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Biomedical subjects

J Flamm

Publications and source records attributed to J Flamm.

At least 19 recordsLinked to original sources
PubMed1992

Tumor-associated tissue inflammatory reaction and eosinophilia in primary superficial bladder cancer.

In a retrospective study the data of 428 patients with primary superficial transitional cell carcinoma of the bladder were evaluated. The histologic slides were reviewed for presence of a tumor-associated tissue inflammatory reaction, especially tumor-associated eosinophilia. Tumor-associated cell infiltration was found in 23.1 percent and tumor-associated eosinophilia in 2.1 percent. Tumor-associated cell infiltration was associated with less recurrences (p = 0.01). Tumor progression rate was not significantly influenced by tumor-associated cell infiltration. Tumor-related death rate was lower in the group with tumor-associated cell infiltrate (p = 0.50). Using the Cox regression model carcinoma in situ of the tumor margin, tumor-associated cell infiltrate, and grade of differentiation appeared to be important factors in the prognosis for survival.

Age Factors↗
PubMed1992

Endoscopic implantation of collagen (GAX) for the treatment of urinary incontinence.

Sixteen women whose ages ranged from 42 to 73 years (mean 57) and 2 men, aged 76 and 80 years respectively, were treated for urinary stress incontinence with transurethral implantation of submucosal glutaraldehyde cross-linked collagen (GAX); 15 females had had several continence operations previously and 1 female was totally incontinent following low anterior resection of the sigmoid colon for cancer. All but 2 patients received 8 ml GAX in a single operative session under general anaesthesia. Before implantation, patients underwent urodynamic evaluation, cystoscopy, urinary stress test and the two-thirds capacity pad weighing test. Post-operative evaluations were carried out after 3, 6 and 9 months and included urinary flow rate, urine analysis, residual urine determination and the two-thirds pad weighing test. The results were encouraging. After 3 months, 8/18 patients were cured, 7/18 had improved and 3/18 had failed to respond. Nine months post-operatively, 7 patients were still continent, 8 had improved and 3 remained unchanged. One of the improved group had a reinjection 18 months post-operatively and has been continent since then. We feel that GAX collagen injection is a safe and easy method for the treatment of urinary stress incontinence; it has no observable or measurable morbidity.

Adult↗
PubMed1991

Adjuvant topical chemotherapy versus immunotherapy in primary superficial transitional cell carcinoma of the bladder.

In a prospective randomised controlled study, the efficacy of ethoglucid was compared with that of keyhole-limpet haemocyanin (KLH) in preventing recurrent tumours following transurethral resection of primary superficial transitional cell carcinoma of the bladder. Patients treated with ethoglucid (n = 39) received 0.565 g (1% solution) ethoglucid weekly for 6 weeks and then monthly for 1 year. Patients treated with KLH (n = 38) were immunised subcutaneously with 1 mg KLH; bladder instillations of 30 mg were then given weekly for 6 weeks and thereafter monthly for 1 year. The recurrence rates, disease-free intervals and tumour progression rates were evaluated. The end-point of the study was either progression in stage or grade or more than 1 recurrence during the observation period. The minimum length of follow-up was 1 year. The recurrence rates, mean disease-free intervals and progression rates in the 2 groups showed no statistically significant differences.

Administration, Intravesical↗
PubMed1991

Complete androgen deprivation prior to radical prostatectomy in patients with stage T3 cancer of the prostate.

Twenty-one patients with stage T3 cancer of the prostate underwent complete androgen deprivation (LH-RH agonist and flutamide) for 3 months prior to radical prostatectomy. Two problems were to be dealt with: the decrease in the volume of the prostate, and the possibility of downstaging (= pT less than pT3 according to the UICC 1987 classification) of the prostatic cancer. A decrease in the volume was noted in each case. A downstaging effect (pT in comparison to T stage) was noted in 33% of the patients. The downstaging effect was noted in 75% of grade 1 tumor, in 31% of grade 2 tumors, but not in grade 3 tumors.

Aged↗
PubMed1991

[Clinical and urodynamic results after various ileum neobladder procedures].

Urinary diversion after cystectomy in 15 male patients suffering from advanced transitional cell carcinoma of the bladder (pT-pT3b) was performed by ileal neobladder in different ways: S type n = 5, U type n = 3, J type n = 3 and W type n = 4. The perioperative mortality was nil, the overall complication rate 60%. The patients were followed up by means of regular urodynamic controls after 3, 6 and 12 months. After a median follow up period of 18 months (12-29) the J type and W type seem to be superior with regard to postoperative continence. All patients with W type neobladder are continent. The capacity of the neobladders varies from 200 to 800 ml; the W pouches have the highest capacity.

Aged↗
PubMed1991

[The value of differentiated transurethral resection in primary superficial bladder cancer].

In a prospective study the efficacy of transurethral resection (n = 60) and differentiated resection (n = 66) in primary superficial bladder cancers was evaluated for persistent tumors and recurrences. At the control examination after 8 weeks an persistent tumor was found in 18.3% of cases after simple resection and in 9.1% after differentiated resection. The frequency of recurrences after a follow-up period of 3 years was 40% after simple resection and 27% after differentiated resection. The necessity of a third resection for complete removal of the tumor was shown in 12.1% following differentiated resection. Understaging or undergrading was detected in 3% with this method.

Aged↗
PubMed1990

The value of tumor-associated tissue inflammatory reaction in primary superficial bladder cancer.

The data of 92 patients who entered the prospective study between 1980 and 1982 were evaluable. The prevalence of tumor-associated tissue inflammatory reaction according to the tumorparameters stage, grade, multiplicity, tumor-weight and concomitant urothelial changes in primary superficial transitional cell cancer was estimated. Using high power field on the microscope tumor-associated cells were classified as lymphocytes, plasma cells, mast cells and eosinophils by morphological criteria. Recurrence rate, tumor progression and survival rate were evaluated for the group with tumor-associated cell infiltration and compared with the data of the group without any tumor-associated inflammatory reaction. According to recurrence rate, progression rate and survival rate there was a tendency to better prognosis for tumors with associated inflammatory reaction but this could not be proven by statistical analyses.

Adult↗
PubMed1990

Recurrent superficial transitional cell carcinoma of the bladder: adjuvant topical chemotherapy versus immunotherapy. A prospective randomized trial.

A multicenter, prospective, randomized controlled study was begun in 1985 on the effect of ethoglucid and keyhole-limpet hemocyanin in the prevention of recurrent superficial transitional cell carcinoma of the bladder (stages pTa to pT1, grades 1 to 3 according to the recommendation of the International Union Against Cancer and the World Health Organization). The study was performed on a selected group of patients at high risk for further recurrences. All of these patients were pre-treated with different chemotherapeutic agents (doxorubicin or mitomycin C) and still had recurrent superficial transitional cell carcinoma. All tumors were removed by transurethral resection and all patients were presumed to be free of tumor at initiation of the prophylactic instillations. Patients in the ethoglucid group received 0.565 gm. (solution of 1%) ethoglucid weekly for 6 weeks and then monthly for 1 year. Patients in the keyhole-limpet hemocyanin group were immunized with 1 mg. keyhole-limpet hemocyanin intracutaneously, and then weekly bladder instillations of 30 mg. were given for 6 weeks and then monthly for 1 year. The percentage of recurrences, recurrence rate, interval free of disease, tumor progression and effect on downstaging were evaluated for both therapeutic arms. The percentage of recurrences (60.9% in the ethoglucid group versus 55.3% in the keyhole-limpet hemocyanin group) and the comparison of interval to recurrence for all patients showed no statistical significant difference (p = 0.808, Mantel-Cox test). A comparison of the interval to recurrence in patients with recurrent tumors only showed a mean interval free of disease of 8.8 months for patients given ethoglucid versus 5.5 months for those given keyhole-limpet hemocyanin (p = 0.006, Wilcoxon test). Recurrence rate (4.8 versus 6.5, respectively) and tumor progression rate (21.7 versus 21.1%, respectively) showed no statistically significant difference (p greater than 0.1).

Administration, Intravesical↗
PubMed1990

Organ-preserving surgery in patients with urothelial tumors of the upper urinary tract.

The Austrian Urological Oncology Group reports on 55 organ-preserving operations in 52 patients with tumors of the upper urinary tract epithelium. The data were gathered from 12 urological departments in the country. There was no evidence of distant metastases in any of the patients at the time of surgery. The observation period ranged from 0.5 to 12 years. 69.2% (36 of 52) of the patients were alive and recurrence-free at the time of data collection, after a mean observation period of 41.4 months. 9.6% died for reasons other than cancer after an average of 18.8 months, and 21.2% were still alive with or had died due to recurrent tumors. The recurrence rate after open surgery was similar in tumors of the upper ureter or pelvis (15.3%) as in tumors of the lower ureter (17.6%). After endoscopic treatment 4 of 9 patients showed recurrences. 92% (22 of 24) of the patients with no compelling indication for organ-preserving therapy were alive and recurrence-free or had died due to other causes. Therefore organ-preserving surgery appears to be appropriate in tumors of the upper urinary tract epithelium.

Aged↗
PubMed1990

Factors affecting survival in primary superficial bladder cancer.

In a retrospective study of 345 patients with primary superficial transitional cell carcinoma of the bladder, factors present at the time of initial evaluation and which affect survival were identified. All patients were treated initially by transurethral resection with separate resection of the tumor base and margin. 89 patients received no further treatment after resection of the tumor, 256 patients received adjuvant topical instillation therapy over a period of 6 weeks. The distribution of risk factors in both groups was comparable; the survival rate after 5 years showed no significant difference. The tumor-related mortality rate was 12.5%. The Cox regression model showed carcinoma in situ in the tumor margin and the absence of a tumor-associated tissue inflammatory reaction to be the most important risk factors. Beside these associated risk factors, poor differentiation of the tumor parameter was the most important prognostic factor.

Aged↗
PubMed1990

Long-term versus short-term doxorubicin hydrochloride instillation after transurethral resection of superficial bladder cancer.

In a prospective randomized study the influence of short-term instillation therapy versus long-term instillation therapy after transurethral resection of superficial transitional cell bladder cancer on tumor recurrence, tumor progression and patient survival were evaluated. The data of 146 patients of 160 who entered the study were evaluable. After transurethral resection of the initial tumor and random biopsies of the bladder, patients were divided into two groups at random: group 1--doxorubicin weekly for 6 weeks and afterwards no further treatment (short-term regimen) and group 2--doxorubicin weekly for 6 weeks and afterwards monthly instillation for 2 years (long-term regimen). The follow-up was 5 years. Neither frequency of recurrences, nor tumor progression nor survival rate was improved significantly by the long-term instillation regimen.

Administration, Intravesical↗
PubMed1990

[The value of surgical therapy in the treatment of urogenital tuberculosis].

A series of 94 patients treated over a period of 22 years for genitourinary tuberculosis is reviewed. The group was made up of 72 patients with isolated urinary tuberculosis, 12 with isolated tuberculosis of the genitalia and 12 with combined disease. In 70 patients surgery was performed in addition to the standardized chemotherapy. Of the 72 patients with urinary tuberculosis, 21 received exclusively conservative treatment, while 16 underwent conservative surgery and the remaining 35, ablational surgery. The high nephrectomy and overall operation rate is explained by the high percentage of advanced state of disease and a large number of patients referred to us for nephrectomy following long-term conservative treatment. A retrospective justification for this procedure is found in the fact that 52% of the surgical specimens showed florid tuberculosis though the patients had been receiving standardized chemotherapy for an average of 9 months.

Adolescent↗
PubMed1989

The significance of bladder quadrant biopsies in patients with primary superficial bladder carcinoma.

The prognostic significance of dysplasia (D I-III, Tis) based on bladder quadrant biopsies was established in 216 patients with primary urothelial carcinoma of the bladder (stage pTaGI-pTGIII). Collectively within the study, 51 of the 216 patients biopsied (24%) were found with abnormal urothelium. Twelve (6%) have coexistent Tis, and 30 (18%) were found with dysplastic changes D I-III. Further concerns included the incidence of dysplastic changes associated with tumor invasion, tumor dedifferentiation, and the presence of primary multifocal disease. The collective recurrence rate was 43%. However, with inclusion of quadrant biopsies, the predictability of positive biopsy results increased to 63% and the negative rate decreased to 37%.

Adult↗
PubMed1989

[Short-term versus long-term chemoprevention of recurrence with Epodyl following transurethral resection of superficial urinary bladder cancer].

This investigation compares the short and long-term administration of intravesical Epodyl (etoglucid), following transurethral bladder tumor resection. This chemoprophylactic agent was used specifically in the treatment of bladder tumors that displayed different associated tumor risk factors: solitary versus multiple tumors, grade(s) I-III, primary versus recurrent tumors, and the presence of associated dysplasia. Within this study, 114 patients with carcinoma of the bladder underwent primary transurethral resection (TUR), followed in 10 days by short-term intravesical therapy (STIT) or long-term intravesical therapy (LTIT). Short-term intravesical therapy was administered to 56 patients. The therapy consisted of a 1% solution of Epodyl, which was given once per week for 6 weeks. Long-term intravesical therapy was given to 58 patients. This consisted of the short-term intravesical therapy protocol, followed by an additional dose once a month during an observation period of 2 years. The follow-up in both groups was for a minimum of 2 years. When the total number of recurrences in patients receiving (STIT) or (LTIT) was compared, no marked differences were noted (39% vs 38%). However, there was a difference when the individual tumor risk features were compared, e.g. for solitary tumors, the recurrence rate was 67% within the (STIT) group and 43% within the (LTIT). These results demonstrate that the decision of whether superficial bladder carcinomas are to be treated with short- or long-term Epodyl should be based on tumor-associated risk factors. Furthermore, if multiple tumor risk factors are present, maximal therapy is require; in the absence of risk factors TUR alone may be sufficient.

Administration, Intravesical↗
PubMed1988

The Escherichia coli biotin biosynthetic enzyme sequences predicted from the nucleotide sequence of the bio operon.

The nucleotide sequence of the biotin (bio) biosynthetic operon of Escherichia coli has been determined. The 5.8-kilobase region contains the five biotin operon genes, bioA, B, F, C, and D. and an open reading frame of unknown function. The operon is negatively regulated and divergently transcribed from a control region between the bioA and bioB genes. The product of the bioA gene, 7,8-diaminopelargonic acid aminotransferase, was discovered to be related to ornithine aminotransferase. The product of the bioF gene, 7-keto-8-aminopelargonic acid synthetase, was found to be similar to 5-aminolevulinic acid synthetase.

5-Aminolevulinate Synthetase↗
PubMed1988

[Complete androgen blockade (orchiectomy + flutamide) versus androgen blockade with cytostasis (orchiectomy + estramustine) in the treatment of virginal advanced prostate cancer].

The results of orchiectomy + flutamide (n = 28) versus orchiectomy + estramustine (n = 27) in the initial therapy of advanced prostatic cancer were compared in a prospective randomized study. The minimum observation period was one year. In the group orchiectomy + flutamide the incidence of side effects was 25%, the response rate (complete + partial remission) was 28% and the progression rate was 18%. 5 patients (18%) died within the first year. In the group orchiectomy + estramustine the incidence of side effects was 22%, the response rate (complete + partial remission) was 29% and the progression rate was 33%. 2 patients (7%) died within 1 year of treatment. There is no significant difference either in the response rate or the progression rate between the two groups.

Aged↗
PubMed1988

[Radical prostatectomy in the treatment of prostatic cancer. Perineal and transpubic methods].

This paper presents a report on 49 patients with prostatic cancer stages A-C (pT1NxMo-pT3Nx-1Mo) treated by radical prostatectomy. 32 patients were operated on perineally without preliminary lymph staging and 17 patients by the transpubic method after pelvic lymph staging. No death occurred perioperationaly in either group. Early complications were seen in 22% of cases after the perineal method and in 12% after the transpubic method; the incidence of late complications was virtually the same in both groups (22% and 23%) and the rate of incontinence was also similar (22% and 18%). The 5 year survival rate was 92% and the 10 year survival rate was 67%. On the basis of these results we feel that radical prostatectomy, especially incorporating the most recent modifications to retain continence and potency, represents the treatment of choice in early stages of prostatic cancer and, indeed, even in stage C cases.

Aged↗