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Biomedical subjects

F M Debruyne

Publications and source records attributed to F M Debruyne.

At least 163 records · Page 9Linked to original sources
PubMed1996

The predictive value of microscopic haematuria in patients with lower urinary tract symptoms and benign prostatic hyperplasia.

OBJECTIVE: To determine the additional value of the presence of microscopic haematuria in patients with benign prostatic hyperplasia (BPH). METHODS: In 750 consecutive patients with BPH urinalysis was performed and the grade of microhaematuria was correlated with other clinical findings. RESULTS: Microscopic haematuria was found in one third of the patients. Only 3 had a bladder tumour and 49 patients had urinary calculi for which only one patient required treatment. There was no correlations between any clinical parameter and the finding of microscopic haematuria. CONCLUSION: Microscopic haematuria is a frequent finding in assessment of BPH patients and additional tests should only be performed if indicated.

Adult↗
PubMed1996

The outcome of renal ultrasound in the assessment of 556 consecutive patients with benign prostatic hyperplasia.

PURPOSE: We determined the additional value of renal ultrasonography in the assessment of patients with benign prostatic hyperplasia. MATERIALS AND METHODS: Renal ultrasound was performed in 556 consecutive patients with benign prostatic hyperplasia and the results were correlated with other clinical parameters. RESULTS: Of the patients 14 (2.5%) had dilatation of the renal pelvis, 65 (11.7%) had renal cysts and 1 (0.18%) had renal cell carcinoma. The serum creatinine level appeared to be correlated with dilatation of the renal pelvis. To predict dilatation additional information can be obtained by including the results of the post-void residual measurements. CONCLUSIONS: Renal ultrasound is indicated only in patients with a specific serum creatinine level and/or post-void residual volume.

Carcinoma, Renal Cell↗
PubMed1996

Urodynamic and clinical effects of terazosin therapy in patients with symptomatic benign prostatic hyperplasia.

PURPOSE: We evaluated the urodynamic and clinical effects of terazosin in patients with symptomatic benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 45 patients who participated in a multicenter trial was evaluated with urodynamic pressure-flow studies before and after 26 weeks of treatment. RESULTS: Maximum flow rate and symptom score improved significantly in 22 patients with and 11 without bladder outlet obstruction who completed 26 weeks of treatment. In patients with bladder outlet obstruction the condition was significantly reduced and in patients without obstruction, significant urodynamic changes could not be detected. CONCLUSIONS: Terazosin treatment results in symptomatic relief and improved urinary flow in patients with and without bladder outlet obstruction, and in significant improvement in patients with urodynamically proved obstruction.

Adrenergic alpha-Antagonists↗
PubMed1996

A new long acting formulation of the luteinizing hormone-releasing hormone analogue goserelin: results of studies in prostate cancer.

PURPOSE: To assess the pharmacodynamic equivalence of the new 10.8 mg. goserelin depot with the current 3.6 mg. depot 3 studies were performed in patients with advanced prostate cancer. MATERIALS AND METHODS: In 2 comparative studies 160 patients were randomized for dosing every 12 weeks using the 10.8 mg. depot or every 4 weeks using the 3.6 mg. depot. In the noncomparative study 35 patients received the 10.8 mg. depot. Blood sampling for serum testosterone and evaluation of toxicity was done during the 48-week study period. RESULTS: Serum testosterone profiles of the 10.8 and 3.6 mg. goserlin depots were similar with testosterone levels decreasing into the castrate range by day 21 after depot administration. The safety profile of 10.8 mg. goserelin is comparable to that of the current monthly depot with the main side effects related to androgen deprivation. CONCLUSIONS: The new long acting depot was pharmacologically equivalent, and well tolerated locally and systemically, and will offer added convenience to patients and health care personnel.

Aged↗
PubMed1996

High energy thermotherapy in the treatment of benign prostatic hyperplasia: results of the European Benign Prostatic Hyperplasia Study Group.

PURPOSE: We documented the results of high energy transurethral microwave thermotherapy in the treatment of benign prostatic hyperplasia. MATERIALS AND METHODS: We evaluated 116 patients following transurethral microwave thermotherapy according to symptom scores, transrectal ultrasound, free voiding and pressure-flow study parameters. RESULTS: Significant improvement was noted in all objective and subjective parameters. Moreover, cavities in the prostatic urethra were observed in almost 40% of the patients. CONCLUSIONS: High energy transurethral microwave thermotherapy is an effective therapy for benign prostatic hyperplasia. Patients with larger prostates and moderate to severe bladder outlet obstruction seem to be the best candidates for this higher energy thermotherapy protocol, although morbidity is increased.

Aged↗
PubMed1996

Evaluation of detrusor activity during micturition in patients with benign prostatic enlargement with a clinical nomogram.

PURPOSE: We investigated the accuracy of analysis of detrusor contraction during micturition with a simple to use pressure-flow nomogram (linear passive urethral resistance relation). The computer derived maximum detrusor contraction parameter was used as a reference. The correlation with bladder emptying capability was used as a control. MATERIALS AND METHODS: Advanced pressure-flow analysis was performed in 224 elderly men with lower urinary tract symptoms. RESULTS: All patients with a contraction classified as normal on the nomogram had good maximum detrusor contractions. However, 50% of the patients with a weak classification on the nomogram showed good maximum detrusor contractions. CONCLUSIONS: The nomogram is useful in the selection of patients with a good detrusor contraction.

Aged↗
PubMed1996

Variability of clinical and pressure-flow study variables after 6 months of watchful waiting in patients with lower urinary tract symptoms and benign prostatic enlargement.

PURPOSE: We quantified the physiological variability of clinical and pressure-flow study variables in patients with symptomatic benign prostatic enlargement. MATERIALS AND METHODS: Symptom scores were measured, and advanced urodynamic studies with pressure-flow analysis were performed in 178 patients before and 6 months after a period a watchful waiting. RESULTS: Patients without bladder outlet obstruction experienced significant symptomatic improvement. Symptoms in patients with obvious bladder outlet obstruction did not improve significantly. The reproducibility of mean pressure-flow variables was evident. However, there was an important intra-individual variability. Patients with obvious bladder outlet obstruction showed a significant decreases in detrusor pressure at maximal flow of 14cm. water, a significant decrease in the urethral resistance factor of 7 cm. water and a significant decrease of 1 obstruction class on the linear passive urethral resistance relation nomogram, indicating less severe bladder outlet obstruction. CONCLUSIONS: Mean differences among therapy groups must be regarded critically, especially when the difference are slight and possibly within physiological variability.

Aged↗
PubMed1996

Molecular prognostic factor in renal cell carcinoma.

Renal cell carcinoma (RCC) is characterized by an unpredictable clinical course. Therefore, prognostic factors are urgently needed. So far, clinical staging is the most powerful predictor of the progression of RCC. A better understanding of cell biological and molecular changes associated with the development of this disease is urgently needed. Recently, application of a number of these have been tested. Whereas some do not seem to have prognostic value over the available classical prognostic markers, quantitative nuclear morphometric measurement and assessment of cadherin-mediated adhesion complexes (catenin immunohistochemistry) have opened new prospectives.

Biomarkers, Tumor↗
PubMed1996

Review on the simultaneous determination of total prostate-specific antigen and free prostate-specific antigen.

BACKGROUND: The total prostate-specific antigen (t-PSA) in serum measured by PSA assays represents the sum of free (f-PSA) and PSA complexed with alpha 1-antichymotrypsin. The f-PSA/t-PSA (F/T) ratio in prostate cancer (PCA) patients is lower than in patients suffering from benign prostatic hyperplasia (BPH). This review summarizes the current literature on the clinical relevance of measurement of the F/T PSA ratio. METHODS: Discussed are: physiology of PSA, assays for t-PSA and F/T ratio, factors which bias the F/T PSA ratio, use of F/T PSA ratio in the detection of PCA, correlation with histological features, and pathological stage. RESULTS: Using the F/T ratio in the intermediate t-PSA range, a reduction of approximately 30% in biopsies can be accomplished in the detection of prostate cancer. CONCLUSIONS: The F/T PSA ratio could become a valuable tool in the differentiation of BPH from PCA. To accomplish this goal, an international standardization not only for the t-PSA measurement but also for the F/T PSA ratio must be a priority for manufacturers of PSA assays.

Biopsy↗
PubMed1996

Predictive value of p53 mutations analyzed in bladder washings for progression of high-risk superficial bladder cancer.

To assess the value of p53 mutations in predicting the progression of superficial bladder cancer [transitional cell carcinoma (TCC)] and to define exactly when p53 mutations occur in the process of tumor progression, 80 consecutive bladder washings from 26 high-risk (indicated by quantitative karyometric analysis) superficial TCC patients were examined by single-strand conformation polymorphism. Six of 13 patients who experienced clinical progression (progression to T2 or higher) were found to have a p53 mutation in one or more of their bladder washings. In the control group (no progression to invasive disease), only 1 of 13 patients had a p53 mutation. For these high-risk superficial TCC patients, the occurrence of a p53 mutation has a positive predictive value of 86% for the progression of disease. A negative predictive value of 63% was observed. Moreover, because p53 mutations were found in samples prior to progression (mean, 8 months), they could identify patients who need changes in their treatment strategies to prevent progression to invasive disease. Despite these promising results, it is obvious that to increase not only the positive predictive value but especially the negative predictive value of this procedure to predict progression, additional prognostic markers are still needed.

Aged↗
PubMed1995

Is detrusor instability in elderly males related to the grade of obstruction?

Analysis of 185 consecutive patients with BPH revealed concomitant detrusor instability in 20% of the patients. Of all patients 30.9% were not obstructed, 51.8% were moderately obstructed and 17.3% were severely obstructed. Patients with detrusor instability during filling cystometry revealed no differences in average age, prostate volume or symptoms. Mean filling cystometry parameters revealed earlier sense of urge correlating with higher pressures at lower volumes in patients with detrusor instability. Pressure-flow analysis showed no differences between the patients with and without detrusor instability in bladder outflow obstruction parameters. Further analysis, however, revealed that the prevalence of patients with detrusor instability reaches a "steady state" at a moderate level of obstruction. On clinical epidemiological grounds, the conclusion is made that detrusor instability is developing in the early phase of obstruction. Probably detrusor instability and bladder outflow obstruction are concomitant, due to the aging process in many of these patients.

Aged↗
PubMed1995

In vitro proton magnetic resonance spectroscopy of four human prostate cancer cell lines.

There is accumulating evidence that some biochemical pathways observable by magnetic resonance spectroscopy, e.g., citrate acid and phospholipid metabolism, are altered in human prostate cancer. Four well-established human prostate cancer cell lines were therefore studied with magnetic resonance spectroscopy to compare differences in metabolic content with tumor biological behavior. Herein we demonstrate that, although each cell line has its own metabolic profile, relative creatine and citrate levels can be used to discriminate the androgen-dependent LNCaP cell line from the androgen-independent DU-145, TSU, and PC-3 cell lines.

Androgens↗
PubMed1995

Durability of laser fibers.

In 90 patients treated with laser prostatectomy using the Urolase (n = 50) or Ultraline (n = 40) laser fiber, the fiber-tip durability was investigated. In general the Urolase fiber tips were less damaged than the Ultraline fiber tips. At visual inspection, 62% of the Urolase fiber tips were graded as minimally damaged in comparison with 28% of the Ultraline group. The Urolase fiber tips are more susceptible than the Ultraline fiber tips to damage caused by tissue contact, whereas the latter seem more fragile. Transmission measurements were performed in a laboratory setting to estimate the loss of energy output at the fiber tip due to damage. These measurements showed a major loss in almost all fibers. None of the Ultraline fibers had less than 10% transmission loss, and 18% of the Urolaser fibers had a transmission value of more than 90%. Finally, there seemed to be a poor correlation between the visual aspects of the fibers used and the changes in transmission.

Equipment Design↗
PubMed1995

Experience with the Ultraline and Urolase laser fibers: is there any difference?

Laser treatment of benign prostatic hyperplasia has enjoyed growing popularity among urologists over the last few years. Various applicators and techniques have been reported. Because this may result in a different overall performance, we performed a prospective randomized study comparing the results of treatment using the Ultraline fiber (n = 44) with that using the Urolase fiber (n = 49). Although different types of fibers and techniques were used, the results of this study were surprisingly similar for both fibers used. The uroflow for the Ultraline group increased from an average of 7.9 ml/s at baseline to 19.3 ml/s at 3 months and 16.9 ml/s at 6 months. In the patients treated with the Urolase fiber the uroflow improved from an average of 7.8 ml/s at baseline to 19.5 and 16.3 ml/s at 3 months and 6 months, respectively. The improvement in symptoms, reflected by changes in the I-PSS symptom scores, for the Ultraline group went from 21.0 at baseline to 7.9 at 3 months and 6.0 at 6 months. The Urolase patients improved from 21.0 at baseline to 8.2 and 5.6 at 3 and 6 month, respectively. The morbidity mainly consisted of a prolonged need for posttreatment catheterization and irritative symptoms lasting for about 2-4 weeks. From this study we conclude that the results achieved by laser treatment of the prostate using the Ultraline and Urolase fibers are both equivocal and excellent; however, the morbidity of these treatments remains considerable.

Aged↗
PubMed1995

Radiolabeled monoclonal antibody G250 in renal-cell carcinoma.

The current status of iodine 131-radiolabeled monoclonal antibody G250 (mAb G250) in renal-cell carcinoma (RCC) is described. This mAb recognizes a tumor-associated antigen that is expressed on the cell surface of almost all RCC but is not expressed on normal tissues, with the exception of gastric mucosa and larger bile ducts. On the basis of these favorable characteristics, this mAb seemed a prime candidate for clinical investigations. Preclinical animal studies and ex vivo perfusion experiments in tumor-bearing kidneys showed excellent targeting of mAb G250 to RCC tumors. Supported by these investigations, a phase I study was initiated to define the imaging and biodistribution characteristics of 131I-labeled mAb G250 in RCC patients. Specific localized of [131I]-mAb G250 to G250-antigen-positive primary and metastatic RCC was observed. In several patients, [131I]-mAb G250 imaging revealed thus far unrecognized, i.e., occult, disease. Values obtained for [131I]-mAb G250 uptake, relative as well as absolute, were among the highest reported for tumor biopsies obtained 8 days after intravenous mAb administration. The specific localization and high accumulation encouraged us to begin a phase I/II radiotherapy trial with [131I]-mAb G250. The maximal tolerable dose was reached at 90 mCi/m2 [131I]-mAb G250. In the subsequent phase I/II radiotherapy study, we observed stable disease in a great number of patients as well as minor responses in a small number of patients. Multiple treatments seemed necessary to achieve better response rates. However, anti-mouse responses prevented multiple dosing with the murine mAb G250.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗