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Biomedical subjects

B Debre

Publications and source records attributed to B Debre.

At least 19 recordsLinked to original sources

Variable expression of CD3-zeta chain in tumor-infiltrating lymphocytes (TIL) derived from renal-cell carcinoma: relationship with TIL phenotype and function.

It has been reported that in mice and in humans, tumor-infiltrating lymphocytes (TIL) may exhibit a defect in CD3-zeta-chain expression. Therefore, the level of CD3-zeta was analyzed in TIL derived from patients with renal-cell carcinoma, and its correlation with TIL phenotype and function was assessed. We identified 4 out of 13 tumor-infiltrating lymphocytes derived from renal-cell carcinoma, with a significant decrease in CD3-zeta-chain expression as compared with control peripheral-blood lymphocytes. This defect was never found after culturing TIL with IL2. In one case, the low expression of zeta chain observed in TIL on day 0 was reversed when TIL were cultured with IL2. The zeta-chain level did not seem to predict the growth of TIL in response to IL2. All the TIL, irrespective of the level of zeta-chain expression, exhibited lower proliferative response when stimulated with PHA or anti-CD3 MAb in comparison with normal peripheral-blood mononuclear cells. Nevertheless, in this limited series of patients, a correlation was observed between the level of zeta-chain expression and T-cell infiltration (p = 0.02). After TIL stimulation with PHA or anti-CD3, in contrast to IL2 or IFN-gamma production, a trend towards a relationship between TNF alpha induction and the level of zeta-chain expression was observed.

CD3 Complex↗

Lack of efficacy of low-dose subcutaneous recombinant interleukin-2 and interferon-alpha in the treatment of metastatic renal cell carcinoma.

OBJECTIVE: To evaluate the efficacy and toxicity of subcutaneous immunotherapy using a combination of recombinant interleukin-2 (r-IL2) and interferon-alpha (IFN-alpha) for the treatment of patients with metastatic renal cell carcinoma (RCC). PATIENTS AND METHODS: Initially a maximum of 45 patients with advanced RCC were to be included in the study, according to a Fleming three-stage procedure. To be included patients had to have measurable metastasis. Of a potential 45 patients with advanced RCC, 15 patients were included in the study (10 men and five women, mean age 51 years, range 25-69). From the first week of treatment r-IL2 was given subcutaneously on day 1 to 5, at 18 x 10(6) units once a day and then 9 x 10(6) units once a day for the following 5 weeks. IFN-alpha was given three times a week for the last 5 weeks. Minimum follow-up was 6 months. RESULTS: All patients initially underwent radical nephrectomy. Seven patients were found to have metastases at the time of diagnosis. All patients received ambulatory therapy, except for the first 5 days of treatment. Overall, 80% of the patients received more than 75% of the complete dose of r-IL2. One patient suffered toxicity greater than the World Health Organization (WHO) grade 2 (neutropenia). No patient had a complete or partial response, two patients had a minor response, two patients had stable disease and 11 patients had disease progression. CONCLUSIONS: Subcutaneous r-IL2 and IFN-alpha had no beneficial effect on the first 15 patients and the study was discontinued, in accordance with the Fleming rules. The dose, administration and combination of r-IL2 and IFN-alpha may explain the lack of efficacy. Other studies have shown that low doses of r-IL2 are not effective and the superiority of the combination of r-IL2 and IFN-alpha has not been proven. Therefore, a high dose of r-IL2, in association with other cytokines, chemotherapy and adoptive immunotherapy, may be the only way to improve the response rate of metastatic RCC.

Adult↗

[Closure of a hypogastric urinary fistula after replacement enterocystoplasty with a flap of the rectus abdominis muscle].

Urinary fistulization to the skin is a rare complication of cystoprostatectomy with replacement enterocystoplasty. In two cases, fistulization did not respond to continuous drainage of the urine and was treated with a muscle flap using the abdominus rectus. This method offers rapid parietal repair giving a reliable rapid cicatrization since the interpositioned flap is well vascularized in an area of poor tissue quality.

Aged↗

[Contribution of urodynamic examinations in the exploration of micturition disorders in patients with Parkinson disease].

24 men (mean age 71.2 years) with micturition disorders and parkinson disease have been studied: irritative symptoms are present in 62.5%. Urodynamics were specially usefull when obstructive symptoms (37.5%). In these cases, 3/4 had a mechanical obstruction to be treated by surgery. 3 men had a neurologic bladder and needed a pharmacological treatment. In this high risk population, urodynamics seemed to be necessary.

Aged↗

[Epidermoid cyst of the testis. Apropos of a case].

The epidermoid cyst of the testis, a rare and benign tumour, continues to create problems. Its definitive diagnosis remains a histopathological one and alters the prognosis and therapy. Based on their case report and a literature review, the authors discuss the different diagnostic, prognostic and therapeutic aspects of this lesion.

Adult↗

Localized hyperthermia versus the sham procedure in obstructive benign hyperplasia of the prostate: a prospective randomized study.

Hyperthermia was shown to cause improvement in 50 to 60% of the patients with benign prostatic hyperplasia (BPH) without considering placebo effects. We studied 68 patients randomly assigned to a treatment group (38) and a sham group (30) who underwent the same manipulation but without applying radio frequency power. The Biodan Prostathermer was used. Criteria for inclusion were based on objective and subjective symptoms. Treatment was performed 6 times at 43 +/- 0.5C for the treatment group. Followup evaluation was performed at 3 months, and the same objective and subjective symptoms were recorded. We observed a statistically significant subjective improvement in the sham group (33%) that was not accompanied by any significant objective improvement. In the treatment group the subjective response was significantly better regarding number of patients (68%) and response rate, and was substantiated by a significant improvement in all objective symptoms (53% of the patients) except voided volume. Therefore, hyperthermia treatment had a definite therapeutic effect on BPH in excess of placebo.

Aged↗

Laser treatment of obstruction from incrusted ureteral catheter.

Incrustations may develop on ureteral catheters and cause obstruction. We report a case in which obstruction was relieved by laser lithotripsy inside the lumen of the catheter. This completely noninvasive technique may prove to be useful in selected cases.

Catheters, Indwelling↗

[Is dysuria an objective or subjective concept?].

A prospective study was carried out in 100 consecutive male patients coming to consultation in the department. These men, whose average age was 65 years (32-82), and who had come for various reasons, answered a questionnaire on the quality of their urine flow, which was rated on a scale ranging from 1 to 4. The results of flow rate measurements were classified in 4 categories according to the maximum flow rate and to the volume of micturation, which always was greater than 150 ml. The comparison of the subjective appreciation and of the objective value showed frequent discrepancies (over- or under-evaluation). These results were analysed according to various parameters, and in particular to the patients' age. It thus appears that one third of the patients only have an accurate appreciation of the quality of their micturation.

Adult↗

Extracorporeal shock-wave lithotripsy to remove calcified ureteral stents.

A patient was seen with a large calcification of the renal end of a silicone catheter placed to intubate a cutaneous ureterostomy. Because of the stone, withdrawal of the catheter was impossible, and the patient presented with obstruction and dilatation of the renal cavities along with febrile bacteriuria and renal failure. Extracorporeal shock-wave lithotripsy, done under intravenous sedation, was found to be an effective noninvasive method to treat such a complication of long-term urinary drainage.

Catheters, Indwelling↗

Clinical experience with a new pulsed dye laser for ureteral stone lithotripsy.

We treated 45 patients (46 ureteral stones) with a new pulsed dye laser. A 250 mu. fiber was used through a rigid (40 stones) or flexible (6) ureteroscope. Stones were in the upper (5 cases), middle (5) or lower (36) third of the ureter. Stone composition was calcium oxalate dihydrate (34 patients) or monohydrate (7), struvite (2) or uric acid (2). Of the calculi 36 (78%) were fragmented, including 14 that also required simultaneous basket removal of fragments. Ten stones were not fragmented: 6 because of the pure monohydrate composition and 4 due to malfunction of the laser. No damage to the ureteral wall was noted. Retrograde rigid ureteroscopy with laser lithotripsy was effective for lower and middle third ureteral stones. Flexible ureteroscopy with laser lithotripsy was effective (impacted stones) but difficult for upper third ureteral stones.

Endoscopy↗

Clinical experience with a new pulsed dye laser for ureteral stone lithotripsy.

Forty-five patients with 46 ureteral stones were treated using a new pulsed dye laser (Pulsolith, TMI). A fiber of 250 micrometers was used through rigid (40 cases) or flexible (6 cases) ureteroscopes. Stones were located in the upper third (5 cases), middle third (5 cases), or lower third (36 cases) of the ureter. Stone composition was calcium oxalate dihydrate or monohydrate, struvite, or uric acid in 34, 7, 2, and 2 patients, respectively. Thirty-six stones (78%) were fragmented, including 14 cases that required basket removal of fragments at the same time. Ten stones were not fragmented, 6 because of the pure monohydrate composition and 4 due to a laser breakdown. No damage to the ureteral wall was noted. Retrograde rigid ureteroscopy with laser lithotripsy was effective for lower and middle third ureteral stones. Flexible ureteroscopy with laser lithotripsy was effective (impacted stones) but difficult for upper third ureteral stones. Laser lithotripsy was not effective for pure calcium oxalate monohydrate stones.

Calcium Oxalate↗

Laser lithotripsy of ureteral calculi: initial experience with a new pulsed dye laser.

Thirty-two patients with ureteral calculi ranging in size from 5 x 5 to 12 x 18 mm underwent lithotripsy with a new pulsed dye laser (Pulsolith, TMI). In 24 cases, the patients were entirely free of stones following laser lithotripsy alone, or with adjunctive stone basket removal. There were three instances of equipment failure and five calcium oxalate monohydrate stones that did not respond to laser energy.

Calcium Oxalate↗