Search PubMed⌕ Search

Biomedical subjects

L Baert

Publications and source records attributed to L Baert.

At least 145 records · Page 8Linked to original sources
PubMed1992

Whole bladder wall photodynamic therapy with in situ light dosimetry for carcinoma in situ of the bladder.

We report on the preliminary results of 12 patients with multifocal carcinoma in situ of the bladder treated with whole bladder wall photodynamic therapy. The total light dose (scattered plus nonscattered light) measured in situ was 100 joules per cm.2 in the first 6 patients (group 1) and 75 joules per cm.2 in the remaining 6 (group 2). These light doses correspond on the average to 27 joules per cm.2 and 15.5 joules per cm.2 nonscattered light as reported by other investigators. Followup ranged from 6 to 22 months (average 11.5). In group 1, 2 tumors recurred after 6 and 9 months, respectively, and 2 other patients had a permanently shrunken bladder without evidence of disease. In group 2, 1 tumor recurred 5 months after photodynamic therapy. In this group the bladder capacity increased on the average to 135% of the pretreatment value 3 months after photodynamic therapy. All recurrences were in patients with a history of invasive bladder cancer (stages T1 and T2). These preliminary results demonstrate the importance of in situ scattered light dosimetry for minimizing local side effects of whole bladder photodynamic therapy.

Aged↗
PubMed1992

Endovaginal sonography: new diagnostic approach for urethral diverticula.

Too often a urethral diverticulum is a long-standing and unrecognized problem. Suprapubic sonography has been proposed for assessment of this pathological condition. We report on endovaginal sonography as a new improved imaging modality for the diagnosis of urethral diverticula. In positive cases additional morphological information can be obtained from positive pressure urethrography or from diverticulography via fine needle puncture under digital guidance or under sonographic control. Direct puncture of the lesion allows the injection of contrast material to facilitate the diverticulectomy.

Adult↗
PubMed1992

Transurethral hyperthermia for benign prostatic hyperplasia patients with retention.

From 1989 to 1990, 32 poor surgical risk patients with urinary retention were treated with transurethral microwave hyperthermia at the department of urology, University of Leuven in Belgium. Mean patient age was 73 years (range 58 to 90 years) and mean duration of retention was 4 weeks (range 3 to 12 weeks). Followup ranged from 13 to 82 weeks, with a mean of 31 weeks. Bilobar or trilobar hyperplasia was diagnosed in 25 patients (78%), while 7 (22%) had median lobe or median bar hypertrophy. The mean prostatic volume was 52 cc (range 25 to 150 cc). Transurethral microwave hyperthermia was given with a helical antenna at 915 MHz. once or twice per week. The mean number of transurethral microwave hyperthermia sessions was 8.9 (range 5 to 10). Each session consisted of a 60-minute treatment at a mean maximum temperature of 45.4C (range 43.7 to 47.2C), average temperature 43.9C (range 42.7 to 45.5C) and minimum temperature 42.0C (range 40.2 to 43.0C). The temperature was continuously monitored, including thermal mapping in all patients. Of the 25 patients who presented with bilobar or trilobar hyperplasia 18 (72%) were catheter-free for the duration of followup. Of the 7 median lobe or median bar patients 1 (14%) showed sufficient improvement to warrant catheter removal. This patient, however, had recurrent retention 4 months after transurethral microwave hyperthermia. In patients with bilobar and trilobar hyperplasia a strong correlation was observed among maximum temperature (p = 0.0006), average temperature (p = 0.0033) and treatment response. As expected, no such correlation existed between minimum temperature and response to treatment (p = 0.56). Our study has again demonstrated therapeutic activity in patients with benign prostatic hyperplasia treated with transurethral microwave hyperthermia. A new finding was a strong correlation between temperature and response.

Aged↗
PubMed1992

Correlation of extrusion forces, raw materials and sphere characteristics.

This communication reports on the correlation between extrusion forces and sphere characteristics. Dicalcium phosphate dihydrate, alpha-lactose monohydrate and anhydrous beta-lactose were models for respectively an insoluble, a medium soluble and a highly soluble drug and were used to produce spheres. Phase diagrams for ternary mixtures consisting of microcrystalline cellulose, water and a third excipient were constructed. The region where good spheres were obtained correlated well with the area of extrusion forces between 630 and 1260 N. This correlation was seen for the insoluble, the medium and the highly soluble products.

Powders↗
PubMed1992

Effect of alkalinization on calcium oxalate monohydrate calculi during extracorporeal shock wave lithotripsy: in vivo experiments.

Previous in vitro experiments demonstrated the reduced microhardness of calcium oxalate monohydrate (COM) calculi, relative to dry values, when saturated with an alkaline solution (pH = 9.5). Nineteen patients with a COM calculus in the distal ureter which had been resistant to prior extracorporeal shock wave lithotripsy in situ, were treated when the stone was surrounded by alkaline urine. The urine of 14 patients was alkalinized orally by administration of acetazolamine and citrate solution; in 5 other patients direct percutaneous irrigation of sodium bicarbonate via a nephrostomy tube was carried out. The urinary pH just before lithotripsy was greater than or equal to 9 in 17/19 patients. 4,000 shock waves, averaging 18.1 kV generated by the Siemens Lithostar, were delivered onto the calculus. No significant increase of comminution rate was apparent at radiographic control immediately after the treatment and only in half of the cases was evacuation obtained within 3 months.

Bicarbonates↗
PubMed1992

A pseudotumoral edema of the urinary bladder secondary to an intramural impacted ureteral lithiasis.

A case of pseudotumor of the urinary bladder secondary to intramural lithiasis is reported. Computer tomography, cystoscopy of the mass and cytology suggested a malignant tumor. A transurethral biopsy from the tumor was therefore performed, but it showed tissue covered with normal transitional cell epithelium but no signs of malignancy. Pseudotumoral edema of the bladder is easily mistaken for a malignant neoplasm (1, 2, 3).

Aged↗
PubMed1992

Radical prostatectomy for localized prostate cancer.

A retrospective analysis of 70 patients, undergoing a radical prostatectomy in 1989 and 1990 is reported. The value of computed tomography (CT) scanning in preoperative lymph node staging should be reconsidered. Evaluation of the resection margins is of utmost importance as is the distinction between capsular invasion, penetration and transgression. The etiology of local failure and its treatment are discussed.

Adenocarcinoma↗
PubMed1992

Neo-adjuvant hormonotherapy does not facilitate radical prostatectomy.

Sixty-eight patients who underwent radical prostatectomy without or after neo-adjuvant hormonotherapy for B2 or C stage prostate cancer were evaluated as concerned to the ease of the surgical procedure. Although it is difficult to assess this parameter, we experienced more difficulties and blood loss was higher in patients who had preoperative hormonal deprivation. Ongoing randomized trials could demonstrate an oncological benefit of neo-adjuvant hormonotherapy before radical prostatectomy. This eventual benefit will have to be balanced against an increased surgical difficulty.

Aged↗
PubMed1991

Treatment response with transurethral microwave hyperthermia in different forms of benign prostatic hyperplasia: a preliminary report.

During a 7-month period, 79 patients with benign prostatic hyperplasia (BPH) were treated with 915 MHz transurethral hyperthermia (TUHT). All patients had obstructive and irritative signs and symptoms which warranted surgical treatment considerations. Of the 79 patients treated, 31 had follow-ups of 12 months or longer and seven additional patients experienced treatment failure requiring surgical management. These 38 patients were studied to evaluate the relationship of treatment response to the pretreatment prostatic morphology assessed during cystoscopy. There was a well-balanced distribution of patients regarding the important pretreatment characteristics in different morphological types of prostatic hypertrophy. These important characteristics included: prostate volume, postvoiding residual volume, mean peak flow rate, and mean symptom score on the FDA scale. The study patients were scheduled to receive five 60-min TUHT sessions with temperature controlled on the urethral surface at 45.5 degrees C. The treatment were well tolerated and administered on an outpatient basis without sedation or anesthesia. There was a significant difference in the incidence of major improvement in patients with lateral lobe hyperplasia and those with median lobe enlargement, 73 vs. 30%, P = 0.018. From this study, it appears that BPH patients who are found at cystoscopy to have a predominance of median lobe hypertrophy should, perhaps, be selected for treatment other than TUHT. A Phase I study utilizing a modified transurethral applicator to accommodate the specific problem of patients with median lobe hyperplasia is currently being planned.

Aged↗
PubMed1991

Transurethral microwave hyperthermia: an alternative treatment for prostadynia?

A total of 15 patients with severe symptoms of prostadynia who were refractory to therapy were treated with transurethral microwave hyperthermia (TUHT) in a phase I trial. All patients had pain as the predominant symptom, 9 (60%) patients gave a history of psychological problems while frequency, urgency, dysuria, nocturia, and impotence were less common symptoms. Treatment consisted of TUHT at 915 MHz given weekly for 5 weeks with a total of 68 treatment sessions and a mean of 4.5 treatments per patient. Each treatment lasted for 60 minutes. The aim was to increase the temperature measured on the urethral surface to greater than or equal to 44 degrees C. T mean for all sessions was 45.5 degrees C. In 91% of treatments, the temperature was greater than or equal to 44 degrees C. Treatment was well tolerated in 87% patients and acute toxicity was mild. Of the 15 patients treated, 2 (13%) did not complete the treatment course due to discomfort during TUHT. Good treatment response, manifested by complete pain relief and a decrease in dysuria, was noted in 7 (47%) patients. A higher (greater than or equal to 46 degrees C) treatment temperature correlated well with good response, P less than .01. Similarly, relief of pain correlated well with the absence of a history of psychological problems, P less than .01. A decrease of obstructive micturition problems was noted in 5 of the 7 patients who had this upon presentation. This study showed evidence of therapeutic activity with the use of TUHT in patients with prostadynia refractory to therapy. The response obtained was limited to less than one-half of the patients. Complete pain relief was obtained in 4 (27%) patients. It is of interest to note that patients who had major benefit did not show evidence of psychological problems and were able to tolerate higher treatment temperatures. The latter could suggest a temperature-related response.

Adult↗
PubMed1991

Review of modern trends in the treatment of chronic bacterial prostatitis (C.B.P.).

Careful, lower urinary tract localization studies have to be used to classify patients in the chronic bacterial prostatitis group and others. Considerable progress has been made in understanding the pathophysiology and developing rational approaches for treatment of patients with chronic bacterial prostatitis. Ciprofloxacin is a new quinolone carboxylic acid derivate with marked activity against both gram-negative and gram-positive bacteria. A critical analysis of the most recent achievements in the area of chronic bacterial prostatitis is presented.

Animals↗
PubMed1991

Eosinophilic granuloma of bladder.

Eosinophilic granuloma of the bladder, a rare and certainly poorly known disease, simulates bladder neoplasms. Clinical aspects, histology, and therapy in a young boy are described.

Adolescent↗