PubMed Health⌕ Search

Biomedical subjects

F M Debruyne

Publications and source records attributed to F M Debruyne.

At least 289 records · Page 16Linked to original sources
PubMed1992

Diagnosis and treatment of urological complications in kidney transplantation.

Between January 1973 and January 1990 we carried out 1,038 kidney transplantations using a transvesical end-to-side implantation of the ureter in the bladder without an antireflux mechanism. Moreover, 30 transplantations were done in 26 patients with a urinary diversion. We examined the urological complications in these 1,068 consecutive transplants. Urinary leakage and obstruction were the two main urological posttransplant complications. Severe leakage occurred in 21 patients (2.0%), and was treated by open surgery; 2 patients had a urinary diversion. The treatment of choice is a pyeloureterostomy (anastomosis between the transplant renal pelvis and the native ureter). There were 35 patients (3.3%) with severe ureteral obstruction of whom 5 had a urinary diversion. In 30 patients open surgical treatment of the obstruction was necessary and in 7 patients a percutaneous endourologic treatment was done (dilatation of a confined ureteral stricture in 6 patients and percutaneous stone treatment in 1). The postoperative mortality in the patients treated for leakage or obstruction was low: 4 patients (7%) died, 3 of septicemia due to leakage and 1 of pulmonary embolism after repair of the obstruction. The results of surgical treatment were good. The graft survival after 2 years in the group of urologically complicated transplants was 68% for the patients with leakage and 80% for those with obstruction. The 2-year graft survival in the patients without complications was 67% and 71% for the patients with a urinary diversion. We conclude from these results that urological complications after renal transplantation can be treated successfully by surgical (or percutaneous) correction.

Cystostomy↗
PubMed1992

Results of a questionnaire among Dutch urologists and general practitioners concerning diagnostics and treatment of patients with prostatitis syndromes.

By means of a questionnaire, all Dutch urologists (n = 250, 136 responded) and regional general practitioners (GPs; n = 400, 176 responded) were contacted concerning current diagnostics and treatment modalities applied in patients with prostatitis syndromes. The patients seen by urologists seem to be younger (30-40 years) and they mostly complain of pain in the perineum, penis or scrotum, while GPs see older patients (> 40 years) mainly presenting with micturition complaints. Urologists think nonbacterial causes (40%) most important, while GPs mention bacterial infections (63%) as the most important cause. The first choice of therapy is antibiotics, mostly co-trimoxazole Sulfatrim for 3 weeks, but patients seen by urologists are more resistant to this therapy. If not successful, urologists frequently prescribe a second course with antibiotics. However, many urologists think psychosomatic causes are an important factor in the etiology of prostatitis.

Family Practice↗
PubMed1992

Research in 'prostatitis syndromes': the use of alfuzosin (a new alpha 1-receptor-blocking agent) in patients mainly presenting with micturition complaints of an irritative nature and confirmed urodynamic abnormalities.

A double-blind, placebo-controlled study in 20 patients with 'prostatitis syndromes' and confirmed urodynamic abnormalities using the alpha 1-receptor-blocking compound alfuzosin is reported. Flow rate recordings are probably the most reliable and useful objective variables in this type of investigation. There is a significant beneficial effect in the group using an active compound concerning maximal flow (p = 0.01), flow time (p = 0.03) and time to maximal flow (p = 0.01). However, compared with the group using a placebo, only the change in the maximal flow rate appeared to be significantly different. Subjective effects were more pronounced in the alfuzosin group, but the spurious nature of the subjective observations is stressed. Based on objective parameters, alfuzosin seems to be effective compared to placebo in the treatment of these patients with micturition complaints of an irritative nature and urodynamic abnormalities, while only minor side effects were noticed.

Adrenergic alpha-Antagonists↗
PubMed1992

Value of biochemical markers in the management of disseminated prostatic cancer.

The biochemical markers alkaline phosphatase (Alk P), prostatic acid phosphatase (PAP) and prostate-specific antigen (PSA) were measured 3-monthly in 61 patients with disseminated prostatic cancer who were treated with LHRH analogues. The decrease in Alk P and PSA during the first 6 months of treatment was significantly related to a better survival. In this follow-up study, only PSA was useful for monitoring prostatic cancer during hormonal treatment. Before it was visible on a bone scan, PSA gave an indication of tumor progression. PSA might permit omission of routine bone scanning. Consensus must be obtained about the cost-saving use of biochemical markers in the treatment of disseminated prostatic cancer. With the number of treatment options increasing, objective measures are of utmost importance. Biochemical markers can be used for prognosis and monitoring of the treatment of patients with disseminated prostatic cancer.

Acid Phosphatase↗
PubMed1992

Identification of new prostate cancer progression markers by differential hybridization analysis.

In studies on the onset and progression of cancer, molecular biology has proven to be very useful. Reasoning that tumorigenesis can be considered as a multistep process in which a normal cell gradually escapes from its delicately regulated growth pattern, one might describe this process in terms of gene expression. The group of genes that are good candidates for such studies are the proto-oncogenes. Recent progress in oncogene research, however, has made us believe that the group of oncogenes is much greater than the 50 so far characterized, since all growth factor-, growth factor receptor-, signal transducer- and transcription-regulating genes have a potency to become oncogenic. Alternatively, recessive genes, such as tumor suppressor genes, might be equally relevant to the onset and progression of cancer. Therefore, new approaches in molecular studies on the genesis and progression of malignancies are urgently needed. One of these methods is the so-called differential or subtraction hybridization analysis. Particularly, the rationale of differential hybridization and the first applications to prostate cancer research are discussed in this paper.

Animals↗
PubMed1992

Impaired immune response by isoniazid treatment during intravesical BCG administration in the guinea pig.

At present, isoniazid (INH) is being used prophylactically to reduce the side effects of intravesical BCG therapy for superficial bladder cancer, although it is not clear whether or not this reduces the antitumor efficacy of BCG. In this study the impact of INH treatment on the immune response after repeated intravesical BCG administration was investigated in guinea pigs. INH was given during 3 days starting on the day prior to the BCG administration. It was found that the administration of INH severely impaired the immunological effects of BCG. The induction of mononuclear cell infiltration in the bladder wall was reduced. Enlargement of the regional lymph nodes (weight and number of cells), and increase of Major Histocompatibility Complex (MHC) class II expression on the lymph node cells, normally observed after intravesical BCG administration, were inhibited by INH. Systemic immunity, measured by the DTH reaction in the skin to PPD, was also diminished due to the combined treatment of BCG with INH. A five-fold increase of the dose of BCG did not overcome the effect of INH. INH probably did not exert a direct suppression of the immune system of the guinea pig as the DNCB skin reactivity was not influenced. Although INH concentrations in the urine were high at the onset of the instillation, in vitro experiments indicated that the effect of INH was probably not caused by killing of the BCG organisms shortly after application in the bladder. In conclusion, our data in guinea pigs suggest that the use of INH may impair the immune response to intravesical BCG. As this response may be important for the antitumor effect of BCG, urologists should be cautious with the prophylactic use of INH. The influence on the antitumor efficacy is now investigated in man.

Administration, Intravesical↗
PubMed1992

The value of laparoscopy in the management of the impalpable cryptorchid testis.

From January 1981 till October 1991, 47 diagnostic laparoscopies were performed in 50 impalpable testicles. In total, 28 intra-abdominal testes were found. In 14 cases no testes were found, but a deferential duct and vessels were seen. In 7 cases the diagnosis of testicular agenesia was made. One laparoscopy was a technical failure. We bring our results of this safe and reliable procedure, and discuss our management. A review of treatment options for intra-abdominal testes is given.

Child↗
PubMed1992

Treatment of stones in caliceal diverticula: extracorporeal shock wave lithotripsy versus percutaneous nephrolitholapaxy.

Stones in caliceal diverticula may cause symptoms for which treatment is indicated. Both extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolitholapaxy (PNL) are recommended. We have evaluated the results of ESWL treatment of stone-containing caliceal diverticula and compared these with the results obtained by percutaneous surgery. In the ESWL group, 15 patients were treated with an electromagnetic lithotriptor (Siemens Lithostar). After 3 months, plain abdominal X-rays revealed that only 2 patients were both stone-free and symptom-free. Of the 13 patients with residual fragments, 7 had no symptoms. The remaining 6 were treated by a lower pole resection (n = 3), a percutaneous procedure (n = 2) and long-term administration of antibiotics (n = 1). Sixteen patients were treated percutaneously. Puncture failed in 3 and they underwent a lumbotomy. In the remaining 13 patients the stones were reached by direct puncture (n = 12) or via an adjacent calix (n = 1). After 3 months, 10 patients were stone-free and had no symptoms. Morbidity consisted of post-operative bleeding (n = 3) and high fever (n = 1). It was concluded that caution should be exercised in the treatment of stone-containing caliceal diverticula. Only in symptomatic cases is treatment indicated and ESWL is the first choice. If ESWL fails (residual stones and persistent symptoms), PNL should be performed, although it is associated with a higher morbidity rate.

Diverticulum↗
PubMed1992

Psychological aspects of female urinary incontinence in general practice.

The aim of this study was to determine whether urge incontinence was associated with a higher prevalence of psychological symptoms than other types of incontinence. The psychological aspects of 110 women presenting with urinary incontinence in general practice were assessed by means of standardised questionnaires and medical history-taking. The results showed no difference in psychological characteristics between patients with urge incontinence and those with other types of incontinence. These findings were contrary to the conclusions of almost all other studies based on populations selected for specialist care. It was concluded that in general practice the psychological approach to urinary incontinence depends more on the individual needs of the patient than specifically on the type of incontinence.

Adult↗
PubMed1992

Ultrasonographic findings in patients with nonbacterial prostatitis.

The potential value of prostatic imaging in the diagnosis of inflammatory disorders of the prostate is largely unexplored. In several studies, specific ultrasonographic characteristics in patients with prostatitis have been described. Also nonspecific echogenic qualities in prostatitis have been pointed out. To evaluate ultrasound of the prostate in patients with nonbacterial prostatitis in this study, ultrasound images of these patients were compared with those of a healthy control group. In contrast with earlier findings, constant dilatation of the periprostatic venous plexus was seen more pronounced in the control group as well as elongation of the seminal vesicles. Finally, prostatic calcifications were frequently encountered in both groups.

Adult↗
PubMed1992

Establishment and characterization of five new human renal tumor xenografts.

Ten different human renal cell carcinoma (RCC) primary tumors were xenografted into BALB/c nu/nu mice. Five of the tumors (NU-10, NU-12, NU-20, NU-22, and NU-28) gave rise to serially transplantable tumors that were further characterized. Histology, DNA index, immunohistochemical characteristics, growth rate, and clonogenic potential were followed from primary tumor to the 5th to 15th transplant passage. Only one of the tumors (NU-20) showed remarkable instability for all tested parameters in the first five transplant passages. Histology of the other tumors was essentially the same to the histology of the primary tumors, although differences between human and host-derived vessels were apparent. DNA index values in general showed a trend toward an aneuploid character of the xenografts. Immunohistochemical analyses showed a loss of intensity of staining but a concomitant rise in the fraction of positively staining cells with antibodies against cytokeratins, vimentin, tumor-associated antigens, and human leukocyte antigen (HLA) class I antigens. Human leukocyte antigen class II antigen expression showed a loss of intensity as well as a decrease in the fraction of positive cells. Tumor doubling time was lowest in transplant passage number 0, and stable growth was noticed in transplant passages 1 through 4. Clonogenic potential of four of the lines was higher for the xenografts than for the primary tumors. The authors conclude that, on xenografting, histologic characteristics of the primary tumor are essentially conserved. Progression in the first transplant passages, however, results in tumors with a more aggressive character.

Adolescent↗
PubMed1991

HLA-class-I and -class-II expression on renal tumor xenografts and the relation to sensitivity for alpha-IFN, gamma-IFN and TNF.

In this study we evaluated the usefulness of the histocompatibility leucocyte antigen (HLA) class-I and class-II expression on renal-cell carcinoma (RCC) xenografts as predictive markers for response to cytokine therapy. Eight different RCC xenografts growing in BALBC nu/nu mice were treated with 0.5 or 5.0 ng/g recombinant human alpha- or gamma-interferon (IFN), or 500 ng/g recombinant human tumor necrosis factor (TNF). Modulation of HLA class-I, -II expression was evaluated immunohistochemically using the monoclonal antibodies (MAbs) W6.32 and B8.11.2 and at the mRNA level using the plasmids pDP001 and DR alpha 120. HLA class-I expression in all lines was upregulated by alpha- and gamma-IFN and was highest in the high-IFN-dose-treated tumors. TNF also stimulated HLA-class-I expression and up-regulated class-I expression still further when combined with IFN. Highest up-regulation of HLA-class-I in all tumors was measured in the alpha-IFN-5.0/TNF-500-ng/g-treated mice, although this was not necessarily the treatment regimen resulting in the most pronounced effect on tumor growth. Hence, maximum upregulation of class-I antigens at a given regimen was not always indicative for the highest achievable anti-tumor effect. HLA-class-II expression which was present on only 3 of the untreated tumors was up-regulated by both alpha and gamma-IFN. TNF itself did not up-regulate class-II expression but enhanced the class-II expression on the alpha-IFN-treated tumors but not on the gamma-IFN-treated tumors. Irrespective of the basic expression level, inducibility of both HLA-class-I and -class-II antigens appear to be correlated to the direct effects on growth of renal-tumor xenografts towards alpha-IFN, gamma-IFN and TNF. Modulation of HLA antigens was studied in the nude mouse, hence T-cell-mediated effector mechanisms cannot explain the good correlation between inducibility and response. Nonetheless, our studies indicate that the extent of modulation of HLA-class-I and -II can serve as predictive marker for response to cytokine therapy, which may serve as a valuable criterion for inclusion of patients in cytokine treatment regimens.

Animals↗
PubMed1991

Synergistic antitumor effects of rat gamma-interferon and human tumor necrosis factor alpha against androgen-dependent and -independent rat prostatic tumors.

We have examined the antitumor effects of rat gamma-interferon (IFN-gamma) and human tumor necrosis factor alpha (TNF) against androgen-dependent and -independent Dunning rat prostatic tumors. In vitro studies, using the double layer soft agar assay, showed a very limited antiproliferative activity of the drugs in the dose range tested (1-1000 units IFN-gamma and/or 1-1000 ng TNF/dish). For in vivo studies IFN-gamma and TNF were administered s.c., peritumorally. IFN-gamma was given 3 times/week, 8,000 or 80,000 units/rat, and TNF 5 times/week, 10 or 100 micrograms/rat. IFN-gamma and TNF monotherapy were not significantly effective in inhibiting tumor growth, except for IFN-gamma against the androgen-independent MatLyLu tumor. Combinations of IFN-gamma and TNF had synergistic antiproliferative effects against all four tumor lines tested; however, complete growth inhibitions could not be achieved. Survival studies showed significant increase in survival of tumor-bearing rats.

Androgens↗