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Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States
Weiner, Joseph P.,Schwartz, David,Shao, Meng,Osborn, Virginia,Choi, Kwang,Schreiber, David The Korean Society for Radiation Oncology 2017 Radiation Oncology Journal Vol.35 No.2
Purpose: To analyze the utilization and fractionation of extreme hypofractionation via stereotactic body radiotherapy (SBRT) in the treatment of prostate cancer. Materials and Methods: Data was analyzed on men diagnosed with localized prostate cancer between 2004-2012 and treated with definitive-intent radiation therapy, as captured in the National Cancer Database. This database is a hospital-based registry that collects an estimated 70% of all diagnosed malignancies in the United States. Results: There were 299,186 patients identified, of which 4,962 (1.7%) were identified as receiving SBRT as primary treatment. Of those men, 2,082 had low risk disease (42.0%), 2,201 had intermediate risk disease (44.4%), and 679 had high risk disease (13.7%). The relative utilization of SBRT increased from 0.1% in 2004 to 4.0% in 2012. Initially SBRT was more commonly used in academic programs, though as time progressed there was a shift to favor an increased absolute number of men treated in the community setting. Delivery of five separate treatments was the most commonly utilized fractionation pattern, with 4,635 patients (91.3%) receiving this number of treatments. The most common dosing pattern was $725cGy{\times}5fractions$ (49.6%) followed by $700cGy{\times}5fractions$ (21.3%). Conclusions: Extreme hypofractionation via SBRT is slowly increasing acceptance. Currently $700-725cGy{\times}5fractions$ appears to be the most commonly employed scheme. As further long-term data regarding the safety and efficacy emerges, the relative utilization of this modality is expected to continue to increase.
Weiner, David B.,Sin, Jeong-Im The Korean Association of Immunobiologists 2005 Immune Network Vol.5 No.2
Background: Costimulation is a critical process in Ag-specific immune responses. Both B7.1 and CD28 molecules have been reported to stimulate T cell responses during antigen presentation. Therefore, we tested whether Ag-specific immune responses as well as protective immunity are influenced by coinjecting with B7.1 and CD28 cDNAs in a mouse HSV-2 challenge model system. Methods: ELISA was used to detect levels of antibodies, cytokines and chemokines while thymidine incorporation assay was used to evaluate T cell proliferation levels. Results: Ag-specific antibody responses were enhanced by CD28 coinjection but not by B7.1 coinjection. Furthermore, CD28 coinjection increased IgG1 production to a significant level, as compared to pgD+pcDNA3, suggesting that CD28 drives Th2 type responses. In contrast, B7.1 coinjection showed the opposite, suggesting a Th1 bias. B7.1 coinjection also enhanced Ag-specific Th cell proliferative responses as well as production of Th1 type cytokines and chemokines significantly higher than pgD+pcDNA3. However, CD28 coinjection decreased Ag-specific Th cell proliferative responses as well as production of Th1 types of cytokines and chemokine significantly lower than pgD+pcDNA3. Only MCP-1 production was enhanced by CD28. B7.1 coimmunized animals exhibited an enhanced survival rate as well as decreased herpetic lesion formation, as compared to pgD+pcDNA3. In contrast, CD28 vaccinated animals exhibited decreased survival from lethal challenge. Conclusion: This study shows that B7.1 enhances protective Th1 type cellular immunity against HSV-2 challenge while CD28 drives a more detrimental Th2 type immunity against HSV-2 challenge, supporting an opposite role of B7.1 and CD28 in Ag-specific immune responses to a Th1 vs Th2 type.
David B. Weiner,신정임 대한면역학회 2005 Immune Network Vol.5 No.2
Background: Costimulation is a critical process in Ag-specific immune responses. Both B7.1 and CD28 molecules have been reported to stimulate T cell responses during antigen presentation. Therefore, we tested whether Ag-specific immune responses as well as protective immunity are influenced by coinjecting with B7.1 and CD28 cDNAs in a mouse HSV-2 challenge model system. Methods: ELISA was used to detect levels of antibodies, cytokines and chemokines while thymidine incorporation assay was used to evaluate T cell proliferation levels. Results: Ag-specific antibody responses were enhanced by CD28 coinjection but not by B7.1 coinjection. Furthermore, CD28 coinjection increased IgG1 production to a significant level, as compared to pgD pcDNA3, suggesting that CD28 drives Th2 type responses. In contrast, B7.1 coinjection showed the opposite, suggesting a Th1 bias. B7.1 coinjection also enhanced Ag-specific Th cell proliferative responses as well as production of Th1 type cytokines and chemokines significantly higher than pgD pcDNA3. However, CD28 coinjection decreased Ag-specific Th cell proliferative responses as well as production of Th1 types of cytokines and chemokine significantly lower than pgD pcDNA3. Only MCP-1 production was enhanced by CD28. B7.1 coimmunized animals exhibited an enhanced survival rate as well as decreased herpetic lesion formation, as compared to pgD pcDNA3. In contrast, CD28 vaccinated animals exhibited decreased survival from lethal challenge. Conclusion: This study shows that B7.1 enhances protective Th1 type cellular immunity against HSV-2 challenge while CD28 drives a more detrimental Th2 type immunity against HSV-2 challenge, supporting an opposite role of B7.1 and CD28 in Ag-specific immune responses to a Th1 vs Th2 type.
Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States
Joseph P. Weiner,David Schwartz,Meng Shao,Virginia Osborn,Kwang Choi,David Schreiber 대한방사선종양학회 2017 Radiation Oncology Journal Vol.35 No.2
Purpose: To analyze the utilization and fractionation of extreme hypofractionation via stereotactic body radiotherapy (SBRT) in the treatment of prostate cancer. Materials and Methods: Data was analyzed on men diagnosed with localized prostate cancer between 2004–2012 and treated with definitive-intent radiation therapy, as captured in the National Cancer Database. This database is a hospital-based registry that collects an estimated 70% of all diagnosed malignancies in the United States. Results: There were 299,186 patients identified, of which 4,962 (1.7%) were identified as receiving SBRT as primary treatment. Of those men, 2,082 had low risk disease (42.0%), 2,201 had intermediate risk disease (44.4%), and 679 had high risk disease (13.7%). The relative utilization of SBRT increased from 0.1% in 2004 to 4.0% in 2012. Initially SBRT was more commonly used in academic programs, though as time progressed there was a shift to favor an increased absolute number of men treated in the community setting. Delivery of five separate treatments was the most commonly utilized fractionation pattern, with 4,635 patients (91.3%) receiving this number of treatments. The most common dosing pattern was 725 cGy × 5 fractions (49.6%) followed by 700 cGy × 5 fractions (21.3%). Conclusions: Extreme hypofractionation via SBRT is slowly increasing acceptance. Currently 700-725 cGy × 5 fractions appears to be the most commonly employed scheme. As further long-term data regarding the safety and efficacy emerges, the relative utilization of this modality is expected to continue to increase.
Leaird, Daniel E.,Weiner, Andrew M.,Seo, Dongsun Institute of Korean Electrical and Electronics Eng 2014 전기전자학회논문지 Vol.18 No.1
We report stable, wideband, flat-topped, 10 GHz optical frequency comb generation from a semiconductor-based mode-locked ring laser with an intra-cavity high finesse Fabry-Perot etalon. We demonstrate a stable 10 GHz comb with greater than 200 lines within a spectral power variation below 1 dB, which is the largest value obtained from a similar mode-locked laser in our knowledge. Greater than 20 dB of the spectral peak to deep ratio at 0.02 nm resolution, ~92 femtosecond timing jitter over 1 kHz to 1 MHz range, and non-averaged time traces of pulses confirm very stable optical frequency comb lines.
자궁근 cGMP 형성에 대한 융모막의 역할과 산모 및 태아혈청의 그 억제효과
김해중,Carl P. Weiner 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.5
The mechanism of uterine quiescence during pregnancy and initiation of labor is unknown. In previous report, we demonstrated myometrial cGMP rises dramatically during pregnancy and then declines just prior to the onset of labor. Further, pregnancy decrease myometrial soluble guanylate cyclase activity while enhancing particulate activity. Theses findings suggest a natriureitc peptide(NP) is responsible for the increase in cGMP. This study was undertaken to evaluate the source of that NP. We incubated myometrium from term guinea pigs in oxygenated buffer in the absence/presence of either amnionic membranes(AM, 400mg), chorionic membrane(CM, 400mg), fetal guinea pig plasma(FP, 1ml), maternal guinea pig plasama(MP, 1ml), or a combination. After incubation, cGMP(mol/mg portein) was measured by radioimmuno assay. Both AM and CM(CM$gt;AM, significantly) increased myometrial cGMP. The stimulation of myometrial cGMP by the CM has a significant linear relationship between fetal weight and the greatest cGMP increase occurred between 51~60 days after which it showed a trend to decrease. Both FP and MP decrease myometrial cGMP and inhibition of cGMP by MP increase significantly with advancing gestational age. Our date indicate that myometrial cGMP is stimulated by a compound produced by the CM and the action of this compound is inhibited by a substance produced by the mother and fetus at the end of a normal pregnancy.