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Biomedical subjects

C A Olsson

Publications and source records attributed to C A Olsson.

At least 163 records · Page 9Linked to original sources

Maytansine as a cause of acute proliferative disorder of bladder urothelium in the rat.

Male Wistar Lewis rats were injected with maytansine at a total dose of 0.425 to 0.6 mg/kg over a 3-week period. Biopsies taken at 5 weeks showed that 23% of the bladders had hyperplasia or other abnormalities. Of the bladder biopsies done for the first time at 8 weeks, 80% demonstrated papillary hyperplasia. A small number of biopsies at 13 and 19 weeks still showed hyperplasia and minimal inflammatory reaction. These results were seen regardless of prior biopsy, the presence of bladder calculi, and/or the dose level used. It is not clear from the data whether the observed changes are reversible or precarcinogenic. However, these changes closely resembled the histologic features described in the evolution of bladder cancer in rats fed N-C4-(5-nitro-2-furyl)-2-thiazolyl formamide.

Animals↗

Chemosensitivity of murine renal carcinoma.

A non-endocrine dependent, spontaneous carcinoma of the kidney in a Wistar-Lewis rat has been studied for sensitivity to chemotherapeutic agents. Two tumour models have been employed. Subcutaneously transplanted flank nodules were used to screen single agents for antitumour activity.. A model of intraperitoneal metastatic disease was employed to test further agents which had demonstrated some effectiveness in the nodule model. Single agents that proved ineffective were streptozotocin, neocarzinostatin, chlorozotocin and carminomycin. 5-FU, bleomycin and hydroxyurea were also ineffective at the doses tested. Agents that were effective included cyclophosphamide, adriamycin, vinblastine, vindesin and maytansine. The most effective combination therapy appeared to be cyclophosphamide with vindesin and cisplatin.

Adenocarcinoma↗

Adjunctive therapy with interstitial irradiation for prostate cancer.

Thirty patients with clinically localized adenocarcinoma of the prostate underwent simultaneous staging pelvic lymphadenectomy and interstitial irradiation. Patients were followed for eighteen to forty-five months with regard to progression of disease and development of long-term complications. Upstaging to Stage D1 by virtue of discovering pelvic node involvement was noted in 16 patients (53.3 per cent). Subsequent disease progression (defined as development of bone or soft tissue metastasis) was seen in 9 of 16 upstaged patients with an average time to progression of 12.2 months. Three Stage D1 patients have died with an average time to death of 19.6 months. Only 1 patient whose lymphadenectomy was negative has experienced disease progression, and none has died. Adjuvant chemotherapy (cyclophosphamide and doxorubicin hydrochloride) was given to 9 upstaged patients, in only 3 did disease progress. In contrast, in 6 of 7 upstaged patients not receiving chemotherapy metastatic disease developed, with an average time to progression of 10.3 months. In an attempt to improve local tumor control achieved by interstitial irradiation alone, 18 patients received additional external beam radiation therapy to the prostate, in doses ranging from 2,000 to 4,000 rad. There were sixteen long-term complications in the 30 patients, 75 per cent of which were seen in patients receiving added external beam irradiation.

Adenocarcinoma↗

Prognostic significance of nucleolar surface area in prostate cancer.

In an effort to define ultrastructural histologic features that might serve as predictors of tumor aggressiveness, a retrospective study was conducted on 52 patients with localized and metastatic adenocarcinomas of the prostate. Nucleolar surface area measurements were made by stereologically analyzing pictures obtained by the backscattered electron imaging (BEI) attachment to a scanning electron microscope (SEM). The data were compared with the Gleason grading system which is based on light microscopic glandular patterns. In patients with no evidence of disease three years or more after radical prostatectomy, the initial biopsy demonstrated nucleolar surface areas which averaged 1.28 micrometers2 (range 0.60 to 2.27 micrometers2) whereas, patients with metastases or dying of cancer exhibited an average nucleolar surface area of 5.17 micrometers2 (range 2.49 to 10.01 micrometers2). With a single exception in this 52-patient survey, progressive disease was always accompanied by nucleolar surface measurements larger than 2.40 micrometers2. There was close correlation in nucleolar surface measurements between the initial biopsy and the radical prostatectomy specimens; in contrast, Gleason grades varied by more than 30 per cent between the initial and final specimens in 70 per cent of the cases. Only 9 of 16 patients with aggressive disease ever demonstrated Gleason grades above 6. The development of an ultrastructural grading system may provide a means of determining prognosis in prostatic cancer in objectivity and specificity to light microscopic grading systems.

Adenocarcinoma↗

Nephrostomy drainage for renal transplant complications.

The use of temporary diverting nephrostomy drainage in the management of immunosuppressed renal transplant patients with supravesical urinary extravasation, fistulas or ureteral obstruction is reviewed. In a literature survey covering an 11-year interval and 4,307 transplants there were 204 cases (4.7 per cent) of ureteral extravasation or fistula and 113 cases (2.6 per cent) of ureteral obstruction. Attempts at urologic repair in these 317 cases resulted in 30.9 per cent failure rate (98 cases), of which 86.7 per cent (85 cases) occurred in patients without nephrostomy compared to 13.3 per cent (13 cases) in patients with nephrostomy. In our 255 consecutive renal transplant patients there were 7 (2.7 per cent) with ureteral extravasation or fistula and 14 (5.5 per cent) with ureteral obstruction. Temporary nephrostomy was done in all 21 patients to protect the urologic repair and, when necessary, to control sepsis and allow for patient stabilization before delayed urinary tract reconstruction. In our series there was no mortality and only 1 renal unit (4.7 per cent) was lost as a consequence of urologic complications. The use of nephrostomy in transplant patients with ureteral extravasation, fistulas or ureteral obstruction is encouraged strongly to optimize patient and renal unit survival.

Drainage↗

Development of a carbon dioxide laser cystoscope.

CO2 laser lesions were created at varying power densities on the exteriorized canine bladders. A 50-watt carbon dioxide continuous laser coupled to a Zeiss surgical microscope was used. A schematic power curve was developed indexing depth of bladder penetration by the laser against laser energy output. Once the optimal power settings for the carbon dioxide laser were established, vertical heat transmission, hemostasis, and healing were studied. A prototype carbon dioxide laser cystoscope was then constructed that allowed endoscopic delivery of the CO2 laser beam into the intact canine bladder. The beam was focussed by a germanium lens and directed out the end of the endoscope, using a movable mirror. Eight dogs were then endoscopically studied in vivo.

Animals↗

The flow rate nomogram: II. Clinical correlation.

Using the previously demonstrated statistical relationship between urinary flow rate and bladder volume we tested 53 patients with clinically evident outflow obstruction by uroflowmetry. Of these patients 32 were tested before and after a successful operation for outflow obstruction. In 98 per cent of the maximum flow measurements in obstructed patients the nomogram values were less than minus 2 standard deviations, indicating a clear separation from the normal population. After operative relief of the obstruction repeat uroflowmetry demonstrated all values to be in the normal range. Furthermore, in each patient the peak flow rate value increased an average of 2.7 standard deviations (minimum increase of 1.5 standard deviations). No significant correlation could be demonstrated between the size of the prostatic resection and the degree of urinary flow impairment. The use of a flow rate nomogram appears to differentiate reliably normal from obstructed individuals and also is highly useful in the postoperative followup of urinary outflow obstruction.

Humans↗

Renal autotransplantation for recurrent renal colic.

Renal autotransplantation as an alternative to ileal interposition has been done successfully in patients with repetitive episodes of renal colic. Urinary tract continuity has been re-established by anastomosis of a Boari tube directly to the renal pelvis. This has resulted in easy egress of recurrent calculi without pain. Furthermore, the musculature of the Boari tube seems to be adequate for prevention of vesicorenal reflux. The procedure has been devoid of electrolyte and mucous urinary retention problems associated with ileal interpositionand it is advocated as an alternative in the management of such patients when medical therapy fails.

Adult↗

Alpha-adrenergic inhibition of renal cortical adenylate cyclase.

Adenylate cyclase in homogenates of rat renal cortex was inhibited by alpha-adrenergic agonists. Inhibition required sodium ion and GTP. A maximum inhibition of 17.8 +/- 1.4% (S.E.M.) was produced by l-epinephrine in the presence of 0.2 M NaCl, 10 microM GTP and 10 microM propranolol. Similar inhibition was produced by l-norepinephrine and alpha-methylnorepinephrine. The EC50 values for l-epinephrine, l-norepinephrine and alpha-methylnorepinephrine were respectively 1.9 +/- 0.7 microM, 2.3 +/- 1.6 microM and 5.1 +/- 1.8 microM. Clonidine was a partial agonist causing 50% as much inhibition as epinephrine. Phenylephrine and methoxamine did not inhibit at concentrations up to 100 microM. Micromolar concentrations of phentolamine and yohimbine prevented the inhibition of adenylate cyclase by epinephrine. However, prazosin was ineffective. Thus the adenylate cyclase coupled alpha-receptors have alpha-2 specificity. Inhibition of adenylate cyclase by alpha-adrenergic agonists was not observed in homogenates of renal medulla.

Adenylyl Cyclase Inhibitors↗

The flow rate nomogram: I. Development.

In normal individuals the flow rate depends on the initial bladder volume in a non-linear fashion. A flow rate nomogram taking this relationship into account was developed as an aid in the interpretation of urinary flow rate data. With this approach excellent differentiation of normal from obstructed individuals was achieved. In addition, the variability in a single individual's flow rate over time was estimated to be relatively small and, thus, uroflowmetry may be used to identify changes in outflow resistance after medical or surgical therapy.

Adult↗

Renal autotransplantation for recurrent renal colic.

Renal autotransplantation as an alternative to ileal interposition has been done successfully in patients with repetitive episodes of renal colic. Urinary tract continuity has been re-established by anastomosis of a Boari tube directly to the renal pelvis. This has resulted in easy egress of recurrent calculi without pain. Furthermore, the musculature of the Boari tube seems to be adequate for prevention of vesicorenal reflux. The procedure has been devoid of electrolyte and mucous urinary retention problems associated with ileal interposition and it is advocated as an alternative in the management of such patients when medical therapy fails.

Adult↗