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Biomedical subjects

F M Debruyne

Publications and source records attributed to F M Debruyne.

At least 325 records · Page 18Linked to original sources
PubMed1991

Nonbacterial prostatitis: a comprehensive review.

The term 'prostatitis' denotes a condition of inflammation of the prostate. Prostatitis is usually employed to describe any unexplained symptom or condition that might possibly emanate from a disorder of the prostate gland. The diagnosis of nonbacterial prostatitis is reserved for those patients with symptoms localized to the prostate, but without bacteria in the expressed prostatic secretion. The purpose of this article is to review etiology, pathology and the recent advances in diagnosis and therapy of nonbacterial prostatitis.

Humans↗
PubMed1991

Extracorporeal shock-wave lithotripsy for small symptomatic renal calculi: is it effective?

Renal calculi with a diameter of less than 5 mm can pass spontaneously. However, some patients have small symptomatic renal calculi for more than 3 months. We evaluated the results of extracorporeal shock-wave lithotripsy in 38 patients with such stones. Patients presented with loin pain, hematuria, infection, or a combination of complaints. Average stone size was 18 mm2. After a wait of 3 months for spontaneous evacuation without success, all patients were treated with a Siemens Lithostar. Three months after treatment, 19 patients (50%) were completely free of stones, but 7 still had complaints; of the 19 patients with residual fragments, 8 (42%) were free of complaints. Both evacuation and resolution of complaints were achieved in only 12 of the 38 patients (32%). We conclude that one should be reluctant to treat small renal calculi, because spontaneous evacuation occurs in about 80% and the results of treatment are restricted.

Adult↗
PubMed1991

Urethral sphincteric responses to sacral root stimulation.

Deafferentation and stimulation of sacral nerves in patients with complete spinal cord lesions is a good model to study the parasympathetic influence on urethral behavior. During intradural sacral deafferentation from S2 to S4/S5 in preparation for implantation of the Finetech-Brindley anterior sacral root stimulator, sacral roots were stimulated with 3 and 30 Hz and 3 and 10 V and the bladder and urethral responses noted. Stimulation of the posterior roots at 3 Hz gives a urethral relaxation without bladder contraction. At this frequency, anterior sacral root stimulation has no effect on bladder nor urethral pressure. Stimulation of the anterior roots at 30 Hz produces simultaneous bladder contraction and urethral relaxation. These findings support the presence of an afferent parasympathetic inhibitory mechanism in the spinal micturition center in the human.

Electric Stimulation↗
PubMed1991

Treatment of carcinoma in situ of the urethra with intraurethral instillations of bacillus Calmette-Guérin. Case report and review of literature.

We present the case of a 60-year-old man with carcinoma in situ of the urethra after previous successful radiotherapy of an invasive bladder tumor. Intraurethral instillations with bacillus Calmette-Guérin were given. In spite of initial success, recurrences developed after two courses of 12 intraurethral instillations, and radical surgery was performed. The use of bacillus Calmette-Guérin is reviewed with regard to the locations of superficial transitional cell carcinoma outside the bladder cavity.

BCG Vaccine↗
PubMed1991

Intravesical BCG administration in the guinea pig. II. Immunohistochemical characterization of cellular infiltrate after one or two cycles of intravesical BCG.

The intravesical administration of bacillus Calmette-Guérin (BCG) is used as an adjuvant therapy after transurethral resection for superficial bladder cancer in man. The aim of this study was to characterize with monoclonal antibodies the cellular infiltrates in the bladder wall occurring after one or two cycles, each comprising six weekly intravesical BCG administrations in guinea pigs. BCG-RIVM and BCG-TICE were instilled once a week in undamaged bladders at weeks 1-6 and 11-16, respectively, and retained in the bladder for 1 h. Autopsy was performed 1 week after the last BCG administration at weeks 7 and 17. By routine histology, a single BCG course induced scattered focal infiltrates consisting of minor to severe accumulations of mononuclear cells. After two cycles of BCG, a much more severe inflammatory reaction sometimes occupying almost the total bladder mucosa was noted. The major component of this inflammation was mononuclear cells, mainly lymphocytes, while typical BCG granulomas were occasionally observed. In general, the epithelial layer of the bladder showed no visible alterations. Immunohistochemical staining showed that the majority of mononuclear cells present in the infiltrate were T-cells. Widely scattered B-cells and macrophages were also present, but were much fewer in number than the T-cells. In general, T-helper/inducer cells were more frequent than T-suppressor/cytotoxic cells. Pseudofollicles, also noted after H&E staining, consisted mainly of B-cells. The second series of BCG administrations produced pseudofollicles in the infiltrates in all animals investigated.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Morphometry, densitometry and pattern analysis of plastic-embedded histologic material from urothelial cell carcinoma of the bladder.

An image analysis method of grading histologic sections of bladder carcinoma was tested. The method was new in four respects. First, for fixation of the biopsies a coagulant fixative was used. Second, 2-microns plastic sections were used to ensure the reproducibility of nuclear imaging. Third, a new stereologic approach was used for calculation of the nuclear volume and DNA content. Fourth, for the classification rule the morphometric, densitometric and texture features were used in concert. The IBAS 2000 instrument was used for the measurements. Texture analysis of the chromatin patterns was performed using Markovian texture features. Using discriminant analysis, of 22 parameters, 2 morphometric, 2 densitometric and 3 texture features were selected for the classification rule. With them, 89% of the bladder carcinomas were correctly classified into the three grades. All grade III tumors were classified correctly. Among the features tested, the densitometry of the DNA had the highest F values. All of the grade III tumors and 45% of the grade II tumor group had DNA histograms indicating aneuploidy. This study showed that plastic-embedded material is well suited to morphometry and densitometry and can be used for quantitative grading of bladder carcinoma.

Carcinoma, Transitional Cell↗
PubMed1991

Controlled trial of pelvic floor exercises in the treatment of urinary stress incontinence in general practice.

The aim of this study was to assess the usefulness of pelvic floor exercises in the treatment of urinary incontinence in women and to analyse the factors which determine a successful outcome. The study involved 66 women who had reported 'genuine stress incontinence' to their general practitioner. They were assigned at random to the treatment or control group. The treatment group received instructions in pelvic floor exercises from a general practitioner. The control group received no therapy. At the start of the trial the severity of the patients' incontinence was assessed objectively. This assessment was repeated after three months and patients were also asked for their own perception of whether their incontinence had improved. After the three months' evaluation the patients in the control group were also given instructions in pelvic floor exercises. After another three months they were assessed in the same way. About 60% of the patients in the treatment group were dry or mildly incontinent after three months compared with only one patient in the control group; the mean weekly frequency of incontinence episodes fell from 17 to five in the treatment group but remained virtually unchanged in the control group; and about 85% of the women in the treatment group felt that their incontinence had improved or was cured compared with no one in the control group. These results were later corroborated by those for the control group. The most important factor in the success of the treatment was the patients' motivation, as demonstrated by their adherence to the daily exercises.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Molecular biology studies of bladder cancer].

The mechanisms that control the biological behaviour of urothelial cancer are complex, and many regulative interactions are involved. So far, few aspects of these control mechanisms have been recognized and characterized. A precondition for better understanding is knowledge the interaction of this factors. Some markers (e.g., chromosomal aberrations, EGFR expression) are correlated with progression of tumour. Whether they are the cause or the result of the aggressive behaviour of growth remains unknown. Only a few markers, especially in flow cytometry, will have any benefit in clinical routine. Whether it is possible to find a marker with prognostic value remains uncertain.

Aneuploidy↗
PubMed1991

Audex Medical, a new system for digital processing and analysis of ultrasonographic images of the prostate.

By transrectal ultrasonography the volume of the prostate is determined two times using the conventional planimetric method. Thereafter the US scanner is placed in a fixture which is retracted repeatedly. For this a motordrive has been developed. The images of each section are improved by digital processing, and the prostatic outline is determined interactively by developed image processing software. In this manner the total volume of the prostate is calculated. In a post-mortem study prostates of 9 cadavers were measured with the conventional planimetry and by means of digital processing and analysis. The results were compared with the results obtained after removal of the prostate. In a clinical study the prostatic volumes of 20 patients were measured in a similar way. The results of the two methods are compared. Both in the cadaver study and the patient study we found a good correlation between the conventional method and the computerized method. In the cadaver study we noticed a better correlation between the prostatic volume found with the computerized method and the volume obtained after prostatectomy. Also the reproducibility of this method turned out to be better.

Humans↗
PubMed1991

[What are the contributions of experimental studies to the diagnosis and therapy of urological tumors?].

The contribution of experimental research in the diagnostics and therapy of urological malignancies is based on different approaches. One of the most important techniques is the development of tumor markers which can predict progression of the tumor. These markers can be detected by molecular biological techniques, by immunohistochemistry or by other quantification techniques such as morphometry and flowcytometry. New indications for progression are initially researched in tumor model systems. The in vitro systems are extremely well suited for those fundamental studies especially molecular biological analysers, because the tumors in these systems are homogeneously composed and lack the heterogeneity of in vivo tumors. The methodology of markers developed by such techniques have subsequently been tested on human tumor material of which the evolution was known (retrospective analyses). Animal models can also contribute to fundamental research in urological tumors, more particularly to evaluate the efficacy of new experimental therapeutic approaches. Therapies with proven effect in the animal models have to be tested subsequently in humans and if effective, have to be investigated further to improve the dose- and/or route of administration. One result of such research is the use of immunotherapeutics in metastatic renal cell carcinoma. Basic research in oncological urology may in this way contribute to the further improvement of the diagnosis and treatment of urological malignancies.

Animals↗
PubMed1991

[Inductive chemotherapy of bladder cancer. A critical evaluation].

Cisplatin-based inductive chemotherapy can induce remissions of locally invasive bladder cancer; these can be observed after two cycles of chemotherapy. Non-transitional cell carcinomas of the bladder do not respond to this therapy. The toxicity of inductive chemotherapy is acceptable. The clinical staging after inductive or neo-adjuvant chemotherapy does not correlate with the pathological staging after cystectomy. This discrepancy indicates that bladder preservation after inductive chemotherapy will not be possible until the diagnostic methods are improved enough to correlate exactly with the pathological findings. Many questions remain open with respect to this form of treatment of locally advanced bladder cancer. This is why patients should only be treated with inductive or neo-adjuvant chemotherapy within the context of controlled prospective clinical trials. On the basis of our current knowledge inductive chemotherapy cannot be considered as a definitive form of treatment for locally invasive bladder tumours.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

A new extra long acting depot preparation of the LHRH analogue Zoladex. First endocrinological and pharmacokinetic data in patients with advanced prostate cancer.

A new depot formulation of the LHRH analogue Zoladex (goserelin acetate) has been developed which releases the drug over a period of at least 3 months as judged by measurement of drug content in depots at intervals after insertion in male rats and by the suppression of oestrogen secretion and oestrus in female rats. This formulation is based on the lactide/glycolide polymer system used for the standard 1-month Zoladex depot, but the dose has been increased to 10.8 mg and the characteristics have been modified to enable a longer release of drug to be achieved. Thirty-eight patients with histologically proven, locally advanced (stage T3 or T4) and/or metastatic prostate cancer were treated with this new longer acting LHRH analogue depot formulation containing 10.8 mg Zoladex. After initial increase of serum testosterone in the first week of therapy, castration levels were reached in all patients after 4 weeks and this was maintained for more than 14 weeks. At the time of depot exhaustion, when escape from castration levels of androgen occurred, all patients received a single injection of a standard 1-month depot containing 3.6 mg Zoladex which restored castration levels of androgen thus showing that the pituitary gland was again suppressed. The tolerance and acceptability of the longer-acting depot is high and comparable to the 1-month depot. Taking into account social and psychological factors, patients with advanced prostate carcinoma will soon be able to be treated with a longer acting LHRH depot formulation every 3 months an alternative of the 1-month depot now widely used clinically.

Aged↗
PubMed1990

Analysis of prognostic factors in disseminated prostatic cancer. An update. Dutch Southeastern Urological Cooperative Group.

A statistical analysis of prognostic factors in 175 patients with hormonally treated disseminated prostatic cancer was done. The prognostic significance of performance status (PS), hemoglobin (Hb), alkaline phosphatase (Alk P), and testosterone was assessed with a univariate analysis. The authors did not find significant prognostic value in age, tumor size or grade, prostatic acid phosphatase, and prostate-specific antigen in these patients. In a multivariate logistic model (Cox regression), PS, Hb, and Alk P were found useful for dividing patients into prognostic groups. The prognosis for high-risk patients on standard hormonal treatment was very poor. The authors concluded that research on prognostic factors is useful and permits a division of patients into risk groups that makes choice of treatment more accurate. The use of new treatment combinations as a start treatment is appropriate for high-risk patients with disseminated prostatic cancer.

Acid Phosphatase↗
PubMed1990

[The treatment of kidney and ureteral stones using a second-generation kidney stone lithotriptor].

In January 1988 a Siemens Lithostar lithotriptor was installed in the Radboud University Hospital in Nijmegen. Over 1600 treatments have been performed since. The results of 582 treatments of the first 500 patients are discussed. After three months 51.3% of the patients were free of stones. After six months this percentage was 64.5 and in addition 25.4% of the patients were free of symptoms although residual particles were still present. In only 10.1% of the patients did the ESWL treatment not succeed. In over 50% of the cases treatment was performed on an outpatient basis. Among 90% of the patients in whom treatment was performed without auxiliary procedures only 50% needed i.v. sedation or analgesia. The other 50% did not need any form of sedation or analgesia. Major complications did not occur although 376 patients (75.2%) suffered from a short period of haematuria and many patients had a skin lesion. With the possibility of outpatient treatment, the use of less anaesthesia and a success rate of 89.9% (residual stones, less than 5 mm in diameter, which can be evacuated spontaneously) after six months, the Lithostar is an improvement in the treatment of urolithiasis.

Adolescent↗
PubMed1990

[Transrectal echography of the prostate and its value in screening for prostatic carcinoma].

In order to assess the value of ultrasonography in the diagnosis of prostatic carcinoma we investigated 130 men, above the age of 50, with both ultrasound and rectal examination in a prospective study. Both investigations were performed independently from each other. When either ultrasonography or rectal examination indicated the presence of malignancy a transrectal prostatic biopsy was performed. Biopsies were taken in 72 (55%) patients. In 33 (46%) of these a carcinoma was diagnosed after histologic examination. Additional histological diagnostic data were obtained on 22 patients on whom a transurethral prostatic resection or open prostatectomy was performed. In 70% ultrasonography and rectal examination gave identical results with respect to diagnosis of carcinoma. Ten out of 33 carcinomas were detected by either ultrasound alone (n = 6) or rectal examination alone (n = 4). The advantages of ultrasound investigation include detection of non-palpable tumors, more correct staging and improved technique of ultrasound guided biopsy.

Aged↗
PubMed1990

Effects of high-energy shock waves combined with biological response modifiers or Adriamycin on a human kidney cancer xenograft.

We have studied the effect of high-energy shock waves (HESW) alone or in combination with biological response modifiers (BRMs) or Adriamycin on the growth of the NU-1 human kidney cancer xenograft. When HESW are administered repeatedly (four sessions of 800 shock waves on days 0, 2, 4 and 6) a prolonged delay in tumor growth was found compared with that following a single administration. This effect was temporary, and several days after stopping the HESW administration the tumor regained its original growth potential (same doubling time). Tumor growth was suppressed for a longer period by the combination of 4 sessions of HESW and a single administration of Adriamycin, 5 mg/kg. Combination of HESW treatment with interferon alpha (5.0 ng/g body weight, three times/week) and tumor necrosis factor alpha (500 ng/g body weight, 5 days/week) s.c. around the tumor resulted in a complete cessation of tumor growth. While Adriamycin had an additive effect on HESW treatment, the combination with BRMs was highly synergistic.

Animals↗