Biomedical subjects
Publications and source records attributed to J U Roosen.
Since it was first introduced, measurement of prostate specific antigen has gained increasing interest, and prostate specific antigen is regarded as being the best tumour marker available. The antigen lacks cancer specificity, limiting the usefulness in early diagnosis, The use of prostate specific antigen in early diagnosis, staging, and in monitoring patients with prostate cancer is reviewed.
Two hundred and fifteen consecutive patients admitted to our department between 1978 and 1988 were included in a retrospective study. Entrance criteria were transitional cell carcinoma of the bladder T1-4, Grade III-IV. Status of nodes and metastases were not recorded. Initially all patients had a macroscopically radical transurethral resection (TUR). Patients were followed with cystoscopies. Recurrent tumours were treated with repeated TUR (RE-TUR). In cases of progression to a higher T-stage or recurrences with multiple papillomas (> 10), adjuvant therapy was recommended. The patients were retrospectively allocated to three different groups. Group 1 had TUR only, Group 2 had TUR + adjuvant irradiation, and Group 3 had TUR and various adjuvant therapies (Table I). Median crude actuarial overall survival was 29 months. In Groups 1, 2 and 3, median crude survival was 37, 13 and 32 months, respectively. In the analysis, most emphasis was put on Group 1. For stages T1-4 in this group, the median survivals was 67, 19, 9 and 2 months, respectively. Differences were statistically significant (p < 0.05). T1 tumour stage seemed to predict a reduced risk of progression compared with the higher tumour stages (p = 0.05, Fisher's test). There was a tendency for females to progress less often than men, but the difference was not statistically significant. In conclusion, macroscopically radical TUR does not seem to offer the same cure rates as radical cystectomy. However, in a selected group of patients with a troublesome medical history, or for patients wishing minimal risk treatment, TUR might be a reasonable treatment modality.
OBJECTIVE: To establish the prognostic value of a series of pre-operative, per-operative and histopathological parameters in relation to renal cell carcinoma (RCC). PATIENTS AND METHODS: This retrospective study involved a consecutive series of 76 patients (46 men and 30 women with a mean age of 65.3 years [range 44-91]) with a histologically confirmed diagnosis of RCC. Patients who were admitted over the period 1980-1984 were included. Data such as erythrocyte sedimentation rate (ESR), alkaline phosphatase level, histological tumour grade, degree of necrosis and presence of tumour vessels were evaluated in relation to actuarial survival. RESULTS: The ESR and alkaline phosphatase level at the time of diagnosis of RCC, the histological tumour grade, degree of necrosis and presence of tumour vessels on angiography were all found to affect the actuarial length of survival significantly (P < or = 0.05 log-rank test). Macroscopic tumour demarcation estimated per-operatively by the surgeon or after surgery by the pathologist, microscopic demarcation, vascular density on histological examination, tumour diameter and vascular density on angiography were found not to affect actuarial survival significantly. CONCLUSION: The value of establishing simple and reliable diagnostic indicators for patients with RCC is stressed.
Suprarenal cysts are rare. A case of a 3.5 l cyst incidentally discovered in a 30 year old woman is described. Operative treatment is recommended in order to avoid spontaneous rupture and to exclude malignancy. Endothelial origin can be established by a specific immunohistochemical staining, factor VIII antibody.
Following urethrotomy approximately 50% develop recurrence within 6 months. Twenty-nine consecutive patients were offered clean intermittent self-catheterization (CISC) as a preventive measure against urethral stricture recurrence following internal urethrotomy. Ten patients dropped out during the scheduled 6-month regimen. Of the 19 patients left, a significantly improved flow was maintained over the period of observation. No reoperations were required. Prior to the trial, 14 of the 19 patients had a history of recurrent urethral stricture; 92% of these recurrences were diagnosed within 6 months following urethrotomy. It is concluded that CISC seems to be a promising preventive measure against recurrence of urethral stricture.
A rare late complication of side-to-side anastomosis; perforation of a blind loop with subsequent localized inflammation of the abdominal wall is presented. Operative intervention with resection of the blind loop and the establishment of an end-to-end anastomosis is recommended.
Of 98 hydroceles (mean volume 125 ml) in a consecutive series of 92 patients, treated initially by aspiration, 14% (mean volume 70 ml) were cured. The 76 recurring hydroceles (mean volume 146 ml) were then randomised to either antazoline sclerotherapy on an out-patient basis or surgery. Cure rates were 89 and 100%, respectively, at follow-up 6 months later. Operated patients were admitted for a mean duration of 2.5 days. The results indicated that aspiration alone was inadequate, and sclerotherapy is advocated as the first choice of treatment for hydrocele.
A patient passed 11 urate calculi after palliative orchidectomy for advanced prostatic cancer, and there was a simultaneous rise in urinary urate excretion. We believe that this rise could be the result of increased purine metabolism from lysis of tumour cells. To our knowledge this has not previously been reported.
Advanced prostatic cancer (PC) involves a serious prognosis. PC cells form growth factors, which affect growth in autocrine or paracrine manner. PC cell lines, hormone dependency, and growth modalities are mentioned. Interference with these model systems by TGF-alpha, TGF-beta and EGF is described. The presence of less characterized growth factors in homogenates and conditioned media from PC cells is mentioned. An abundance of EGF and EGF-receptors has been found in PC compared to BPH samples. New strategies for treatment are outlined.
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Twenty-three consecutive patients with acute traumatic dislocation of the patella were followed up for a mean period of 39 months. All patients had a medial capsulorrhaphy and in eight cases a supplementary lateral capsulotomy. Dislocation recurred in two cases, one of whom had had a supplementary lateral capsulotomy. Chondromalacia was demonstrated at followup in eight patients, six of whom belonged to the lateral capsulotomy group. We conclude that lateral capsulotomy confers no advantage in the operative repair of acute dislocation of the patella.
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