Ureteral colic. Epidemiologic and therapeutic aspects.
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Biomedical subjects
Publications and source records attributed to A Fritjofsson.
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Plasma concentrations of estramustine phosphate and its major metabolites were measured in patients with prostatic carcinoma treated with increasing oral doses, 70-650 mg/day, of estramustine phosphate (Estracyt). Parent drug and estradiol were measured by radioimmunoassay, and estramustine and its estrone analogue (Leo 271) utilizing gas chromatography. The concentrations of estramustine phosphate and estramustine were below or close to the limits of the methods. A linear correlation was found between the daily dose of estramustine phosphate, and plasma concentrations of Leo 271-the main metabolite-and estradiol, which suggests that no capacity limiting processes are involved in the pharmacokinetics of estramustine phosphate in man. Plasma was also analyzed during prolonged treatment with 560 mg/day. The metabolite pattern was not changed by two to three years of estramustine phosphate treatment.
Ten patients with previously untreated prostatic carcinoma were studied to evaluate the hormonal effects of different doses of estramustine phosphate (Estracyt). The drug was given by mouth in increasing doses; during the first month 70 mg daily, during the second 140 mg, during the third 280 mg and during the fourth and following months 560 mg. The following hormonal parameters were studied before the treatment and then once weekly during a period of four months: testosterone, dihydrotestosterone, androstenedione, cortisol, FSH and LH. The levels of the steroids were also re-assessed one to two years later. The patients were also followed clinically at regular intervals. Initial testosterone levels of approximately 20 nmol/l plasma were reduced to approximately 0.6 nmol/l already by the lowest Estracyt dose of 70 mg/day. No further decrease was obtained by a stepwise increase of doses up to 560 mg/day. The plasma levels of dihydrotestosterone, androstenedione, FSH and LH were also reduced significantly following the administration of the lowest daily Estracyt dose and then remained at that low level. Cortisol levels increased steadily during the four months of the study. After longterm treatment the hormonal indices were by and large the same as during the last initial treatment period. Initially, the clinical effect of the treatment was excellent. In 4 patients, however, the therapy had to be discontinued after some time, because of complicating oedema (2 patients) or refractoriness to therapy (2 patients). Three years after initiating the therapy 6 patients still were on Estracyt treatment. All of them were doing well subjectively. In 5 patients the prostatic cancer was in remission or at least stable. In one patient, however, skeletal metastases were progressing. In conclusion, Estracyt was found to possess a maximal hormonal (oestrogenic) effect already in doses far below those usually recommended.
In 10 infertile men with sperm-agglutinating antibodies in serum and a history of inguinal herniorrhaphy the site of the previous operation was explored. Five of the men had an occlusion of the vas deferens and in three others spermatoceles were noted in the epididymis. The occlusion of the vas deferens was in the area of the previous herniorrhaphy. Infertility caused by the development of sperm antibodies may occasionally be a long-term consequence of inguinal herniorrhaphy.
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A test for antidoby-coated bacteria in the urine for the diagnosis of the anatomical level of urinary tract infection was evaluated in an unselected series of patients with urinary tract infection as a complication of other diseases of the uro-genital tract. Of 19 patients with cancer of the bladder, prostata and the kidney who had clinical signs of lower tract infection, 14 had antibody-coated bacteria in the urine. Among adult patients without cancer of the urinary tract but a clearcut history of upper tract infection, 17 had antibody-coated bacteria, while 8 had not. Six patients also without history of cancer, with clearcut lower tract infection, had antibody-coated bacteria; 38 had not. The results indicate that cancer of the urinary tract seems to influence the correct establishing of level of infection by this method. In patients with diseases of the urinary tract in additional to infection, antibody coating by bacteria in the urine must be interpreted with caution.
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