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Biomedical subjects

F Keuppens

Publications and source records attributed to F Keuppens.

At least 19 recordsLinked to original sources

Adjuvant chemotherapy of recurrent superficial transitional cell carcinoma: results of a European organization for research on treatment of cancer randomized trial comparing intravesical instillation of thiotepa, doxorubicin and cisplatin. The European Organization for Research on Treatment of Cancer Genitourinary Group.

A total of 356 patients with recurrent superficial transitional cell carcinoma of the bladder was entered in a randomized clinical trial to compare intravesical thiotepa, doxorubicin and cisplatin with respect to the recurrence rate and disease-free interval. After complete transurethral resection of all visible lesions, the drugs were administered weekly for 4 weeks and monthly for 11 months. The recurrence rates per year were 0.50 for thiotepa, 0.54 for doxorubicin and 0.58 for cisplatin. Of 266 patients (mean followup 41 months) 35 reported an increase in T category and 19 of them had distant metastases. No association between treatment and progression was noted. Thus, there is no difference among treatments with respect to efficacy. However, severe anaphylactic reactions were observed in the cisplatin arm and chemical cystitis was more frequently reported in patients who received doxorubicin.

Administration, Intravesical

The value of dynamic color duplex scanning in the diagnosis of venogenic impotence.

To determine the value of color duplex scanning in the diagnosis of venogenic impotence we examined 53 patients. The control population consisted of 26 psychogenically impotent men and 8 normal potent men who all had a firm erection after pharmacological stimulation. There was no significant difference in the values of duplex parameters between these 2 groups. The venous leak population was characterized by a bad erectile response to pharmacological stimulation despite a good arterial compliance and by a persistent diastolic flow as shown by duplex scanning. There was a significant difference with the control population for the parameters of resistance index after 10 minutes (p = 0.001), minimal resistance index (p = 0.016) and corporeal volume increase (p = 0.010). There was a good correlation between the results of duplex scanning and those of pharmacocavernosography-pharmacocavernosometry (93%). We conclude that dynamic color duplex scanning can be used as a screening procedure to diagnose significant venous leakage in an objective manner with the resistance index.

Aged

Pseudotuberculous pyelonephritis associated with nephrolithiasis.

This report describes a 40-year-old man with an unusual form of granulomatous pyelonephritis, associated with nephrolithiasis, resulting in end-stage kidney disease and right pretransplant nephrectomy. The kidney specimen contained a staghorn calculus and showed chronic inflammation with confluent caseating granulomas and multinucleated giant cells, resembling renal tuberculosis. However, neither tubercle bacilli nor other microorganisms were demonstrated in the renal tissue or in urine cultures. Because these findings do not support a tuberculous etiology of the granulomatous pyelonephritis, we conclude that this patient had a pseudotuberculous reaction as a consequence of nephrolithiasis.

Adult

Replacing 99Tcm-DMSA for renal imaging?

We have tried to evaluate the usefulness of an early 99Tcm-MAG3 image, obtained during the second minute after injection of the tracer, in predicting the renal alterations seen on a 99Tcm-DMSA scintigraph, in children clinically suspected of pyelonephritis. It appears that the accuracy of the MAG3 image is population dependent: when, in most of the patients of a study group, DMSA scintigraphy is either normal or very abnormal, the MAG3 image will correctly reflect the DMSA scintigraph. However, when the DMSA alterations are less pronounced, the early MAG3 image will miss the lesions in about 50% of the cases.

Acute Disease

The use of prostaglandins for diagnosis and treatment of erectile impotence.

The authors present their experience in using PGE-1 for the assessment of 77 impotent patients. This drug can be safely used as a screening test for vasculogenic impotence but is also useful in more invasive diagnostic tests. PGE-1 is probably the only natural product that can be used commonly for the treatment of erectile impotence, because it is a safe and effective drug.

Alprostadil

Total androgen ablation: European experience. The EORTC GU Group.

Zoladex plus flutamide significantly delays the time to progression (subjective, objective, first progression) compared with orchiectomy, but no difference in survival (death from all causes or from malignant disease) could be detected. Thus, a delay in the appearance of progression has not improved survival. In fact, the duration of survival after progression tends to be shorter on Zoladex plus flutamide. There is thus no evidence to suggest any survival benefit with Zoladex plus flutamide. The quality control of our data revealed acknowledged problems in defining responses in patients with advanced prostate cancer. The review of the Bone Scan Committee provided the data for Tables 5 to 7. These data must provoke some reflections and emphasize once again the heterogeneity of the studied patient population. Table 4 on pain response after 4 weeks is just one of the many items to be analyzed by the committees for response criteria and quality of life. We expect that the other trials face similar problems. More work and patience are needed to obtain a firm answer to this clinical problem. These efforts will never be wasted, however, because the combined results of these trials will increase our knowledge of the treated history of prostate cancer and will, we hope, indicate a net treatment benefit in some subsets of patients. An individually tailored treatment for each patient selected from the anonymous mass of cases of advanced prostate cancer would be the highest reward of our continued collaboration with all the study groups.

Aged

Orchidectomy versus Zoladex plus Eulexin in patients with metastatic prostate cancer (EORTC 30853).

A total of 327 patients with metastatic prostate cancer have been randomized to either orchidectomy or treatment with goserelin (Zoladez) 3.6 mg depot preparation combined with flutamide (Eulexin) 250 mg t.i.d. in a phase III study (EORTC 30853). A small but statistically significant difference in time to subjective and objective progression of disease was found in favour of the combination treatment. However, time from objective progression to death was longer in the group initially allocated to orchidectomy. Thus no difference was found in overall survival between the two treatment groups. The clinical significance of these differences requires further follow up and analysis.

Aged

Zoladex and flutamide versus bilateral orchiectomy. A randomized phase III EORTC 30853 study. The EORTC GU Group.

A total of 327 patients with metastatic prostatic cancer were randomized to either bilateral orchiectomy or treatment with zoladex depot supplemented by flutamide 250 mg 3 qid. Statistically significant increases in time to subjective and objective progression were recorded in favor of the combination treatment. No differences in time to death by cancer or overall death were recorded. The clinical significance of these differences will be reassessed once additional follow-up is available and further analysis of the overall clinical material has been carried out.

Aged

Orchidectomy vs. Zoladex plus flutamide in patients with metastatic prostate cancer. The EORTC GU Group.

Treatment with bilateral orchidectomy was compared with Zoladex, 3.6 mg depot, plus flutamide, 250 mg t.i.d., in a randomized prospective study by the European Organization for Research and Treatment of Cancer (EORTC). Small but statistically significant differences in time to subjective and objective progression of disease were found in favor of Zoladex plus flutamide. However, time from objective progression to death was longer in the orchidectomy group. The clinical significance of these differences requires further follow-up and analysis. No difference was found in overall survival between the 2 treatment groups.

Aged

Ultrasonically guided prostatic biopsy: technical improvements.

Combining the use of a longitudinal real-time transrectal ultrasound scanner (Bruel & Kjaer 8537 7 MHz Sector Scan), an attachable puncture guide (Bruel & Kjaer UA 0875) and the Biopty-Cut apparatus (Radioplast), one can now easily perform all prostatic biopsies with ultrasonic guidance. We evaluated this method in 75 patients and found it to be a most elegant and accurate method for the histological diagnosis of prostate cancer.

Biopsy, Needle

[Echographic anatomy of the male urethra].

Sonographic urethrography is used as a new tool in understanding urethral pathology. Although a prospective study is necessary to demonstrate it, this examination seems to be complementary to retrograde Urethrography.

Humans

Antenatal diagnosis of urological disorders by ultrasound: a critical review.

The suspected diagnosis of urological disorders made on the basis of antenatal ultrasonography was compared with the final outcome in 23 cases. In 18 cases the initial diagnosis could be confirmed, whereas 5 showed no postnatal urological anomalies. Further efforts should be undertaken to improve prenatal diagnosis in order to facilitate treatment as early as possible.

Female

Radioisotopic transit parameters in obstruction of pelviureteral junction.

Cortical and whole kidney radionuclide transit parameters were studied in 16 patients who underwent a pyeloplasty for unilateral pelviureteral junction (PUJ) obstruction. As expected, the whole kidney mean transit time was found to be very sensitive but, due to the low specificity, not very helpful in the distinction between obstructed and nonobstructed kidneys. The cortical transit reflected, in some cases, the favorable surgical outcome. In other cases, however, it could not be considered as a reliable parameter of the clinical status, since it was found to be normal preoperatively and prolonged postoperatively in patients whose parenchymal function improved significantly after surgery and who had their clinical symptoms relieved.

Humans

Asymptomatic nephrocutaneous fistula: a report of 2 cases.

We report 2 rare cases of a spontaneous nephrocutaneous fistula. The diagnosis was made incidentally during hospitalization for other reasons. The role of calculus in the etiological pathogenesis of nephrocutaneous fistula is emphasized. Although classically surgical treatment is indicated a more conservative approach can be advocated in some asymptomatic cases.

Aged