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Biomedical subjects

F M Debruyne

Publications and source records attributed to F M Debruyne.

At least 361 records · Page 20Linked to original sources
PubMed1989

Immunological aspects of intravesical administration of Bacillus Calmette-Guérin (BCG) in the guinea pig.

The only form of effective immunotherapy for human cancer is the intravesical administration of BCG in the treatment of superficial bladder tumors. In this study BCG was administered intravesically (once a week for six consecutive weeks) in guinea pigs to investigate the immune response. Both specific immune responses against BCG itself and nonspecific immune responses such as leukocyte subset distribution, mitogenic (ConA, PHA, LPS) lymphocyte stimulation and spontaneous cytotoxic (NK and LAK cell) activity were determined in the regional draining (iliac) lymph node and in the spleen. The PPD skin test became positive after the fourth intravesical instillation of BCG when 1 X 10(5) culturable particles or higher dosages of BCG were administered. A low dose of 1 X 10(3) c.p. of BCG induced a positive PPD skin reaction in 2 of 4 animals after six BCG instillations. After six BCG instillation BCG immune lymphocytes were present both in the iliac lymph nodes and in the spleen. No differences in mitogenic responses to ConA, PHA and LPS were observed in iliac lymph nodes or the spleen between placebo or BCG treated animals. In the regional iliac lymph nodes a significantly increased number of leukocytes was present. These lymph node cells showed a significant increase in the expression of MHC class II (Ia) immune response antigen on their surface. In the spleen no differences were observed after BCG administration regarding the number of cells present and in terms of the Ia antigen expression of the leukocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravesical↗
PubMed1989

Antegrade percutaneous dilation of ureteral strictures after kidney transplantation.

Ureteral obstruction after renal transplantation is due mostly to retroperitoneal fibrosis in the area of surgical dissection, and pyeloureterostomy is the treatment of choice for such an obstruction. For confined strictures, especially at the site of the ureteroneocystostomy, endoscopic dilation may be a good alternative. Antegrade percutaneous dilation was used to treat six patients with ureteral stricture after kidney transplantation. Four patients had stricture at the ureterovesical junction, one a confined midureteral stricture, and one a secondary stricture at the site of pyeloureterostomy. Percutaneous antegrade dilation of the stricture to 14 Fr with semirigid fascial dilators and external ureteral stenting with a 12-Fr silicon splint for 6 weeks was successful in the four patients with ureterovesical junction obstruction, but not in the two other patients. Results were judged on the basis of serum creatinine concentration, renal ultrasonography, and intravenous urography (IVU). The follow-up period was 12-20 months (mean 15 months). None of the six patients died and perioperative morbidity was minimal.

Dilatation↗
PubMed1989

Ketoconazole high dose in management of hormonally pretreated patients with progressive metastatic prostate cancer. Dutch South-Eastern Urological Cooperative Group.

Ketoconazole high dose (H.D.) effectively reduces the testosterone production in both adrenals and testes. Its use in the management of (metastatic) prostate cancer has been advocated. Even in relapsing patients, after previous hormonal therapy, ketoconazole H.D. could be of value. Twenty-eight relapsing patients, of whom 15 were evaluable at three months, have been treated with ketoconazole H.D. As could be expected, objective response was seen in only a small number of patients followed up till nine months. Subjective improvement, however, was noticed in the majority of symptomatic patients. The side effects and toxicity of the therapy remain a major limitation for the use of ketoconazole, be it as first line treatment or as therapy for relapsing patients.

Acid Phosphatase↗
PubMed1989

Ultrasonic determination of prostatic volume: a cadaver study.

In a cadaver study we aimed to prove that the application of Hastak's technique of planimetric volumetry of the prostate, using transrectal ultrasonography, is an accurate method. We used Brüel and Kjaer equipment (type 1846 + 1850, 4 mHz) in measuring 25 prostates of cadavers (all older than 40 years). Ultrasonically and physically measured volumes were compared. Only small differences (+4 to -6 cm3) were due to measurement errors. We conclude that planimetric volumetry of the prostate by transrectal ultrasonography is accurate.

Adult↗
PubMed1989

Determination of prostatic volume by ultrasonography. A useful procedure in patients with prostatism?

Digital palpation is rather unreliable for estimating the volume of the prostate. Ultrasonographic measurements have been advocated as a more appropriate method. We examined 47 patients ultrasonographically. Of these, 34 underwent a transurethral resection of the prostate (TURP) (ultrasonographic volume 29 patients: prostate less than 60 cm3, 5 patients with cardiovascular problems: prostate greater than 60 cm3) and 13 an open prostatectomy according to Hryntschak (prostate greater than 60 cm3). In all patients ultrasonically determined volumes were compared with the operatively removed volume of prostatic tissue. If the size of the prostate had been estimated by digital palpation only, 12 patients would have undergone the wrong procedure (TURP instead of Hryntschack procedure). Ultrasonographic calculation of the prostatic volume demonstrated that all of these patients could be treated with less risk. After resection or abdominal prostatectomy some prostatic tissue remains. We concluded that there is no clear difference in the incidence of secondary prostatic obstruction (in need of re-TURP) either after abdominal prostatectomy or after TURP.

Adult↗
PubMed1989

Phase II study of recombinant interferon alpha-2a and vinblastine in advanced renal cell carcinoma.

A total of 66 patients with advanced renal cell cancer received a combination of recombinant interferon alpha-2a (18 times 10(6) units subcutaneously 3 times weekly) and vinblastine (0.1 mg. per kg. intravenously every 3 weeks). Four patients were ineligible and 6 were inevaluable for response but evaluable for toxicity. There were no complete and 9 partial responses among the 56 evaluable patients, for a response rate of 16 per cent. Median duration of response was 26 weeks, with a range of 8 to 50 weeks. Responses were observed predominantly in patients with lung and soft tissue metastases. Patients who had undergone nephrectomy did not show a better response rate than those who had not. Almost all patients had a flu-like syndrome, fatigue and anorexia. Other side effects included leukopenia, nausea, vomiting, liver function disturbances and neurotoxicity. Most of the side effects were World Health Organization grade 1 or 2; no grade 4 toxicity was observed. Antibodies against interferon developed in 6 patients during the course of treatment. However, there was no relationship between the appearance of antibodies and disease progression. The combination of recombinant interferon alpha-2a and vinblastine has modest but definite activity in patients with advanced renal cell carcinoma, although the role of vinblastine is unclear.

Carcinoma, Renal Cell↗
PubMed1989

The predictive value of repeated urine cell culture in soft agar for recurrences of transitional cell carcinoma.

To evaluate the predictive value for recurrences of repeated urine cell culture in double layer soft-agar in patients with transitional cell carcinoma, 272 urine samples were collected from 75 patients. After a limited period of follow-up (mean 19.5 +/- 15.1 months) nine out of 46 patients with at least one evaluable culture and evaluable for clinical follow-up had a histologically proven recurrence preceded or accompanied by tumor colony growth in culture; one patient had tumor recurrence with growth negative urine cell culture; 15 patients had growth negative urine cell cultures and at first evaluation no recurrence of transitional cell carcinoma; 21 patients had growth positive urine cell cultures and no recurrence at first evaluation of follow-up. These two latter groups were evaluated again after an additional 30 months of follow-up. In the group with growth positive urine cell cultures (21 patients) nine patients (47.6%) developed a recurrence; 10 developed no recurrence. In the other group of patients with growth negative urine cell cultures (15 patients) six patients (40%) developed a recurrence, three following a growth positive urine cell culture. In the group of 46 evaluable patients in this study, 25 patients developed a recurrence, 21 had at least one growth positive culture. The sensitivity is 84% (21/25). Of 33 patients with positive cultures 21 have had a recurrence (64%) while 12/33 (36.7%) are "false positive." The false negative rate is 36.4% (four of 11 patients developed recurrences not preceded by growth positive urine cell cultures).(ABSTRACT TRUNCATED AT 250 WORDS)

Agar↗
PubMed1989

Renal trauma and hypertension.

A retrospective study (1972-1983) was made of 622 consecutive patients who suffered renal trauma, in order to assess the incidence and prevalence of post-traumatic renal hypertension. In 435 (76%) of the 569 survivors long-term followup data and blood pressure recordings were obtained, 13 months to 12 years after trauma (mean, 5.6 years). Renal trauma could not be linked to an increased incidence of hypertension: on first control, only 94 patients (21%) demonstrated a casual elevated blood pressure (greater than 140/90 mm Hg). The presence of a fixed hypertension was validated in only 14 patients. Twelve of them were extensively screened in the Department of Internal Medicine. In none of these patients could a definite relationship between hypertension and renal trauma be documented. Furthermore, an extensive review was done of 223 cases of post-traumatic renal hypertension reported in the literature from 1951 until 1984. Careful analysis of these previously described cases (71 publications) leads us to criticize the widespread accepted cause-effect condition with regard to post-traumatic renal hypertension. It is concluded that adequate management of renal injuries with early diagnosis and individualised surgical treatment can prevent this extremely rare complication.

Adolescent↗
PubMed1989

Factors determining the outcome following implantation of the AMS 800 artificial urinary sphincter.

Erosion and infection are major complications following implantation of the AMS 800 artificial urinary sphincter. In the present study, 17 patients with this prosthesis were investigated urodynamically. All were continent. Urethral pressure profilometry showed a significantly lower intra-urethral pressure than would have been expected from the pressure installed in the pressure regulating balloon during operation. The maximal urethral pressure was 69.9% of the expected pressure and did not vary significantly in relation to the various balloon pressures. The mean maximal urethral pressure (+/- SEM) between the cuff when inflated and when deflated was also significantly different, although the absolute difference was small (14.1 cm H2O +/- 10.0). There was good correlation between maximal urethral pressure and urethral leakage pressure as measured by retrograde perfusion sphincterometry. The mean functional urethral length became significantly longer after implantation of the cuff. A combination of low urethral pressure and increased functional length may help to prevent cuff erosion and maintain continence.

Adolescent↗
PubMed1989

The value of intravesical echography combined with double-surface coil magnetic resonance imaging in staging bladder cancer.

Correct staging of bladder tumours is essential for planning the best therapeutic strategy and is therefore directly related to the prognosis. In this study of 15 patients with bladder cancer, a new method using magnetic resonance imaging (MRI) with a newly developed double-surface coil was tested for bladder cancer staging and compared with other existing techniques. Ultrasonography produced 2 cases of overstaging and 2 of understaging. This was due to the inability of this method to evaluate muscular infiltration accurately. All superficial bladder tumours were staged correctly with ultrasound with the exception of 1 case that was overstaged because of superficial tumour calcification. Double-surface coil MRI correctly staged all infiltrating tumours. Two small superficial tumours were missed by MRI, while another superficial tumour was overstaged. It is suggested that double-surface coil MRI and intravesical ultrasonography are good complementary examinations in the pre-operative staging of bladder tumours. Larger studies are necessary to prove the reliability of this conclusion.

Adult↗
PubMed1989

Bladder carcinoma in patients less than 40 years of age.

Between March 1983 and March 1988 we registered and treated 49 patients with bladder cancer less than 40 years of age (7 patients less than 30 years of age). Hematuria was present in 40 cases (81.6%). 33 of the patients had a pTA tumor (67.3%). 47 patients had transitional carcinoma of the bladder, of which 21 (44.7%) showed hallmarks of aggressive behavior (muscle invasion, recurrences, associated severe epithelial atypia); all of these patients were between 31 and 39 years of age. 15 patients had a recurrence (30.6%), of which 3 showed progression (all between 31 and 39 years of age). This report supports the view that transitional cell carcinoma of the bladder is less aggressive in patients less than 30 years of age. We still advise however to do a full diagnostic workup in case of symptoms of bladder tumor, and to treat the patient according to the pathological classification, regardless of the age.

Adolescent↗
PubMed1989

Ultrasonic determination of the residual bladder volume.

In a clinical study the ultrasonic determination of the residual bladder volume is evaluated by applying several echographic methods described in the literature. 163 patients (age 3-89 years, 114 males and 49 females) and 13 students were examined. Only in the latter group the bladder volume was also determined by a planimetric method. The most practical method showed a good agreement (with a maximum deviation of 25%) between the ultrasonically measured volumes and the volumes measured by catheterization in 66% of the cases. This method makes use of the formula Vus = 0.5(Vt + Vl), where Vus = residual volume estimated by ultrasonography; Vt = volume measured by the computer using the largest transversal ultrasonic bladder section, and Vl = volume measured for the largest longitudinal section). Factors that influence image quality and accuracy because of changes in the form of the bladder were analyzed. The magnitude of the residual volume determined the image quality and the accuracy above all: lower volumes give worse images and are less accurate. Other factors seem to be relatively unimportant. To avoid discomfort, caused by urine tract infection and urethral strictures, ultrasonic determination of the residual urine is recommended for clinical application.

Female↗
PubMed1989

Non-radical hysterectomy and the function of the lower urinary tract. I: Urodynamic quantification of changes in storage function.

The intermediate sequelae of non-radical abdominal and vaginal hysterectomies on the storage function of the lower urinary tract were studied by comparison of pre- and postoperative urodynamic parameters. A statistically significant reduction in maximum cystometric capacity after abdominal extrafascial and vaginal hysterectomies was found, together with a decline in bladder compliance. Both findings are attributed to a decrease in the musculoelastic properties of the detrusor muscle caused by edema and surgical injury. This reduction in capacity and compliance, however, appeared to have no clinical importance. Sensory innervation remained unaltered. In general no evidence was found that hysterectomy contributed to the development of involuntary detrusor contractions and motor urge incontinence. Urethral competence, assessed by urethral pressure profilometry and urethral leakage pressure measurement, remained unaffected. No increase in stress incontinence was seen after hysterectomy. Vaginal hysterectomy appeared to influence storage function slightly more than abdominal hysterectomy did. Postoperative lower urinary tract dysfunction is for the most part determined by the preoperative urological status.

Female↗
PubMed1989

Non-radical hysterectomy and the function of the lower urinary tract. II: Urodynamic quantification of changes in evacuation function.

The intermediate sequelae of non-radical abdominal and vaginal hysterectomies on the evacuation function of the lower urinary tract were studied by comparison of pre- and postoperative urodynamic parameters. No significant changes were observed in detrusor contractility or the contribution of abdominal straining after hysterectomy. Pressure-flow studies revealed no development towards obstructive patterns. Uroflowmetry did not demonstrate any changes in flow rates or in flow patterns. Except in one woman, no major variations were seen in residual urine volumes. There were no differences between abdominal and vaginal hysterectomies. It is concluded that lower urinary tract evacuation function remains unaltered by total hysterectomy.

Abdomen↗
PubMed1989

Radical hysterectomy and the function of the lower urinary tract. Urodynamic quantification of changes in storage and evacuation function.

The intermediate sequelae of radical hysterectomy on the storage and evacuation function of the lower urinary tract were studied by comparison of pre- and postoperative urodynamic parameters. A modified surgical technique was employed in order to remove only the necessary part of the upper part of the vagina and paravaginal tissues. A non-significant reduction in bladder capacity and compliance was found. Urethral function remained unaltered. The most prominent finding was a significant reduction in detrusor contractility and the development of abdominal straining in order to empty the bladder. The pathophysiologic mechanisms by which lower urinary tract is changed after radical hysterectomy are a decrease in the musculo-elastic properties of the bladder wall caused by surgical injury, and partial damage to the neural innervation of the bladder.

Female↗