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Biomedical subjects

S E Strup

Publications and source records attributed to S E Strup.

24 records · Page 2Linked to original sources

Analysis of 99 microdissected prostate carcinomas reveals a high frequency of allelic loss on chromosome 8p12-21.

To investigate the possible involvement of a tumor suppressor gene(s) on chromosome 8 in prostatic neoplasms, we performed a comprehensive loss of heterozygosity (LOH) study on 99 tumors from 97 prostate cancer patients. One of the carcinomas was a lymph node metastasis; the other 98 were primary carcinomas. Pure populations of carcinoma cells and normal epithelia were procured by tissue microdissection. Two separate tumor foci were obtained from each of two patients. Microsatellite markers from 25 loci on the short arm and one locus on the long arm of chromosome 8 were used for PCR-based LOH analysis on matched normal and tumor DNA samples. The overall LOH on 8p in this study was 85.9% (85 of 99) of carcinomas. The loss was highest at markers D8S133, D8S136, NEFL, and D8S137 (62,72, 64, and 75%, respectively), which are located at 8p12-21. Seventy-nine of 99 tumors exhibited loss in at least one of these four loci. In contrast, LOH at 8p22 was much lower: 17,18,18, and 19% at D8S549, D8S602, D8S254, and D8S261, respectively, with 25 of 99 tumors showing deletion in one or more of the four loci. All but 5 tumors with deletions in this more distal region had at least one retained locus between the 8p22 deletion and a more proximal region of loss at 8p12-21; 1 tumor had loss at 8p22 but not 8p12-21. This suggests there may be two distinct regions of loss and, therefore, two tumor suppressor genes on this chromosomal arm. The loss on 8p12-21 showed little or no correlation with grade or stage of disease.

Aged↗

Endoscopic ureteroneocystostomy for complete obstruction at the ureterovesical junction.

PURPOSE: We evaluated the technical and long-term success of endoscopic ureteroneocystostomy in patients with complete obstruction of the distal ureter. MATERIALS AND METHODS: We treated 7 patients with complete obstruction at the ureterovesical junction via a combined antegrade and retrograde endoscopic approach (endoscopic ureteroneocystostomy). The etiology of obstruction included ureteroscopy for ureteral calculi in 3 patients and previous resection of bladder tumors or the prostate in 4. Six patients had proximal drainage with a percutaneous nephrostomy catheter at referral. An antegrade approach was used for localization, and a retrograde approach was used for direct visual ureteral meatotomy or ureterotomy with the endoscopic scissors or a cold-knife urethrotome. RESULTS: Continuity at the ureterovesical junction was restored in all 7 patients, and 6 are currently stricture-free with followup of 14 to 64 months. The sole failure in this series was due to recurrent invasive transitional cell carcinoma. CONCLUSIONS: Endoscopic ureteroneocystostomy is a safe and effective treatment of complete obstruction of the ureterovesical junction.

Adolescent↗

The use of transureteroureterostomy in the management of complex ureteral problems.

PURPOSE: Transureteroureterostomy has primarily been performed for benign disease in children with reflux or undergoing undiversion, and in adults with lower ureteral injury. We report the use of transureteroureterostomy for other than these traditional indications, including malignant disease. MATERIALS AND METHODS: Transureteroureterostomy was performed in 6 patients at the time of tumor resection to bypass large ureteral defects and in 4 as a secondary operation, usually associated with a ureteral leak after previous surgery. RESULTS: Complications related to transureteroureterostomy included 1 ureteral stricture and 1 ureteral leak. Good renal function was maintained with a mean followup of 77.9 months. CONCLUSIONS: Our experience suggests that transureteroureterostomy can be useful for urinary diversion when a segment of lower ureter is involved with malignant disease.

Adult↗

Laparoscopic pelvic lymphadenectomy combined with inguinal herniorrhaphy.

Laparoscopic surgical interventions are being widely applied for a variety of procedures that have been traditionally managed through open surgical approaches. Laparoscopic pelvic lymphadenectomy is used as a staging tool for prostate cancer, and the laparoscopic repair of inguinal hernias is becoming commonplace. We report on a case of laparoscopic inguinal hernia repair combined with lymphadenectomy in a patient who was to undergo definitive radiation therapy for localized carcinoma of the prostate. Urologic surgeons should be familiar with the anatomic considerations and laparoscopic approaches associated with inguinal hernias because the presence of an inguinal hernia may alter the approach to procedures such as laparoscopic pelvic lymphadenectomy.

Aged↗

The effect of intermittent pneumatic compression devices on intraoperative blood loss during radical prostatectomy and radical cystectomy.

Intermittent pneumatic compression devices are a widely used, effective and presumed risk-free method of deep venous thrombosis prophylaxis, presumably by increasing peak venous blood velocity, and stimulating local and systemic fibrinolysis. We investigated whether intermittent pneumatic compression devices had any effect on intraoperative blood loss or transfusion during radical pelvic urological surgery. To our knowledge no previous study has addressed these issues. Records were reviewed for patients undergoing radical retropubic prostatectomy or radical cystectomy with diversion from 1985 to 1990. A total of 91 cases was reviewed: 38 radical retropubic prostatectomies and 53 radical cystectomies with diversion (34 male and 19 female patients). There were 59 patients with intermittent pneumatic compression devices (29 radical retropubic prostatectomies and 30 radical cystectomies with diversion) and 32 without intermittent pneumatic compression devices (9 radical retropubic prostatectomies and 23 radical cystectomies with diversion). Intraoperative blood loss and transfusions were calculated for each group with and without intermittent pneumatic compression devices. No clinically apparent lower extremity deep venous thrombosis or pulmonary embolus was diagnosed in any patient. For the group with intermittent pneumatic compression devices mean intraoperative blood loss was 2,541 ml. (range 700 to 8,850) versus 1,807 ml. (range 450 to 5,100) without a device, for a statistically significant difference of 734 ml. (p = 0.005). When 5 patients with excessive intraoperative blood loss (more than 5,000 ml.) were excluded the statistically significant difference was maintained. When comparing radical retropubic prostatectomy and radical cystectomy with diversion, with and without intermittent pneumatic compression devices, blood loss was greater for the group with a device for each procedure. Differences in intraoperative blood loss were independent of sex or tumor stage. Intraoperative transfusions were increased by approximately 0.6 units per patient with the device. Our study suggests that intermittent pneumatic compression devices may increase blood loss during a radical pelvic operation.

Blood Loss, Surgical↗