormalities, especially differentiating BPH from prostate cancer and prostatitis. © 2014 Blackwell Verlag GmbH.

Mutations in the prostate specific antigen (PSA/KLK3) correlate with male infertility.

Science.gov (United States)

Gupta, Nishi; Sudhakar, Digumarthi V S; Gangwar, Pravin Kumar; Sankhwar, Satya Narayan; Gupta, Nalini J; Chakraborty, Baidyanath; Thangaraj, Kumarasamy; Gupta, Gopal; Rajender, Singh

2017-09-11

Prostate specific antigen (PSA/KLK3) is known to be the chief executor of the fragmentation of semenogelins, dissolution of semen coagulum, thereby releasing sperm for active motility. Recent research has found that semenogelins also play significant roles in sperm fertility by affecting hyaluronidase activity, capacitation and motility, thereby making PSA important for sperm fertility beyond simple semen liquefaction. PSA level in semen has been shown to correlate with sperm motility, suggesting that PSA level/activity can affect fertility. However, no study investigating the genetic variations in the KLK3/PSA gene in male fertility has been undertaken. We analyzed the complete coding region of the KLK3 gene in ethnically matched 875 infertile and 290 fertile men to find if genetic variations in KLK3 correlate with infertility. Interestingly, this study identified 28 substitutions, of which 8 were novel (not available in public databases). Statistical comparison of the genotype frequencies showed that five SNPs, rs266881 (OR = 2.92, P  C, was more freuqent in the control group, showing protective association. Our findings suggest that polymorphisms in the KLK3 gene correlate with infertility risk.

Study on Quantification for Multi-unit Seismic PSA Model using Monte Carlo Sampling

International Nuclear Information System (INIS)

Oh, Kyemin; Han, Sang Hoon; Jang, Seung-cheol; Park, Jin Hee; Lim, Ho-Gon; Yang, Joon Eon; Heo, Gyunyoung

2015-01-01

In existing PSA, frequency for accident sequences occurred in single-unit has been estimated. While multi-unit PSA has to consider various combinations because accident sequence in each units can be different. However, it is difficult to quantify all of combination between inter-units using traditional method such as Minimal Cut Upper Bound (MCUB). For this reason, we used Monte Carlo sampling as a method to quantify multi-unit PSA model. In this paper, Monte Carlo method was used to quantify multi-unit PSA model. The advantage of this method is to consider all of combinations by the increase of number of unit and to calculate nearly exact value compared to other method. However, it is difficult to get detailed information such as minimal cut sets and accident sequence. To solve partially this problem, FTeMC was modified. In multi-unit PSA, quantification for both internal and external multi-unit accidents is the significant issue. Although our result above mentioned was one of the case studies to check application of method suggested in this paper, it is expected that this method can be used in practical assessment for multi-unit risk

Can Propensity Score Analysis Approximate Randomized Experiments Using Pretest and Demographic Information in Pre-K Intervention Research?

Science.gov (United States)

Dong, Nianbo; Lipsey, Mark W

2017-01-01

It is unclear whether propensity score analysis (PSA) based on pretest and demographic covariates will meet the ignorability assumption for replicating the results of randomized experiments. This study applies within-study comparisons to assess whether pre-Kindergarten (pre-K) treatment effects on achievement outcomes estimated using PSA based on a pretest and demographic covariates can approximate those found in a randomized experiment. Data-Four studies with samples of pre-K children each provided data on two math achievement outcome measures with baseline pretests and child demographic variables that included race, gender, age, language spoken at home, and mother's highest education. Research Design and Data Analysis-A randomized study of a pre-K math curriculum provided benchmark estimates of effects on achievement measures. Comparison samples from other pre-K studies were then substituted for the original randomized control and the effects were reestimated using PSA. The correspondence was evaluated using multiple criteria. The effect estimates using PSA were in the same direction as the benchmark estimates, had similar but not identical statistical significance, and did not differ from the benchmarks at statistically significant levels. However, the magnitude of the effect sizes differed and displayed both absolute and relative bias larger than required to show statistical equivalence with formal tests, but those results were not definitive because of the limited statistical power. We conclude that treatment effect estimates based on a single pretest and demographic covariates in PSA correspond to those from a randomized experiment on the most general criteria for equivalence.

Possible factors influencing high serum Prostate-specific Antigen (PSA in Indonesian patients with Benign Prostatic Hyperplasia (BPH

Directory of Open Access Journals (Sweden)

Djoko Rahardjo

2001-03-01

Full Text Available Benign prostatic hyperplasia (BPH cases in Indonesia frequently associated with high serum prostate specific antigen (PSA. To explore possible factors that could increase serum PSA level, we performed a retrospective, cross-sectional study on 805 consecutive patients in Sumber Waras and Dr. Cipto Mangunkusumo Hospitals from 1994 to 1997. Clinical manifestations were evaluated and prostate biopsies were performed if indicated. Complete histopathological data were only available in 82 BPH patients with no urinary retention from 1998-1999 and a thin section of paraffin blocks of BPH patients which still could be found from 1994-1999 was analyzed using flow cytometer to obtain the S-phase fraction as a parameter of proliferative activity, From 805 patients, 461 (57% presented with urinary retention and need to be catheteized. Catheteization significantly increased PSA level if compared to noncatheterized patients (16.3 vs. 6,8 ng/mL, p= 0,000. Another data of 82 uncatheteized patients from 1998-1999 has revealed that 79 patients (96.3% had chronic prostatitis and 19 (23.2% showed the presence of prostatic-intraepithelial neoplasia (PIN with an increase of PSA level (5.4 ng/mL. The S-phase fraction of BPH without PIN cases was significantly higher in cases with PSA > 4 ng/ml than patients with PSA ≤ 4 ng/ml (I3.1% vs. 8.9%, p=0,008. As conclusion, the high serum PSA level was mostly due to urethral catheteization and increased prostate volume. There was a tendency of increasing PSA in subclinical inflammation and PIN. Cases with high PSA also showed high proliferative activities which is suggestive of mitogenic activity. (Med J Indones 2001; 10:22-8Keywords: BPH, high PSA, PIN, proliferative activity, s-phase fraction

The use of PSA in the French regulatory practice

International Nuclear Information System (INIS)

Mennesiez, H.

1994-01-01

The presentation gives a description of fundamental documents (since 1977-1978) through which have been set up in France probabilistic objectives, and PSAs, including shutdown states, performed for 900-1300 MWe PWR-type nuclear power plants. PSA developments and use, including fire PSA, level 2 and PSA for the future French-German European Pressurized Reactor (EPR) are also discussed

Methodology for fire PSA during design process

International Nuclear Information System (INIS)

Kollasko, Heiko; Blombach, Joerg

2009-01-01

Fire PSA is an essential part of a full scope level 1 PSA. Cable fires play an important role in fire PSA. Usually, cable routing is therefore modeled in detail. During the design of new nuclear power plants the information on cable routing is not yet available. However, for the use of probabilistic safety insights during the design and for licensing purposes a fire PSA may be requested. Therefore a methodology has been developed which makes use of the strictly divisional separation of redundancies in the design of modern nuclear power plants: cable routing is not needed within one division but replaced by the conservative assumption that all equipment fails due to a fire in the concerned division; critical fire areas are defined where components belonging to different divisions may be affected by a fire. For the determination of fire frequencies a component based approach is proposed. The resulting core damage frequencies due to fire are conservative. (orig.)

Evaluation of postradiotherapy PSA patterns and correlation with 10-year disease free survival outcomes for prostate cancer

International Nuclear Information System (INIS)

Zelefsky, Michael J.; Ben-Porat, Leah; Chan, Heather M.; Fearn, Paul A.; Venkatraman, Ennapadam S.

2006-01-01

Purpose: To describe the prostate-specific antigen (PSA) pattern profiles observed after external beam radiotherapy with and without short-term neoadjuvant androgen deprivation therapy (ST-ADT) and to report the association of established posttreatment PSA patterns with long-term disease-free survival outcomes. Methods and Materials: A total of 1,665 patients were treated with conformal external beam radiotherapy for clinically localized prostate cancer. Of 570 patients who had the requisite >10 consecutive PSA measurements for statistical analysis, 194 patients received a median of 3 months of ADT before radiotherapy and 376 were treated with radiotherapy alone. The median follow up was 103 months. Results: In the group treated with ST-ADT, three distinct postradiotherapy PSA patterns were identified: a stable trend (44%), an increasing trend followed by stabilization of the PSA (25%), and an increasing trend (31%). Among the subgroup that demonstrated a rising and subsequent stabilizing patterns, PSA levels had gradually risen to a median value of 0.9 ng/mL after therapy, stabilized, and remained durably suppressed. The only identified trends among patients treated with external beam radiotherapy without ST-ADT were declining PSA levels followed by stable PSA trends or declining patterns followed by rising levels. Patients whose PSA levels stabilized after an initial rise or those with slowly rising PSA profiles had a lower incidence of distant metastasis compared to those with accelerated rises after therapy. Conclusions: For those treated with external beam radiotherapy in conjunction with ST-ADT, a significant percentage who develop a rising PSA after treatment are expected to manifest subsequent stabilization at plateaued levels of approximately 1.0 ng/mL, which can remain durably suppressed. The likelihood of distant metastasis in these patients is low despite the PSA stabilization at levels 1.0 ng/mL or higher and comparable to outcomes observed for those

Proteins Annexin A2 and PSA in Prostate Cancer Biopsies Do Not Predict Biochemical Failure.

Science.gov (United States)

Lamb, David S; Sondhauss, Sven; Dunne, Jonathan C; Woods, Lisa; Delahunt, Brett; Ferguson, Peter; Murray, Judith; Nacey, John N; Denham, James W; Jordan, T William

2017-12-01

We previously reported the use of mass spectrometry and western blotting to identify proteins from tumour regions of formalin-fixed paraffin-embedded biopsies from 16 men who presented with apparently localized prostate cancer, and found that annexin A2 (ANXA2) appeared to be a better predictor of subsequent biochemical failure than prostate-specific antigen (PSA). In this follow-up study, ANXA2 and PSA were measured using western blotting of proteins extracted from biopsies from 37 men from a subsequent prostate cancer trial. No significant differences in ANXA2 and PSA levels were observed between men with and without biochemical failure. The statistical effect sizes were small, d=0.116 for ANXA2, and 0.266 for PSA. ANXA2 and PSA proteins measured from biopsy tumour regions are unlikely to be good biomarkers for prediction of the clinical outcome of prostate cancer presenting with apparently localized disease. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Diagnostic value of combined tet of cPSA, IGF-1 and TGFα for prostate cancer

International Nuclear Information System (INIS)

Dai Feng; Yang Qingling

2006-01-01

To assess the clinical value of serum complexed prostate specific antigen (cPSA), insulinlike growth factor(IGF-1),transforming growth factor a (TGFα) in the diagnosis of pros- tate cancer (PCα), serum samples were obtained from 46 men with PCa, 64 men with untreated benign prostatic hyperplasia(BPH) and 73 men of a healthy control group. The levels of cPSA, IGF-1 and TGFα were determined by autoimmunochemistry luminescence method, IRMA and RIA method. Postoperative observation was conducted for the change of cPSA, IGF-1 and TGFa in the serum from men with PCa obtained in one month, three months and six months after the operations. Results showed that the levels of cPSA, IGF-1 and TGFα in PCa serum were significantly higher than the BPH group and control group(P 0.05). The combined test of cPSA, IGF-1 and TGFα is meaningful for the prevision, diagnosis and therapy of PCa. (authors)

Risk Metrics and Measures for an Extended PSA

International Nuclear Information System (INIS)

Wielenberg, A.; Loeffler, H.; Hasnaoui, C.; Burgazzi, L.; Cazzoli, E.; Jan, P.; La Rovere, S.; Siklossy, T.; Vitazkova, J.; Raimond, E.

2016-01-01

This report provides a review of the main used risk measures for Level 1 and Level 2 PSA. It depicts their advantages, limitations and disadvantages and develops some more precise risk measures relevant for extended PSAs and helpful for decision-making. This report does not recommend or suggest any quantitative value for the risk measures. It does not discuss in details decision-making based on PSA results neither. The choice of one appropriate risk measure or a set of risk measures depends on the decision making approach as well as on the issue to be decided. The general approach for decision making aims at a multi-attribute approach. This can include the use of several risk measures as appropriate. Section 5 provides some recommendations on the main risk metrics to be used for an extended PSA. For Level 1 PSA, Fuel Damage Frequency and Radionuclide Mobilization Frequency are recommended. For Level 2 PSA, the characterization of loss of containment function and a total risk measure based on the aggregated activity releases of all sequences rated by their frequencies is proposed. (authors)

Updating the Psoriatic Arthritis (PsA) Core Domain Set

DEFF Research Database (Denmark)

Orbai, Ana-Maria; de Wit, Maarten; Mease, Philip J

2017-01-01

OBJECTIVE: To include the patient perspective in accordance with the Outcome Measures in Rheumatology (OMERACT) Filter 2.0 in the updated Psoriatic Arthritis (PsA) Core Domain Set for randomized controlled trials (RCT) and longitudinal observational studies (LOS). METHODS: At OMERACT 2016, research...... conducted to update the PsA Core Domain Set was presented and discussed in breakout groups. The updated PsA Core Domain Set was voted on and endorsed by OMERACT participants. RESULTS: We conducted a systematic literature review of domains measured in PsA RCT and LOS, and identified 24 domains. We conducted...... and breakout groups at OMERACT 2016 in which findings were presented and discussed. The updated PsA Core Domain Set endorsed with 90% agreement by OMERACT 2016 participants included musculoskeletal disease activity, skin disease activity, fatigue, pain, patient's global assessment, physical function, health...

Treatment Outcomes from 68Ga-PSMA PET/CT-Informed Salvage Radiation Treatment in Men with Rising PSA After Radical Prostatectomy: Prognostic Value of a Negative PSMA PET.

Science.gov (United States)

Emmett, Louise; van Leeuwen, Pim J; Nandurkar, Rohan; Scheltema, Matthijs J; Cusick, Thomas; Hruby, George; Kneebone, Andrew; Eade, Thomas; Fogarty, Gerald; Jagavkar, Raj; Nguyen, Quoc; Ho, Bao; Joshua, Anthony M; Stricker, Phillip

2017-12-01

analysis, PSMA and serum PSA significantly correlated with treatment response, whereas pT stage, Gleason score, and surgical margin status did not. Conclusion: PSMA PET is independently predictive of treatment response to SRT and stratifies men into a high treatment response to SRT (negative or fossa-confined PSMA) versus men with poor response to SRT (nodes or distant-disease PSMA). In particular, a negative PSMA PET result predicts a high response to salvage fossa radiotherapy. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

Development of Integrated PSA Database and Application Technology

Energy Technology Data Exchange (ETDEWEB)

Han, Sang Hoon; Park, Jin Hee; Kim, Seung Hwan; Choi, Sun Yeong; Jung, Woo Sik; Jeong, Kwang Sub; Ha Jae Joo; Yang, Joon Eon; Min Kyung Ran; Kim, Tae Woon

2005-04-15

The purpose of this project is to develop 1) the reliability database framework, 2) the methodology for the reactor trip and abnormal event analysis, and 3) the prototype PSA information DB system. We already have a part of the reactor trip and component reliability data. In this study, we extend the collection of data up to 2002. We construct the pilot reliability database for common cause failure and piping failure data. A reactor trip or a component failure may have an impact on the safety of a nuclear power plant. We perform the precursor analysis for such events that occurred in the KSNP, and to develop a procedure for the precursor analysis. A risk monitor provides a mean to trace the changes in the risk following the changes in the plant configurations. We develop a methodology incorporating the model of secondary system related to the reactor trip into the risk monitor model. We develop a prototype PSA information system for the UCN 3 and 4 PSA models where information for the PSA is inputted into the system such as PSA reports, analysis reports, thermal-hydraulic analysis results, system notebooks, and so on. We develop a unique coherent BDD method to quantify a fault tree and the fastest fault tree quantification engine FTREX. We develop quantification software for a full PSA model and a one top model.

PSA LEVEL 3 DAN IMPLEMENTASINYA PADA KAJIAN KESELAMATAN PWR

Directory of Open Access Journals (Sweden)

Pande Made Udiyani

2015-03-01

Full Text Available Kajian keselamatan PLTN menggunakan metodologi kajian probabilistik sangat penting selain kajian deterministik. Metodologi kajian menggunakan Probabilistic Safety Assessment (PSA Level 3 diperlukan terutama untuk estimasi kecelakaan parah atau kecelakaan luar dasar desain PLTN. Metode ini banyak dilakukan setelah kejadian kecelakaan Fukushima. Dalam penelitian ini dilakukan implementasi PSA Level 3 pada kajian keselamatan PWR, postulasi kecelakan luar dasar desain PWR AP-1000 dan disimulasikan di contoh tapak Bangka Barat. Rangkaian perhitungan yang dilakukan adalah: menghitung suku sumber dari kegagalan teras yang terjadi, pemodelan kondisi meteorologi tapak dan lingkungan, pemodelan jalur paparan, analisis dispersi radionuklida dan transportasi fenomena di lingkungan, analisis deposisi radionuklida, analisis dosis radiasi, analisis perlindungan & mitigasi, dan analisis risiko. Kajian menggunakan rangkaian subsistem pada perangkat lunak PC Cosyma. Hasil penelitian membuktikan bahwa implementasi metode kajian keselamatan PSA Level 3 sangat efektif dan komprehensif terhadap estimasi dampak, konsekuensi, risiko, kesiapsiagaan kedaruratan nuklir (nuclear emergency preparedness, dan manajemen kecelakaan reaktor terutama untuk kecelakaan parah atau kecelakaan luar dasar desain PLTN. Hasil kajian dapat digunakan sebagai umpan balik untuk kajian keselamatan PSA Level 1 dan PSA Level 2. Kata kunci: PSA level 3, kecelakaan, PWR   Reactor safety assessment of nuclear power plants using probabilistic assessment methodology is most important in addition to the deterministic assessment. The methodology of Level 3 Probabilistic Safety Assessment (PSA is especially required to estimate severe accident or beyond design basis accidents of nuclear power plants. This method is carried out after the Fukushima accident. In this research, the postulations beyond design basis accidentsof PWR AP - 1000 would be taken, and simulated at West Bangka sample site. The

Cost implications of PSA screening differ by age.

Science.gov (United States)

Rao, Karthik; Liang, Stella; Cardamone, Michael; Joshu, Corinne E; Marmen, Kyle; Bhavsar, Nrupen; Nelson, William G; Ballentine Carter, H; Albert, Michael C; Platz, Elizabeth A; Pollack, Craig E

2018-05-09

Multiple guidelines seek to alter rates of prostate-specific antigen (PSA)-based prostate cancer screening. The costs borne by payers associated with PSA-based screening for men of different age groups-including the costs of screening and subsequent diagnosis, treatment, and adverse events-remain uncertain. We sought to develop a model of PSA costs that could be used by payers and health care systems to inform cost considerations under a range of different scenarios. We determined the prevalence of PSA screening among men aged 50 and higher using 2013-2014 data from a large, multispecialty group, obtained reimbursed costs associated with screening, diagnosis, and treatment from a commercial health plan, and identified transition probabilities for biopsy, diagnosis, treatment, and complications from the literature to generate a cost model. We estimated annual total costs for groups of men ages 50-54, 55-69, and 70+ years, and varied annual prostate cancer screening prevalence in each group from 5 to 50% and tested hypothetical examples of different test characteristics (e.g., true/false positive rate). Under the baseline screening patterns, costs of the PSA screening represented 10.1% of the total costs; costs of biopsies and associated complications were 23.3% of total costs; and, although only 0.3% of all screen eligible patients were treated, they accounted for 66.7% of total costs. For each 5-percentage point decrease in PSA screening among men aged 70 and older for a single calendar year, total costs associated with prostate cancer screening decreased by 13.8%. For each 5-percentage point decrease in PSA screening among men 50-54 and 55-69 years old, costs were 2.3% and 7.3% lower respectively. With constrained financial resources and with national pressure to decrease use of clinically unnecessary PSA-based prostate cancer screening, there is an opportunity for cost savings, especially by focusing on the downstream costs disproportionately associated with

PSA as a tool for decision making

Energy Technology Data Exchange (ETDEWEB)

Niehaus, F; Lederman, L

1986-05-01

The question on ''How safe is safe enough'' is being responded presently by deterministic criteria. Probabilistic criteria in support to more rational and less emotional decisions in regulatory and licensing issues, rationalization of resource allocation and research prioritization, among others, have a potential which is only marginally being explored. This paper discussed PSA limitations and proposes three areas for the use of PSA in decision making, namely: preventing accidents, mitigating accidents, and defining regulatory requirements. Current activities of the International Atomic Energy Agency in these areas are mentioned. PSA studies depict clearly the uncertainties and this is viewed as a positive aspect, which is unique to the use of probabilistic methods.

Elevation of PSA after prostate radiotherapy: Rebound or biochemical recurrence?

International Nuclear Information System (INIS)

Toledano, A.; Kanoui, A.; Chiche, R.; Lamallem, H.; Beley, S.; Thibault, F.; Sebe, P.

2008-01-01

The fact that external beam radiotherapy and brachytherapy are now considered to be curative techniques has led to major review of the modalities of follow-up after radiotherapy for prostate cancer. The problem concerns both the diagnosis of recurrence, rapidly announced by elevation of prostatic-specific antigen (PSA), usually at a subclinical stage, and the validity of criteria of biochemical recurrence to allow comparison of various study. Physicians involved in follow-up should be aware of the potential of bounce in PSA follow-up after external beam radiotherapy or brachytherapy. The PSA bounce phenomenon was defined by a rise of PSA values (+ 0.1 -0.8 ng/ml) with a subsequent fall. Biochemical failure after external beam radiotherapy or brachytherapy (with or without hormonotherapy) was defined by Phoenix criteria by a rise of 2 ng/ml above an initial PSA nadir. This definition was more correlated to PSA bounce phenomenon. (authors)

Applicability of PSA Issues for Risk Assessment during Optimisation of In-Service Inspection

International Nuclear Information System (INIS)

Kolykhanov, V.; Skalozubov, V.; Kovrigkin, Y.

2006-01-01

The current codes determining periodicity of in-service inspection of the NPP equipment have been formed using deterministic approaches and have an unnecessary degree of conservatism. A perspective direction of perfection of normative base is decision making on a basis of risk-informed methodologies. It allows to increase safety of NPP equipment's operation and to optimise programs on inspection of the equipment subject to limited resources by focusing efforts on the most safety significant elements of the equipment. It is internationally accepted that methodology of the probabilistic safety analysis (PSA) is the most universal and comprehensive tool focused on the general assessment of safety of NPP as a whole. By now, PSA Level 1 is fulfilled for all pilot units of the Ukrainian NPPs that is a valuable result, which should be taken into account at an assessment of reliability of the equipment. However, specificity of PSA methodology should be taken into account at the decision of the particular tasks aimed at optimisation of maintenance of the equipment within individual systems. The estimation of the contribution to core damage frequency (CDF) is a PSA issue usually used to assess the significance of consequences of failure of a system/equipment during risk-informed decision-making. This work shows that above factor is only a part of assessment of the significance of consequences as core damage can be expressed in different amount of the damaged fuel elements and, hence, severity of consequences. Besides CDF is directly affected only by active elements which failure can be an initiating event. PSA methodology uses averaged reliability factors of the equipment for all possible operating modes occurring at transitive accident process. Here, there are limited opportunities to account impact of periodicity of maintenance of the equipment on reliability and to predict impact of change of the inspection program. PSA methodology does not allow taking into account

Prostate specific cancer volume: a significant prognostic factor in prostate cancer patients at intermediate risk of failing radiotherapy

International Nuclear Information System (INIS)

Lankford, S.P.; Pollack, A.; Zagars, G.K.

1996-01-01

Purpose: Although the pretreatment serum prostate specific antigen level (PSAL) is the single most significant predictor of local and biochemical control in prostate cancer patients treated with radiotherapy, it is relatively insensitive for patients with a PSAL in the intermediate range (4-20 ng/ml). PSA density (PSAD) has been shown to be slightly more predictive of outcome than PSAL for this intermediate risk group; however, this improvement is small and of little use clinically. PSA cancer volume (PSACV) is an estimate of cancer volume based on PSA that was recently described by D'Amico and Propert (IJROBP 32:232, 1995) as providing significant and independent prognostic information in addition to PSAL. We report here a detailed comparison between this new prognostic factor, PSAL, and PSAD. Methods and Materials: The records of 356 patients treated with definitive external beam radiotherapy for regionally localized (T1-4, Nx, M0) adenocarcinoma of the prostate were reviewed. Each patient had a PSAL, biopsy Gleason score, and pretreatment prostate volume by transrectal ultrasonography. The median PSAL was 9.3 ng/ml and 66% had Gleason scores in the 2-6 range. The median radiation dose was 66.0 Gy and the median follow-up for those living was 27 months. PSACV is a calculated parameter that takes into account PSAL (total PSA), ultrasonographic prostate volume (estimate of PSA from benign epithelium), and Gleason grade (estimate of PSA per tumor volume). The median PSACV was 1.43 cc. Biochemical failure was defined as increases in two consecutive follow-up PSA levels, one increase by a factor > 1.5, or an absolute increase of > 1 ng/ml. Local failure was defined as a cancer-positive prostate biopsy, usually undertaken because of evidence of biochemical failure. Results: The distributions of PSACV and PSAL were similar and, when normalized by log-transformation, were highly correlated (p 4 cc, as compared to those with a PSACV ≤ 0.5 cc, was over 30%. Conclusion

Flooding PSA by considering the operating experience data of Korean PWRs

International Nuclear Information System (INIS)

Choi, Sun Yeong; Yang, Joon Eon

2007-01-01

The existing flooding Probabilistic Safety Analysis (PSA) was updated to reflect the Korean plant specific operating experience data into the flooding frequency to improve the PSA quality. Both the Nuclear Power Experience (NPE) database and the Korea Nuclear PIPE Failure Database (NuPIPE) databases were used in this study, and from these databases, only the Pressurized Water Reactor (PWR) data were used for the flooding frequencies of the flooding areas in the primary auxiliary building. With these databases and a Bayesian method, the flooding frequencies for the flooding areas were estimated. Subsequently, the Core Damage Frequency (CDF) for the flooding PSA of the UlChiN (UCN) unit 3 and 4 plants based on the Korean Standard Nuclear power Plant (KSNP) internal full-power PSA model was recalculated. The evaluation results showed that sixteen flooding events are potentially significant according to the screening criterion, while there were two flooding events exceeding the screening criterion of the existing UCN 3 and 4 flooding PSA. The result was compared with two kinds of cases: 1) the flooding frequency and CDF from the method of the existing flooding PSA with the PWR and Boiled Water Reactor (BWR) data of the NPE database and the Maximum Likelihood Estimate (MLE) method and 2) the flooding frequency and CDF with the NPE database (PWR and BWR data), NuPIPE database, and a Bayesian method. From the comparison, a difference in CDF results was revealed more clearly between the CDF from this study and case 2) than between case 1) and case 2). That is, the number of flooding events exceeding the screen criterion further increased when only the PWR data were used for the primary auxiliary building than when the Korean specific data were used

Rate of PSA rise predicts metastatic versus local recurrence after definitive radiotherapy

International Nuclear Information System (INIS)

Sartor, C.I.; Strawderman, M.H.; Lin, X.; Kish, K.E.; McLaughlin, P.W.; Lichter, A.S.; Sandler, H.S.

1995-01-01

Objective: A rising PSA following treatment for adenocarcinoma of the prostate indicates eventual clinical failure, but the rate of rise can be quite different from patient to patient, as can the pattern of clinical failure. We sought to determine whether the rate of PSA rise could differentiate future local vs. metastatic failure. Materials and Methods: PSA values from our series of 671 patients treated between 1987 and 1994 with 3-D conformal radiotherapy for localized adenocarcinoma were analyzed. Patients who had a pre-treatment PSA and >4 post-treatment PSA values available, had received no hormonal therapy, and had information detailing clinical outcome were used in this analysis. First site of failure was determined by abnormal DRE or biopsy, abnormal bone scan or radiographic evidence of metastasis as directed by clinical symptoms or follow-up clinical exam. Each patient's PSA pattern was defined by the function PSA(t)=C 1 e - a 1 (t) + C 2 e a 2 (t) where -a 1 relates to the rate of decline and a 2 to the rate of rise, if any. Univariate analysis was used to determine the correlation between initial PSA or rising PSA and clinical failure. Adjacent category logistic regression analysis was used to analyze the rate of rise and pattern of clinical failure. Results: 671 patients were reviewed; 401 patients met the requirements and 2667 PSA values were analyzed. We confirmed the finding of others that pre-treatment PSA is a prognostic indicator: patients presenting with PSA 3-20ng/ml had a relative risk of 9 (p=0.03) and PSA>20ng/ml had a RR of 26 (p=0.002) for clinical failure when compared to presenting PSA 2 >1.5/year predicted metastatic as opposed to local failure when compared to PSA rise with a 2 between 0.5-1.5/yr or 1.5 log(ng/ml)/year vs. 0.5-1.5 log(ng/ml)/yr or <0.5 log(ng/ml)/yr. Conclusions: The rate of rise of PSA following definitive radiotherapy can predict clinical failure patterns, with a rapidly rising PSA indicating metastatic as opposed to

Review of SFR Design Safety using Preliminary Regulatory PSA Model

International Nuclear Information System (INIS)

Na, Hyun Ju; Lee, Yong Suk; Shin, Andong; Suh, Nam Duk

2013-01-01

The major objective of this research is to develop a risk model for regulatory verification of the SFR design, and thereby, make sure that the SFR design is adequate from a risk perspective. In this paper, the development result of preliminary regulatory PSA model of SFR is discussed. In this paper, development and quantification result of preliminary regulatory PSA model of SFR is discussed. It was confirmed that the importance PDRC and ADRC dampers is significant as stated in the result of KAERI PSA model. However, the importance can be changed significantly depending on assumption of CCCG and CCF factor of PDRC and ADRC dampers. SFR (sodium-cooled fast reactor) which is Gen-IV nuclear energy system, is designed to accord with the concept of stability, sustainability and proliferation resistance. KALIMER-600, which is under development in Korea, includes passive safety systems (e. g. passive reactor shutdown, passive residual heat removal, and etc.) as well as active safety systems. Risk analysis from a regulatory perspective is needed to support the regulatory body in its safety and licensing review for SFR (KALIMER-600). Safety issues should be identified in the early design phase in order to prevent the unexpected cost increase and delay of the SFR licensing schedule that may be caused otherwise

Significance of clinical evaluation of the metacarpophalangeal joint in relation to synovial/bone pathology in rheumatoid and psoriatic arthritis detected by magnetic resonance imaging.

Science.gov (United States)

Stone, Millicent A; White, Lawrence M; Gladman, Dafna D; Inman, Robert D; Chaya, Sam; Lax, Matthew; Salonen, David; Weber, Deborah A; Guthrie, Judy A; Pomeroy, Emma; Podbielski, Dominik; Keystone, Edward C

2009-12-01

Rheumatologists base many clinical decisions regarding the management of inflammatory joint diseases on joint counts performed at clinic. We investigated the reliability and accuracy of physically examining the metacarpophalangeal (MCP) joints to detect inflammatory synovitis using magnetic resonance imaging (MRI) as the gold standard. MCP joints 2 to 5 in both hands of 5 patients with rheumatoid arthritis (RA) and 5 with psoriatic arthritis (PsA) were assessed by 5 independent examiners for joint-line swelling (visually and by palpation); joint-line tenderness by palpation (tender joint count, TJC) and stress pain; and by MRI (1.5 Tesla superconducting magnet). Interrater reliability was assessed using kappa statistics, and agreement between examination and corresponding MRI assessment was assessed by Fisher's exact tests (p 0.8) and positive predictive value (= 0.8). For PsA, significant associations exist between TJC and MRI synovitis scores (p < 0.01) and stress pain and MRI edema scores (p < 0.04). Assessment of swelling by palpation was not significantly associated with synovitis or edema as determined by MRI in RA or PsA (p = 0.54-1.0). In inflammatory arthritis, disease activity in MCP joints can be reliably assessed at the bedside by examining for joint-line tenderness (TJC) and visual inspection for swelling. Clinical assessment may have to be complemented by other methods for evaluating disease activity in the joint, such as MRI, particularly in patients with PsA.

Ascertaining the international state of the art of PSA methodology

International Nuclear Information System (INIS)

Linden, J. von

1998-01-01

Plant-specific PSAs, to be performed within the framework of the Periodic Safety Review of German Nuclear Power Plants require further development of the methodology. For that purpose foreign PSA-guidelines and PSA-reviewes as well as relevant literature are examined and appropriate insights are adopted within task A.2 of project SR 2096. The main goal of these activities is to achieve a comparison of the state of the art of PSA-methodologies applied abroad and in Germany. The German state of the art refers to the extent as is documented in the German PSA Guide (Leitfaden Probabilistische Sicherheitsanalyse /PSUe97/) which has to be used for the Periodic Safety Review of German Nuclear Power Plants. The structure for the evaluation is based on the working steps of a PSA. In total, according to the objectives of the Periodic Safety Review the German approach for plant-specific PSAs based on the German PSA Guide is conform to the state of the art abroad. Identified deviations in some details are evaluated reflecting the view of GRS. Particular aspects resulting from the evaluation should be considered for further development of the German PSA Guide. (orig.) [de

Age-Specific Cutoff Value for the Application of Percent Free Prostate-Specific Antigen (PSA) in Chinese Men with Serum PSA Levels of 4.0–10.0 ng/ml

Science.gov (United States)

Xie, Liping; He, Dalin; Zhou, Liqun; Xu, Chuanliang; Gao, Xu; Ren, Shancheng; Wang, Fubo; Ma, Lulin; Wei, Qiang; Yin, Changjun; Tian, Ye; Sun, Zhongquan; Fu, Qiang; Ding, Qiang; Zheng, Junhua; Ye, Zhangqun; Ye, Dingwei; Xu, Danfeng; Hou, Jianquan; Xu, Kexin; Yuan, Jianlin; Gao, Xin; Liu, Chunxiao; Pan, Tiejun; Sun, Yinghao

2015-01-01

Objective The influence of age on the performance of percent free prostate-specific antigen (%fPSA) in diagnosing prostate cancer (PCa) in East Asians is controversial. We tested the diagnostic performance of %fPSA in a multi-center biopsy cohort in China and identified the proper age-specific cutoff values to avoid unnecessary biopsies. Methods Consecutive patients with a prostate-specific antigen (PSA) level of 4.0–10.0 ng/ml or 10.1–20.0 ng/ml who underwent transrectal ultrasound-guided or transperineal prostate biopsy were enrolled from 22 Chinese medical centers from Jan 1, 2010 to Dec 31, 2013. The diagnostic accuracy of PSA and %fPSA was determined using the area under the receiver operating characteristic (ROC) curve (AUC). Age-specific cutoff values were calculated using ROC curve analysis. Results The median %fPSA was much lower in younger patients compared with older patients with a PSA level of 4.0–10.0 ng/ml or 10.1–20.0 ng/ml. The AUC of %fPSA was higher than PSA only in older patients. In patients aged 50 to 59 years, %fPSA failed to improve the diagnosis compared with PSA in these two PSA ranges. Age-specific cutoff values were 24%, 27% and 32% for patients aged 60–69, 70–79 and ≥80 years, respectively, to reduce unnecessary biopsies in men with PSA levels of 4.0–10.0 ng/ml to detect 90% of all PCa. Conclusions The effectiveness of %fPSA is correlated with age in the Chinese population. Age-specific cutoff values would help avoid unnecessary biopsies in the Chinese population. PMID:26091007

The Effect of Increasing Doses of Saw Palmetto Fruit Extract on Serum PSA Levels: Analysis of the CAMUS Randomized Trial

Science.gov (United States)

Andriole, Gerald L.; McCullum-Hill, Christie; Sandhu, Gurdarshan S.; Crawford, E. David; Barry, Michael J.; Cantor, Alan

2014-01-01

Purpose Saw palmetto extracts are used for treating lower urinary tract symptoms in men despite level I evidence concluding that saw palmetto was ineffective in reducing lower urinary symptoms. We sought to determine whether higher doses of saw palmetto as studied in CAMUS affect serum PSA levels. Materials and Methods The CAMUS trial was a randomized, placebo-controlled double blind multi-centered North American trial conducted between June 5, 2008 and October 10, 2012 in which 369 men >45 years of age with AUA symptom score ≥ 8 and ≤ 24 were randomly assigned to placebo or dose escalation saw palmetto, which consisted of 320mg for first 24 weeks to 640mg for next 24 weeks to 960mg for last 24 weeks of this 72 week trial. Serum PSA levels (Beckman-Coulter) were obtained at baseline and at weeks 24, 48 and 72 and were compared between treatment groups using the pooled t and Fisher's exact tests. Results Serum PSA levels were similar at baseline for the placebo (1.93 ± 1.59 ng/ml) and saw palmetto groups (2.20 ± 1.95, p = 0.16). Changes in PSA levels over the course of the study were similar: placebo group mean change 0.16 ± 1.08 ng/ml and saw palmetto group mean change 0.23 ± 0.83 ng/ml (p value 0.50). Additionally, no differential effect on serum PSA levels was observed between treatment arms when groups were stratified by baseline PSA values. Conclusions Saw palmetto extract does not affect serum PSA levels more than placebo even at relatively high doses. PMID:23253958

Very Early PSA Response to Abiraterone in mCRPC Patients: A Novel Prognostic Factor Predicting Overall Survival.

Science.gov (United States)

Facchini, Gaetano; Caffo, Orazio; Ortega, Cinzia; D'Aniello, Carmine; Di Napoli, Marilena; Cecere, Sabrina C; Della Pepa, Chiara; Crispo, Anna; Maines, Francesca; Ruatta, Fiorella; Iovane, Gelsomina; Pisconti, Salvatore; Montella, Maurizio; Berretta, Massimiliano; Pignata, Sandro; Cavaliere, Carla

2016-01-01

Abiraterone Acetate (AA) is approved for the treatment of mCRPC after failure of androgen deprivation therapy in whom chemotherapy is not yet clinically indicated and for treatment of mCRPC progressed during or after docetaxel-based chemotherapy regimen. The aim of this study is to evaluate the role of early PSA decline for detection of therapy success or failure in mCRPC patients treated with AA in post chemotherapy setting. We retrospectively evaluated 87 patients with mCRPC treated with AA. Serum PSA levels were evaluated after 15, 90 days and then monthly. The PSA flare phenomenon was evaluated, according to a confirmation value at least 1 week apart. The primary endpoint was to demonstrate that an early PSA decline correlates with a longer progression free survival (PFS) and overall survival (OS). The secondary endpoind was to demonstrate a correlation between better outcome and demographic and clinical patient characteristics. We have collected data of 87 patients between Sep 2011 and Sep 2014. Early PSA response (≥50% from baseline at 15 days) was found in 56% evaluated patients and confirmed in 29 patients after 90 days. The median PFS was 5.5 months (4.6-6.5) and the median OS was 17.1 months (8.8-25.2). In early responders patients (PSA RR ≥ 50% at 15 days), we found a significant statistical advantage in terms of PFS at 1 year, HR 0.28, 95%CI 0.12-0.65, p = 0.003, and OS, HR 0.21 95% CI 0.06-0.72, p = 0.01. The results in PFS at 1 years and OS reached statistical significance also in the evaluation at 90 days. A significant proportion (78.6%) of patients achieved a rapid response in terms of PSA decline. Early PSA RR (≥50% at 15 days after start of AA) can provide clinically meaningful information and can be considered a surrogate of longer PFS and OS.

Relationship between PSA kinetics and [{sup 18}F]fluorocholine PET/CT detection rates of recurrence in patients with prostate cancer after total prostatectomy

Energy Technology Data Exchange (ETDEWEB)

Graute, Vera; Jansen, Nathalie; Uebleis, Christopher; Cumming, Paul; Klanke, Katharina; Tiling, Reinhold; Bartenstein, Peter; Hacker, Marcus [University of Munich, Department of Nuclear Medicine, Munich (Germany); Seitz, Michael [University of Munich, Department of Urology, Munich (Germany); Hartenbach, Markus [Bundeswehrkrankenhaus Ulm, Department of Nuclear Medicine, Ulm (Germany); Scherr, Michael Karl; Thieme, Sven [University of Munich, Institute of Clinical Radiology, Munich (Germany)

2012-02-15

The aim of the present study was to identify prostate-specific antigen (PSA) threshold levels, as well as PSA velocity, progression rate and doubling time in relation to the detectability and localization of recurrent lesions with [{sup 18}F]fluorocholine (FC) PET/CT in patients after radical prostatectomy. The study group comprised 82 consecutive patients with biochemical relapse after radical prostatectomy. PSA levels measured at the time of imaging were correlated with the FC PET/CT detection rates in the entire group with PSA velocity (in 48 patients), with PSA doubling time (in 47 patients) and with PSA progression (in 29 patients). FC PET/CT detected recurrent lesions in 51 of the 82 patients (62%). The median PSA value was significantly higher in PET-positive than in PET-negative patients (4.3 ng/ml vs. 1.0 ng/ml; p < 0.01). The optimal PSA threshold from ROC analysis for the detection of recurrent prostate cancer lesions was 1.74 ng/ml (AUC 0.818, 82% sensitivity, 74% specificity). Significant differences between PET-positive and PET-negative patients were found for median PSA velocity (6.4 vs. 1.1 ng/ml per year; p < 0.01) and PSA progression (5.0 vs. 0.3 ng/ml per year, p < 0.01) with corresponding optimal thresholds of 1.27 ng/ml per year and 1.28 ng/ml per year, respectively. The PSA doubling time suggested a threshold of 3.2 months, but this just failed to reach statistical significance (p = 0.071). In a study cohort of patients with biochemical recurrence of prostate cancer after radical prostatectomy there emerged clear PSA thresholds for the presence of FC PET/CT-detectable lesions. (orig.)

Seminal plasma PSA in spinal cord injured men

DEFF Research Database (Denmark)

Brasso, K; Sønksen, J; Sommer, P

1998-01-01

The aim of the study was to evaluate the impact of spinal cord injury on seminal plasma PSA concentration.......The aim of the study was to evaluate the impact of spinal cord injury on seminal plasma PSA concentration....

PSA modeling of long-term accident sequences

International Nuclear Information System (INIS)

Georgescu, Gabriel; Corenwinder, Francois; Lanore, Jeanne-Marie

2014-01-01

In the context of the extension of PSA scope to include external hazards, in France, both operator (EDF) and IRSN work for the improvement of methods to better take into account in the PSA the accident sequences induced by initiators which affect a whole site containing several nuclear units (reactors, fuel pools,...). These methodological improvements represent an essential prerequisite for the development of external hazards PSA. However, it has to be noted that in French PSA, even before Fukushima, long term accident sequences were taken into account: many insight were therefore used, as complementary information, to enhance the safety level of the plants. IRSN proposed an external events PSA development program. One of the first steps of the program is the development of methods to model in the PSA the long term accident sequences, based on the experience gained. At short term IRSN intends to enhance the modeling of the 'long term' accident sequences induced by the loss of the heat sink or/and the loss of external power supply. The experience gained by IRSN and EDF from the development of several probabilistic studies treating long term accident sequences shows that the simple extension of the mission time of the mitigation systems from 24 hours to longer times is not sufficient to realistically quantify the risk and to obtain a correct ranking of the risk contributions and that treatment of recoveries is also necessary. IRSN intends to develop a generic study which can be used as a general methodology for the assessment of the long term accident sequences, mainly generated by external hazards and their combinations. This first attempt to develop this generic study allowed identifying some aspects, which may be hazard (or combinations of hazards) or related to initial boundary conditions, which should be taken into account for further developments. (authors)

PSA in licensing, safety reviews and design as applied in Germany

International Nuclear Information System (INIS)

Berg, H.P.; Goertz, R.; Schott, H.; Wendling, R.D.

1994-01-01

In this paper, two topics - the application of PSA in the regulatory process and the effort to improve PSA methods and models - are addressed. From the regulators' point of view, the most important application of PSA in Germany is presently within the safety reviews of nuclear power plants in operation. The current status of regulatory guidance which shall be provided to establish a uniform procedure for a periodic safety review is described with special emphasis on the role of PSA. An important goal is to have all plant-specific PSAs comparable as far as possible. Guidance for PSA review is under development likewise. Furthermore, the application of PSA in licensing of nuclear power plants is addressed as well as its use in the design process of future pressurized water reactors. The development of models and methods to be applied in PSA has been and will be supported by a number of studies and investigations. An overview of the main issues of these investigations is provided. A specific task was the elaboration of a proposal for incorporating fire events into the PSA. The status of these efforts is outlined. (author). 7 refs, 3 figs, 2 tabs

PSA as a tool for decision making

International Nuclear Information System (INIS)

Niehaus, F.; Lederman, L.

1986-01-01

The question on ''How safe is safe enough'' is being responded presently by deterministic criteria. Probabilistic criteria in support to more rational and less emotional decisions in regulatory and licensing issues, rationalization of resource allocation and research prioritization, among others, have a potential which is only marginally being explored. This paper discussed PSA limitations and proposes three areas for the use of PSA in decision making, namely: preventing accidents, mitigating accidents, and defining regulatory requirements. Current activities of the International Atomic Energy Agency in these areas are mentioned. PSA studies depict clearly the uncertainties and this is viewed as a positive aspect, which is unique to the use of probabilistic methods. (orig.)

[Use of prostatic specific antigen in primary care (PSA)].

Science.gov (United States)

Panach-Navarrete, J; Gironés-Montagud, A; Sánchez-Cano, E; Doménech-Pérez, C; Martínez-Jabaloyas, J M

2017-04-01

In the literature it is shown that the use of PSA is occasionally wrong, by requesting this marker in very young or very old men, and repeated measurements in short periods of time. The main objective of this study was to describe the use of PSA in daily practice by primary care physicians in our area, dealing with aspects such as the importance of patient age, the value in the screening for prostate cancer, or the subjective beliefs about its usefulness. A secondary objective was the comparison of use, and beliefs among doctors who claim to know PSA well, and those who do not. A descriptive and comparative study was conducted using questionnaires that were handed to primary care doctors in all health centres in our area. A descriptive analysis was performed and response rates among doctors who thought they had enough information about PSA, and those who did not, were compared using the Chi-squared test. A total of 103 questionnaires were received from the physicians, with 83.5% claiming to have sufficient knowledge about the PSA. The professionals in this latter group request PSA at an earlier age (P=.029), with a higher frequency (P=.011) and have more doubts about its usefulness (P=.009) than those with less knowledge. Almost half (49.5%) said they request less than 50 determinations per year, and 33% between 50 and 100. More than half (53.4%) of doctors would not request the first PSA on a patient until their 50s, and up to 49% request it up to 80 years. The true value of PSA has been established many times by 64.1% of requesters, and 29.1% believe it is unhelpful in the diagnosis of cancer. In our study, 64% of primary care physicians have considered the true value of the PSA several times, and 29% believe it to be of little use in the diagnosis of prostate cancer. In addition, some data suggest it has limited use due to the fact that 50% made less than 50 PSA requests per years, and 28% of the professionals would never request it on a male without urinary

ASAMPSA-E guidance for level 2 PSA Volume 3. Verification and improvement of SAM strategies with L2 PSA

International Nuclear Information System (INIS)

Rahni, N.; Raimond, E.; Jan, P.; Lopez, J.; Loeffler, H.; Mildenberger, O.; Kubicek, J.; Vitazkova, J.; Ivanov, I.; Groudev, P.; Lajtha, G.; Serrano, C.; Zhabin, O.; Prosek, Andrej; Dirksen, G.; Yu, S.; Oury, L.; Hultqvist, G.

2016-01-01

For each NPP, severe accident management (SAM) strategies shall make use of components or systems and human resources to limit as far as possible the consequences of any severe accident on-site and off-site. L2 PSA is one of the tools that can be used to verify and improve these strategies. The present report (deliverable D40.5 of the project ASAMPSA-E) provides an opportunity for a comparison of objectives in the different countries in terms of SAM strategies verification and improvement. The report summarizes also experience of each partner (including potential deficiencies) involved in this activity, in order to derive some good practices and required progress, addressing: - SAM modeling in L2 PSA, - Positive and negative aspects in current SAM practices, - Discussion on possible criteria related to L2 PSA for verification and improvement: risk reduction (in relation with WP30 activities on risk metrics), reduction of uncertainties on the severe accident progression paths until NPP stabilization, reduction of human failure conditional probabilities (depending on the SAM strategy, the environmental conditions...), - Review with a perspective of verification and improvement of the main SAM strategies (corium cooling, RCS depressurization, control of flammable gases, reactivity control, containment function, containment pressure control, limitation of radioactive releases,...), - SAM strategies to be considered in the context of an extended L2 PSA (as far possible, depending on existing experience), taking into account all operating modes, accidents also occurring in the SFPs and long term and multi-unit accidents. The deliverable D40.5 is developed from the partners' experience. Many of the topics described here are beyond the common practices of L2 PSA applications: in some countries, L2 PSA application is limited to the calculations of frequencies of release categories with no formal requirement for SAM verification and improvement. (authors)

Institute of nuclear power operations perspectives on PSA applications

International Nuclear Information System (INIS)

Webster, W.E.; Miller, W.J. Jr.

1996-01-01

The investment to develop a PSA is very substantial, and therefore, there is motivation to recover this investment through further use of the techniques used to develop it. It is not surprising that nuclear power plant staff are beginning to use PSA to make operational decisions. The Institute of Nuclear Power Operations is interested in those factors that impact the conduct of plant operations and therefore is actively monitoring the increased usage of PSA techniques. The purpose of this paper is to provide some thoughts and perspectives on the use of PSA as a factor in operational decision making, including decision making in activities performed by engineering, maintenance and operation personnel. (author)

Safety and efficacy of procedural sedation and analgesia (PSA ...

African Journals Online (AJOL)

Safety and efficacy of procedural sedation and analgesia (PSA) conducted by medical officers in a level 1 hospital in Cape Town. ... Respiratory complications were treated with simple airway manoeuvres; no patient required intubation or experienced respiratory problems after waking up. There was no significant difference ...

Noninvasive scoring system for significant inflammation related to chronic hepatitis B

Science.gov (United States)

Hong, Mei-Zhu; Ye, Linglong; Jin, Li-Xin; Ren, Yan-Dan; Yu, Xiao-Fang; Liu, Xiao-Bin; Zhang, Ru-Mian; Fang, Kuangnan; Pan, Jin-Shui

2017-03-01

Although a liver stiffness measurement-based model can precisely predict significant intrahepatic inflammation, transient elastography is not commonly available in a primary care center. Additionally, high body mass index and bilirubinemia have notable effects on the accuracy of transient elastography. The present study aimed to create a noninvasive scoring system for the prediction of intrahepatic inflammatory activity related to chronic hepatitis B, without the aid of transient elastography. A total of 396 patients with chronic hepatitis B were enrolled in the present study. Liver biopsies were performed, liver histology was scored using the Scheuer scoring system, and serum markers and liver function were investigated. Inflammatory activity scoring models were constructed for both hepatitis B envelope antigen (+) and hepatitis B envelope antigen (-) patients. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve were 86.00%, 84.80%, 62.32%, 95.39%, and 0.9219, respectively, in the hepatitis B envelope antigen (+) group and 91.89%, 89.86%, 70.83%, 97.64%, and 0.9691, respectively, in the hepatitis B envelope antigen (-) group. Significant inflammation related to chronic hepatitis B can be predicted with satisfactory accuracy by using our logistic regression-based scoring system.

Defining the appropriate radiation dose for pretreatment PSA no. <=no. 10 ng/mL prostate cancer

International Nuclear Information System (INIS)

Pinover, Wayne H.; Hanlon, Alexandra L.; Horwitz, Eric M.; Hanks, Gerald E.

2000-01-01

Purpose: To investigate whether a dose response exists for biochemical no evidence of disease (bNED) control in prostate cancer patients with pretreatment prostate-specific antigen (PSA) no. =no. 7600 cGy. Median dose in these three groups was 7067 cGy, 7278 cGy, and 7734 cGy, respectively. Univariate analysis was performed to determine differences in bNED control (American Society for Therapeutic Radiology and Oncology [ASTRO] Consensus Guidelines definition of failure) by dose group for the entire cohort, for 310 good prognosis patients (T1-T2A, Gleason score 2-6, absence of PNI), and for 178 poor prognosis patients (T2B-T3 or Gleason score 7-10 or presence of PNI) . Multivariate analysis (MVA) was performed to determine if dose was an independent predictor of bNED control. Median follow-up was 36 months. Results: A dose response was not demonstrated for the entire group of patients with pretreatment PSA no. =no. 7600 cGy were associated with 5-year bNED control rates of 73%, 86%, and 89%, respectively (p = 0.12). MVA demonstrated prognosis group (p = 0.038) to be the only independent predictor of bNED control. Good prognosis patients had a 5-year bNED of 85% and no dose response was seen. The subgroup of poor prognosis patients demonstrated a 5-year bNED control rate of 81% and a dose response was seen for those receiving no. >=no. 7600 cGy, compared to the two lower dose groups (94% vs. 75% vs. 70%; p = 0.0062). MVA for the poor prognosis subset demonstrated dose (p = 0.01) to be the only independent predictor for improved bNED control. Conclusions: The poor prognosis subset of PSA no. <=no. 10 ng/mL prostate cancer patients benefit from dose escalation. A dose response is not demonstrated for prostate cancer patients with pretreatment PSA no. <=no. 10 ng/mL and other favorable features

European Randomized Study of Screening for Prostate Cancer Risk Calculator: External Validation, Variability, and Clinical Significance.

Science.gov (United States)

Gómez-Gómez, Enrique; Carrasco-Valiente, Julia; Blanca-Pedregosa, Ana; Barco-Sánchez, Beatriz; Fernandez-Rueda, Jose Luis; Molina-Abril, Helena; Valero-Rosa, Jose; Font-Ugalde, Pilar; Requena-Tapia, Maria José

2017-04-01

To externally validate the European Randomized Study of Screening for Prostate Cancer (ERSPC) risk calculator (RC) and to evaluate its variability between 2 consecutive prostate-specific antigen (PSA) values. We prospectively catalogued 1021 consecutive patients before prostate biopsy for suspicion of prostate cancer (PCa). The risk of PCa and significant PCa (Gleason score ≥7) from 749 patients was calculated according to ERSPC-RC (digital rectal examination-based version 3 of 4) for 2 consecutive PSA tests per patient. The calculators' predictions were analyzed using calibration plots and the area under the receiver operating characteristic curve (area under the curve). Cohen kappa coefficient was used to compare the ability and variability. Of 749 patients, PCa was detected in 251 (33.5%) and significant PCa was detected in 133 (17.8%). Calibration plots showed an acceptable parallelism and similar discrimination ability for both PSA levels with an area under the curve of 0.69 for PCa and 0.74 for significant PCa. The ERSPC showed 226 (30.2%) unnecessary biopsies with the loss of 10 significant PCa. The variability of the RC was 16% for PCa and 20% for significant PCa, and a higher variability was associated with a reduced risk of significant PCa. We can conclude that the performance of the ERSPC-RC in the present cohort shows a high similitude between the 2 PSA levels; however, the RC variability value is associated with a decreased risk of significant PCa. The use of the ERSPC in our cohort detects a high number of unnecessary biopsies. Thus, the incorporation of ERSPC-RC could help the clinical decision to carry out a prostate biopsy. Copyright © 2016 Elsevier Inc. All rights reserved.

Challenges and status of multi-unit PSA development in Canada

International Nuclear Information System (INIS)

Yalaoui, Smain

2015-01-01

Firstly, this paper discusses the issues and challenges related to the development of a Multi-Unit PSA (MU-PSA) and the general recommendations and conclusions from the MU-PSA Workshop organized by the CNSC in Ottawa, November 2014. This includes a discussion regarding the issue related to the methodological challenges in performing MU-PSA, the site-based risk metrics to be adopted, and the issue of risk aggregation across all hazards and all units. The paper also addresses the challenges for establishing site-based safety goals as the current safety goals were established on a per-unit basis. CNSC Staff efforts, both at the national and international level, on developing whole-site safety goals and guidance on MU-PSA and risk aggregation methodologies will also be discussed. Finally, the paper will provide a summary of the industry effort and road map for completing the pilot Whole-site PSA project for the Pickering Nuclear Generating Station, as requested by the Commission following to the public hearing for licence renewal in February 20 and May 29-31, 2013. (author)

Development of PSA procedure for a criticality in reprocessing facilities

International Nuclear Information System (INIS)

Endo, Shigeki; Takanashi, Mitsuhiro; Ueda, Yoshinori

2012-08-01

Utilization of risk information for the nuclear safety regulation is being discussed in Japan. The development of probabilistic safety assessment (PSA) procedure is indispensable for the utilization of risk information. The Japan Nuclear Energy Safety Organization (JNES) has been conducting trial PSA to a model plant for major events, i.e. hydrogen explosion, solution boiling, rapid decomposition of TBP complexes, criticality, solvent fire, leakage of molten glass, leakage of high active concentrated liquid waste, loss of all AC electricity, drop of a fuel assembly, for the purpose of developing the PSA procedure for reprocessing facilities. For criticality events results of trial PSA were summarized as a report in which how to evaluate an amount of radioactive materials released from a facility and a health effect on the public were emphasized. Therefore, for criticality events the results of trial PSA were summarized in this report to emphasize procedures from making event progression scenarios to quantifying event sequences, which were not handled in the previous report, in a style of a document describing PSA procedures. (author)

Oncologic control obtained after radical prostatectomy in men with a pathological Gleason score ≥ 8: a single-center experience.

Science.gov (United States)

Audenet, François; Comperat, Eva; Seringe, Elise; Drouin, Sarah J; Richard, François; Cussenot, Olivier; Bitker, Marc-Olivier; Rouprêt, Morgan

2011-01-01

To assess the oncologic control afforded by radical prostatectomy (RP) in high-risk prostate cancers with a Gleason score ≥ 8. We performed a retrospective review of prostate cancer patients who underwent RP between 1995 and 2005 for prostate cancer and who had a pathologic Gleason score ≥ 8. Biochemical recurrence was defined as a single rise in PSA levels over 0.2 ng/ml after surgery. Overall, 64 patients were included and followed for a median time of 84.3 months. The mean age was 63 ± 5.2 years. The mean preoperative PSA was 11.9 ± 7.3 ng/ml (1.9-31), and 29 patients (46%) had a PSA > 10 ng/ml. The biopsy Gleason score was ≤ 7 for 49 patients (76.6%). After pathologic analysis, there were 25 (39%) stage pT2, 37 (58%) stage pT3, and 2 (3%) stage pT4 patients. Nine patients had lymph node involvement (14%). The surgical margins were positive in 25 patients (39%). In 51 patients, (80%) the Gleason score was underestimated by biopsies: 40 patients with a definitive score of Gleason 8 had a Gleason score of 6 or 7 on biopsies, while 11 patients with a Gleason score of 9 initially, had a Gleason score of 7 or 8. Twenty-seven patients underwent adjuvant treatment: external radiation therapy (n = 19), HRT (n = 3), or both (n = 5). During follow-up, 41 patients (64%) presented with a biochemical recurrence, and 11 (17%) died. The PSA-free survival rate at five year was 44%. RP remains a possible therapeutic option in certain cases of the high-risk cohort of patients with a Gleason score ≥ 8. However, patients should be warned that surgery might only be the first step of a multi-modal treatment approach. The modalities of adjuvant treatments and the right schedule to deliver it following RP still need to be defined. Copyright © 2011 Elsevier Inc. All rights reserved.

Babesiosis PSA (:60)

Centers for Disease Control (CDC) Podcasts

2012-04-25

This 60 second PSA describes babesiosis, a preventable and treatable tickborne disease, including the signs and symptoms of infection and ways to prevent it.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/26/2012.

Recent Developments in Level 2 PSA and Severe Accident Management

International Nuclear Information System (INIS)

Ang, Ming Leang; Shepherd, Charles; Gauntt, Randall; Landgren, Vickie; Van Dorsselaere, Jean Pierre; Chaumont, Bernard; Raimond, Emmanuel; Magallon, Daniel; Prior, Robert; Mlady, Ondrej; Khatib-Rahbar, Mohsen; Lajtha, Gabor; Tinkler, Charles; Siu, Nathan

2007-01-01

In 1997, CSNI WGRISK produced a report on the state of the art in Level 2 PSA and severe accident management - NEA/CSNI/R(1997)11. Since then, there have been significant developments in that more Level 2 PSAs have been carried out worldwide for a variety of nuclear power plant designs including some that were not addressed in the original report. In addition, there is now a better understanding of the severe accident phenomena that can occur following core damage and the way that they should be modelled in the PSA. As requested by CSNI in December 2005, the objective of this study was to produce a report that updates the original report and gives an account of the developments that have taken place since 1997. The aim has been to capture the most significant new developments that have occurred rather than to provide a full update of the original report, most of which is still valid. This report is organised using the same structure as the original report as follows: Chapter 2: Summary on state of application, results and insights from recent Level 2 PSAs. Chapter 3: Discussion on key severe accident phenomena and modelling issues, identification of severe accident issues that should be treated in Level 2 PSAs for accident management applications, review of severe accident computer codes and the use of these codes in Level 2 PSAs. Chapter 4: Review of approaches and practices for accident management and SAM, evaluation of actions in Level 2 PSAs. Chapter 5: Review of available Level 2 PSA methodologies, including accident progression event tree / containment event tree development. Chapter 6: Aspects important to quantification, including the use of expert judgement and treatment of uncertainties. Chapter 7: Examples of the use of the results and insights from the Level 2 PSA in the context of an integrated (risk informed) decision making process

PSA Level 2 as element of an integral safety assessment before plant commissioning

International Nuclear Information System (INIS)

Loeffler, H.; Mildenberger, O.; Sonnenkalb, M.; Steinroetter, T.

2012-01-01

In Argentina the Central Nuclear Atucha II is near to completion. This is a pressurized heavy water reactor. PSA (Probability Safety Assessment) level 1, level 2 and level 3 have to be performed in order to show compliance with the Argentinean dose limit. Such studies have been done first by the former KWU in the 1980's to get the construction license (FABIAN 1985). Nowadays the plant owner NA-SA performs PSA level 1 and provides information about the core damage states to GRS, who does the subsequent PSA level 2 part. GRS delivers source terms to the environment and the associated frequencies to the Argentinean research institute CNEA, which performs level 3 together with NA-SA. Since GRS is situated in the middle of the chain, interface definition with both ends has been a significant task of the GRS activities. Experience gained during this process will be highlighted in the presentation. The analysis of PSA level 2 proper follows a traditional approach: -) deterministic accident simulation with integral code MELCOR; -) analyses of specific issues which are not covered by MELCOR; and -) probabilistic accident progression analysis with EVNTRE event tree methodology. It appears that MELCOR and EVNTRE and PSA guidelines in general are flexible enough to analyse new or uncommon reactor designs. It also appears that the plant specific design features may require analyses beyond present code capabilities, calling for expert judgment and they can largely determine PSA results. The behaviour of iodine is not yet covered satisfactorily by state-of-the-art models in MELCOR

Construction and Quantification of the One Top model of the Fire Events PSA

International Nuclear Information System (INIS)

Kang, Dae Il; Lee, Yoon Hwan; Han, Sang Hoon

2008-01-01

KAERI constructed the one top model of the fire events PSA for Ulchin Unit 3 and 4 by using the 'mapping technique'. The mapping technique was developed for the construction and quantification of external events PSA models with a one top model for an internal events PSA. With 'AIMS', the mapping technique can be implemented by the construction of mapping tables. The mapping tables include fire rooms, fire ignition frequency, related initiating events, fire transfer events, and the internal PSA basic events affected by a fire. The constructed one top fire PSA model is based on previously conducted fire PSA results for Ulchin Unit 3 and 4. In this paper, we introduce the construction procedure and quantification results of the one top model of the fire events PSA by using the mapping technique. As the one top model of the fire events PSA developed in this study is based on the previous study, we also introduce the previous fire PSA approach focused on quantification

FATORES DEMOGRÁFICOS ASSOCIADOS À REALIZAÇÃO DO ANTÍGENO PROSTÁTICO ESPECÍFICO (PSA EM MUNICÍPIO SUL BRASILEIRO

Directory of Open Access Journals (Sweden)

Willian Augusto Melo

2012-12-01

Full Text Available The Prostate Specific Antigen (PSA is considered the most important marker to detect, monitor and internship prostate cancer. This study aimed to characterize the men who were examined for measurement of PSA in 2009 in a basic health unit of Maringá-PR. Were collected information about age, race, PSA test result and place of residence. The independent variable was PSA values (normal or abnormal. Were used descriptive statistics of the variables through the frequencies and bivariate analysis by Fisher's Exact Test. Was reached that 53.5% of men who underwent PSA testing were younger than 60 years, where these, 1.2% had their PSA level abnormal or above 4.01 Ng-mL. Being over 70 years was statistically significant PSA changes. It is concluded that age is a triggering factor for benign and malignant prostatic abnormalities.

Use of PSA for improving the safety of French PWRs

International Nuclear Information System (INIS)

Lanore, J.M.; Chambon, J.L.

1994-06-01

Two French PWR Probabilistic Safety Assessment (PSA) studies were conducted for the standardized PWR series of 900 and 1300 MWe. Both PSA 900 and PSA 1300 are level 1 PSAs, that means their objective is the evaluation of core meltdown frequency. These studies have some specific features, in particular the treatment of shutdown conditions, the treatment of long term post-accidental situations, and a wide use of French experience feedback. The PSAs are used for safety improvements of the French PWRs. Following the PSA results, several modifications to plants concerning the dominant sequences were decided. (R.P.). 2 refs., 4 figs

Programmable automation systems in PSA

International Nuclear Information System (INIS)

Pulkkinen, U.

1997-06-01

The Finnish safety authority (STUK) requires plant specific PSAs, and quantitative safety goals are set on different levels. The reliability analysis is more problematic when critical safety functions are realized by applying programmable automation systems. Conventional modeling techniques do not necessarily apply to the analysis of these systems, and the quantification seems to be impossible. However, it is important to analyze contribution of programmable automation systems to the plant safety and PSA is the only method with system analytical view over the safety. This report discusses the applicability of PSA methodology (fault tree analyses, failure modes and effects analyses) in the analysis of programmable automation systems. The problem of how to decompose programmable automation systems for reliability modeling purposes is discussed. In addition to the qualitative analysis and structural reliability modeling issues, the possibility to evaluate failure probabilities of programmable automation systems is considered. One solution to the quantification issue is the use of expert judgements, and the principles to apply expert judgements is discussed in the paper. A framework to apply expert judgements is outlined. Further, the impacts of subjective estimates on the interpretation of PSA results are discussed. (orig.) (13 refs.)

Analytical and clinical performances of immunoradiometric assay of total and free PSA developed locally

International Nuclear Information System (INIS)

Boucekkine, N.; Korso, R.; Bellazoug, K.; Ferd, N.; Bouyoucef, S.E.; Boudjemai, S.; Benzaid, A.; Bouhila, Z.

2002-01-01

A specific assay was developed for total and free PSA (PSAt, PSAf). Both assay use a two site IRMA with polyclonal anti PSA antibodies coated on tubes. Polyclonal antibodies were obtained after rabbit's immunisation using an under skin injection of pure PSA in multiple site. For quantification, two monoclonal antibodies were selected, the first highly specific to free PSA and the second recognising both free and bound PSA. A correlation study was performed comparatively with two commercial kits from CIS Bio and Immunotech. For that purpose, 464 serums samples ranging from 0.5 ng/ml to 3399 ng/ml were used to characterise the analytical performance of the new test. The analytical detection limit of the new test was equal to 0.05 ng/ml for the total PSA and 0.02ng/ml for the free PSA. The within run and between-day coefficients of variation were to 20 ng/ml. For BPH, no significant difference was found between the three test for the ratio PSAf/PSAt using a cut off of 14% (all were>to 14%). For the 120 patients with PC, all PSAt were > to 2 ng/ml. However the mean value of PSAt was higher for the commercial kits (14.74 ng/ml against 12.48ng/ml for the new test) but all ratio of PSAf/PSAt for the 120 newly diagnosed cancer were <14%. In conclusion, our immunoradiometric assay developed locally has a good analytical performance and its outputs are well correlated to clinical findings in prostate disease. Furthermore, a cut off of 14% for the ratio PSAf/PSAt appears to be the most accurate tools to depict a prostate cancer

A formal treatment of uncertainty sources in a level 2 PSA

International Nuclear Information System (INIS)

Ahn, Kwang Il; Yang, Joon Eon

2003-01-01

The methodological framework of the level 2 PSA appears to be currently standardized in a formalized fashion, but there have been different opinions on the way the sources of uncertainty are characterized and treated. This is primarily because the level 2 PSA deals with complex phenomenological processes that are deterministic in nature rather than random processes, and there are no probabilistic models characterizing them clearly. As a result, the probabilistic quantification of the level 2 PSA is often subjected to two sources of uncertainty: (a) incomplete modeling of accident pathways or different predictions for the behavior of phenomenological events and (b) expert-to-expert variation in estimating the occurrence probability of phenomenological events. While a clear definition of the two sources of uncertainty involved in the level 2 PSA makes it possible to treat an uncertainty in a consistent manner, careless application of these different sources of uncertainty may produce different conclusions in the decision-making process. The primary purpose of this paper is to characterize typical sources of uncertainty that would often be addressed in the level 2 PSA and their impacts on the PSA level 2 risk results. An additional purpose of this paper is to give a formal approach on how to combine random uncertainties addressed in the level 1 PSA with subjectivistic uncertainties addressed in the level 2 PSA

Testing statistical significance scores of sequence comparison methods with structure similarity

Directory of Open Access Journals (Sweden)

Leunissen Jack AM

2006-10-01

Full Text Available Abstract Background In the past years the Smith-Waterman sequence comparison algorithm has gained popularity due to improved implementations and rapidly increasing computing power. However, the quality and sensitivity of a database search is not only determined by the algorithm but also by the statistical significance testing for an alignment. The e-value is the most commonly used statistical validation method for sequence database searching. The CluSTr database and the Protein World database have been created using an alternative statistical significance test: a Z-score based on Monte-Carlo statistics. Several papers have described the superiority of the Z-score as compared to the e-value, using simulated data. We were interested if this could be validated when applied to existing, evolutionary related protein sequences. Results All experiments are performed on the ASTRAL SCOP database. The Smith-Waterman sequence comparison algorithm with both e-value and Z-score statistics is evaluated, using ROC, CVE and AP measures. The BLAST and FASTA algorithms are used as reference. We find that two out of three Smith-Waterman implementations with e-value are better at predicting structural similarities between proteins than the Smith-Waterman implementation with Z-score. SSEARCH especially has very high scores. Conclusion The compute intensive Z-score does not have a clear advantage over the e-value. The Smith-Waterman implementations give generally better results than their heuristic counterparts. We recommend using the SSEARCH algorithm combined with e-values for pairwise sequence comparisons.

Immunohistochemical staining of precursor forms of prostate-specific antigen (proPSA) in metastatic prostate cancer.

Science.gov (United States)

Parwani, Anil V; Marlow, Cameron; Demarzo, Angelo M; Mikolajczyk, Stephen D; Rittenhouse, Harry G; Veltri, Robert W; Chan, Theresa Y

2006-10-01

Precursors of prostate-specific antigen (proPSA) have been previously shown to be more concentrated in prostate cancer tissue. This study characterizes the immunohistochemical staining (IHS) of proPSA forms in metastatic prostate cancer compared with prostate specific antigen (PSA) and prostatic acid phosphatase (PAP). A tissue microarray, consisting of 74 cases of metastatic prostate carcinoma and control tissues, was used. IHS, using monoclonal antibodies against proPSA with a truncated proleader peptide containing 2 amino acids ([-2]pPSA), native ([-5/-7]pPSA), PSA, and PAP, was analyzed. The monoclonal antibodies were specific for both benign and malignant prostatic glandular tissue. IHS with [-5/-7]pPSA showed the least number of cases with negative staining (3%), and the most number of cases with moderate or strong staining (76%). In the 60 cases where all 4 stains could be evaluated, none of them were negative for proPSA and positive for PSA or PAP, and all 7 cases that were negative for both PSA and PAP showed IHS to proPSA. [-5/-7]pPSA (native proPSA) may be a better marker than PSA and PAP in characterizing metastatic prostate adenocarcinoma, with most of the cases showing positivity for the marker. Even cases that were negative for PSA and PAP, were reactive for proPSA. Such enhanced detection is particularly important in poorly differentiated carcinomas involving metastatic sites where prostate carcinoma is a consideration. A panel of markers, including proPSA, should be performed when metastatic prostate carcinoma is in the differential diagnosis.

Guidance to Risk-Informed Evaluation of Technical Specifications using PSA

International Nuclear Information System (INIS)

Baeckstroem, Ola; Haeggstroem, Anna; Maennistoe, Ilkka

2010-04-01

This report presents guidance for evaluation of Technical Specification conditions with PSA. It covers quality in PSA, how to verify that the PSA model is sufficiently robust and sufficiently complete and general requirements on methods. Acceptance criteria for evaluation of changes in the TS conditions are presented. As the probabilistic safety assessment (PSA) has developed over the years, it has demonstrated to constitute a useful tool for evaluating many aspects of the TS from a risk point of view. and in that way making the PSAs as well as the decision tools better. This also means that it will be possible to take credit for safety system overcapacity as well as inherent safety features and strength of non-safety classed systems. However, PSA is only one of the tools that shall be used in an evaluation process of TS changes (strengthening/relaxation). PSA is an excellent tool to be used to verify the importance, and thereby possibly relaxation, of TS requirements. But, since PSA is only one tool in the evaluation, it is not sufficient in itself for defining which equipment that shall or shall not have TS requirements. The purpose of this guidance document is to provide general requirements, requirements on methods and acceptance criteria on risk-informed evaluation of TS changes based on PSA. The purpose is not to provide a single solution. As part of the review of the TS conditions this guidance specify requirements on: - Quality verification of the PSA model; - Verification that the PSA model is sufficiently robust with regard to SSCs for which requirements both are and are not defined by the TS; - Verification that the SSCs, for which TS demands are to be evaluated, are modelled in a sufficient manner; - Methods for performing the evaluation; - Which evaluation criteria that shall be used (and how that is verified to be correct); - Acceptance criteria: This guidance also briefly discusses the documentation of the analysis of the TS changes. This guidance

Guidance to risk-informed evaluation of technical specifications using PSA

International Nuclear Information System (INIS)

Baeckstroem, O.; Haeggstroem, A.; Maennistoe, I.

2010-10-01

This report presents guidance for evaluation of Technical Specification conditions with PSA. It covers quality in PSA, how to verify that the PSA model is sufficiently robust and sufficiently complete and general requirements on methods. Acceptance criteria for evaluation of changes in the TS conditions are presented. As the probabilistic safety assessment (PSA) has developed over the years, it has demonstrated to constitute a useful tool for evaluating many aspects of the TS from a risk point of view. and in that way making the PSAs as well as the decision tools better. This also means that it will be possible to take credit for safety system overcapacity as well as inherent safety features and strength of non-safety classed systems. However, PSA is only one of the tools that shall be used in an evaluation process of TS changes (strengthening/relaxation). PSA is an excellent tool to be used to verify the importance, and thereby possibly relaxation, of TS requirements. But, since PSA is only one tool in the evaluation, it is not sufficient in itself for defining which equipment that shall or shall not have TS requirements. The purpose of this guidance document is to provide general requirements, requirements on methods and acceptance criteria on risk-informed evaluation of TS changes based on PSA. The purpose is not to provide a single solution. As part of the review of the TS conditions this guidance specify requirements on: - Quality verification of the PSA model; - Verification that the PSA model is sufficiently robust with regard to SSCs for which requirements both are and are not defined by the TS; - Verification that the SSCs, for which TS demands are to be evaluated, are modelled in a sufficient manner; - Methods for performing the evaluation; - Which evaluation criteria that shall be used (and how that is verified to be correct); - Acceptance criteria: This guidance also briefly discusses the documentation of the analysis of the TS changes. This guidance

Guidance to risk-informed evaluation of technical specifications using PSA

Energy Technology Data Exchange (ETDEWEB)

Baeckstroem, O.; Haeggstroem, A. (Scandpower AB, Stockholm (Sweden)); Maennistoe, I. (VTT, Helsingfors (Finland))

2010-04-15

This report presents guidance for evaluation of Technical Specification conditions with PSA. It covers quality in PSA, how to verify that the PSA model is sufficiently robust and sufficiently complete and general requirements on methods. Acceptance criteria for evaluation of changes in the TS conditions are presented. As the probabilistic safety assessment (PSA) has developed over the years, it has demonstrated to constitute a useful tool for evaluating many aspects of the TS from a risk point of view. and in that way making the PSAs as well as the decision tools better. This also means that it will be possible to take credit for safety system overcapacity as well as inherent safety features and strength of non-safety classed systems. However, PSA is only one of the tools that shall be used in an evaluation process of TS changes (strengthening/relaxation). PSA is an excellent tool to be used to verify the importance, and thereby possibly relaxation, of TS requirements. But, since PSA is only one tool in the evaluation, it is not sufficient in itself for defining which equipment that shall or shall not have TS requirements. The purpose of this guidance document is to provide general requirements, requirements on methods and acceptance criteria on risk-informed evaluation of TS changes based on PSA. The purpose is not to provide a single solution. As part of the review of the TS conditions this guidance specify requirements on: - Quality verification of the PSA model; - Verification that the PSA model is sufficiently robust with regard to SSCs for which requirements both are and are not defined by the TS; - Verification that the SSCs, for which TS demands are to be evaluated, are modelled in a sufficient manner; - Methods for performing the evaluation; - Which evaluation criteria that shall be used (and how that is verified to be correct); - Acceptance criteria: This guidance also briefly discusses the documentation of the analysis of the TS changes. This guidance

Guidance to Risk-Informed Evaluation of Technical Specifications using PSA

Energy Technology Data Exchange (ETDEWEB)

Baeckstroem, Ola; Haeggstroem, Anna (Scandpower AB, Stockholm (Sweden)); Maennistoe, Ilkka (VTT, Helsingfors (Finland))

2010-04-15

This report presents guidance for evaluation of Technical Specification conditions with PSA. It covers quality in PSA, how to verify that the PSA model is sufficiently robust and sufficiently complete and general requirements on methods. Acceptance criteria for evaluation of changes in the TS conditions are presented. As the probabilistic safety assessment (PSA) has developed over the years, it has demonstrated to constitute a useful tool for evaluating many aspects of the TS from a risk point of view. and in that way making the PSAs as well as the decision tools better. This also means that it will be possible to take credit for safety system overcapacity as well as inherent safety features and strength of non-safety classed systems. However, PSA is only one of the tools that shall be used in an evaluation process of TS changes (strengthening/relaxation). PSA is an excellent tool to be used to verify the importance, and thereby possibly relaxation, of TS requirements. But, since PSA is only one tool in the evaluation, it is not sufficient in itself for defining which equipment that shall or shall not have TS requirements. The purpose of this guidance document is to provide general requirements, requirements on methods and acceptance criteria on risk-informed evaluation of TS changes based on PSA. The purpose is not to provide a single solution. As part of the review of the TS conditions this guidance specify requirements on: - Quality verification of the PSA model; - Verification that the PSA model is sufficiently robust with regard to SSCs for which requirements both are and are not defined by the TS; - Verification that the SSCs, for which TS demands are to be evaluated, are modelled in a sufficient manner; - Methods for performing the evaluation; - Which evaluation criteria that shall be used (and how that is verified to be correct); - Acceptance criteria: This guidance also briefly discusses the documentation of the analysis of the TS changes. This guidance

Flooding PSA with Plant Specific Operating Experiences of Korean PWRs

International Nuclear Information System (INIS)

Choi, Sun Yeong; Yang, Joon Yull

2006-01-01

The purpose of this paper is to update the flooding PSA with Korean plant specific operating experience data and the appropriate estimation method for the flooding frequency to improve the PSA quality. The existing flooding PSA used the NPE (Nuclear Power Experience) database up to 1985 for the flooding frequency. They are all USA plant operating experiences. So an upgraded flooding frequency with Korean specific plant operation experience is required. We also propose a method of only using the PWR (Pressurized Water Reactor) data for the flooding frequency estimation in the case of the flooding area in the primary building even though the existing flooding PSA used both PWR and BWR (Boiled Water Reactor) data for all kinds of plant areas. We evaluate the CDF (Core Damage Frequency) with the modified flooding frequency and compare the results with that of the existing flooding PSA method

Guidance for Decision Making based on Extended PSA. Volume 1 - Summary report

International Nuclear Information System (INIS)

Loeffler, H.; Kumar, M.; Raimond, E.

2016-01-01

This report of ASAMPSA-E project is a summary report of the WP30 activities which were intended to develop guidance on decision-making process based on extended PSA results, when the PSA scope has been extended to all sources of radioactivity, all internal and relevant external events. It summarizes the ASAMPSA-E recommendations on: - the lessons of Fukushima Dai-ichi accident for PSA, - the risk metrics, - the method for identifying Initiating Events and Hazards for an Extended PSA (screening), - the link between extended PSA and the defense-in-depth concept. The report then provides some general considerations on application of extended PSA results, criteria that can be applied and also some difficulties inherent to the status of extended PSAs. (authors)

Application of PSA in risk informed decision making

International Nuclear Information System (INIS)

Hari Prasad, M.; Vinod, Gopika; Saraf, R.K.; Ghosh, A.K.; Kushwaha, H.S.

2006-01-01

Probabilistic Safety Assessment (PSA) models have been successfully employed during design evaluation to assess weak links and carry out design modifications to improve system reliability and safety. Recently, studies are directed towards applying PSA in various decision making issues concerned with plant operations and safety regulations. This necessitates development of software tools like Living PSA, Risk Monitor etc. Risk Monitor is a PC based tool developed to assess the risk, based on the actual status of systems and components. Such tools find wide application with plant personnel and regulatory authorities since they can provide solutions to various plant issues and regulatory decision making issues respectively. (author)

Pretreatment PSA predicts for biochemical disease free survival in patients treated with post-prostatectomy external beam irradiation

International Nuclear Information System (INIS)

Crane, C.H.; Kelly, M.; Rich, T.A.

1996-01-01

Objective: To assess the outcome and determine prognostic factors for patients treated with external beam radiotherapy following radical prostatectomy. Methods and Materials: Forty-four patients were treated after prostatectomy with radiotherapy between March 1988 and October 1993. All patients were free from clinically or radiographically suspicious local or distant disease. One patient underwent neoadjuvant hormonal therapy, but no other patients received hormonal therapy prior to radiation. Pre-radiotherapy PSA and follow-up PSA data were available in all patients. Four patients had undetectable PSA ( 7, and 11% had nodal involvement. Survival was analyzed using the life table method. Actuarial freedom from biochemical (BCM) failure, defined as a rise of greater than 10% or an undetectable PSA becoming detectable, was the primary endpoint studied. Results: Fifty-nine percent of patients had a detectable PSA return to undetectable levels after XRT. The actuarial five year freedom from biochemical failure for all patients was 24%. A significant difference in BCM disease free survival was seen for patients irradiated with a pre-XRT PSA ≤2.7 versus a pre-XRT PSA >2.7 (p=0.0001). Sixty percent of the former group were BCM disease free versus 0% in the latter. Biochemical disease free survival was not affected by preoperative PSA level, presence of undetectable PSA after surgery, surgery to radiation interval, seminal vesicle invasion, clinical stage, pathologic stage, Gleasons grade, or total dose. There were no symptomatic or clinically suspicious local failures, and there were no grade 3, 4, or 5 acute or late complications. There were 69% grade 1 and 2 acute reactions and one grade 2 late complication. Conclusions: Pelvic radiotherapy for patients with a PSA of ≤2.7 after prostatectomy was effective in biochemically controlling 60% of the patients with four years median follow up. To our knowledge these data represent the longest follow-up for this patient

Regulatory aspects of the use of PSA to evaluate technical specifications

International Nuclear Information System (INIS)

Rumpf, J.

1991-01-01

Based on experiences gained in PSA activities the regulatory body of the GDR initiated a programme to investigate the feasibility of using PSA for the evaluation of technical specifications. This programme is just under work. In addition, to improve PSA, the GDR takes part in a programme which is aimed at performing plant specific level 1, PSA as well as and which enables operating organizations to carry out PSA on their own. The most important of some preliminary general findings presented in this paper are: - Technical specifications form a well established envelope of operational conditions and procedures. A total re-evaluation is not considered necessary; Probabilistic evaluation of technical specifications should be an integrated part of PSA activities (at least level 1). Single assessment is not considered reasonable; Probabilistic evaluation of technical specifications has to be based on plant specific information and realistic accident sequence calculations; Up to now no quantitative probabilistic criteria for technical specifications have been established. (author)

Workshop on PSA applications, Sofia, Bulgaria, 7-11 October 1996. Lecturing materials

International Nuclear Information System (INIS)

1997-01-01

The objective of this workshop was to present detailed, systematic and useful information about PSA-based tools and PSA applications. The first presentation of the workshop was titled ''The role of PSA in safety management''. This topic served to introduce the workshop and to highlight several concepts that were afterwards stressed during the week, i.e. the defence in depth principle and the use of deterministic and probabilistic approaches in a complementary way. This presentation provided a basis for the discussion of ''PSA applications''. As a complement to the theoretical lectures, there was a workshop during which three different exercises were run in parallel. For two of these, computer-based PSA tools were used. One of them was focused towards the analysis of design modifications and the other one towards demonstrating configuration control strategies. The objective of the third practice was to obtain Allowed Outage Times using different PSA-based approaches and to discuss the differences observed and the insights obtained. To conclude the workshop, stress was put on the importance of the quality of the PSA (the development of a high quality Living PSA should be the first step), the necessity to be cautious (before taking decisions both the qualitative and numerical results should be carefully analyzed), and the logical order for the implementation of PSA applications. Refs, figs, tabs

Use of PSA to support accident management at NPPs

International Nuclear Information System (INIS)

Gomez Cobo, A.

1997-01-01

The presentation discusses the following: Overview of PSA level 2; Introduction: Framework; Accident Progression Phenomena in the Confinement/containment; Severe Accident Sequences; Examples; Results and Insights. Accident Management: Concepts; Process; Use of PSA to support Accident; Management

Apparent diffusion coefficient ratio correlates significantly with prostate cancer gleason score at final pathology

DEFF Research Database (Denmark)

Boesen, Lars; Chabanova, Elizaveta; Løgager, Vibeke

2015-01-01

PURPOSE: To evaluate the correlation between apparent diffusion coefficient measurements (ADCtumor and ADCratio ) and the Gleason score from radical prostatectomy specimens. MATERIALS AND METHODS: Seventy-one patients with clinically localized prostate cancer scheduled for radical prostatectomy...... correlated with the Gleason score from the prostatectomy specimens. RESULTS: The association between ADC measurements and Gleason score showed a significant negative correlation (P ... ) and 0.90 (ADCratio ) when discriminating Gleason score ≤7(3+4) from Gleason score ≥7(4+3). CONCLUSION: ADC measurements showed a significant correlation with tumor Gleason score at final pathology. The ADCratio demonstrated the best correlation compared to the ADCtumor value and radically improved...

Applying strategies from libertarian paternalism to decision making for prostate specific antigen (PSA) screening.

Science.gov (United States)

Wheeler, David C; Szymanski, Konrad M; Black, Amanda; Nelson, David E

2011-04-21

Despite the recent publication of results from two randomized clinical trials, prostate specific antigen (PSA) screening for prostate cancer remains a controversial issue. There is lack of agreement across studies that PSA screening significantly reduces prostate cancer mortality. In spite of these facts, the widespread use of PSA testing in the United States leads to overdetection and overtreatment of clinically indolent prostate cancer, and its associated harms of incontinence and impotence. Given the inconclusive results from clinical trials and incongruent PSA screening guidelines, the decision to screen for prostate cancer with PSA testing is an uncertain one for patients and health care providers. Screening guidelines from some health organizations recommend an informed decision making (IDM) or shared decision making (SDM) approach for deciding on PSA screening. These approaches aim to empower patients to choose among the available options by making them active participants in the decision making process. By increasing involvement of patients in the clinical decision-making process, IDM/SDM places more of the responsibility for a complex decision on the patient. Research suggests, however, that patients are not well-informed of the harms and benefits associated with prostate cancer screening and are also subject to an assortment of biases, emotion, fears, and irrational thought that interferes with making an informed decision. In response, the IDM/SDM approaches can be augmented with strategies from the philosophy of libertarian paternalism (LP) to improve decision making. LP uses the insights of behavioural economics to help people better make better choices. Some of the main strategies of LP applicable to PSA decision making are a default decision rule, framing of decision aids, and timing of the decision. In this paper, we propose that applying strategies from libertarian paternalism can help with PSA screening decision-making. Our proposal to augment IDM

Study on communicating risk information obtained from PSA within nuclear power plants

International Nuclear Information System (INIS)

Nunogane, Nobuaki; Onoue, Akira; Kojima, Shigeo

2000-01-01

In this study, the communication of PSA information in nuclear power plants (NPPs), namely, how the risk information obtained from the probabilistic safety assessment (PSA) should be presented and communicated to plant personnel, was examined assuming that the safety management system based on the risk information was introduced to NPPs. This is called PSA communication. First, when risk-informed safety management is to be introduced into NPPs, plant personnel should have sufficient related knowledge. In order to provide such knowledge to the personnel through training, risk information is classified into three types: basic information, detailed information and task information. A hierarchical risk information summary for reporting, coordinating and communicating tasks is proposed. In this summary, the concerns of those who have received the information are placed at the top and the related risk information positioned below. At the same time, and by way of a trial, the risk information relating to on-line maintenance (OLM) is prepared. In order to enhance the safety-consciousness and the safety of the entire plant, specific plans such as 'risk tags' which indicate the safety significance of equipment is proposed. Finally, a guideline providing examination procedures for developing detailed PSA communication plans is introduced. (author)

Permanent 125I-seed prostate brachytherapy: early prostate specific antigen value as a predictor of PSA bounce occurrence

Directory of Open Access Journals (Sweden)

Mazeron Renaud

2012-03-01

Full Text Available Abstract Purpose To evaluate predictive factors for PSA bounce after 125I permanent seed prostate brachytherapy and identify criteria that distinguish between benign bounces and biochemical relapses. Materials and methods Men treated with exclusive permanent 125I seed brachytherapy from November 1999, with at least a 36 months follow-up were included. Bounce was defined as an increase ≥ 0.2 ng/ml above the nadir, followed by a spontaneous return to the nadir. Biochemical failure (BF was defined using the criteria of the Phoenix conference: nadir +2 ng/ml. Results 198 men were included. After a median follow-up of 63.9 months, 21 patients experienced a BF, and 35.9% had at least one bounce which occurred after a median period of 17 months after implantation (4-50. Bounce amplitude was 0.6 ng/ml (0.2-5.1, and duration was 13.6 months (4.0-44.9. In 12.5%, bounce magnitude exceeded the threshold defining BF. Age at the time of treatment and high PSA level assessed at 6 weeks were significantly correlated with bounce but not with BF. Bounce patients had a higher BF free survival than the others (100% versus 92%, p = 0,007. In case of PSA increase, PSA doubling time and velocity were not significantly different between bounce and BF patients. Bounces occurred significantly earlier than relapses and than nadir + 0.2 ng/ml in BF patients (17 vs 27.8 months, p Conclusion High PSA value assessed 6 weeks after brachytherapy and young age were significantly associated to a higher risk of bounces but not to BF. Long delays between brachytherapy and PSA increase are more indicative of BF.

International network on incorporation of ageing effects into PSA

International Nuclear Information System (INIS)

Kirchsteiger, C.; Patrik, M.

2006-01-01

This paper describes the background and status of a new International Network on ''Incorporating Ageing Effects into Probabilistic Safety Assessment''. The Joint Research Centre (JRC) of the European Commission organized in September 2004 the kickoff meeting of this Network at JRC's Institute for Energy in Petten, Netherlands, with the aims to open the APSA Network, to start discussion of ageing issues in relation to incorporating ageing effects into PSA tools and to come to consensus on objectives and work packages of the Network, taking into account the specific expectations of potential Network partners. The presentations and discussions at the meeting confirmed the main conclusion from the previously organized PSAM 7 pre-conference workshop on ''Incorporating PSA into Ageing Management'', Budapest, June 2004, namely that incorporating ageing effects into PSA seems to be more and more a hot topic particularly for risk assessment and ageing management of nuclear power plants operating at advanced age (more than 25-30 years) and for the purpose of plant life extension. However, it also appeared that, especially regarding the situation in Europe, at present there are several on-going feasibility or full studies in this area, but not yet a completed Ageing PSA leading to applications. The project's working method is a NETWORK of operators, industry, research, academia and consultants with an active interest in the area (physical networking via a series of workshops and virtual networking via the Internet). The resulting knowledge should help PSA developers and users to incorporate the effects of equipment ageing into current PSA tools and models, to identify and/or develop most effective corresponding methods, to focus on dominant ageing contributors and components and to promote the use of PSA for ageing management of Nuclear Power Plants. (orig.)

Prostate-Specific Antigen (PSA) Screening and New Biomarkers for Prostate Cancer (PCa).

Science.gov (United States)

Stephan, Carsten; Rittenhouse, Harry; Hu, Xinhai; Cammann, Henning; Jung, Klaus

2014-04-01

PSA screening reduces PCa-mortality but the disadvantages overdiagnosis and overtreatment require multivariable risk-prediction tools to select appropriate treatment or active surveillance. This review explains the differences between the two largest screening trials and discusses the drawbacks of screening and its meta-analysisxs. The current American and European screening strategies are described. Nonetheless, PSA is one of the most widely used tumor markers and strongly correlates with the risk of harboring PCa. However, while PSA has limitations for PCa detection with its low specificity there are several potential biomarkers presented in this review with utility for PCa currently being studied. There is an urgent need for new biomarkers especially to detect clinically significant and aggressive PCa. From all PSA-based markers, the FDA-approved prostate health index (phi) shows improved specificity over percent free and total PSA. Another kallikrein panel, 4K, which includes KLK2 has recently shown promise in clinical research studies but has not yet undergone formal validation studies. In urine, prostate cancer gene 3 (PCA3) has also been validated and approved by the FDA for its utility to detect PCa. The potential correlation of PCA3 with cancer aggressiveness requires more clinical studies. The detection of the fusion of androgen-regulated genes with genes of the regulatory transcription factors in tissue of (~)50% of all PCa-patients is a milestone in PCa research. A combination of the urinary assays for TMPRSS2:ERG gene fusion and PCA3 shows an improved accuracy for PCa detection. Overall, the field of PCa biomarker discovery is very exciting and prospective.

Estimation Procedure of Common Cause Failure Parameters for CAFE-PSA

International Nuclear Information System (INIS)

Kang, Dae Il; Hwang, M. J.; Han, S. H.

2009-03-01

Detailed common cause failure (CCF) analysis generally needs the data for CCF events from other nuclear power plants because the CCF events rarely occur. Since 2002, KAERI has participated in the international common cause failure data exchange (ICDE) project to get data for CCF events. The operation office of the ICDE project sent about 400 CCF event data for emergency diesel generators, motor operated valves, check valves, pumps, and breakers to KAERI in 2009. However, there was no program available to analyze the ICDE CCF event data. Therefore, we developed the CAFE-PSA (common CAuse Failure Event analysis program for PSA) to estimate CCF parameters by using the ICDE CCF event data. With CAFE-PSA, the CCF events in the ICDE database can be qualitatively and quantitatively analyzed. The qualitative analysis results of the ICDE CCF data, by using the CAFE-PSA, showed that the major root cause of CCF events, for motor operated valves, check valves, and pumps, was the fault of their internal parts, and that for emergency diesel generators and breakers was the inadequacy of design/manufacture or construction. The quantitative analysis results of the ICDE CCF data, by using the CAFE-PSA, showed that the estimated Alpha Factors of components, mentioned above, were lower than those previously used in the PSA for domestic nuclear power plants, but were higher than those in USNRC 2007 CCF data. Through performing qualitative and quantitative analysis of the ICDE CCF data, by using the CAFE-PSA, a plan for coping with CCF events for design and operation of nuclear power plants can be produced and reasonable values for CCF parameters can be estimated. In addition, it is expected that the technical adequacy of PSA can be improved

Procedure for Application of Software Reliability Growth Models to NPP PSA

International Nuclear Information System (INIS)

Son, Han Seong; Kang, Hyun Gook; Chang, Seung Cheol

2009-01-01

As the use of software increases at nuclear power plants (NPPs), the necessity for including software reliability and/or safety into the NPP Probabilistic Safety Assessment (PSA) rises. This work proposes an application procedure of software reliability growth models (RGMs), which are most widely used to quantify software reliability, to NPP PSA. Through the proposed procedure, it can be determined if a software reliability growth model can be applied to the NPP PSA before its real application. The procedure proposed in this work is expected to be very helpful for incorporating software into NPP PSA

PyPSA: Python for Power System Analysis

Directory of Open Access Journals (Sweden)

Thomas Brown

2018-01-01

Full Text Available Python for Power System Analysis (PyPSA is a free software toolbox for simulating and optimising modern electrical power systems over multiple periods. PyPSA includes models for conventional generators with unit commitment, variable renewable generation, storage units, coupling to other energy sectors, and mixed alternating and direct current networks. It is designed to be easily extensible and to scale well with large networks and long time series. In this paper the basic functionality of PyPSA is described, including the formulation of the full power flow equations and the multi-period optimisation of operation and investment with linear power flow equations. PyPSA is positioned in the existing free software landscape as a bridge between traditional power flow analysis tools for steady-state analysis and full multi-period energy system models. The functionality is demonstrated on two open datasets of the transmission system in Germany (based on SciGRID and Europe (based on GridKit.   Funding statement: This research was conducted as part of the CoNDyNet project, which is supported by the German Federal Ministry of Education and Research under grant no. 03SF0472C. The responsibility for the contents lies solely with the authors

Formulation of the bivalent prostate cancer vaccine with surgifoam elicits antigen-specific effector T cells in PSA-transgenic mice.

Science.gov (United States)

Karan, Dev

2017-10-13

We previously developed and characterized an adenoviral-based prostate cancer vaccine for simultaneous targeting of prostate-specific antigen (PSA) and prostate stem cell antigen (PSCA). We also demonstrated that immunization of mice with the bivalent vaccine (Ad 5 -PSA+PSCA) inhibited the growth of established prostate tumors. However, there are multiple challenges hindering the success of immunological therapies in the clinic. One of the prime concerns has been to overcome the immunological tolerance and maintenance of long-term effector T cells. In this study, we further characterized the use of the bivalent vaccine (Ad 5 -PSA+PSCA) in a transgenic mouse model expressing human PSA in the mouse prostate. We demonstrated the expression of PSA analyzed at the mRNA level (by RT-PCR) and protein level (by immunohistochemistry) in the prostate lobes harvested from the PSA-transgenic (PSA-Tg) mice. We established that the administration of the bivalent vaccine in surgifoam to the PSA-Tg mice induces strong PSA-specific effector CD8 + T cells as measured by IFN-γ secretion and in vitro cytotoxic T-cell assay. Furthermore, the use of surgifoam with Ad 5 -PSA+PSCA vaccine allows multiple boosting vaccinations with a significant increase in antigen-specific CD8 + T cells. These observations suggest that the formulation of the bivalent prostate cancer vaccine (Ad 5 -PSA+PSCA) with surgifoam bypasses the neutralizing antibody response, thus allowing multiple boosting. This formulation is also helpful for inducing an antigen-specific immune response in the presence of self-antigen, and maintains long-term effector CD8 + T cells. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Improvement of level-1 PSA computer code package

Energy Technology Data Exchange (ETDEWEB)

Kim, Tae Woon; Park, C. K.; Kim, K. Y.; Han, S. H.; Jung, W. D.; Chang, S. C.; Yang, J. E.; Sung, T. Y.; Kang, D. I.; Park, J. H.; Lee, Y. H.; Kim, S. H.; Hwang, M. J.; Choi, S. Y.

1997-07-01

This year the fifth (final) year of the phase-I of the Government-sponsored Mid- and Long-term Nuclear Power Technology Development Project. The scope of this subproject titled on `The improvement of level-1 PSA Computer Codes` is divided into two main activities : (1) improvement of level-1 PSA methodology, (2) development of applications methodology of PSA techniques to operations and maintenance of nuclear power plant. Level-1 PSA code KIRAP is converted to PC-Windows environment. For the improvement of efficiency in performing PSA, the fast cutset generation algorithm and an analytical technique for handling logical loop in fault tree modeling are developed. Using about 30 foreign generic data sources, generic component reliability database (GDB) are developed considering dependency among source data. A computer program which handles dependency among data sources are also developed based on three stage bayesian updating technique. Common cause failure (CCF) analysis methods are reviewed and CCF database are established. Impact vectors can be estimated from this CCF database. A computer code, called MPRIDP, which handles CCF database are also developed. A CCF analysis reflecting plant-specific defensive strategy against CCF event is also performed. A risk monitor computer program, called Risk Monster, are being developed for the application to the operation and maintenance of nuclear power plant. The PSA application technique is applied to review the feasibility study of on-line maintenance and to the prioritization of in-service test (IST) of motor-operated valves (MOV). Finally, the root cause analysis (RCA) and reliability-centered maintenance (RCM) technologies are adopted and applied to the improvement of reliability of emergency diesel generators (EDG) of nuclear power plant. To help RCA and RCM analyses, two software programs are developed, which are EPIS and RAM Pro. (author). 129 refs., 20 tabs., 60 figs.

Improvement of level-1 PSA computer code package

International Nuclear Information System (INIS)

Kim, Tae Woon; Park, C. K.; Kim, K. Y.; Han, S. H.; Jung, W. D.; Chang, S. C.; Yang, J. E.; Sung, T. Y.; Kang, D. I.; Park, J. H.; Lee, Y. H.; Kim, S. H.; Hwang, M. J.; Choi, S. Y.

1997-07-01

This year the fifth (final) year of the phase-I of the Government-sponsored Mid- and Long-term Nuclear Power Technology Development Project. The scope of this subproject titled on 'The improvement of level-1 PSA Computer Codes' is divided into two main activities : 1) improvement of level-1 PSA methodology, 2) development of applications methodology of PSA techniques to operations and maintenance of nuclear power plant. Level-1 PSA code KIRAP is converted to PC-Windows environment. For the improvement of efficiency in performing PSA, the fast cutset generation algorithm and an analytical technique for handling logical loop in fault tree modeling are developed. Using about 30 foreign generic data sources, generic component reliability database (GDB) are developed considering dependency among source data. A computer program which handles dependency among data sources are also developed based on three stage bayesian updating technique. Common cause failure (CCF) analysis methods are reviewed and CCF database are established. Impact vectors can be estimated from this CCF database. A computer code, called MPRIDP, which handles CCF database are also developed. A CCF analysis reflecting plant-specific defensive strategy against CCF event is also performed. A risk monitor computer program, called Risk Monster, are being developed for the application to the operation and maintenance of nuclear power plant. The PSA application technique is applied to review the feasibility study of on-line maintenance and to the prioritization of in-service test (IST) of motor-operated valves (MOV). Finally, the root cause analysis (RCA) and reliability-centered maintenance (RCM) technologies are adopted and applied to the improvement of reliability of emergency diesel generators (EDG) of nuclear power plant. To help RCA and RCM analyses, two software programs are developed, which are EPIS and RAM Pro. (author). 129 refs., 20 tabs., 60 figs

3D label-free prostate specific antigen (PSA) immunosensor based on graphene-gold composites.

Science.gov (United States)

Jang, Hee Dong; Kim, Sun Kyung; Chang, Hankwon; Choi, Jeong-Woo

2015-01-15

Highly sensitive and label-free detection of the prostate specific antigen (PSA) remains a challenge in the diagnosis of prostate cancer. Here, a novel three-dimensional (3D) electrochemical immunosensor capable of sensitive and label-free detection of PSA is reported. This unique immunosensor is equipped with a highly conductive graphene (GR)-based gold (Au) composite modified electrode. The GR-based Au composite is prepared using aerosol spray pyrolysis and the morphology of the composite is the shape of a crumpled GR ball decorated with Au nanoparticles. Unlike the previous research, this novel 3D immunosensor functions very well over a broad linear range of 0-10 ng/mL with a low detection limit of 0.59 ng/mL; furthermore, it exhibits a significantly increased electron transfer and high sensitivity toward PSA. The highest rate of current change with respect to the PSA concentration is 5 μA/(ng/mL). Satisfactory selectivity, reproducibility, and stability of the 3D immunosensor are also exhibited. Copyright © 2014 Elsevier B.V. All rights reserved.

Whooping Cough PSA (:30)

Centers for Disease Control (CDC) Podcasts

This 30 second PSA encourages pregnant women to get the whooping cough vaccine, called Tdap, during the third trimester of each pregnancy in order to pass antibodies to their babies so they are born with protection against this serious disease.

The New Planetary Science Archive (PSA): Exploration and Discovery of Scientific Datasets from ESA's Planetary Missions

Science.gov (United States)

Heather, David; Besse, Sebastien; Vallat, Claire; Barbarisi, Isa; Arviset, Christophe; De Marchi, Guido; Barthelemy, Maud; Coia, Daniela; Costa, Marc; Docasal, Ruben; Fraga, Diego; Grotheer, Emmanuel; Lim, Tanya; MacFarlane, Alan; Martinez, Santa; Rios, Carlos; Vallejo, Fran; Saiz, Jaime

2017-04-01

The Planetary Science Archive (PSA) is the European Space Agency's (ESA) repository of science data from all planetary science and exploration missions. The PSA provides access to scientific datasets through various interfaces at http://psa.esa.int. All datasets are scientifically peer-reviewed by independent scientists, and are compliant with the Planetary Data System (PDS) standards. The PSA is currently implementing a number of significant improvements, mostly driven by the evolution of the PDS standard, and the growing need for better interfaces and advanced applications to support science exploitation. As of the end of 2016, the PSA is hosting data from all of ESA's planetary missions. This includes ESA's first planetary mission Giotto that encountered comet 1P/Halley in 1986 with a flyby at 800km. Science data from Venus Express, Mars Express, Huygens and the SMART-1 mission are also all available at the PSA. The PSA also contains all science data from Rosetta, which explored comet 67P/Churyumov-Gerasimenko and asteroids Steins and Lutetia. The year 2016 has seen the arrival of the ExoMars 2016 data in the archive. In the upcoming years, at least three new projects are foreseen to be fully archived at the PSA. The BepiColombo mission is scheduled for launch in 2018. Following that, the ExoMars Rover Surface Platform (RSP) in 2020, and then the JUpiter ICy moon Explorer (JUICE). All of these will archive their data in the PSA. In addition, a few ground-based support programmes are also available, especially for the Venus Express and Rosetta missions. The newly designed PSA will enhance the user experience and will significantly reduce the complexity for users to find their data promoting one-click access to the scientific datasets with more customized views when needed. This includes a better integration with Planetary GIS analysis tools and Planetary interoperability services (search and retrieve data, supporting e.g. PDAP, EPN-TAP). It will also be up

Generation of risk importance information from severe accident PSA model

International Nuclear Information System (INIS)

Seo, Mi Ro; Kim, Hyeong Taek; Moon, Chan Kook

2012-01-01

One of the important objects conducting Probabilistic Safety Assessment (PSA) is the relative evaluation of importance of the component or function that is greatly affected to the plant safety. This evaluation is performed by the importance assessment methods such as Risk Reduction Worth, Risk Achievement Worth, and Fuss el Vessley method from the aspect of core damage frequency (CDF). In the Level 1 PSA model, the importance of each component can be evaluated since the CDF is calculated by the combination of the branch probability of event tree and the component failure probability in the fault tree. But, the Level 2 PSA model in order to assess the containment integrity cannot evaluate the risk importance by the above methods because the model is consisted of 3 parts, plant damage status, containment event tree, and source term category. So, in the field that the Level 2 PSA risk importance information should be reflected, such as maintenance rule program, risk importance has been determined by the subjective judgment of the model developer. This study was performed in order to generate the risk importance information more objectively and systematically in the Level 2 PSA model, focused on the containment event tree in the domain PHWR Level 2 PSA model

Analysis of urinary PSA glycosylation is not indicative of high-risk prostate cancer.

Science.gov (United States)

Barrabés, Sílvia; Llop, Esther; Ferrer-Batallé, Montserrat; Ramírez, Manel; Aleixandre, Rosa N; Perry, Antoinette S; de Llorens, Rafael; Peracaula, Rosa

2017-07-01

The levels of core fucosylation and α2,3-linked sialic acid in serum Prostate Specific Antigen (PSA), using the lectins Pholiota squarrosa lectin (PhoSL) and Sambucus nigra agglutinin (SNA), can discriminate between Benign Prostatic Hyperplasia (BPH) and indolent prostate cancer (PCa) from aggressive PCa. In the present work we evaluated whether these glycosylation determinants could also be altered in urinary PSA obtained after digital rectal examination (DRE) and could also be useful for diagnosis determinations. For this purpose, α2,6-sialic acid and α1,6-fucose levels of urinary PSA from 53 patients, 18 biopsy-negative and 35 PCa patients of different aggressiveness degree, were analyzed by sandwich ELLA (Enzyme Linked Lectin Assay) using PhoSL and SNA. Changes in the levels of specific glycosylation determinants, that in serum PSA samples were indicative of PCa aggressiveness, were not found in PSA from DRE urine samples. Although urine is a simpler matrix for analyzing PSA glycosylation compared to serum, an immunopurification step was necessary to specifically detect the glycans on the PSA molecule. Those specific glycosylation determinants on urinary PSA were however not useful to improve PCa diagnosis. This could be probably due to the low proportion of PSA from the tumor in urine samples, which precludes the identification of aberrantly glycosylated PSA. Copyright © 2017 Elsevier B.V. All rights reserved.

EOP Improvement Proposal for SGTR based on The OPR PSA Update

Energy Technology Data Exchange (ETDEWEB)

Park, Jin Hee; Cho, Jae Hyun; Kim, Dong San; Yang, Joon Eon [KAERI, Daejeon (Korea, Republic of)

2016-05-15

This updating process was also focused to enhance the PSA quality and to respect the as built and as operated conditions of target plants. For this purpose, the EOP(Emergency Operating Procedure) and AOP(Abnormal Operating Procedure) of target plant were reviewed in detail and various thermal hydraulic(T/H) analysis were also performed to analyze the realistic PSA accident sequence model. In this paper, the unreasonable point of SGTR (Steam Generator Tube Rupture) EOP based on PSA perspective was identified and the initial proposal for EOP change items from PSA insight was proposed. In this paper, the unreasonable point of SGTR EOP based on PSA perspective was identified and the EOP improvement items are proposed to enhance safety and operator's convenience for the target plant.

Prostate-Specific Antigen (PSA)–Based Population Screening for Prostate Cancer: An Evidence-Based Analysis