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Biomedical subjects

A Le Duc

Publications and source records attributed to A Le Duc.

At least 109 records · Page 6Linked to original sources

[Should fragments of stone expelled after extracorporeal lithotripsy always be analyzed?].

The morphological and constitutional analysis of renal stone fragments expelled after extracorporeal shock wave lithotripsy enables the structure and morphological type of stones to be reconstructed in 92.8 per cent of the cases as regards surface and section and in 74.5 per cent of the cases down to the core. A study of the molecular and crystalline composition of such fragments demonstrated the preponderance of whewellite in both sexes (men 85.4 per cent; women 72.4 per cent). The frequency of weddellite was 1.6 times higher in men (73.8 per cent) than in women (44.8 per cent), and the frequencies of struvite and ammonium urate were 2.8 and 2.6 times respectively higher in women than in men, despite a significant fall in frequency as compared to a previous series. Correlations between morphological type of stone and biochemical data (when available) could be established in 84 per cent of the cases. This made it possible to initiate treatments aimed at preventing recurrences, the cost of these treatments in the long term being lower than that of the curative urological treatments, including extracorporeal shock wave lithotripsy.

Adult↗

A multicenter, double-blind, placebo-controlled trial of the efficacy of prazosin in the treatment of dysuria associated with benign prostatic hypertrophy.

An 8-center, double-blind, placebo-controlled trial of 39 patients with benign prostatic hypertrophy was conducted to assess the effects of prazosin HCl treatment on functional urologic variables after a treatment period of 4 weeks. The randomized groups were comparable for demographic variables and symptoms, except for the mean residual urinary volume, which was significantly higher in the prazosin HCl group. Prazosin HCl elicited statistically significant improvements in the mean prostatic urethral pressure and prostate area (Mann-Whitney U test: p = 0.001 for both variables as compared with the placebo group). Functional bladder capacity also improved significantly in the group receiving the test drug (Mann-Whitney U test: p = 0.05, as compared with the placebo group). Clinical improvements were also observed in the mean maximum urinary flow, decreased nocturia frequency, and residual urinary volume. Patient preference significantly favored the prazosin HCl treatment (Mann-Whitney U test: p = 0.001). Seven patients on prazosin HCl and 5 receiving placebo reported one or more side effects during the trial phase; these were mild to moderate and disappeared or were tolerated. No statistically significant effects on blood pressure or heart rate were observed.

Double-Blind Method↗

[Detection of cancer of the prostate. A study of 600 cases].

A free screening consultation for carcinoma of the prostate was proposed to men over the age of 50 years working in different companies in the areas of Paris. This consultation included a digital rectal examination, a blood test for determination of serum acid phosphatase and prostatic specific antigen, and two dimensional trans-rectal ultrasonography of the prostate. 600 patients were seen. 575 were evaluable. Prostate biopsy was recommended in 152 men. Ninety-three prostate biopsies were performed. Eighteen prostatic cancers and 1 urothelial cancer invading the prostate were detected with an overall incidence of prostate cancer of 3.1%. Radical prostatectomies were performed in 10 of the 18 patients with a prostate cancer. Sensitivity of digital rectal examination ultrasonography and PSA were respectively 42.8%, 47.3% and 68.4% with an abnormal serum PSA level defined as being greater than 5 ng/ml. The predictive value of a positive ultrasonography (18.7%) contrasts with the predictive value of a positive digital rectal examination (30.7%) and serum PSA (30%). Digital rectal examination and determination of serum prostatic specific antigen seem to be the most useful tests for mass screening of prostate cancer. Transrectal ultrasonography is very useful for guided prostatic biopsy and for a better topographic evaluation of the tumor.

Aged↗

Radioimmunodetection of lymph node invasion in prostatic cancer. The use of iodine 123 (123I)-labeled monoclonal anti-prostatic acid phosphatase (PAP) 227 A F(ab')2 antibody fragments in vivo.

The therapeutic indications in prostatic cancer depend on the regional and distant extension of the cancer and are difficult to assess before lymphadenectomy. Radioimmunodetection of lymph node involvement with monoclonal anti-prostatic acid phosphatase (PAP) antibodies can be proposed as a noninvasive alternative to lymphadenectomy. Fifteen patients with various stages of histologically proven prostatic cancer were examined by immunolymphoscintigraphy (ILS) before treatment to detect lymph node metastases. These patients had Stage A (n = 7), Stage B (n = 3), Stage C (n = 2), and Stage D (n = 3) tumors. They received between 100 and 400 micrograms of monoclonal antibody 227 A in the form of F(ab')2 fragments labeled with iodine 123 (123I). The antibody was injected directly into the periprostatic area. ILS images were obtained after 1, 3, 6, and 24 hours. Three days later, each patient underwent a lymphadenectomy for histologic examination. The results of the histologic examination and ILS were compared. In ten patients, the examination did not show any images capable of being interpreted as lymphadenopathy and histologic examination confirmed the integrity of the nodes examined. In five cases, scintigraphy suggested the presence of lymph node invasion by prostatic cancer and this was confirmed by histologic examination in three of the five cases. Overall, in terms of lymphadenopathy, this examination had a sensitivity of 100% and a specificity of 83%. Therefore, ILS appears to be capable of detecting lymph node metastases in prostatic cancer.

Acid Phosphatase↗

[Culturing of normal and tumor cells of the human prostate].

Cell lines of neoplastic human prostate gland tissue are uncommon. We studied the condition of long term prostatic cell culture; 18 primary cultures of epithelial prostatic cells and 15 subcultures were maintained for several months. The optimum medium for primary prostatic cell cultures contains: little calcium, epithelial growth factor (EGF), phosphoethanolamine, spermine and cholera toxin, the cell characterisation for cultivation of normal, hyperplastic and neoplastic prostate gland tissue in subcultures uses monoclonal antibody against cytokeratin, prostatic acid phosphatase and prostatic specific antigen.

Adenocarcinoma↗

[Magnetic resonance imaging of cancer of the prostate. Preliminary study].

Twenty-two patients with prostatic carcinoma have been studied by magnetic resonance imaging (MRI). Twenty-three examinations have been done for 2 stage A, 11 stage B, 2 stage C and 7 stage D. Prostatic signal and locoregional extension have been compared with rectal examination and the 3 prostatectomies. Cancer looked homogeneous in 4 cases, heterogeneous in 10 cases with a nodule in 5 cases either with hyper of hyposignal compared to the normal prostate. Local extension in stages C and D is seen, especially to the periprostatic fat and seminal vesicles. MRI appears to be sensitive but poorly specific in the diagnosis of prostatic cancer. On the other hand, it is an interesting examination in the staging of prostatic cancer. These results must be confirmed with more comparisons of images and prostatectomy specimens.

Aged↗

[Leiomyoma of the urinary excretory tract].

Four cases of leiomyoma of the urinary tract are presented: 3 locations in the bladder and one location in the ureter. Leiomyomas of the urinary tract are rare. These benign mesothelial tumors require conservative resection. Small lesions can be managed with endoscopic techniques.

Female↗

[Xanthogranulomatous pyelonephritis. Value of magnetic resonance imaging].

Xanthogranulomatous pyelonephritis is a rare disease which frequently has a pseudotumoral appearance. Preoperative diagnosis is hazardous in spite of ultrasonography and CT scan correlation. Recently developed magnetic resonance imaging (MRI) identifies fatty tissue which is specific for XGP. The frequency of invasive investigations has decreased because of this new data and partial nephrectomy has become possible in localized forms of XGP. Magnetic resonance imaging provides an accurate reproduction of the lesions in three dimensions which allows detection of complications (abscess and fistulae) and a study of resection difficulties.

Aged↗

[Initial results in man of immunolymphoscintigraphy of cancer of the prostate].

The loco-regional investigation of carcinoma of the prostate usually comprises ilio-obturator lymphadenectomy. This procedure carries a significant morbidity. Immunolymphoscintigraphy may provide a non-invasive alternative to this operation. Monoclonal (MAB) 227 A anti-prostatic acid phosphatase antibodies have been produced and selected for their affinity and specificity. This MAB was fragmented to its F (ab')2 form and marked with Iodine 123. Fifteen patients with prostate cancer were given 100 to 400 micrograms of the MAB by periprostatic perineal injection. The region was scanned 1 hr, 3 hrs, 6 hrs and 24 hrs after the injection. The results of the immunolymphoscintigraphy were compared with the histology of the ganglia removed at surgery or needle biopsy guided by CT scanning. In 13 cases the results were concordant for the two techniques (10 negatives and 3 positives). Two patients showed extra-prostatic fixation whilst the histology remained negative. Immunolymphoscintigraphy may therefore provide a simple method of detecting local metastases of carcinoma of the prostate if these initial results are confirmed.

Aged↗

Prostate-specific antigen in prostatic cancer.

In an attempt to establish the value of prostate-specific antigen (PSA) in prostatic cancer, serum PSA measurements were performed in 600 patients, including 75 previously untreated prostatic cancer patients. The mean PSA levels in the benign prostatic hypertrophy (BPH) and cancer groups were highly significantly different, but less difference was found between BPH and localized prostatic cancer. A PSA level above 50 ng/ml was never recorded for BPH, but lower levels can be due to either prostatic cancer or to BPH. Our data suggest that PSA is not a specific marker of prostatic cancer but increased serum PSA levels must draw the physician's attention to the possible presence of prostatic cancer.

Antigens, Neoplasm↗

[Prostate-specific antigen in prostatic pathology].

UNLABELLED: Prostate-specific antigen (PSA), like prostate acid phosphatase (PAP), are prostate tissue markers that are useful in prostate disorders. Increased PSA levels are often seen in carcinomas of the prostate, but have also been reported in benign inflammatory disorders of the prostate. We therefore studied PSA levels in 600 patients aged 22 to 89 years to evaluate the usefulness of this marker in prostate disorders. The 600 patients were divided into four groups: 120 normal subjects, 180 patients with carcinoma of organs other than the prostate, 75 patients with carcinoma of the prostate, and 225 patients with benign hypertrophy of the prostate. RESULTS: a significant difference in PSA levels was found between carcinomas and adenomas of the prostate, as well as between stage A carcinomas and adenomas of the prostate. Conversely, non significant difference was evidenced between stage A carcinomas and benign prostatic hypertrophy with inflammation. Rather than a specific marker for cancer, PSA indicates the presence of active prostatic disease, other investigations being necessary to determine whether this disease is malignant. PSA remains extremely useful for monitoring prostate carcinoma patients, especially following radical prostatectomy.

Adult↗

[13 cases of drug-induced calculi].

All urinary stones should undergo detailed studies to identify those related to drug therapy. Among 520 stones analyzed by infrared spectrophotometry, we found 13 drug-induced stones (13/520: 2.5%). Drug-induced stones were caused by glafenine in 7 cases, piridoxylate in 4 cases, triamterene in one case and an unknown organic compound in one case. Glafenine stones appear to develop more readily in infected urine. Triamterene stones are often associated with uric acid disorders. Piridoxylate induces the formation of glyoxylate which is responsible for hyperoxaluria and formation of oxalocalcium stones.

Aged↗