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Biomedical subjects

L Baert

Publications and source records attributed to L Baert.

At least 253 records · Page 14Linked to original sources

Pharmacokinetics of amikacin in patients with renal insufficiency: relation of half-life and creatinine clearance.

The half-life of amikacin after a single intramuscular injection was determined in patients with severe renal failure who received 3.75 mg of drug/kg and in patients with various degrees of renal function who received 7.5 mg of drug/kg. The relation of the half-life of amikacin to levels of serum creatinine is practically identical to that of kanamycin. However, although concentrations of serum creatinine remained practically unchanged, rates of creatinine clearance may by considerably decreased in older subjects. This decrease may result in overestimation of the rate of glomerular filtration and subsequent overdosage. Therefore, the half-life of amikacin should be derived from values of rates of creatinine clearance or be predicted with use of a nomogram. The calculated half-life values may be used for development of appropriate dosage schedules for patients with various degrees of renal function. Such schedules would ensure therapeutic levels of drug and avoid potentially toxic accumulation of antibiotic.

Aged↗

Glans ischemia after penis revascularization: therapeutic embolization.

A case of hypervascularization of the penis with glans ischemia after venous leakage procedure followed by revascularization of the penis is reported. The venous bypass between the inferior epigastric artery and the dorsal penile artery was misplaced on the deep dorsal vein leading to venous hypertension of the glans. Transcatheter embolization of the venous bypass cured this complication.

Adult↗

Renal pseudotumor due to a retained perirenal sponge: CT features.

A case of a surgically retained, encapsulated sponge presenting as an unusual cause of renal pseudotumor is described in a man who had a partial nephrectomy for renal cell carcinoma 1 year before. The nonspecific sonographic appearance of a hyperechoic renal mass and the atypical CT features of a thick-walled indeterminate mass suggested a hematoma, a hemorrhagic cyst, or a hemorrhagic neoplasm. A retained surgical sponge within a thick fibrotic capsule adhesive to the renal capsule was found at surgery.

Diagnosis, Differential↗

Controlled double-blind trail of flavoxate in painful conditions of the lower urinary tract.

A double-blind, placebo-controlled trial of the antispasmodic flavoxate (600 mg. daily) was carried out in 60 patients suffering from painful conditions of the lower urinary tract arising from inflammation and/or infection or from spasm following diagnostic or therapeutic procedures. Statistically significant improvement was noted in frequency and suprapubic pain, and marked relief was also afforded in dysuria, hesitancy and burning. Apart from dryness of the mouth, the incidence and type of side-effects reported were similar in both groups of patients and were probably not drug related. Fewer patients interrupted treatment with flavoxate because of inefficacy than in the placebo group, the difference being statistically significant.

Adult↗

Heating characteristics of a helical microwave applicator for transurethral hyperthermia of benign prostatic hyperplasia.

A new applicator for intraurethral hyperthermic treatment of benign prostatic hyperplasia is described. The applicator uses an insulated helical antenna wound on the outer surface of a silicone urological (Foley) balloon catheter. The balloon catheter assures rapid and reproducible localization of the antenna in the prostatic urethra. Two small cannulae are fixed to the exterior surface of the applicator. One holds a temperature control sensor at a fixed location, the other is used to map temperature along the applicator. Two-dimensional SAR and steady-state temperature distributions measured in a plane tangent to the applicator in a tissue-equivalent phantom are presented, as well as longitudinal temperature distributions measured in situ at the applicator-urethral interface. Prostatic temperatures were also measured intraoperatively. The applicator appears to be capable of elevating temperature to greater than 42 degrees C in a cylindrically symmetric volume of about 4 cm length and about 0.5 cm radial penetration surrounding the antenna. The heating characteristics of this applicator are similar to an earlier design that employed an array of three dipoles. The helical applicator is narrower, more flexible and simpler to use than the earlier design.

Biomedical Engineering↗

Histopathology of prostatic tissue after transurethral hyperthermia.

Histopathological changes were studied in four patients who had moderate to severe urinary outflow obstruction due to benign prostatic hyperplasia (BPH) and were treated with transurethral microwave hyperthermia (TUMH). All these patients received TUMH with a helical antenna using a BSD 300 unit. The temperature was controlled on the urethral surface at 45 degrees C +/- 1 degree C. Each treatment session lasted 70 min at this temperature. Histological changes were periurethral, extending up to 6 mm radially and 4-5 cm longitudinally. They were symmetrical and most severe in the immediate periurethral zone. The severity and distribution of these histological changes correlated well with the thermal profile of the helical antenna. Acute changes, observed 24-48 h following administration of a single TUMH session, consisted of periurethral oedema, parenchymal haemorrhages and occasional, partial small-vessel thrombosis. Selective coagulation necrosis of the parenchymal smooth muscles with sparing of smooth muscle fibres in the vessel walls was noted. Histopathological changes found in patients 7 or 26 days following the administration of 10 TUMH treatments given twice-weekly for 5 weeks showed more severe and deeper lesions. They consisted of interstitial haemorrhages, complete obliteration of blood vessel lumina due to thrombosis and further evidence of coagulation and haemorrhagic necrosis. Evidence of a reparative process with ingrowth of granulation tissue in various stages of organization was clearly demonstrated. The effect of TUMH on BPH-obstructed urethra is probably expressed through selective shrinking and retraction of the periurethral prostatic parenchyma due to organizing localized tissue necrosis and cicatrization. Details of this complex process will be presented.

Granulation Tissue↗