Biomedical subjects

W Boeckmann

Publications and source records attributed to W Boeckmann.

31 records · Page 2Linked to original sources

PubMed1995

Evaluation of patients with diseases of the prostate using prostate-specific antigen density.

OBJECTIVE: To compare the efficacy of two tests, prostatic-specific antigen (PSA) and the PSA/prostate volume ratio (PSAD), as diagnostic and staging markers to discriminate patients with benign prostatic hyperplasia (BPH) from patients with cancer of the prostate (CaP). PATIENTS AND METHODS: Prostate gland volumes were estimated in 60 patients with BPH and 88 patients with clinically organ-confined CaP by performing transrectal ultrasonography (TRUS) and using the prolate ellipse formula. Serum PSA concentration was determined using an enzyme immunoassay. In patients with BPH, the prostates were removed either by transurethral resection or retropubic prostatectomy. Patients with CaP underwent laparoscopic pelvic lymphadenectomy followed by radical perineal prostatectomy. PSAD was calculated by relating the serum PSA level to the TRUS-estimated prostate volume. RESULTS: The median PSA level was 4.4 ng/mL in patients with BPH, 9.3 ng/mL in patients with CaP-NO disease and 24 ng/mL in those with CaP-N+ disease. However, imposing a PSA limit of 4 ng/mL for the diagnosis of CaP gave a positive predictive value of only 64.8%, whereas a limit of 10 ng/mL gave a positive predictive value of 71.4%. In contrast, the median PSAD was 0.086 ng/mL/cm3 in patients with BPH, but was 0.295 ng/mL/cm3 in patients with NO-disease and 0.775 ng/mL/cm3 in those with N(+)-disease. With a limit of 0.15 ng/mL/cm3 the positive predictive value of PSAD was 81%. Furthermore, a limit of 0.6 ng/mL/cm3 revealed a positive predictive value of 81% for the diagnosis of metastatic lymph node involvement. CONCLUSIONS: There was a considerable overlap of PSA concentrations in patients with BPH and CaP, and PSA was not sufficiently accurate to distinguish between them. In contrast, PSAD enhanced the discrimination between BPH and CaP and may provide additional information about the status of the lymph nodes in patients with CaP.

Aged↗

PubMed1995

Management of rectal injury during perineal prostatectomy.

109 patients with locally confined prostate cancer underwent radical perineal prostatectomy. In 12 (11%) patients a rectal laceration was noted intraoperatively and closed in two layers. No patient had complications or prolonged hospital stay associated with the laceration.

Aged↗

PubMed1995

Determination of prostate gland volume by transrectal ultrasound: correlation with radical prostatectomy specimens.

Estimation of the prostate gland volume employing transrectal ultrasound provides important additional information in patients with benign and malignant diseases of the prostate. Twenty-five patients underwent transrectal ultrasound of the prostate prior to radical prostatectomy for organ-confined cancer of the prostate. The prostate gland volume was calculated employing two different methods. The prostate specimen weights were compared with the results of each of the volume estimation method. The prolate ellipse formula, widely used as an alternative to planimetry, demonstrated a correlation coefficient of r2 = 0.831. However, a variation of the prolate ellipse formula expressed as (width x width x height) x pi/6, which is easier to perform as described by Terris and Stamey, exhibited a correlation coefficient of r2 = 0.829. It appears to be a reliable means of estimating prostate gland volume, especially in cases in whom the original formula is difficult to apply.

Aged↗

PubMed1994

Renal oncocytoma with a translocation t(9;11)(p23;q13).

We report a case of renal oncocytoma and confirm a tumor type specific translocation between chromosomes 9 and 11, that is t(9;11)(p23;q13q23). Each of the 45 cytogenetically analyzed metaphases of tumor cells showed a translocation of the long arm of chromosome 11 at q13 to chromosome 9 at 9p23 and to chromosome 20 at 20q13 that resulted in the following karyotype: 46,XX,der(11)ins(9;11)(p23;q13q23)ins(20;11)(q13;q23q25),del (22q13). Since genes encoding mitochondrial enzymes are clustered around the translocation site of chromosomes 11 and 20, they may have a role in the tumorigenesis of renal oncocytoma. In addition, if the development of oncocytomas shows different cytogenetic pathways the cytogenetic aberration of t(9;11)(p23;q12q13) can be of diagnostic help in differentiating a subset of oncocytoma from renal cell carcinoma.

Adenoma, Oxyphilic↗

PubMed1994

Spontaneous bladder rupture following enterocystoplasty can be treated conservatively.

Spontaneous bladder rupture following enterocystoplasty has been reported recently. The etiology remains unclear but appears to be multifactorial. Common factors are a high outlet resistance with total urinary continence and the presence of an augmented, dysfunctional native bladder, which may result in the development of high intravesical pressures or increased wall tension. We present a case of spontaneous bladder rupture 4 weeks following enterocystoplasty in which a segment of detubularized ileum was used to augment a contracted bladder. Our patient was treated by continuous bladder drainage for 21 days, antibiotics and appropriate supportive care.

Aged↗

PubMed1994

Differentiation of benign prostatic hyperplasia and prostate cancer employing prostatic-specific antigen density.

To enhance the ability of prostate-specific antigen (PSA) to distinguish benign prostatic hyperplasia (BPH) from cancer of the prostate (CaP) Benson et al. defined a new parameter, PSA density (PSAD), which is the ratio of the serum PSA concentration to the volume of the prostate. We have employed this parameter in a prospective study of 28 patients with clinically localised CaP and 57 patients with BPH. Mean PSAD was 0.116 for the BPH patients and 0.46 for the CaP patients (p < 0.005). The authors conclude that the information provided by PSAD is superior to absolute PSA values in the differentiation between BPH and CaP.

Biomarkers, Tumor↗

PubMed1994

Spontaneous kidney rupture due to a metastatic renal tumour. Case report.

Spontaneous rupture of the kidney is an uncommon entity. In most cases the non-traumatic rupture is associated with underlying diseases of the kidney, the most frequent being renal tumours. We report the case of a spontaneous kidney rupture due to a renal metastasis from an adenocarcinoma of the colon.

Abdomen, Acute↗

PubMed1994

Laparoscopic pelvic lymphadenectomy.

We analyzed our first 41 patients with localized prostate cancer treated with laparoscopic pelvic lymph node dissection (LPLND) as staging procedure followed either by radical perineal prostatectomy or interstitial radiotherapy. 7/41 patients (17%) had pelvic lymph node metastases and received endocrine therapy. Overall complication rate was low (7.5%) and no major complication occurred. LPLND is minimally invasive and provides staging accuracy in prostate cancer.

Ecchymosis↗

PubMed1992

Immunoscintigraphic localization of renal tumours in an extracorporeal perfusion model with a monoclonal antibody against gamma-glutamyltransferase.

Monoclonal antibody 138H11 against human gamma-glutamyltransferase has been shown to react immunohistochemically with 98% of all tested clear-cell type and chromophilic renal cell carcinomas, but not with renal chromophobic carcinomas, Duct-Bellini carcinomas or oncocytomas. In normal kidney the target epitopes of mAb 138H11 are located in the luminal brush-border membrane of proximal tubule cells, whereas in renal carcinomas the epitopes are found surrounding the whole tumour cells. These results form the basis of the present immunoscintigraphic study designed to evaluate mAb 138H11 in an extracorporeal perfusion model. Immediately after nephrectomy, human tumour-bearing kidneys were perfused with 99mTc-labelled mAb 138H11 in Euro-Collins solution. High specific uptake in 4/4 renal clear cell carcinomas could be demonstrated by planar immunoscintigraphy and single-photon-emission computed tomography, "regions of interest" investigation and immunohistochemistry. In contrast, a perfused oncocytoma showed up as an unlabelled lesion. The results indicate a possible use for mAb 138H11 in immunoscintigraphy or even therapy, provided high tumour uptake can be confirmed in patients.

Adenocarcinoma↗

PubMed1990

Tumour imaging of bladder carcinomas and their metastases with 111indium-labelled monoclonal anti-CEA antibody BW 431/26.

Fifty-one patients with muscle-infiltrating bladder carcinoma (T2-T4, N0-3, M0-1) were studied with a new imaging technique using murine monoclonal antibody directed against the carcinoembryonic antigen (CEA). A total number of 67 investigations were performed. The intact 111indium-labelled antibody (BW 431/26, Behringwerke Marburg) detected 86% of primary tumours, 93% of local and 75% of distant metastases whether there was an elevated CEA level in serum or not. Immunohistologically (avidin-biotin-peroxidase method) positive frozen tissue sections from tumour biopsies stained with the same monoclonal anti-CEA antibody, thus confirming the presence of the CEA antigen in vitro. The method was of much higher sensitivity in detecting even very small metastases than X-ray computed tomography (86% versus less than 30%). The specificity was in the region of 90%. The response to chemotherapy (MVEC regimen) was shown by repeated studies demonstrating reduced uptake (partial remission) or no accumulation (complete remission) in the second immunoscan. We suggest immunoscintigraphy of bladder tumours and their metastases as an additional method in preoperative staging and postoperative care.

Antibodies, Monoclonal↗

PubMed1986

Bilateral testicular germ cell tumors. Report of nine cases and review of the literature.

In a series of 181 patients with testicular germ cell tumors, the phenomenon of bilateral involvement of the testicles was observed nine times (5%). Two patients evidenced a simultaneous bilateral tumor, and, in seven others, a second tumor occurred after an interval ranging between 8 months and 6 years and 11 months. The incidence, histologic findings, therapy, and prognosis of bilateral testicular tumors are discussed on the basis of a survey of the literature. Emphasis is placed on the significance of a long-term follow-up period as well as on the important role of sonography in the early detection of a contralateral tumor.

Adolescent↗

PubMedDate not supplied

Increased discrimination between benign prostatic hyperplasia and prostate cancer through measurement of percentage free PSA.

OBJECTIVE: The value of Prostate-Specific Antigen (PSA) for the early detection of Prostate Cancer (CaP) is controversial due to an appreciable false positive rate causing unnecessary biopsies. As PSA exits in both free and bound forms the percentage of free PSA was found to be lower in CaP than in Benign Prostatic Hyperplasia (BPH). We investigated whether the percentage of free PSA offers better discrimination on the detection of CaP. MATERIAL AND METHODS: In a retrospective analysis the percentage of free PSA was determined in the sera of 50 consecutive patients with histologically proven BPH (n = 30) and clinically localised CaP without metastases (n = 20; pT1-3 No Mo). Serum levels of free PSA and total PSA were determined employing a chemiluminescent enzyme immunoassay. RESULTS: Patients with CaP demonstrated a lower percentage of free PSA (median: 8.5, range: 2.7-24.5) than patients with BPH (median: 22.35, range: 8.9-66.7). (p < 0.001). CONCLUSION: Determination of percentage of free PSA enhances the discrimination between BPH and CaP and may reduce the number of unnecessary biopsies in patients with elevated PSA.

Diagnosis, Differential↗

PubMedDate not supplied

Metastatic workup of patients with prostate cancer employing skeletal alkaline phosphatase.

PURPOSE: To compare the efficacy of two tests, prostate-specific antigen (PSA) and skeletal alkaline phosphatase (SAP) as staging markers to discriminate patients with cancer of the prostate (CaP) with bony metastases (M1) from those without bony metastases (Mo). MATERIAL AND METHODS: Forty-seven untreated patients with Mo (n = 26) and M1 (n = 21) CaP were entered in this study. Serum concentrations for SAP and PSA were determined using two immunoassays. RESULTS: None of the Mo patients but 65% of the M1 patients exhibited a SAP value above the reference range (< 19 ng/ml). A corresponding cut-offpoint of 100 ng/ml for PSA showed that 27% of Mo patients and only 65% of the M1 patients exhibited a value > 100 ng/ml. This resulted in a sensitivity and specificity of 65% and 100% for SAP and 65% and 73% for PSA. CONCLUSION: Our findings suggest that SAP could become a useful marker in the evaluation of patients with newly diagnosed CaP as it seems to provide additional information concerning the skeletal status of these patients.

Adult↗