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Biomedical subjects

F M Debruyne

Publications and source records attributed to F M Debruyne.

At least 397 records · Page 22Linked to original sources
PubMed1988

Urinary tract injuries in children: are they different from adults?

A retrospective study was carried out of 103 consecutive cases of urologic trauma in childhood. All data were compared with those of a study in 550 adult urological trauma patients to identify problems specific to the paediatric age group. Differences in anatomy and physiology make children more likely to sustain urological injury than adults, in cases of direct as well as indirect trauma. In childhood there is a significant higher incidence of preexisting renal disease. Assessment of urinary tract injuries in paediatric patients requires a higher index of suspicion and a broader indication for immediate radiographic evaluation. The therapeutic approach of urinary tract injuries in children should be identical to that in adults. The controversial renal lacerations can be managed medically (shallow renal lacerations) as well as surgically (major bleeding or extravasation, transsection of the kidney). Whenever possible, operation should be performed as an elective delayed procedure 2 to 6 days after injury. With this approach maximal renal salvation can be achieved without raising overall mortality and morbidity rates.

Adolescent↗
PubMed1988

TNM classification of genitourinary tumours 1987--position of the EORTC Genitourinary Group.

This report analyses the changes in the classification of the genitourinary tumours introduced by the 1987 edition of the TNM system. Criticism and suggestions for improvement are given. These are based on the extensive experience of the EORTC GU Group with clinical trial work particularly the identification of prognostic factors, on their success in reaching international consensus on tumour classification, and on information from the literature. Many of the changes introduced in the 1987 system are not considered to be strictly necessary. These include the introduction of the new additional descriptors, including "C" and "R", the changes in the T classification of prostatic and renal cancer, and the introduction of uniform N categories for all tumours and other features. We regret the omission of minimal requirements, the omission of the V classification for macroscopic or microscopic vascular invasion, the changes in the T categories of carcinoma of the bladder and the introduction of stage groupings for all urological tumours. Some of these changes are considered unacceptable. The attitude of the EORTC GU Group toward the use of the new TNM classification is indicated in detail.

Female↗
PubMed1988

Grading in superficial bladder cancer. (1). Morphological criteria.

In a prospective study on the grading of superficial papillary neoplasms of the bladder a distinction was made between tumours showing only increased cellularity without appreciable cellular and nuclear deviation (grade 1), tumours showing slight cellular variation (grade 2a), and tumours showing clear cytological deviation and a tendency to lose normal polarity (grade 2b). Ninety-one patients with a superficial tumour were followed up for a mean of 24 months. Grade 2a tumours recurred later and in fewer patients than grade 2b tumours. Progression was seen in 4% of grade 2a tumours and in 33% of grade 2b carcinomas. Adapting our results to the WHO grading system, we suggest that all tumours in this study defined as grades 1 and 2a should be classified as low grade and tumours defined as grade 2b should be classified as intermediate grade.

Carcinoma, Papillary↗
PubMed1988

Grading in superficial bladder cancer. (2). Cytogenetic classification.

Cytogenic analysis was performed in 92 newly diagnosed transitional cell bladder carcinomas and the results were correlated with the clinical course in superficial tumours. Low grade tumours appeared to have hypodiploid or peridiploid chromosomal numbers. Intermediate grade tumours were characterised by chromosomal counts up to the hyperdiploid range but could have a peridiploid modal number. In high grade tumours the modal number was hyperdiploid. The range in chromosomal counts appeared to be more reliable than the modal number as a predictor of the course of superficial tumours. The significant difference in chromosome numbers between low, intermediate and high grade tumours indicates that grading reflects major cytogenetic changes in the tumour cells.

Carcinoma, Transitional Cell↗
PubMed1988

Intravesical and intradermal Bacillus Calmette-Guérin application. A phase I study to the toxicity of a Dutch Bacillus Calmette-Guérin preparation in patients with superficial bladder cancer.

In 30 patients toxic side effects of Bacillus Calmette-Guérin (BCG) were evaluated after intradermal and intravesical administration. The BCG preparation (BCG-RIVM) was produced in a homogeneously dispersed culture yielding a relatively high number of culturable particles per milligram dry weight BCG. All patients had a history of recurrent multiple noninvasive superficial transitional cell carcinoma of the bladder, and were previously unsuccessfully treated with intravesical chemotherapy (epodyl and/or adriamycin). BCG-RIVM (1 X 10(9) culturable particles) was instilled in the bladder, in combination with intradermal BCG-RIVM (8 X 10(7) culturable particles) administration once a week for 6 consecutive weeks. BCG was applied intradermally by a multiple-puncture technique. During and after therapy, subjective and objective side effects and toxicity were registered. Hematology and blood chemistry, including hepatic and renal function, was monitored. Only minor toxicity and/or side effects were observed during therapy and for a period of 6 months after treatment. After a period of 7 days no significant amount of BCG bacteria could be detected in the urine of 24 investigated patients.

Administration, Intravesical↗
PubMed1988

Results of a Dutch trial with the LHRH agonist buserelin in patients with metastatic prostatic cancer and results of EORTC studies in prostatic cancer.

Superactive analogues of luteinizing hormone-releasing hormone (LHRH) have now widely been used in the management of metastatic prostate cancer. In a multicentric study, we have studied the effectiveness of buserelin in patients with previously untreated histologically confirmed metastatic prostate cancer. Fifty-eight patients were enrolled in the study and are now followed for at least 12 months. The treatment consisted of 500 micrograms buserelin administered subcutaneously (s.c.) 3 times daily for the first seven days and thereafter a thrice-daily dose of 400 micrograms buserelin administered intranasally (i.n.). A continuous reduction of testosterone to castrate levels could be obtained in all patients. The following objective responses were seen during the 12 months study period: 5 patients (8.6%) achieved complete regression after 3-10 months (mean 6.4 m); 24 patients (41.4%) achieved partial regression after 1-12 months (mean 4.5 m); 7 patients (12%) remained stable throughout the study; 22 patients (32.3%) developed progression after 2-12 months (mean 7.2 m). Toxicity was minimal. Only one patient dropped out of the study because of side effects. These results are comparable with results of other forms of hormonal treatment of prostate cancer. Long-term results of 3 EORTC GU group comparative studies in metastatic prostate cancer are now available. The first study, 30761, compared cyproterone acetate, medroxy-progesterone acetate, and DES. No differences between the 3 treatment arms were observed except for medroxy-progesterone acetate, which showed less therapeutic effect in the dosage used. Protocol 30762 compared DES and estramustine phosphate. No significant difference in objective response and survival was noted. Protocol 30805 studied a comparison between orchiectomy alone and orchiectomy supplemented by cyproterone acetate and DES. Again no statistically significant difference was found between the three therapeutic arms.

Aged↗
PubMed1987

Tissue-specific markers in flow cytometry of urological cancers. III. Comparing chromosomal and flow cytometric DNA analysis of bladder tumors.

Thirty-seven transitional-cell carcinomas (TCC) of the urinary bladder were analyzed by DNA flow cytometry (FCM). After labelling of the cell suspensions with antibodies to cytokeratin, the cytokeratin-positive cells and the non-epithelial cytokeratin-negative cells could be analyzed separately. After estimation of S- and G2M phase, 3/17 cases (18%) with a normal DNA index showed elevated proliferative levels, among cytokeratin-labelled suspensions only. Of these 17 cases, 14 showed chromosomal abnormalities. The remaining 20 cases were abnormal, irrespective of the technique used. Although immuno-labeling of tumor cells for cytokeratin in FCM increases the sensitivity of this method in detecting aneuploid tumors or tumors with high proliferation fractions, the discriminating power of chromosomal analysis of TCC is greater than FCM.

Carcinoma, Transitional Cell↗
PubMed1987

Comparison of tissue disaggregation techniques of transitional cell bladder carcinomas for flow cytometry and chromosomal analysis.

DNA index (DI) measurements and chromosomal analysis of 42 transitional cell carcinomas were done after mechanical and enzymatical disaggregation of the tumor specimens. The results obtained with these different disaggregation techniques were compared in the 33 cases (79%) that showed recognizable chromosomes. The enzymatically obtained cell suspensions could not be used for chromosomal analysis after short-term culture of 24 hours. In four cases, the DI after enzymatical treatment could not be estimated. In most cases, the DI obtained from the tumor cells was similar for both aggregation techniques, with the exception of four cases of enzymatically treated cell suspensions in which the DI could not be estimated. The average DI of the aneuploid tumors was 13% higher than the corresponding chromosome count. In 19% of the aneuploid tumors the proportion of aneuploid cells could not be measured after enzymatical treatment. In the remaining suspensions the proportion of diploid cells was higher after enzymatical disaggregation than after mechanical treatment. It is concluded that for flow cytometric and direct chromosomal analysis of bladder tumors, the mechanical disaggregation technique is most suitable.

Adult↗
PubMed1987

Expression of proto-oncogenes in xenografts of human renal cell carcinomas.

In a recent paper, we described the expression pattern of proto-oncogenes in primary human renal cell carcinoma [12]. To test the possibility of using xenografts as a useful alternative for such studies, we analyzed xenografts of a number of human renal cell carcinomas in nu/nu mice. Xenografts included RC2, RC14, RC21, RC43 and NC65. Northern blot analysis indicated that c-Ras was expressed in all these xenografts. The identity of the ras transcripts in the individual xenografts was further specified as c-Ha-ras, c-Ki-ras or N-ras. Expression of c-myc and the p53 gene was also found in a number of these tumors. Only RC21 failed to express the c-myc or the p53 gene. In all xenografts, a 3.0 kb c-fes/fps mRNA was present. In RC2, RC14, RC21 and RC43, low levels of the 4.8 kb ab 1 transcript were detectable. Transcripts of myb and sis could not be detected in any of the xenografts. The results indicated that the expression pattern of a variety of proto-oncogenes in xenografts of human renal cell carcinomas was similar to that in the primary tumors.

Animals↗
PubMed1987

Influence of ketanserin (serotonin antagonist) on bladder and urethral function.

As it is known that serotonin or 5-hydroxytryptamine can enhance bladder activity, we studied urodynamically the effect of ketanserin, a serotonin antagonist, in 17 patients, in the hope that this drug might be useful in treating unstable bladders. However, a relaxant effect on bladder contractility could not be demonstrated. On the contrary, a significant decrease of the urethral pressure was observed, suggesting that ketanserin might still have a possible role in promotion of bladder emptying. The relaxant effect on the urethra suggests some alpha-sympathicolytic activity of ketanserin.

Adolescent↗
PubMed1987

Cytogenetic analysis in urothelial cell carcinoma.

Tissue specimens from 96 patients with urothelial cell carcinoma were subjected to cytogenetic examination to determine whether there is a correlation between chromosomal abnormalities and tumor behavior. Recognizable metaphases were found in 43 patients (45 per cent). The range in chromosomal counts appeared to be a better reflection of invasion than the modal number. Noninvasive tumors nearly always were hypodiploid or diploid. All invasive tumors showed hyperploid cells. Cytogenetically, there was no difference between invasive grade 2 and grade 3 tumors. During our limited followup tumor progression was found only in tumors with hyperploid cells. With a direct technique we found no difference in the frequency of marker chromosomes according to tumor stage and grade.

Carcinoma, Transitional Cell↗