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Biomedical subjects

A Jardin

Publications and source records attributed to A Jardin.

At least 19 recordsLinked to original sources

[Diagnosis of lymphatic metastases in pelvic urologic tumors. Value of puncture biopsy].

In 119 patients with pelvic urogenital tumours the diagnosis of lymph node metastasis was made by lymphography-guided fine needle biopsy. The results of this technique, performed without anaesthesia and devoid of morbidity, could be interpreted in 88 percent of the cases. In the search for micro- and macroscopically invaded lymph nodes fine needle biopsy had a sensitivity of 66 percent, a specificity of 100 percent, a positive predictive value of 100 percent and a negative predictive value of 92.3 percent. In cases with macroscopically invaded nodes its sensitivity was 82.3 percent.

Adult

[The value of retrograde urethrography in the diagnosis of sub-urethral diverticula in women].

Urethral diverticulum in women is not a frequent disease. The diagnosis of this lesion is based on history and careful physical examination looking for a swelling on the anterior vaginal wall. A study of 15 cases is reported. The authors insist on investigations as a help to confirm and localise the diverticulum. A new technique of retrograde urethrography using a prehension cannula ("Bomelaer") is described. By this well tolerated and minimally invasive test, the visualisation of the urethral diverticulum was obtained in 14/15 patients. Associated with intravenous urography, it is certainly the most adapted strategy for diagnosis and management.

Contrast Media

[Arterial stenosis in the renal graft. Indication for endoluminal dilatation].

One hundred and thirty eight patients with renal transplant artery stenosis were reported in a series of 1200 renal transplants. These cases included 47 patients in whom hypertension was well controlled by means of hypotensive drugs, 39 patients treated by surgical repair (SR) and 49 treated by percutaneous angioplasty (PTA). The long-term success rate was 81.5 percent in the SR group compared with 40.8 percent in the PTA group. PTA morbidity was greater than that of SR, and we believe that after the initial optimism, the results of this technique should be reevaluated according to the anatomical pattern of the renal artery stenosis.

Adolescent

[Preservation of the bladder in transitional cell tumors infiltrating the lamina propria].

Thirty-two patients with transitional cell cancer of the bladder infiltrating the lamina propria were treated with intravesical BCG. Seventy-five percent of these patients could keep their bladder at the cost of regular BCG treatment and strict endoscopic monitoring. A better evaluation of prognostic criteria, including malignancy grade, total amount of vesical muscle removed during the initial resection and investigation for lymphatic system emboli, should help in a better selection of patients, separating those who might have recurrent infiltrative tumours from those who would benefit from a conservative treatment and offering the former a more aggressive therapy.

Aged

Alfuzosin for treatment of benign prostatic hypertrophy. The BPH-ALF Group.

To assess the long-term efficacy and safety of alfuzosin, a selective alpha 1-adrenergic antagonist, 518 symptomatic patients with benign prostatic hypertrophy (BPH) were randomised to received either alfuzosin (daily dose 7.5-10 mg) or placebo for 6 months. Obstructive and irritative symptoms, assessed according to the Boyarsky scale, significantly improved in the alfuzosin group compared with the placebo group (p = 0.0004). Fewer patients in the alfuzosin group than in the placebo group dropped out due to lack of efficacy (6.8% vs 14.6%, p = 0.004) and the prevalence of spontaneous acute urine retention was lower in the alfuzosin group (0.4% vs 2.6%, p = 0.04). By 6 months, mean urinary flow rates had increased (p less than 0.05) and residual volume had decreased (p = 0.017) in the alfuzosin group, although the two groups were broadly similar with respect to increase in peak flow rate. The overall incidence of adverse events was similar in the two groups, which led to the withdrawal of 10.8% and 9.0% of patients, respectively. The findings emphasise the magnitude of the placebo response in symptomatic patients with BPH and show that treatment with alpha 1 adrenergic antagonist drugs provides long-lasting improvement in such patients.

Adrenergic alpha-Antagonists

Decrease in renal vascular resistance in University of Wisconsin solution preserved kidney transplants.

Renal vascular resistance was compared in 2 groups of renal grafts: group 1-16 kidneys perfused with University of Wisconsin solution and group 2-16 kidneys perfused with Euro-Collins solution. Both groups had comparable donors and recipient criteria. Renal blood flow was measured by a miniaturized pulsed Doppler probe fixed on the graft renal artery. Renal vascular resistance was calculated either according to the formula: renal vascular resistance (mm. Hg/ml. per second) = systemic arterial pressure (P)/renal blood flow or through the renal vascular resistive index (RVRI): RVRI = systolic flow velocity - diastolic flow velocity/systolic flow velocity = (S-D)/S. Renal vascular resistance estimation seems to be more contributory than renal blood flow in assessment of renal graft reperfusion disorders. Our results show that University of Wisconsin solution seems to preserve intrarenal arterial caliber better with a decrease in intrarenal vascular resistance, thus, allowing for a higher arterial graft perfusion flow.

Adenosine

[Histologic identification of the afferent fibers of the pelvic plexus].

The inferior hypogastric (pelvic) plexus conveys two types of fibres: sympathetic fibres originating in the thoracolumbar sympathetic chain and parasympathetic fibers originating in the sacral anterior rami. By using a histofluorescent stain (glyoxalic acid) and a histochemical stain (thiocholine) in 17 fresh cadavres, we have demonstrated that the sympathetic fibres arise from sacral sympathetic ganglia. These fibres participate in the constitution of the pelvic splanchnic nerves. In this study, we confirm that the inferior roots of the pelvic plexus are not only parasympathetic, but also sympathetic.

Adrenergic Fibers

[Félix Guyon].

Explore the source record for details and available documents.

Female Urogenital Diseases

A general practitioner multicenter study: fosfomycin trometamol single dose versus pipemidic acid multiple dose.

In order to evaluate the efficacy and safety of fosfomycin trometamol as single dose oral treatment for acute cystitis in women, an open, multicenter comparative study was carried out in general practices in France, 386 women, aged 16 to 75 years, with clinical symptoms of acute cystitis were enrolled in the study to receive either a single 3 g oral dose of fosfomycin trometamol or a five-day course of 400 mg pipemidic acid twice daily. The diagnosis of cystitis was based on clinical symptoms and significant bacteriuria (greater than or equal to 10(5) cfu/ml midstream urine). Follow-up examinations were carried out five to ten and 28 days after the end of treatment, 289 and 244 patients, respectively, were available for clinical and bacteriological evaluation at short-term (five to ten days) and medium-term (28 days) post-treatment follow-up. Both regimens were comparable for clinical and bacteriological efficacy with short-term eradication rates of 122/146 in the fosfomycin trometamol group and 130/143 in the pipemidic acid group. The results of medium-term follow-up were 113/122 and 114/122 for the eradication rates of the respective groups. Both drugs were well tolerated. Side effects were mild and of significantly shorter duration in the fosfomycin trometamol group.

Administration, Oral

[Autosomal dominant polycystic kidney in adults and transplantation].

Seventy-six patients with polycystic kidneys were followed in the Bicêtre renal transplantation unit. Fifty four were transplanted. Fifty two nephrectomies were performed in these patients essentially because of the size of the kidney and for renal infections. Fifty four patients were transplanted at a mean of 44 years. The actuarial survival of the patients at one year and at three years was 92% and 88% and the actuarial survival of the grafts at one year and at five years was 87% and 71%. These results are comparable to those obtained in other patients transplanted in the unit. Pre-transplantation nephrectomy and the patient's age do not aggravate the prognosis. Nephrectomy may be justified in these patients when they must be transplanted as transplantation currently gives very good results.

Adult

[Harvesting multiple organs].

The development of organ transplants is limited by the shortage of organs. The improvement of this situation depends on two factors: increased awareness by the general public that refraining from refusing the removal of organs from the body of a patient with brain death is the most modern form of solidarity; and increased awareness by the medical profession that removal of organs should be proposed for every patient with brain death and that adequate resuscitative techniques should be used to preserve the organs in these patients. When the decision to harvest organs is taken, the transplant specialists must decide whether an organ should be used or not. Advances have been made in preservation techniques but are still insufficient to allow a reduction in immunosuppression. The UW solution is a major advance for liver, kidney and pancreas transplants. During harvesting, the separation of the vascular pedicles requires a good knowledge of surgical anatomy. Furthermore, the needs of the other surgical groups should be taken into account and concessions made to allow the harvesting of the greatest possible number of organs and consequently the treatment of the largest number of patients awaiting organs.

Brain Death

[Computer-assisted prostate reconstruction].

The authors report a technique of computer assisted three-dimensional reconstruction using the information obtained from serial sections collected on a digitalizing table. This reconstruction was performed with a popular personal computer: Macintosh. This technique was applied to the reconstruction of the animal prostate.

Animals

[Treatment of PT1 tumors of the bladder using transurethral resection and intravesical immunotherapy].

Twenty-six patients with a PT1 urothelial bladder tumour were treated by transurethral resection and endovesical BCG. The authors compared previously untreated patients with patients with a history of bladder tumour present for an average of 4.6 years. The results of this study show that 72% of bladders in the first group were preserved compared with 53% in the second group. 45% of patients in whom the tumour invaded the superficial lamina propria developed a recurrence compared with 100% of tumours with invasion of the deep lamina propria. 25% of patients who developed a recurrence died in the course of this study.

Administration, Intravesical