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Biomedical subjects

F M Debruyne

Publications and source records attributed to F M Debruyne.

At least 379 records · Page 21Linked to original sources
PubMed1989

A practical guide to the use of intravesical BCG for the management of stage Ta, T1, CIS, transitional cell cancer.

Intravesical instillations of BCG are effective in preventing tumor recurrence, eliminating existing tumor and treating CIS in a substantial number of patients. As with any type of therapy, side effects can occur. Because a live organism is being used, care must be taken in the handling and administration of the product. Patients should be informed about the common types of reactions so that these may be reported to the urologist. In turn, the urologist must decide if the treatment plan needs to be modified or the patient started on medications which can prevent or reduce the severity of the side effects. At times a decision must be made regarding withholding or delaying treatment and there are situations when BCG should be stopped.

Administration, Intravesical↗
PubMed1989

Replacement of the early-control IVU after ureteral reimplantation by ultrasonography.

Many intravenous urographies (IVU) are still made shortly after ureteral reimplantation as a routine procedure to evaluate the function of both kidneys and to exclude a severe distal ureteral obstruction known as a complication of the operation (Broaddus et al., 1978). By studying two groups of patients we present an evaluation of the use of this IVU and the possible replacement by ultrasonography (US). The first group consisted of 119 cases with 155 reimplanted ureters. All of the patients underwent an IVU within two weeks and again three months after the operation. The second group included 35 patients, who underwent 55 reimplantations: US of the kidneys was performed within two weeks and three months and also one year after operation. In the first group three patients needed a second reimplantation because of a developed distal ureteral stenosis after three months. The second IVU showed severe dilatation in all of them. In two patients of the second group we also saw an increase in dilatation during follow-up within three months, for which a ureteral reimplantation was indicated. There was not a single case in which the outcome of the early IVU or US gave rise to a serious change in postoperative management. Our conclusion is that the early postoperative IVU, should be replaced by US of the kidneys, the result of which should function as a baseline for further follow-up studies.

Adolescent↗
PubMed1988

Differential expression of keratins in the basal and luminal compartments of rat prostatic epithelium during degeneration and regeneration.

The role of the different epithelial compartments during degeneration and regeneration of the rat prostate is examined on basis of intermediate filament protein (IFP) expression pattern. With the monoclonal antibodies RCK 103 and RGE 53, directed against specific keratins, it was possible to differentiate between the basal (RCK 103+) and luminal (RGE 53+) cells of the prostatic epithelium. After testosterone deprivation, by orchiectomy, an extensive and rapid cell loss was observed which appeared to affect mainly the luminal cells. In the process of prostate regeneration, induced by testosterone administration, using silastic implants, the luminal compartment rapidly regained its normal thickness. A heterogeneous population of morphologically luminal cells was observed showing keratin expression patterns intermediate between basal and luminal cells. These findings support the idea of a relationship between basal and luminal cells as being members of the same lineage of differentiation.

Animals↗
PubMed1988

Effectiveness of ultrasound in the preoperative evaluation of patients with prostatism.

To avoid the disadvantages of intravenous urography (IVU) and urethrocystoscopy (UCS), we investigated prospectively their replacement by ultrasound, performed during one visit in the outpatient department, in the evaluation of patients with symptoms of prostatism. One hundred twenty patients (aged 44-89 years) were included in this study. All patients underwent two main diagnostic procedures: ultrasound of the kidneys and bladder and transrectal ultrasound of the prostate (procedure A1). This was compared with IVU and UCS (procedure A2). Following procedure A1, the main diagnoses made were benign prostatic hypertrophy in 84 patients, prostatitis in 24 patients, and prostatic cancer in 12 patients. By following procedure A2, the diagnosis was changed in 20 cases. Fourteen patients had a bladder neck sclerosis, and six had a urethral stricture. There was no relevant diagnostic difference between IVU and ultrasound of the kidneys and bladder. Ultrasound of the prostate gives better information on prostatic abnormalities than does IVU or UCS. A patient with prostatism can be screened completely during one visit at the outpatient department. Only for detection of bladder neck sclerosis and urethral strictures does UCS remain preferable.

Aged↗
PubMed1988

Alpha and gamma interferon in the treatment of advanced renal cell carcinoma.

Thirty-two patients with proven progressive metastatic renal cell carcinoma were treated with the combination of 0.1 mg/m2 (2 X 10(6) IU/m2) r-interferon (r-IFN)-gamma and 6 micrograms/m2 (2 X 10(6) IU/m2) r-IFN-alpha. In case of progressive disease (PD) or stable disease (SD), after 8 weeks, the dose of r-IFN-alpha was escalated by 6 micrograms/m2 every 2 weeks until the maximum tolerable dose was reached, while r-IFN-gamma was maintained at the low dose. The rationale for this study is provided by the dose-related efficacy of IFN-alpha as a monotherapy, the potent immunostimulatory activity of IFN-gamma, and the alleged synergistic effect of the combination. Fourteen patients are evaluable for 8 weeks of low-dose combination treatment (7 X SD, 5 X PD, 2 X early progression), while so far 6 of 24 patients (25%) who started dose escalation of IFN-alpha have reached a partial response. These data indicate better efficacy with higher doses of IFN-alpha. Because of the infrequent administration and the relative low doses, compared to other trials, the treatment regimen was well tolerated. Although preliminary results are promising, definite efficacy remains to be proven.

Adult↗
PubMed1988

Effect of alpha- and gamma-interferon and tumor necrosis factor on colony formation of two human renal tumor xenografts in vitro.

The in vitro antitumor activity of alpha- and gamma-interferon as well as tumor necrosis factor was tested on two human renal cell carcinoma xenografts--RC-43 and NC-65. A dose-dependent inhibition of colony formation in soft agar was found for both tumor lines. NC-65, however, showed no sensitivity for gamma-interferon. Combination drug tests showed a synergistic effect on colony formation of both tumor lines. The strongest inhibition was shown by the combination of alpha-interferon and tumor necrosis factor. We conclude that both interferons as well as tumor necrosis factor show direct in vitro cytostatic effects against renal tumor direct in vitro cytostatic effects against renal tumor cells.

Animals↗
PubMed1988

In vitro antiproliferative efficacy of interferon-alpha, -gamma and tumor necrosis factor on two human renal tumor xenografts.

The in vitro antitumor activity of recombinant alpha- and gamma-Interferon as well as recombinant Tumor Necrosis Factor alpha was tested on renal cell carcinoma xenografts using the double layer soft agar method. Using this assay, the effect of the drugs on the clonogenic potential of tumor cells in soft agar was determined and used as an indication for the antiproliferative capacity of these drugs. There appeared to be a differential response of the tested xenografts towards these drugs in a dose dependent way. However, when used in combination in most cases an additive or synergistic effect was observed. Even though again the response was differential, the combination of alpha-Interferon (10 ng/dish) and Tumor Necrosis Factor (100 ng/dish) resulted in a complete inhibition of colony formation in soft agar for both tumor lines. We conclude that there is a direct effect of alpha-Interferon, gamma-Interferon and Tumor Necrosis Factor on renal cell carcinoma xenografts. In combination drug tests the effect of alpha-Interferon and Tumor Necrosis Factor was strongly synergistic. The implication of these studies for in vivo use of these drugs remain to be established.

Animals↗
PubMed1988

Intravesical BCG administration in the guinea pig. A histomorphological study.

Intravesical BCG administration is used as an adjuvant therapy after transurethral resection for superficial bladder cancer in man. The mechanisms of its antitumor activity are not known. The aim of this study was to characterize the histomorphological changes in various organs of the guinea pig after intravesical BCG administration. The BCG preparation used was BCG-RIVM, a Dutch BCG preparation. Instillations were performed in previously undamaged bladders weekly for 6 consecutive weeks and lasted 30 min or 1 h. Different doses were used ranging from 10(3) culturable particles (c.p.) to 5 x 10(7) c.p. of BCG. After 6 weeks, the animals were killed and postmortem examination was performed. The bladder wall, retroperitoneal lymph nodes, spleen, liver, lungs and distant lymph nodes were examined histologically. The BCG therapy, with a dose of 10(6) culturable particles and higher, induced an inflammatory reaction consisting of mononuclear infiltrates in the subepithelial tissue of the bladder wall. In approximately 50% of the animals investigated, the infiltrates were accompanied by non-caseating granulomatous lesions indicated by the presence of epithelioid cells. In general, the epithelial layer of the bladder showed no visible alterations. Similarly, a granulomatous inflammatory reaction was observed in the first retroperitoneal (iliac) lymph nodes draining the bladder. Granulomatous lesions were occasionally also present in liver and lung. In three of the 29 animals investigated, lesions were present both in liver and lungs, and in two of these three animals a granulomatous reaction was observed in the spleen and distant lymph nodes indicating a generalized inflammatory response induced by BCG.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Renal injury management: no longer controversial.

Optimal management of renal injuries used to be a subject of controversy between the advocates of 'early intervention' and 'expectant' approach. Nowadays, most opinions have blended into a consensus for all but a small number and type of renal injuries. The purpose of this study was to investigate if the therapeutic approach in renal injuries is no longer controversial. We report the long-term results in 622 consecutive patients with renal injury, admitted to the University Hospital St Radboud in Nijmegen, The Netherlands, between 1972 and 1983. During this 11-year period a middle-course management was followed relative to indication and timing of operative intervention. This type of approach proved quite successful not only in reducing the nephrectomy rate but at the same time in lowering the incidence of early and late complications. It is concluded that choice and timing of therapy in renal injuries should depend on: 1. Accurate diagnosis of the extent of the renal injury, 2. Associated major injuries and 3. Clinical condition of the patient. Such an individualized approach most benefits the patient.

Adolescent↗
PubMed1988

Rational guidelines in renal trauma assessment.

Optimal management in renal trauma necessitates an adequate delineation of location and extent of the renal injury. However, as a result of the rapid rise in the costs of medical care, a complete and elaborate radiographic evaluation of all patients with suspected renal injury no longer seems justified. We reviewed our experience with 622 consecutive cases of renal injury to find the most economical diagnostic sequence with the clearest findings. An intravenous pyelography (IVP) still is the first and mostly the sole examination to do in patients with clinical or laboratory evidence of renal trauma. Microscopic hematuria alone is no longer an indication to perform urography. If indicated, an IVP should be performed as an emergency procedure in all cases and especially in the patient with multiple trauma. Children are more susceptible to renal trauma and require a higher index of suspicion. In the few patients with indeterminate findings on urography, renal angiography must be considered (especially when renal pedicle injury is suspected) or a computerized tomography (CT) scan (especially in the patient with multiple trauma). Ultrasound and CT examinations are not to be done on a routine basis in the initial assessment or the follow-up of renal trauma.

Adolescent↗
PubMed1988

Can combined DES and LHRH depot therapy (ICI 118630) prevent endocrinologic and clinical flare-up in metastatic prostate cancer?

Medical castration obtained with luteinizing hormone releasing hormone (LHRH) analogues in patients with prostate cancer is now well established. To block the initial stimulation of testosterone production and prevent the risk of the so-called flare-up with this medication, we investigated short-term combination therapy with 1 mg of diethylstilbestrol (DES). Fourteen previously untreated patients with histologically proved metastatic prostatic carcinoma were treated with 1 mg DES po daily one week prior to the initiation of therapy with LHRH analogues depot injection of Zoladex (ICI 116630) and continued during four weeks after the first depot injection. LHRH depot form was maintained as long as patients experienced clinical benefit. Endocrinologic results show that in spite of 1 mg of DES a significant increase of testosterone is still observed in the first week after injection of the LHRH depot form. Hence, this combination is not useful to prevent endocrinologic and clinical flare-up in patients with prostate cancer treated with LHRH analogues.

Aged↗
PubMed1988

Long-term therapy with a depot luteinizing hormone-releasing hormone analogue (Zoladex) in patients with advanced prostatic carcinoma.

We treated 191 patients with histologically proved locally advanced stage (T3 or T4) and/or metastatic prostate cancer with a biodegradable depot formulation of a luteinizing hormone-releasing hormone analogue (Zoladex). After an initial increase in serum testosterone in week 1 of therapy a continuous decrease of testosterone to castrate levels was obtained. With a monthly injection of the luteinizing hormone-releasing hormone analogue 4 patients (2 per cent) experienced a transient increase in bone pain, 1 had ureteral obstruction and 1 suffered paraplegia during the first few weeks of therapy. Over-all objective and subjective responses were similar to those obtained by castration or estrogen therapy. The absence of local and systemic (long-term) side effects proves the validity of this approach for patients with advanced prostatic cancer.

Aged↗
PubMed1988

Blood group isoantigen deletion and chromosomal abnormalities in bladder cancer.

The presence or absence of blood group isoantigens in 78 patients with transitional cell carcinoma of the bladder was correlated with tumor stage and grade, and results of chromosomal analysis. For blood group isoantigen detection the indirect immunoperoxidase method with monoclonal antibodies to A, B and H antigen was used. In 51 per cent of the 59 superficial tumors blood group isoantigens were demonstrable, whereas all deeper infiltrating and higher grade tumors were negative. However in superficial tumors the mode of blood group isoantigen expression did not correlate significantly with tumor recurrence and progression. A consistent correlation was demonstrated among chromosomal numbers, tumor grade and clinical course. The chromosomal abnormalities found and mode of blood group isoantigen expression, even in combination, had no prognostic value additional to the grading criteria used.

ABO Blood-Group System↗