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Biomedical subjects

L Coppens

Publications and source records attributed to L Coppens.

At least 19 recordsLinked to original sources
PubMed2001

PSA kinetics after external beam radiotherapy alone or combined with an iridium brachytherapy boost to deliver 85 grays to prostatic adenocarcinoma.

PURPOSE: Increasing the dose to prostatic adenocarcinoma in conformal external beam therapy (EBT) has resulted in increased levels of PSA normalization and increased percentage of biochemical disease-free survival rates. However technical problems due to prostate motion inside the pelvis or patients' set-up make difficult the realization of the EBT boost fields above 72 Gy. Brachytherapy which overcomes these problems was investigated to deliver the boost dose to achieve 85 Gy. PSA nadir which has been identified as the strongest independent predictor of any failure in many studies has been used as the end point for early evaluation of this work. PATIENTS AND METHODS: In a retrospective way we report on 163 patients' PSA kinetics after EBT alone to 68 Gy or EBT first and a brachytherapy boost up to 75 or 85 Gy. RESULTS: At 12 months follow-up, PSA nadirs percentage < or = 0.5 or < or = 1 ng/ml increased from 7.5 and 20.7% after 68 Gy EBT to 49.8 and 71.2% after a brachytherapy boost to deliver 85 Gy (p < 0.0001). In the Cox PH model analysis, the total dose remained the most important factor for predicting PSA normalization. CONCLUSIONS: These results are in accordance with the most recent results published after conformal EBT at the same 80 Gy level of dose. If confirmed on a higher number of patients they could place brachytherapy among the most accurate methods of boosting in the radiation treatment of prostatic carcinoma.

Adenocarcinoma↗
PubMed2001

Remote control for a stand-alone freely movable treatment couch with limitation system.

One of our linear accelerators is equipped with a free-movable treatment couch. An additional projects was to develop a system that first protects the free-movable couch against collisions, secondly build a remote control for moving the couch from outside the treatment room and finally implement this remote control/limitation system in an automatic position algorithm using an electronic portal image. The latter has been the subject of an on-going departmental investigation on intra-fractional correction of set-up errors. A few years ago, we developed a limitation system to protect both the table and the accelerator against collisions. In this paper we describe the second part of this project, the remote control system.

Algorithms↗
PubMed2001

Detection of the 67-kD laminin receptor in prostate cancer biopsies as a predictor of recurrence after radical prostatectomy.

OBJECTIVES: Reliable prognostic indicators are needed for a better pretherapeutic assessment of the agressiveness of organ-confined prostate cancer (PC) lesions. The 67-kD laminin receptor (67LR) is a cell-surface-associated protein involved in the acquisition of the invasive and metastatic phenotype of a variety of human cancer cell types. We have previously shown that 67LR detection in PC tissues from radical prostatectomy (RP) specimens is an independent predictor of biochemical (PSA) relapse in patients with clinically localized PC. In this study, we assessed 67LR detection in diagnostic PC biopsies as a predictor of biochemical relapse after RP. METHODS: Diagnostic biopsy and subsequent RP tissue specimens from 151 patients with clinically localized PC were immunohistochemically analyzed for 67LR expression. The level of 67LR expression was evaluated by both intensity and extent of the staining. Clinicopathological preoperative and postoperative parameters, including 67LR expression, were correlated with each other and tested as predictors of biochemical relapse. RESULTS: 67LR was detected in 67.5 and 68.2% of biopsies and RPs, respectively. 67LR detection in RP specimens was an independent predictor of relapse. The level of 67LR expression in the biopsy was significantly associated with the biopsy Gleason score (p<0.05) but failed to predict the pathological stage (p>0.1). Biochemical progression-free estimates for patients whose biopsy did or did not express the protein differed with only borderline statistical significance (p = 0.05). Multivariate analysis identified biopsy Gleason score as the only independent preoperative predictor of recurrence. Significant discrepancies in levels of 67LR expression were found between matched biopsy and RP specimens (p<0.05), with exact agreement rates <40%. CONCLUSIONS: 67LR detection in PC biopsies was not a significant preoperative predictor of outcome after RP. Heterogeneity of 67LR expression and biopsy sampling errors most likely represented the main reasons for discordant results between biopsy and RP specimens.

Adenocarcinoma↗
PubMed2000

A computerized remote table control for fast on-line patient repositioning: implementation and clinical feasibility.

A computerized remote control for a Siemens ZXT treatment couch was implemented and its characteristics were investigated to establish its feasibility for on-line setup corrections, using portal imaging. Communication with the table was obtained by connecting it via a serial line to a work station. The treatment couch enables "goto" commands in the three main directions and around the isocenter. The accuracy of the movements after giving such a command was checked and the time for each movement was recorded. First, the movements into a single direction were studied (range of -4 to +4 cm and -4 degrees to +4 degrees). Each command was repeated four times. Second, the table was moved into the three main directions simultaneously. For this experiment a clinically relevant three-dimensional (3-D) normal distribution of shifts was used [N = 200, standard deviation (SD) 5 mm in the three main directions]. This latter experiment was done twice: without and with rotations (a distribution with SD 1 degrees). During the first experiment, with shifts into one direction, no systematic deviations were found. The overall accuracy of the shifts was 0.6 mm (1 SD) in each direction and 0.04 degrees (1 SD) for the rotations. The time required for a translation ranged between 4 and 13 s and for the rotation between 8 and 20 s. The second experiment with the 3-D distribution of setup errors yielded an error in the 3-D vector length equal to 0.96 mm (1 SD), independent of rotations. Shifts were performed in less than 11 s for 95% of the cases without rotations. When rotations were also performed, 95% of the movements finished in less than 16 s. In conclusion, the table movements are accurate and enable on-line setup corrections in daily clinical practice.

Feasibility Studies↗
PubMed1999

[Surgery, radiotherapy or hormonal therapy in the treatment of prostate cancer].

Prostatic cancer (PC) became the first diagnosed cancer in western men and is the second leading cause of cancer death in men. Wide utilisation of serum PSA and free PSA measurements, identifies patients requiring transrectalultrasonography (TRUS) and TRUS guided biopsies. Most prostatic cancers diagnosed today are locally limited and may be treated by radical surgery or radiotherapy. In case of disseminated disease, hormonal manipulations remain the treatment of choice. In that field, many new drugs have been designed to allow medical castration with less complications, especially regarding sexual potency.

Adult↗
PubMed1998

Microprocessor controlled limitation system for a stand-alone freely movable treatment couch.

Because of the capability of free movement in the treatment room, we recently introduced a Hercules treatment couch on one of our linear accelerators. One of the advantages of this couch is that it allows for a more flexible way of patient setup and that it can be moved entirely out of the way to enable treatment with a hospital bed. A disadvantage, however, is that the couch can hit a wall or a cover of the accelerator accidentally. A limitation system has been developed to protect both the table and the accelerator against such collisions.

Algorithms↗
PubMed1998

[Antegrade scrotal embolization of varicocele: results].

The aim of this study is to judge the effectiveness of the new treatment of varicoceles, introduced in 1987 by Tauber: the antegradal scrotal sclerotherapy of varicoceles. From february 1996 to april 1998, we have realised 150 antegrade embolisations of varicoceles. The study is lead on 75 patients with mean time follow-up of 12 months. Patient's mean age is 20 years. 85% of patients had a grade 3 left varicocele and 15% a grade 2 left varicocele. The criterium of success rests on the lack of veinous flow-back during clinical examination, which is than confirmed by doppler-ultrasound. Clinical success is obtained in 87% of the cases and the doppler control is normal in 80% of the cases. We have 9% of minor complications, and no major complication. The number of failures in our study is higher than in Tauber' study, but is the same as those described in the other procedures of treatment of varicocele. On the other hand the surgical procedure is simple and the morbidity is low.

Adolescent↗
PubMed1997

[Diagnosis and treatment of obstructive seminal vesicle pathology].

Ejaculatory duct(s) obstruction(s) (EDO) may be responsible for as much as one third of azoospermia- or severe oligospermia-related infertility; it's clinical presentation also includes some low urinary tract irritative symptoms, such as repeated epididymitis, pelvi-perineal pain, hematospermia and other ejaculatory disturbances. The diagnosis of EDO is based on patient's history, semen analysis (hypospermia, azoospermia, low fructose level), and transrectal ultrasound (TRUS), which can demonstrate seminal vesicle(s), vas ampulla(s) and/or ejaculatory duct(s) dilatation, Müllerian or utricular cyst, and ejaculatory duct(s) or seminal calcification(s). Confirmation of the suspected diagnosis, if needed, requires classical vasography or TRUS-guided seminal tract puncture and vesiculography. Treatment is usually successfully achieved with transurethral endoscopic procedures: retrograde ejaculatory duct(s) catheterisation, dilatation, incision or resection; seminal tract endoscopy is seldom performed. Very few complications occur; evaluation of long term results is lacking. Indications of such endoscopic procedures remain to be defined, especially in cases of partial EDO.

Blood↗
PubMed1996

Muscular actinomycosis in the back.

We present an unusual observation actinomycosis involving muscles of the back and probably of one thigh in a patient with pulmonary lesions. The patient was alcoholic and a heavy smoker and his teeth were in very poor repair. Opportunity is taken to review the literature on the rare cases of muscular actinomycosis.

Abscess↗
PubMed1995

Yersinia enterolitica bacteremia with intracranial extension.

We report an unusual observation of Yersinia enterolitica (YE) bacteremia with subcutaneous with subcutaneous abscesses on the scalp and, by gradual extension, cerebritis in a diabetic patient. All clinical signs disappeared after surgical drainage of the abscesses and protracted antibiotherapy. The well-known affinity of YE for iron led us to demonstrate an unrecognized hemochromatosis.

Adult↗
PubMed1994

[Diagnostic approach to candidates for radical prostatectomy: value of echographic staging].

The last 118 candidates to RPV in the urological department of the CHU Liège were retrospectively analyzed in regard of echographic patterns, anatomopathology and PSA levels. The local extension of the cancer was defined following its echographic patterns with reference to the TNM classification (UICC, 1992). The PSA density (PSAd) and the histological grade of the bioptic specimens were studied. There is a good correlation between the echographic stage, the mean level of PSAd and the anatomical extent of the cancer on the surgical specimen. In cancers classified as T2, 2 sub sub-groups may be identified with different prognosis: T2A and T2B in which a nodal extension or an extra-capsular growth is present in 1/3 of the cases and T2C in which such an extension is observed in one half of the cases. In biopsy grades IV or V, a microscopic involvement of the nodes is observed in 50% of the cases. In the remaining 50% with negative nodes, the surgical specimen shows an extra-capsular extension in 2 cases out of 3 (roughly, 80% of the grades IV-V are over the possibility of cure with surgery alone). The analysis of the specific echographic patterns identifies 3 morphological aspects which seem to carry a bad prognosis: posterior capsular deformity, junctional irregularity and heterogeneity of the lesion. The analysis of PSAd and of the tumoral volume measured by ultrasounds identifies 2 clear-cut values (PSAd > 1 and volume > 3 cm3) over which we now advocate a coelioscopic LAD (important risk of positive nodes).

Adenocarcinoma↗
PubMed1994

The experience of radical prostatectomy for locally confined prostate cancer in Liège.

The authors report their experience of 148 radical prostatectomies performed for adeno-carcinoma. They expose the reasons which have led them to adopt this kind of treatment and the reasons explaining a nearly exponential increase of the frequency of the operation during the last 5 years. They underline the importance of lymphadenectomy and the safety of frozen sections of the nodes. The surgical technique is briefly commented and the (low) morbidity of the operation is reviewed. They compare the results of RPV to those of external radiotherapy, watchful attitude or immediate hormonal treatment and they conclude in insisting on the benefit of the surgical approach as far as indications (which are defined) are strictly followed.

Adenocarcinoma↗
PubMed1992

Original lithotomy positioning for transperineal extracorporeal shockwave lithotripsy for distal ureteric calculi with Tripter X1.

Extracorporeal shockwave lithotripsy (ESWL) has been initially designed for stones located in the kidney and the upper ureter. Our lithotripter is no exception. Its components (the table and the orientation of the semi-ellipsoid reflector) are adapted for the treatment of kidney or lumbar ureter stones. However, the elements forming the unit of treatment (the table, the C-arm and the Tripter) can be modified in such a way that focalization of stones of the lower ureter becomes possible through a perineal exposure. The aim is to avoid the pelvic bone shield while a good focalization of the stone is realized. From June 1989 to March 1991, 35 patients were treated for distal ureteric stones by ESWL in this original positioning.

Adolescent↗