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Biomedical subjects

A Jardin

Publications and source records attributed to A Jardin.

At least 73 records · Page 4Linked to original sources
PubMed1995

Enhanced detection of hematogenous circulating prostatic cells in patients with prostate adenocarcinoma by using nested reverse transcription polymerase chain reaction assay based on prostate-specific membrane antigen.

We report the development of a new sensitive nested reverse transcription-polymerase chain reaction (RT-PCR) assay, using primers derived from the prostate-specific membrane antigen (PSM) cDNA sequence, to detect an hematogenous spread of prostate adenocarcinoma cells. In 60 patients with a biopsy-proven prostate cancer, PSM and PSA RT-PCR detected circulating prostate cells in 40 and 20 patients, respectively. In pT4 M+ and pT3 M+ disease patients, nested PSM primers detected cells in 28 of 33 patients (85%), whereas nested PSA primers detected cells in 17 of 33 (51%). In patients with organ-confined cancer spread (pT2a and pT2b patients) before radical prostatectomy, nested PSM RT-PCR detected circulating prostatic epithelial cells in 6 of 17 patients (35%), which suggests that an hematogenous spread of prostate cells may occur early in prostate cancer history. Altogether, these results suggest that the detection of PSM-expressing cells in blood may predict the development of cancer in patients without clinically apparent prostate cancer. Nevertheless, the potential application and the clinical significance of detection of hematogenous prostate cells through the use of nested PSM primers need an extensive longitudinal study.

Adenocarcinoma↗
PubMed1995

[Treatment using concomitant radiochemotherapy of N+ M0 stage urothelial tumors of the bladder].

Seventeen patients with N+ urothelial bladder tumours were treated by a combination of deep endoscopic resection and concomitant radiochemotherapy (5FU cisplatin). 15 patients completed their course of treatment. 52.9% of these 17 patients are in complete remission at 6 months, 35.2% are in complete remission at 1 year, 30% of patients in complete remission developed distant metastases, 52.9% developed local progression and 40% developed distant metastases. This protocol of deep resection combined with radiochemotherapy can therefore be effective in the local control of the tumour and can allow preservation of the bladder in the case of complete remission. However, it is insufficient to prevent the development of distant metastases. It is therefore preferable to intensify this treatment by performing complete endoscopic resection, by increasing the radiotherapy dose rate and by intensifying the chemotherapy protocol.

Adult↗
PubMed1994

[Erection disorders: efficacy and tolerability after 6 months of intracavernous self-injections of alprostadil. Groupe Français d'Etude de l'Alprostadil].

OBJECTIVES: Self-administered intracavernous injections, notably with alprostadil are currently the most widely used non-psychotherapeutical treatment of erectile dysfunction. We assessed the effectiveness of this treatment after 6 months of self-injections. METHODS: Efficacy, acceptability and tolerance to alprostadil self-administered via intracavernous injections for 6 months was evaluated in 144 men, age 24 to 72 years, and followed monthly after an initial training period and search for the optimal dose. RESULTS: The mean number of self-injections was 5.5 at a mean dose of 18.6 micrograms per injection. From the first to sixth month, the frequency of complete erections after self-injection rose from 62% to 77% and failures declined from 8% to 3%. After six months, 40% of the patients had abandoned the treatment including 9% who abandoned during the first month, usually due to poor acceptance and because of cure in two patients (4.5%). Patients reported sexual intercourse after self-injections as satisfactory in 81% of the cases; 66% of their partners reported satisfactory intercourse. Tolerance assessment revealed pain in 14% of the patients and decreasing effect with time in two patients who discontinued self-injections for this reason. Other undesirable side effects were infrequent, usually related to technical injection errors and decreasing effect with time. One case of priapism and two indurations of the cavernous bodies were also observed. CONCLUSION: Self-administration of intracavernous alprostadil can lead to rigid erection in patients with erectile dysfunction. Patients are generally well satisfied and tolerance is good.

Adult↗
PubMed1994

[Diagnosis and treatment of impotence. Indications of intracavernous injections].

Based on progress in our understanding of the physiology of erection, intracavernous injections of vasoactive substances have completely changed the treatment of impotence. Essentially, erection results from the effect of smooth muscle relaxation in the vascular walls leading to local fall in vascular resistance and increased arterial flow combined with smooth muscle relaxation within the sinusoid spaces of the cavernous bodies. Smooth muscle cell tone is regulated not only by the classical norepinephrine and acetylcholine neurotransmitters, but also by other non-adrenergic and non-cholinergic neurotransmitters released locally. Although the "erectile neurotransmitter" has not been identified parasympathetic nerve terminaisons release nitric oxide (NO) a powerful myorelaxant agent. NO is also synthetized by the endothelial cells on the internal surface of the sinusoidal spaces. These recent findings have led to the use of papaverin to reduce the level of intracellular calcium, alpha-blockers to antagonize alpha-receptor and prostaglandin to inhibit norepinephrine release. Vasoactive intestinal polypeptide, a myorelaxing agent, and linsidomine which favours NO release have also been used. Diagnostic tests by intracavernous injections are indicated as part of the complete work-up in patients consulting for impotence. Therapeutic indications for auto-injections require careful choice of the agent and the dosage to inject depending on the cause of the impotence and the patient's demands and capacity to learn the technique. Papaverin or prostaglandin E1 alone or in combination with phentolamine give good results. Rigid erections can be obtained in over 60% of the patients. Alpha-blockers appear to be the least active in terms of rigidity. Mid-term results of intracavernous fibroses have been reported after papaverine injections. Priapism is the main secondary effect of intracavernous injections.

Humans↗
PubMed1994

[Cancer of the kidney, prognostic value of nuclear grading for the early diagnosis of metastasis].

OBJECTIVES: Since immunotherapy or surgery can sometimes lead to remission of metastatic renal cell carcinoma, it is important to recognize factors predicting metastasis. We therefore evaluated the usefulness of nuclear grading in predicting metastasis of renal cell carcinoma. METHODS: We retrospectively reviewed 95 patients (69 males, 26 females; mean age 63.9 years) who successively underwent surgical exeresis of a renal cell carcinoma. The TNM classification was established on the basis of preoperative work-up (thoraco-abdominal computed tomography, bone scintigraphy) and pathology examination of the surgical specimen. Nuclear grading was performed by a pathologist who was unaware of the histology results. Outcome was evaluated on the basis of physical examination and computed tomography results 6 months after surgery. RESULTS: There were 34 cases of clear cell carcinoma, 10 granulosus tumours, 2 oncocyte tumours and 16 renal cell carcinomas of undetermined type. Mean tumour diameter was 70.3 +/- 37.8 cm. Tumour classification gave (< 5 cm, n = 23; > 5 cm, n = 26; local invasion, n = 28; invasion of neighbouring organs, n = 2). Metastases had been identified in 11 patients before surgery. Nuclear grading according to the Führman scale gave F1 (n = 3), F2 (n = 28), F3 (n = 34) and F4 (n = 24). Tumour size and the TNM classification were correlated with the observed nuclear grading scores. Within one year of surgery, metastasis was observed in 6 patients whose Führman grades were F3 (n = 1) and F4 (n = 5). Metastasis occurred in 26% of the patients with a Führman grade 4. CONCLUSION: Nuclear grading can be used to identify patients who should be closely followed after surgical removal of renal cell carcinoma in order to improve early diagnose of metastasis.

Adenocarcinoma↗
PubMed1994

Anatomy of the prostatic nerves.

The entire prostate of a 10 year old boy was cut with a microtome in to 4300 serial slices. The nerves were stained using a monoclonal antibody called anti PS 100. All information was recorded using a computer reconstruction programme. The prostatic nerve supply is very abundant. The nerve fibers of the cranial prostate (central zone) follow a pathway parallel to the anterior surface of the seminal vesicles going towards the caudal prostate. The periurethral zone is widely innervated by nerves arising from the periphery. The caudal prostate also contains many nerve fibers of variable size. We identified many nerve fibers along the anterior surface of the seminal vesicles and surrounding the lateral aspect of the prostatic capsule. They penetrate the capsule and the whole circumference of the caudal prostate. The prostatic capsule is covered by numerous nerve fibers and ganglia, which form a true periprostatic nerve network. The urethra is supplied by numerous thick fibers of more than 30 microns in diameter.

Child↗
PubMed1994

Long-term treatment of benign prostatic hyperplasia with alfuzosin: a 24-30 month survey. BPHALF Group.

OBJECTIVE: To address the long-term results of alfuzosin, an alpha 1-antagonist, in patients with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: A 6-month, placebo-controlled study involving 518 patients was followed by two successive one-year, open extensions. Only centres who wished to continue the trial participated in the extensions; 131 patients entered the first extension, with 50 continuing into the second year extension. The results of the second year follow-up are presented here. RESULTS: Depending on their initial randomization to either the placebo or alfuzosin arm, patients were treated with alfuzosin for 24 (n = 50) or 30 months (n = 22). The data collected on those 50 patients in comparison to baseline confirmed that the clinical efficacy observed in short/medium-term studies was maintained. A clinically significant improvement in urinary symptoms was observed; the Boyarsky score decreased from 8.7 (+/- 0.3) at baseline to 5.2 (+/- 0.3) at 24 months, with no deterioration in the objective parameters. In patients treated for 30 months (n = 22), symptomatic assessment and urodynamic parameters remained stable, indicating the sustained effectiveness of therapy. No serious or unexpected side-effect related to long-term exposure to alfuzosin was observed. No complications associated with BPH occurred. Two patients (4%) reported dizziness, neither of whom withdrew from the study. In this population, where 40% of patients were receiving concomitant cardiovascular therapy, no clinically significant change in standing systolic blood pressure, diastolic blood pressure or heart rate was apparent between baseline data and those at 24 months. CONCLUSION: These data demonstrate the usefulness of long-term treatment with alfuzosin in patients with uncomplicated, moderate BPH.

Adrenergic alpha-Antagonists↗
PubMed1994

[Cytopuncture: an alternative to pelviscopy in the diagnosis of lymphatic metastases of urologic pelvic tumors].

119 patients with prostatic or vesical tumours without metastases were studied by lymphography-aspiration cytology to detect lymph node metastases. 12% of aspiration cytologies were uninterpretable, corresponding to N-patients. 12% of the 105 interpretable cases were positive. Some of the patients with negative biopsies were treated nonsurgically. 28 bladder tumours were treated intravesically. 11 prostatic cancers were treated by radiotherapy and 63 patients underwent surgical resection. These 63 patients had an interpretable aspiration cytology and surgical control. Aspiration cytology was falsely negative in 7 cases: 4 microscopic metastases and 3 macroscopic metastases. The sensitivity of aspiration cytology after lymphography is 66% and its specificity is 100%. The positive predictive value is 100% and the negative predictive value is 92.3%. These 7 false-negative results included 3 macroscopic metastases already identified on CT scan and 4 micrometastases in which surgical resection was legitimate.

Adenocarcinoma↗
PubMed1994

Incidence of vascular complications in kidney transplantation: is there any interference with the nature of the perfusion solution?

Two non-randomized groups of 100 kidney transplants each were compared in relation to the flush-out solution used. The two groups were similar with the exceptions of the number of multiple artery kidneys and the proportion of kidneys procured in our center. The rate of vascular complications such as arterial venous thrombosis and renal artery stenosis was higher in the Eurocollins (19) group than in the UW group (4) p < 0.01, even if the multiple artery kidneys are excluded. These results need to be confirmed by a randomized study but it is clear that the use of the UW solution leads to a better arterial flow with fewer vascular complications.

Adenosine↗