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Biomedical subjects

A Borkowski

Publications and source records attributed to A Borkowski.

At least 91 records · Page 5Linked to original sources
PubMed1986

Treatment of malignancy-associated hypercalcemia with intravenous aminohydroxypropylidene diphosphonate.

Treatment of malignancy-associated hypercalcemia remains unsatisfactory. We have prospectively treated 26 consecutive hypercalcemic cancer patients with intravenous (IV) aminohydroxypropylidene diphosphonate (APD). The drug was administered daily as a 15-mg two-hour IV infusion until both serum and urinary calcium had been normalized for 48 hours. Twenty-four patients were fully evaluable (eight head and neck tumors, seven breast cancers, three epidermoid tumors of the lung, and six miscellaneous neoplasms). Whereas rehydration had only inconsistent effects, APD normalized serum calcium in all patients after a mean of three daily doses: serum calcium decreased from 13.3 +/- 0.4 mg/dL (mean +/- SEM) before APD to 8.0 +/- 0.1 mg/dL at the end of treatment. Ionized calcium declined in parallel to total calcium. APD was as effective in hypercalcemia due to bone metastases as in paraneoplastic hypercalcemia. The drug was tolerated without toxicity and had a prolonged effect: serum calcium remained normal during 3+ weeks (1 + to 8 +) in 17 patients who did not receive or did not respond to antitumoral treatment. APD normalized serum calcium by inhibiting bone resorption, as evidenced by the dramatic decrease in urinary excretion of calcium and hydroxyproline. Inhibition of bone resorption was probably also responsible for the decrease in serum phosphorus from 2.9 +/- 0.2 to 2.0 +/- 0.1 mg/dL. In summary, IV APD constitutes a major advance in the treatment of malignancy-associated hypercalcemia: it is very effective, well tolerated, and has a prolonged efficacy.

Adult↗
PubMed1986

Calcitonin deficiency in primary hypothyroidism.

The relative lack of sensitivity and specificity of current assays for plasma calcitonin (CT) have made it difficult to study possible CT deficiency conditions. Using a new extraction method that considerably improves the sensitivity of the assay for CT monomer, CT levels were measured before and after a short calcium (Ca) stimulation test (2 mg Ca/kg over 5 min) to determine C-cell secretory reserve in women with autoimmune primary hypothyroidism and normal women. Mean basal plasma CT concentrations were lower in the hypothyroid women [0.9 +/- 0.1 (+/- SEM) pg/ml] than in the normal women (1.5 +/- 0.2 pg/ml; P less than 0.01). Serum Ca increased similarly in both groups, but postinfusion CT levels were lower in the women with primary hypothyroidism (3.8 +/- 1.3 pg/ml) than in normal women (15.9 +/- 3.0 pg/ml; P less than 0.001). The functional thyroid status at the time of the study did not influence CT levels; both hypothyroid patients (n = 10) and patients who were euthyroid during T4 treatment (n = 11) were CT deficient to the same extent. Unlike that in primary hypothyroidism, CT secretion was normal in four patients with hypothyroidism of pituitary origin. We conclude that the process that causes hypothyroidism in patients with autoimmune thyroid disease can also cause marked CT deficiency. This first demonstration of spontaneous CT deficiency in adults should contribute to the understanding of CT physiology; it also suggests that bone metabolism should be closely monitored during the treatment of primary hypothyroidism.

Calcitonin↗
PubMed1984

Calicopyelocystostomy in auto- and allotransplanted kidneys. Report of 2 cases.

A case of calicopyelocystostomy and one of pyelocystostomy are reported. In the first case, the operation was performed on an autotransplanted kidney. The operation was done in a patient with sponge kidney to facilitate spontaneous excretion of calculi. In the second case, the operation was performed in a patient with long-lasting urinary fistula which developed in a cadaver kidney transplant. Although the authors present only 2 cases, calicopyelocystostomy and pyelocystostomy can be recommended as a valuable method in complicated cases of recurrent nephrolithiasis and in patients with nonhealing long-lasting urinary fistulas which developed in transplanted kidneys.

Adult↗
PubMed1984

Human chorionic gonadotropin-like substance in plasma of normal nonpregnant subjects and women with breast cancer.

To understand ectopic hormone secretion in cancer we compared the plasma concentrations of the hCG-like substance in normal nonpregnant subjects and in women with breast cancer. In 45 normal men the plasma concentrations did not vary with age (median, 5 pg/ml; range, less than 3-169) whereas in 45 normal women they increased after menopause (median, 48 pg/ml; range, less than 5 -569, n = 20, P less than 0.0001). In 56 women with breast cancer the plasma concentrations of the hCG-like substance after menopause were much higher than in normal women (median, 202 pg/ml; range, 14-1561; n = 35; P less than 0.001), with no abnormally high pituitary gonadotropin values and no relationship with the tumor burden (same median after mastectomy, 198 pg/ml; n = 21). This hCG-like substance was glycosylated and similar to standard hCG according to molecular size, ionic strength, and immunoreactivity. Our data are compatible with the following conclusions: 1) the plasma concentration of the hCG-like substance is normally very low but dependent on gonadal function in women. Its source might be the pituitary gland or peripheral tissues. 2) Its concentration is much increased in postmenopausal women with breast carcinoma. This increase is found with normal pituitary gonadotropin values and is independent of the tumor burden, suggesting it is of extrapituitary and nontumoral origin.

Breast Neoplasms↗
PubMed1984

[Surgical treatment of total urinary incontinence based on Leadbetter's technic].

Ten patients (4 boys and 1 girl, 4 adult women and 1 man) were operated upon for incontinence due to epispadias (5 children and 2 women), or the result of multiple operations for stress incontinence (2 women), or of a transurethral bladder neck resection (the adult man), using Leadbetter's technique, which is described. In 4 patients with a sufficiently long trigonum, it was not considered necessary to perform ureterovesical reimplantation. Interesting results were obtained as they were assessed as very good in 4 and good in 2 of the 7 cases of epispadias, good in 1 of the 2 cases of sphincter lesions following surgery, and poor after endoscopic resection of the bladder neck in the man. All patients retained a normal upper urinary tract. In those patients who became continent, the new urethra measured 3.3 to 5 cm in length, whereas it was too short and dilated in cases remaining incontinent. Initial pollakiuria improved in the children after several months. These findings suggest that the ureter should be reimplanted in all cases, to allow the formation of a muscular, newly formed urethra of sufficient length. This operation appears to be effective for treating incontinence due to epispadias and traumatic sphincter lesions in women. It gives poor results in incontinence after prostate surgery and from neurological bladder. Reeducation of the child is as important as selection of patients for operation and a strict operative technique.

Adolescent↗
PubMed1983

Ureteral duplication with a blind-ending branch.

Three cases of ureteral duplication with blind-ending branch are described. Clinical observations are supplemented with a survey of the literature pertaining to the statistics, embryology, method of diagnosis and treatment of this urological developmental anomaly.

Adult↗
PubMed1983

Bladder flap for reconstruction of congenital absence of the vagina.

An original method for vaginal reconstruction, using a pedunculated bladder wall flap is described. The method can be applied for vaginal reconstruction in cases of congenital absence or hypoplasia, as well as in cases of male transsexualism. 4 patients have been operated by this method without complications. In 2 patients, with 11 and 8 months follow-up, the results are satisfactory. The authors clearly describe the technical method of operation.

Adult↗