Biomedical subjects
H O Beisland
Publications and source records attributed to H O Beisland.
Scandinavian clinical study of finasteride in the treatment of benign prostatic hyperplasia.
The effects of finasteride, a potent 5 alpha-reductase inhibitor, were assessed in patients with benign prostatic hyperplasia. Patients were treated with finasteride or placebo for 24 weeks in a double-blind multicenter study followed by a 12-month open-extension period. After 24 weeks, finasteride-treated patients, when compared to placebo-treated patients, showed a significant reduction in prostate volume (22.5% median decrease) and prostate significant antigen (32.4% median decrease), a significant increase in maximum urinary flow (1.6 ml/s mean increase from baseline) and a significant improvement in their obstructive symptom scores (two-point decrease from baseline). Finasteride was well tolerated, and the improvements in prostate volume, maximum urinary flow rate and obstructive symptom scores observed in the controlled study were maintained throughout the extension study.
[Laser in urology].
The Neodymium YAG-laser is particularly suited for endoscopic urologic surgery because the YAG-laser light can be conducted in flexible fibers. Superficial bladder tumours can be treated under local anaesthesia in the outpatient department. The frequency of local recurrences is low, significantly lower than after electroresection or electrocoagulation. Selected cases of T2-muscle invasive bladder tumours can be cured with laser coagulation applied subsequently to transurethral resection. Combined treatment with electroresection and laser coagulation of localized prostatic cancer is a promising method which compares favourably with results obtained by other treatment modalities. Tumours in the upper urinary tract can be laser-treated through ureteroscopes or nephroscopes, but the treatment should be limited to low stage, low grade tumours. Laser is the treatment of choice for intraurethral condylomatas. Laser treatment of pencil carcinoma gives excellent cosmetic and functional results and few local recurrences. Laser lithotripsy is a new technique for treatment of ureteric stones and photodynamic laser therapy is a promising technique for treatment of carcinoma in situ in the bladder epithelium. However, neither of these techniques are available for clinical use in Norway as yet.
Localized prostate carcinoma treated with TUR and neodymium-YAG laser irradiation.
Neodymium-YAG laser irradiation subsequent to extended transurethral resection has been practised in our department since 1981 as an alternative treatment for patients with localized prostate carcinoma. The treatment is performed endoscopically in two separate steps. The procedure is simple and complications are few. One hundred and twenty-four patients have been treated and followed up for more than 6 months. One hundred and ten patients are evaluated as disease free survivors and the overall actuarial disease free survival rate is 88% at 4-9 years of follow-up. The initial promising results persist and the results from other clinics confirm the method to be a fair alternative or patients with localized prostate carcinoma.
Transurethral resection and laser irradiation in low stage prostatic carcinoma.
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[Does preoperative urethral catheter increase the risk of complications in transurethral prostate resection?].
In a material consisting of 243 patients treated with transurethral prostate resection 76 had preoperatively been drained for urine by indwelling urethral catheter. Delayed recovery or increased risk for complications due to the resection could not be demonstrated in this group compared to 167 patients without use of preoperative catheter. Peroperative antibiotic prophylaxis is to recommend in patients operated upon directly after catheter drainage.
Neodymium-YAG laser irradiation of stage T2 muscle-invasive bladder cancer. Long-term results.
The study group consisted of 15 patients with solitary stage T2 bladder tumours treated with transurethral resection (TUR) and subsequent neodymium-YAG laser irradiation. Ten patients are alive without evidence of cancer 56 to 78 months (mean 67) after treatment; 1 died of cardiovascular disease 2 years after treatment and autopsy revealed no cancer. In 4 patients the treatment failed and cystectomy or external beam radiation was carried out. The long-term results indicate the combination of TUR and laser irradiation to be beneficial in the management of T2 tumours in selected cases.
Possibilities of laser in the treatment of urinary bladder cancer.
Clinical use of laser in the treatment of urinary bladder tumours has been practiced since 1976. Today, the method is widely accepted as a simple and effective method for destroying superficial bladder tumours. In selected cases of muscle invasive tumours of stage T-2 beneficial long term results are reported. Locally advanced tumours of stage T-3 or T-4 are beyond the possibility of cure by the laser.
Neodymium-YAG laser in the treatment of localized prostate cancer.
The combination of transurethral resection and subsequent Neodymium-YAG laser irradiation has been practiced for radical treatment of localized prostate cancer since 1981. One hundred and eighteen patients have been treated and the observation time ranges 6-98 months. The treatment is performed endoscopically in two separate steps. The procedure is simple and complications are few. One hundred and four patients are evaluated as disease-free survivors. The overall actuarial disease-free survival rate is 88% in the 4-8 year period. The results compare satisfactorily with results obtained by other methods. Recently published results from other clinics confirm the laser to be promising in the treatment of localized prostate cancer.
[Intravesical BCG vaccine in bladder cancer].
We present a preliminary report on intravesical BCG instillation in four patients. The indications are prevention of new superficial tumors and treatment of carsinoma in situ. 120 mg Connaught BCG-vaccine in 50 cc saline is instillated weekly for a total of six treatments. Follow-up was performed every three months and included cystoscopy and urine cytology. The prophylactic effect is encouraging, even in patients who have previously not responded to intravesical chemotherapy. There were no serious complications and the common side effects of fever and dysuria did not delay or interrupt treatment.
A contribution to the special discussion on YAG laser irradiation of superficial bladder cancer.
In a randomized prospective study on YAG-laser irradiation versus TUR in the treatment of superficial bladder tumors 38% of the patients in the TUR group had local tumor recurrence in treated area within two years compared to non in the laser group. There was no difference between the groups in regard to new occurrence of tumors in remote areas. The rationale of these results are discussed and a plea is made for specification between true recurrences in treated area and new occurrence of tumors in remote areas when evaluating patients treated with laser.
Neodymium-YAG laser in the treatment of localized prostatic cancer.
Transurethral resection with subsequent Neodymium-YAG laser irradiation is introduced as a method for radical treatment of localized prostatic cancer. 101 patients are treated and follow up ranges 6-81 months. 90 patients are evaluated as disease-free survivors. The actuarial disease-free survival rates are 98% on one year, 90% on 2 years, 88% on 3 years and 86% in the 4-7 year period. Six patients developed distant metastases and 5 patients had local tumor recurrence. The treatment procedure is simple and without serious complications.
[Tetracycline sclerotherapy in hydrocele and epididymal cysts].
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Combined TUR and laser in the treatment of localized prostatic cancer.
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The microcirculation in neodymium-YAG laser irradiated and in electrocoagulated urinary bladder tumors evaluated with laser Doppler flowmetry.
Neodymium-YAG laser irradiation is a relatively new therapeutic modality for the treatment of urinary bladder tumors which is suggested to produce an instantaneous arrest of the blood circulation and a homogeneous coagulation of the tumor tissue. Utilizing the laser Doppler flowmetry principle the microcirculatory changes in laser irradiated tumors were compared to the changes in tumors coagulated with diathermy. In laser treated tumors the blood cell flux decreased to near baseline levels throughout coagulated area. Vascular stasis was demonstrated in the erythematous zone encircling the necrosis. In tumors coagulated with diathermy a corresponding constant decrease in blood cell flux could not be demonstrated. Thus the neodymium-YAG laser irradiation seems preferable to electrocoagulation in the treatment of urinary bladder tumors as more complete and homogeneous arrest of the blood circulation in the treated area is achieved.
Transrectal ultrasonography before and after neodymium-YAG laser irradiation of localized prostatic carcinoma.
Transrectal ultrasonography was used to evaluate 54 patients with localized prostatic carcinoma treated with neodymium-YAG laser irradiation. Both pre- and postirradiation scans were obtained in 30 patients, while additional 24 cases were examined after laser irradiation only. The procedure represents a valuable contribution to proper preoperative staging and is mandatory for the follow-up of patients selected for this particular treatment. The shrinkage of the capsule is negligible after laser irradiation. No specific ultrasonic changes due to the laser effect are to be found. Abnormal parenchymal echoes and capsular irregularities are the major parameters indicating early recurrence of disease. The presence of malignancy must be confirmed by biopsy.