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Biomedical subjects

A Jardin

Publications and source records attributed to A Jardin.

At least 91 records · Page 5Linked to original sources
PubMed1993

[Emergency treatment of calculi of the lower ureter].

Two-hundred patients were hospitalized as an emergency for lower ureteral calculi. Eighty-two of these patients has a less than 6 mm wide calculus which was evacuated by medical treatment; 5 had stagnant infected urine which was drained by endoprosthesis; 113 had an obstructive calculus which resisted medical treatment and was treated by ureteroscopy: the stone could be removed by means of a basket catheter in 58 cases, but this method failed in the other cases and the calculus has to be broken by laser. There were 6 failures due to the nature of the stone (monohydrated oxalate) in 3 cases and to technical laser problems in 3 cases. The success rate of ureteroscopy (basket catheter or laser) was 95 percent in patients whose pain had persisted under medical treatment.

Adult↗
PubMed1993

[Surgery for male infertility].

Biological improvement reduces number of infertile couples, but surgical treatment of male infertility still remains disappointing. Surgeons play an important role within multi-disciplinary teams dealing with infecund couples. Even through biological and microsurgical approach in the operating room, postoperative results with carefully selected patients remain poor. Surgery will be reserved for the only clear and simple cases, and surgeons will not yield under pressure of patients or practitioners and carry out a "last chance" procedure.

Adult↗
PubMed1993

Gastrointestinal complications in renal transplantation.

One wonders whether the use of cyclosporin, histamine receptor antagonists, low doses of steroids, and early diagnosis and treatment actually modify the incidence, morbidity, and mortality of gastrointestinal (GI) and pancreatic complications in renal transplantation. To find out, we reviewed 614 kidney transplant recipients between January 1984 and December 1988. One hundred patients (16.2%) were found to have GI and/or pancreatic complications in the following distribution: 9.6% gastroduodenal, 1.3% pancreatic, 4% colonic, and 0.4% small bowel. None of the patients presenting a gastroduodenal ulcer had perforation or bleeding. Fifty-five percent of the patients with this complication had a past history of eso-gastroduodenal disease, compared to 19.6% in recipients without gastroduodenal complications. Some 4.4% of the patients had a small bowel or a colonic complication and four died of peritonitis due to bowel perforation. Mortality was 35% in those having intestinal resection and/or perforation with peritonitis. Sixteen percent of patients with colonic complications had a known history of diverticula, compared to 3% for those without colonic complications. The incidence of GI and/or pancreatic complications in renal transplant recipients remains high and has caused 1.1% of the deaths in our series. Mortality is essentially due to upper GI bleeding, peritonitis following perforation, and infectious colitis. Better detection of gastroduodenal and colonic disease before transplantation seems to be mandatory. Prevention with histamine H2 receptor antagonists and early surgical treatment of complicated colonic diverticula help to reduce the morbidity and mortality in kidney graft recipients.

Adult↗
PubMed1993

Reflections and suggestions on the nomenclature of the prostate.

The prostate has been given different and contradictory nomenclatures. The nomenclature of the normal prostatic gland must allow for the concepts of comparative anatomy, human anatomy and pathologic anatomy. The object of this study, based on a review of the literature, is to analyse the discordant terminologies, which give rise to misunderstandings, and to suggest a simple nomenclature conformant to anatomic rules and the descriptions of leading authors. It seems necessary to suggest a schema utilising the studies of comparative anatomists and the original descriptions of Albarran and correlating all this information. One must distinguish between the prostate, the prostatic gland and the periprostatic fibromuscular tissue. The central glands are those situated at the center of the prostate in the urethral wall. The prostatic glands themselves are found around the urethra. Within these glands there is a distinction between the cranial glands situated around the ejaculatory ducts, which drain above the seminal colliculus, and the caudal glands situated below the ejaculatory ducts which drain into the urethra below the colliculus. Between the wall of the urethra which contains the central glands and the peripheral glands is the transitional zone.

Animals↗
PubMed1993

Percutaneous antegrade dilation of ureteral strictures in kidney transplants.

Transplant ureteral stricture can be treated by either incisional surgery or percutaneous endoluminal dilation. We present 17 cases of percutaneous antegrade endoluminal dilation. The results of this procedure were satisfactory, with a 70% success rate that seems to be maintained during long-term followup. The results were better if dilation was done on a short and recent juxta-anastomotic stricture stented with a 10F Double-J* catheter for 2 months.

Adult↗
PubMed1993

Antierectile role of the sympathetic nervous system in rats.

The effects of the pharmacological changes of sympathetic innervation were studied in a rat model of electrically induced erection. Stimulation of the cavernous nerve elicited an erectile response measured by intracavernous pressure and separated into latency phase, tumescence (corresponding to corpora cavernosa filling), full erection (ICPE: intravenous pressure during full erection) and detumescence (corpora cavernosa emptying). A close dependence of the corpora cavernosa filling rate, ICPE and corpora cavernosa emptying rate on arterial blood pressure was demonstrated. Ganglionic blockade by mecamylamine decreased ICPE. Chemical sympathectomy by 6-hydroxydopamine improved the entire erectile response. Phentolamine (alpha-adrenoreceptor blocking agent) and propranolol (beta-adrenoreceptor blocking agent) increased the latency phase. Phentolamine increased the corpora cavernosa filling rate and the ICPE, while propranolol decreased them. These results demonstrate that a sympathetic inhibition decreases the erectile response to stimulation and that this inhibition is due not only to norepinephrine, but possibly to a nonadrenergic noncholinergic transmitter, colocalized with norepinephrine.

Animals↗
PubMed1993

Electrophysiological study of relations between the dorsal nerve of the penis and the lumbar sympathetic chain in the rat.

Afferent sensory inputs from the penis are carried by the dorsal nerve of the penis (DNP) to the spinal cord. Sympathetic outflow involved in the control of the urogenital tract is partly conveyed by the lumbosacral sympathetic chain. Our aim was to search for a sympathetic component in the DNP and relations between DNP afferents and sympathetic fibers conveyed by the distal sympathetic chain in anesthetized adult male rats. Stimulation of the lumbar sympathetic chain at the L4-L5 level (LSC4-5) elicited an evoked discharge on the DNP. This discharge was abolished by cutting the sympathetic chain distal to the stimulation site. Ganglionic blockade with hexamethonium and various neural sections revealed the presence of sympathetic postganglionic fibers in the DNP, originating in the sympathetic chain. Stimulation of the DNP evoked a reflex discharge in the LSC. This reflex was spinally mediated since it was abolished by acute spinal cord transection at the L5 level. Acute spinalization at the T8 level significantly reduced the latency of the evoked response. We hypothesize that both spinal and supraspinal control exist over relations of the DNP afferents with sympathetic outflow to the pelvis. Increase in sympathetic tone elicited by activation of penile sensory fibers could play a role in regulation of sexual function.

Afferent Pathways↗
PubMed1993

Autonomic control of penile erection: modulation by testosterone in the rat.

The role of testosterone on peripheral autonomic control of penile erection was studied in rats. Erectile response to cavernous nerve stimulation was measured by intracavernous pressure associated with arterial blood pressure monitoring in anesthetized adult males. Comparison was performed between control (Co), castrated (Ox) and castrated, testosterone-replaced (OxT) rats. Ox rats exhibited smaller erectile responses. Testosterone replacement restored these responses in OxT rats. To identify the peripheral target of testosterone, postganglionic neurons of the major pelvic ganglion, innervating the corpora cavernosa through the cavernous nerves, were separated from the spinal cord by preganglionic axotomy of the pelvic nerves in three other groups of rats (PNx). Erectile response was unchanged in PNx rats, decreased in OxPNx more than in Ox rats, and restored by testosterone replacement (OxPNxT rats). We ruled out the participation of a somatic component in the erectile response in this model as there was no difference between curarized and Co rats. We infer that testosterone enhances the erectile response of cavernous nerve stimulation, acting peripherally to the spinal cord. Arguments are provided that the sites of action for testosterone or its metabolites are situated on neurons rather than on penile erectile tissue. Proerectile postganglionic parasympathetic neurons seem to be the exact target for gonadal steroids.

Animals↗
PubMed1993

Long-term treatment of benign prostatic hyperplasia with alfuzosin: a 12-18 month assessment. BPHALF Group.

In order to assess the efficacy and safety of alfuzosin, an alpha-1 blocker, in symptomatic patients with benign prostatic hyperplasia (BPH), 131 patients who had completed a 6-month placebo-controlled trial conducted on parallel groups entered a 12-month open study; 122 patients were treated with alfuzosin for 12 months and 56 patients for 18 months. After 12 months, all obstructive and irritative symptoms assessed according to the Boyarsky scale were significantly improved, as were peak flow rates in obstructed patients and mean flow rates and residual urine in the whole population. Voiding symptoms showed sustained improvement after treatment for 12 to 18 months. Only 5.3% of patients experienced vasodilatory side effects, none of which led to withdrawal from the study. No side effect related to long-term administration was reported. Alfuzosin has a beneficial effect on voiding symptoms in patients with BPH and can be safely used in long-term administration.

Adrenergic alpha-Antagonists↗
PubMed1993

[Calculi of the ilio-pelvic ureter: therapeutic approach and importance of ureteroscopy regarding 200 cases].

The authors report their experience of 200 consecutive emergency admissions for iliopelvic uteric stones. 82 patients (41%) eliminated their stones with medical treatment. 118 patients (59%) required ureteroscopic treatment either by immediate basket extraction (n = 58) or by contact fragmentation (pulsed laser = 57, ultrasound = 1, electrohydraulic catheter = 2). 6 failures were observed and one case of distant ureteric stenosis was successfully treated by balloon dilatation. This therapeutic approach cured 187 (93.5%) of the patients of their stones within an average of 8 days (82 "spontaneous", 105 "endourological") with a mean hospital stay of 2.3 days and 2.7 days, respectively. Ureteroscopy had a success rate of 95% and appears to be the most effective treatment, but the medical option remains the basic treatment for stones of the lower ureter.

Adult↗
PubMed1992

[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↗
PubMed1992

[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↗
PubMed1991

[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↗