PubMed Health⌕ Search

Biomedical subjects

Imre Romics

Publications and source records attributed to Imre Romics.

At least 19 recordsLinked to original sources
PubMed2006

[Experiences with radical cystectomy combined with urinary diversion by ureteral sigmapouch (Mainz-pouch II) in bladder cancer patients].

INTRODUCTION: The tumour of the bladder is the third most frequent urological malignancy. Muscle invasive cancer can be cured by radical cystectomy. After removing the bladder; a sufficient urinary diversion should be performed. AIM AND METHOD: The authors introduce the operative process of the pouch and their experiences with the procedure. The analysis of results were performed retrospectively. RESULTS: Between 1998 and 2005 the authors performed radical cystectomy in 76 patients followed by: Mainz pouch II urinary diversion. The average age of the patients was 59.8 (20-78) years. The distribution by gender was: 58 male, 18 female patients. The average pathological T stage was 2.3; 22 patients (29%) had metastatic lymph nodes. 94% of the cases were transitional cell cancers, 3 (4%) of them had adenocarcinoma and one leiomyosarcoma. Reoperation was carried out in 7 cases (9.2%) because of wound healing defects, and one patient was reoperated because of bleeding and ileus respectively. Transitionally nephrostomy was performed in 5 cases (6.5%) because of upper urinary tract dilatation due to a stricture of ureter anastomosis. The average survival period was 24.4 (1-98) months. CONCLUSION: Urinary diversion Mainz pouch II provides for safe, continent diversion requiring no urine bag; with an acceptable QL (quality of life). On the basis of the low number of complications and the acceptable QL; the authors consider this method as appropriate.

Adenocarcinoma↗
PubMed2006

[Prostate cancer].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed2006

E-cadherin expression in transitional cell carcinomas.

The authors analyzed the expression of E-cadherin, one of the most important cell adhesion molecules, on histological slides of tumors of bladder cancer patients. The aim of the study was to see whether there is any association between E-cadherin expression and tumor grade, stage, age and gender of the patients, number of recurrences, or overall survival. The samples were examined in 51 primary bladder transitional cell carcinomas (TCC) of 50 patients, resected by transurethral resection (TUR) between January 1, 1996 and January 1, 1997. Immunoreactions were performed with monoclonal anti-human E-cadherin antibody. Forty of the fifty patients could be clinically followed. The analysis of the results on these forty patients was performed by contingency analysis and significance was assessed by chi2 test. No significant association between E-cadherin expression and tumor grade, stage, age or gender of the patients, the number of recurrences, or overall survival could be seen.

Adult↗
PubMed2006

[Our results with radical retropubic prostatectomy in the first hundred patients].

INTRODUCTION: The most used treatment of localised prostate cancer is: retropubic radical prostatectomy. OBJECTIVE: The authors present their own results, on the basis of detailed discussions of 100 cases and compare them with international ones. METHODOLOGY: The authors analyse the data of 100 radically operated patients suffering of localised prostate cancer. The indication of the operations was based on the results of rectal digital examinations, serum PSA concentration levels and ultrasound guided, rectally performed, prostate biopsies. The average preoperative PSA level was 13.6 ng/ml; the mean age of the patients was 61.1 years. They analyse the early and late complications. They follow up the patients on a regular basis assessing the PSA level, continence and potency. RESULTS: The operation time, blood loss, amount of blood transfusion all decreased linearly during operations performed between 1998 and 2005. The longest period of follow up lasted for 70 months; the shortest lasted for 5 months. None of the patients died in the course of an operation or in 30 days following it; they lost one patient 18 months after the operation because of progression. From the late complications: in 22% of all cases they noticed anastomotic stricture constrictions which were resolved by urethrotomy. From all patients: 86% are fully continent; the rest mostly have grade 1 incontinence (requiring 1 pad per day). Altogether 18% of all patients have retained their potency without the use of drugs or appliances. CONCLUSIONS: The results are comparable to international data and are in harmony with them. Therefore early recognition and radical surgery of prostate tumors would be advisable.

Aged↗
PubMed2006

[Chromosomal disorders in the background of azoospermia].

INTRODUCTION: Nowadays more and more couples face the fact that they cannot have babies in spite of many years of trying. The male factor can be identified in about half of these cases. AIM: The aim of this study was to analyse chromosomal alterations in patients with azoospermia. These patients may be candidates for testicular sperm retrieval and intracytoplasmatic sperm injection. MATERIALS AND METHODS: Preoperative evaluation included routine andrological investigation with 2 semen analysis, ultrasound, hormonal and genetic examination. Traditional histological examination and embryological diagnostic of tissue samples was performed. Cryopreservation of retrieved testicular tissue was also done. Between January 2001 and June 2005 73 biopsies were performed in 71 patients for testicular sperm extraction. In order to obtain an exact diagnosis, the traditional cytogenetic methods and fluorescence in situ hybridization analyses were performed in combination with molecular genetic techniques. Patients were offered to participate in the assisted reproduction programme on the base of their genetic results. RESULTS: In this study, the most characteristic cases were numerical deviations, such as 47,XXY (2 cases), mosaic 47,XXY/49,XXXXY (1 case), 47,XYY (1 case) and mosaic 46,XY/45,X (1 case) karyotypes. Non-obstructive azoospermia was diagnosed in 53 patients (79%). CONCLUSIONS: Authors emphasised the importance of cyto- and molecular examinations in cases of genetical disorders. The results provide a chance for patients to be spared from long-drawn moreover psychological burdening examinations. In addition the costs of different clinical intervention could be saved too.

Adult↗
PubMed2006

Urinary incontinence and voiding dysfunction after radical retropubic prostatectomy (prospective urodynamic study).

AIMS: During this prospective study we analyzed the effects of radical retropubic prostatectomy (RRP) on bladder and sphincter function by comparing preoperative and postoperative urodynamic data. The aim of the study was to determine the reason for urinary incontinence after RRP and explain why one group of patients will be immediately continent after catheter removal, while others need some time to reach complete continence. METHODS: Urodynamic examination was performed in 63 patients 3-7 days before and 2 months after surgery. RESULTS: Forty-three (68.2%) and 53 (84.1%) patients regained continence at 2 and 9 months following RRP, respectively. Ten patients (15.9%) were immediately continent after catheter removal. Urodynamic stress incontinence was detected in 18 (28.6%), and detrusor overactivity incontinence in 2 (3.2%) patients 2 months after surgery. The amplitude of preoperative maximal voluntary sphincteric contractions was significantly higher in the postoperative continent group (125 vs. 96.5 cmH(2)O, P < 0.0001). The patients who were immediately continent following catheter removal had no lower urinary tract symptoms (LUTS) and urodynamic abnormality preoperatively, and they had significantly higher preoperative and postoperative maximum urethral closure pressure (at rest and during voluntary sphincter contraction) than those who became continent later on. CONCLUSIONS: These data suggest that the main cause of incontinence after RRP is sphincteric weakness. In the continent group, those who became immediately continent had significantly higher maximum urethral closure pressure values at rest and at voluntary sphincteric contraction even before the surgery.

Aged↗
PubMed2006

A novel approach to the treatment of benign prostatic hyperplasia.

OBJECTIVE: To assess the clinical efficacy and safety of the combined alpha1- and postsynaptic alpha2-blocker GYKI-16084 compared to placebo during a 28-day active treatment of patients with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: After a 28-day placebo run-in phase, 7.5 and 15 mg GYKI-16084 or placebo were administered twice daily for 28 days to patients with BPH in a randomized single-blind Phase II study. Efficacy was primarily determined by changes in the American Urological Association (AUA) symptom scores and maximum urinary flow (Q(max)), while safety was assessed by orthostatic changes and adverse-event profile. A simplified International Index of Erectile Function questionnaire was used to assess effects on erectile function. RESULTS: Data from 63 patients were evaluated; the decrease in the AUA score during the active phase was greater in the 15 mg group (-6.05, -32.7%) than in the placebo (-4.3, 22.7%) or 7.5 mg (-3.55, -19.5%) groups. Q(max) improved in both active treatment groups (+3.3 and +2.16 mL for the 7.5 and 15 mg groups, respectively) compared to placebo (+1.29 mL). None of the drug-related adverse events associated with selective alpha1-blockers were reported. CONCLUSION: The combined alpha1- and postsynaptically selective alpha2-blocker GYKI-16084 significantly improved the AUA symptom scores and increased Q(max) in patients with BPH, without inducing any adverse reaction, orthostatic changes or erectile dysfunction.

Adrenergic alpha-Antagonists↗
PubMed2004

Cyclophosphamide is contraindicated in patients with a history of transitional cell carcinoma.

Cyclophosphamide is a urotoxic agent that increases the incidence of malignant neoplasms of the urinary tract. The aim of this study was to evaluate the long-term impact of cyclophosphamide on patients with a history of superficial bladder cancer. Between July 1986 and January 1988, 58 consecutive patients with primary superficial transitional cell carcinoma of the bladder were included in this study. All patients had a transurethral R0 resection. Then 6 weekly intravesical instillations of 120 mg bacillus Calmette-Guérin (BCG) were performed. Until June 1987, 22 consecutive patients (group A) received an additional intravenous application of 700 mg/m(2) cyclophosphamide prior to the BCG immunotherapy, while from July 1987 36 patients were treated without cyclophosphamide. Survival was calculated using the Kaplan-Meier method and comparison of survival using the log rank test. Tumor staging, grading, and size were equally distributed in both groups. No significant difference could be observed regarding the 10-year overall survival rate (group A: 59%, group B: 58%), the 10-year tumor-specific survival rate (89 vs 94%), and the 10-year progression-free survival rate (85 vs 97%). There was a statistically significant deterioration of the 10-year recurrence-free survival rate in the cyclophosphamide group (44 vs 70%, log rank test: p < 0.05). Whereas there were no recurrences in the upper urinary tract among the patients of group B, 2 of the 22 patients from group A developed cancer of the renal pelvis. In patients with a history of superficial bladder cancer, a single dose of cyclophosphamide poses a significantly increased risk of tumor recurrence in the lower and in the upper urinary tract as well.

Administration, Intravesical↗
PubMed2004

The technique of ultrasound guided prostate biopsy.

This article discusses the preparations for ultrasound guided prostate biopsy, the conditions used and the process of performing a biopsy. The first step in preparing the patient is a cleansing enema before biopsy. Every author proposes the use of a preoperative antibiotic based prophylaxis. Differences may be found in the type, dosage and the duration of this preoperative application, which can last from 2 h to 2 days. For anaesthesia, lidocaine has been proposed, which may be used as a gel applied in the rectum or in the form of a prostate infiltrate. Quite a few colleagues administer a brief intravenous narcosis. A major debate goes on in respect of defining the number of biopsy samples needed. Hodge proposed sextant biopsy in 1989, for which we had false negative findings in 20% of all cases. Because of this, it has recently been suggested that eight or rather ten samples be taken. There are some who question even this. Twelve biopsy samples do offer an advantage compared to six, although in the case of eight this is not the case. We shall present an in depth discussion of the various opinions on the different numbers of biopsies samples required. For the sample site, the apex, the base and the middle part are proposed, and (completing the process) two additional samples can also be taken from the transition zone (TZ), since 20% of all prostate cancers originate from TZ. In case of a palpable nodule or any lesion made visible by TRUS, an additional, targeted, biopsy has to be performed. Certain new techniques like the 3-D Doppler, contrast, intermittent and others shall also be presented. The control of the full length of samples taken by a gun, as well as the proper conservation of the samples, are parts of pathological processing and of the technical tasks. A repeated biopsy is necessary in the case of PIN atypia, beyond which the author also discusses other indications for a repeated biopsy. We may expect the occurrence of direct postoperative complications and it is necessary to know how to treat these.

Biopsy↗
PubMed2004

[Review of our experiences and results with renal cell cancer patients in the last five years].

PATIENTS AND METHODS: The authors have collected and processed data of 307 patients at Urological Department Semmelweis University, who were treated for renal tumour from June 1997 to December 2002. RESULTS: During this process on the basis of their work, they formed their opinion of the main steps of diagnostical, surgical and conservative therapeutical procedure with patients suffering from renal cell cancer. They established the fact that the data is parallel with retraceable international literature, therefore this work can be the starting-point of long term prospective studies. They call attention to the fact that 70% of the tumours were recognized without any symptoms, during examination indicated for other reasons, due to the widely spreading of ultrasound, computed tomography and other imaging techniques. CONCLUSION: The tumours are recognized and removed in earlier stages and it is to be hoped that it prolongs their life expectancy, and makes the quality of life of our patients much better.

Adult↗
PubMed2004

Genetic profile of bone metastases in renal cell carcinoma.

OBJECTIVE: The aim of this study was to define specific genetic alterations which are common in bone metastases in renal cancer patients. METHODS: Tumor DNA from 31 metastases and 13 related primary tumors was extracted from paraffin embedded tissue sections. DOP-PCR was performed to amplify the whole DNA. After labelling by PCR, CGH was performed according to standard protocols. RESULTS: The mean number of aberrations per metastasis was 6.3 (1-13). Losses of chromosomes 3p (76%), 6 (20%), 8p (20%), 9 (34%), 14q (27%) and 18 (20%) as well as gains of chromosomes 5 (45%), 8q (34%) and 17 (27%) were detected frequently. Thirteen related primary tumors were also investigated. In 7 cases, at least one identical alteration was found in both primary tumor and metastases. In these cases, the number of alterations was mostly higher in primary tumors than in metastases without statistical significance. However, in general, the frequency of alterations was higher in metastases. CONCLUSIONS: Bone metastases from renal cell carcinoma are characterized by typical genetic alterations. Changes leading to metastasizing happen early in tumor pathogenesis. However, further accumulation of genetic changes occurs in metastases leading to a more complex genetic pattern which might be necessary for progression to clinically relevant metastases.

Bone Neoplasms↗
PubMed2003

[Value of testing the abdominal leak point pressure in the differential diagnosis of urinary stress incontinence].

INTRODUCTION: The two main reasons of stress incontinence, according to the present consensus, are urethral hypermotility due to descended bladder floor and intrinsic sphincter deficiency. Distinction between them used to be achieved by determining urethral pressure profile only. In recent years a less invasive method, measuring the Valsalva Leak Point Pressure, has been developed for a differentiation. AIMS: To determine Valsalva Leak Point Pressure using a simple technique for differential diagnosis of stress incontinence without a complete urodynamic test. METHOD: A minimally invasive technique is presented. Authors have performed parallel measurements of leak point pressure and urethral pressure profile during urodynamic examination in 43 stress incontinent patients. Difference in the results have also been evaluated. RESULTS: A specificity of 98% and a sensitivity of 51% with the method was found in intrinsic sphincter deficiency. In cases without vaginal descent the sensitivity was 100%, while in patients with urethral hypermobility the sensitivity and the specificity were 91% and 58% respectively. CONSEQUENCES: In stress incontinent patients without urethral hypermotility an abdominal leak point pressure of less than 40 H2O cm perfectly reflects weakness of the urethral sphincter. Based on these data we suggest that the invasive urethral pressure profile test can be avoided in appr. 20% of stress incontinence cases by weakness of the sphincter.

Abdominal Wall↗
PubMed2003

[Summary of our clinical experience with the determination of serum prostate-specific antigen level in the first five years].

The authors determined serum PSA levels in combination with digital rectal examination (DRE) and evaluated their role in the differential diagnosis of prostate diseases with special reference to cancer. The possible causes of differences between the observed cut-off level of PSA and the standard level PSA were analyzed. In the last few years the PSA determination found its clinical role in the diagnosis of prostate cancer.

Adult↗
PubMed2003

[Pharmacologic treatment of benign prostatic hyperplasia].

Medical treatment for benign prostatic hyperplasia is reviewed by the author. Experiences with herbal extracts have been known for more than 2 decades. Treating benign prostatic hyperplasia with these extracts are recommended in initial phase. Effectiveness of these drugs are approved by some placebo controlled double blind studies. However effectiveness of these are not as good as medical drugs'. It is well known that they have no side effects and are cheaper than medicines. Prostate volume is decreased and mechanical component of dysuria is improved by treating for long time (months, years) with 5 alfa reductase finasterid which contain hormone. This drug is indicated when volume of the prostate is over 40 g. Dynamical component of benign prostatic hyperplasia is treated with a receptor blockers which act on the bladder neck. These medicines effect earlier and are recommended for all benign prostatic hyperplasia patients independently of prostate volume. These might have some side effect like hypotension.

5-alpha Reductase Inhibitors↗