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Biomedical subjects

A Steg

Publications and source records attributed to A Steg.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Treatment of superficial tumors and carcinomas in situ of the bladder by intravesical BCG therapy].

89 patients with a superficial tumor of the bladder were treated with intravesical BCG: 150 mg of the Pasteur strain was instilled once a week for 6 weeks, once every other week for 3 months and once a month for 2 years, in 4 groups of patients. Group I: 20 patients with primary carcinoma in situ (CIS); 18 have been monitored for more than 6 months: in each, cytology has become negative; 16 were controlled by TUR: in all but one complete regression of CIS was observed. Group II: 24 patients with stage O tumor; in 16, follow up is greater than 12 months : the recurrence rate dropped from 11.12/100 months patients to 1.52/100 months patients. Group III: 12 patients with stage A tumor: in 10, follow up is greater than 12 months; 2 patients had tumor recurrence. Group IV: 28 patients with stage O or stage A tumor associated with CIS; in 17, followup is greater than 12 months: CIS disappeared in 13, but in 2 recurrences were observed (stage O without CIS). In addition to irritative side effects on the bladder, we observed complications in four cases: epididymitis in 2 patients and BCG spread with granulomatous hepatitis and bronchopulmonary lesions in two others.

Administration, Topical↗
PubMed1985

[Treatment of advanced prostatic cancer with a gonadorelin agonist, dTrp6 LHRH. 41 cases].

Forty-one patients with prostatic cancer were treated with DTrp6 LH-RH, a luteinizing hormone releasing hormone agonist. Thirty-eight of them had advanced cancer with either metastases or major local spread. In all cases with plasma testosterone levels were normal before treatment, the LH-RH agonist brought them down to values observed after surgical castration. An objective response ("improvement" or "stabilization") was obtained in 68% of the patients, but virtually all "improved" patients were those without previous hormonal treatment. As with all LH-RH agonists, the pharmacological castration produced by DTrp6 LH-RH is of considerable value in the treatment of prostatic cancer, especially since this compound, unlike estrogens, does not seem to cause cardiovascular accidents. However, transient hyperandrogenism may occur during the first days of treatment (as it did in 9 of our patients) and may be responsable for an acute flare-up of the tumoral process, as suggested by 2 of our cases. The concomitant administration of an anti-androgenic drug should perhaps be considered.

Aged↗
PubMed1985

Bladder neck reconstruction using an anterior bladder flap in post-prostatectomy incontinence.

Bladder neck reconstruction using an anterior bladder flap was used in 10 patients with total diurnal urinary incontinence, persistent 1 year after suprapubic (n = 6) or transurethral (n = 4) prostatectomy. 8 patients achieved symptomatic improvement, 6 of them with excellent or good results. Bladder neck reconstruction is undoubtedly able to correct post-prostatectomy incontinence, provided there is no residual bladder neck obstruction or alteration of the bladder musculature due to previous surgery. These cases should be considered for artificial sphincter implantation.

Aged↗
PubMed1985

Anatomical study of total cystoprostatectomy.

The authors describe an anatomical study of total cystoprostatectomy. They show that Denonvilliers' fascia is made up of many membranous layers starting at the bladder. They recall the fact that the preprostatic veins are attached at the bottom, not only to the venae dorsales penis, but also to the venae pudendae internae which runs under the levator ani muscle. These preprostatic veins lie inside a vessel-bearing blade of tissue made of muscular and collagenous tissue derived from the anterior vesical wall. This anatomical study recalls the fact that the interprostatorectal dissection line is behind Denonvilliers' fascia and that the preprostatic vein dissection line is on the anterior aspect of the membranous urethra.

Fascia↗
PubMed1985

Suprapubic ultrasonography in the follow-up of superficial bladder tumors.

40 patients with superficial (grade 1-3, stage 0) transitional cell carcinoma of the bladder were followed using urinary cytology, cystoscopy and suprapubic ultrasonography. Sonography detected tumors as small as 2.5 mm, but missed lesions that developed in the dome as well as flat anomalies associated with positive urinary cytology. Although, not a definitive alternative to cystoscopy, suprapubic ultrasonography of the bladder can, in selected cases, be used to widen the interval between endoscopic controls.

Carcinoma, Transitional Cell↗
PubMed1985

The predictive value of pre-orchidectomy serum tumor markers in non seminomatous germ cell tumors of the testis (N.S.G.C.T.T.).

A.F.P. and B.H.C.G. serum levels were measured using a radio-immunoassay in 22 patients with a N.S.G.C.T.T. before and 15 days after orchidectomy. The results were confronted to the stage of the disease as determined by R.P.L.N.D. in the absence of gross metastatic disease. 4 of 6 patients with normal tumor markers had stage II or III disease, and 2 of 7 in whom the markers returned to normal were stage II. Pre-orchidectomy A.F.P. levels over 100 ng/ml are consistent with metastatic disease as well as vascular and/or cord involvement irrespective of the markers status. These results should be born in mind when deciding a simple surveillance policy in clinical stage I N.S.G.C.T.T. Serum tumor markers, alfa foetoprotein (A.F.P.) and the B fraction of human choriogonadotropin (B.H.C.G) are commonly used to monitor surveillance as well as therapeutic response in patients with N.S.G.C.T.T. It is however well known that 30% of the patients with stage IIa, IIb, N.S.G.C.T.T. have normal post-orchidectomy serum markers (SKINNER). These false negative which may proceed from absence or undetectable tumor markers secretion by the metastases, question the safety of the wait and see policy based on serial serum markers determination as well as abdominal and thoracic C.T. Scan. Nevertheless, the level of pre-orchidectomy serum tumor markers as well as their evolution after orchidectomy may be more meaningful.

Adolescent↗
PubMed1985

[Calcium oxalate monohydrate (whewellite) renal lithiasis].

Pure calcium oxalate monohydrate lithiasis is rare--about 5 to 10% of total renal lithiases. The proportion is the same in men and women. Pure calcium oxalate stones are a polished dark brown color, and are very hard. They are visualized radiologically as regular and homogeneous. From a biological standpoint, this type of stone is frequently associated with normal calciuria and oxaluria. Pure calcium oxalate monohydrate stones rarely evolve.

Adult↗
PubMed1985

[What can be expected of x-ray computed tomography in the assessment of the loco-regional extension of kidney cancer?].

The authors assess the role of CT scanning in investigations for the extension of renal tumors with the aid of a series of 40 patients. A complete inventory of the lesions was obtained in 30 patients who had undergone radical surgery. Capsular damage is visualized with a high percentage of uncertainty, and, setting aside a few exceptions, it is impossible to specify the histological nature of adenomegalies. On the other hand, venous exploration can be performed with growing accuracy thanks to series of angioscans. This method of investigation would therefore not seem suitable for staging tumors on Robson's scale, but it is most useful in selecting surgical tactics in the preoperative assessment of the lesions.

Adenocarcinoma↗
PubMed1985

[Urinary incontinence following prostatectomy. Results of cervico-urethral plasty using Tanagho's tubular vesical flap].

Seven patients suffering from urinary incontinence after prostatectomy were treated by cervico-urethral plasty with a tubular vesical flap. Results were good or very good in four cases, and fairly good in one. There were two setbacks. The procedure should be reserved to patients not afflicted with vesical instability, cervico-urethral obstruction or fibrosis of the anterior surface of the bladder. Patients suffering from the last two conditions require an artificial sphincter after removal of the obstructive lesions.

Humans↗
PubMed1985

[Cancer of the colon following ureterosigmoidostomy or following bladder enlargement using a colonic graft].

The role of carcinogenic factors following urinary diversion are here studied on the basis of three very different cases. In the first, an adenocarcinoma developed at the site of a ureterocolic anastomosis thirty one years after Coffey's operation for bladder exstrophy. In the second, the tumor had developed, 31 years after uretero-sigmoidostomy, for ureteral trauma. The anastomosis had moreover ceased to function ten years previously. In the third case, the patient had undergone a right nephrectomy for urinary tuberculosis and a colocystoplasty to enlarge the bladder with re-implantation of the left ureter in the graft. Twenty one years later, an adenocarcinoma developed at the site of the anastomosis between the colonic graft and the bladder. This was an exceptional case (possibly the first) of a cryptal tumor developing out of contact with material. It thus runs counter to the alleged role of facies in the development of adenocarcinomas following urinary diversion.

Adenocarcinoma↗
PubMed1985

[Systemic cisplatin-based chemotherapy in the treatment of advanced bladder cancer].

Twenty one patients with advanced bladder cancer (metastases and/or loco-regional recurrences) were treated by cisplatin-based chemotherapy (cisplatin, adriamycin, cyclo-phosphamide (8 patients), cisplatin, methotrexate (8 patients) and cisplatin and radiotherapy (5 patients). The results with pure chemotherapy were, on the whole, disappointing, with a remission rate of 25% and a response rate of 50%. Only the combination of cisplatin-based chemotherapy and radiotherapy gave spectacular results with 50% complete response, but even then at the price of a high morbidity rate.

Aged↗
PubMed1985

[Calcium oxalate stones and hyperoxaluria secondary to treatment with pyridoxilate].

Pyridoxilate is a salt formed from glyoxylic acid and pyridoxine. It has been used therapeutically as an antianoxic drug in the treatment of various arterial complaints. Its use is based theoretically on its ability to block the conversion of glyoxylic acid into oxalic acid. The following cases suggest, however, that pyridoxilate can cause stones. Intraperitoneal injection of glyoxylate in doses of 130 mg/kg will cause oxalate stones in rats. The same effect results from injection of 427 mg/kg pyridoxilate (i.e. an equivalent dose of glyoxylate). In human subjects, intravenous injection of 200 mg of pyridoxilate results in a fourfold increase in the urinary oxalic acid content in the two hours following the injection. Thirteen cases of chronic progressive oxalate stone disease have recently been reported in patients receiving a prolonged course of pyridoxilate at 450 to 600 mg daily. Eight of these patients had no previous history of lithiasis. Oxaluria levels of 80 to 100 mg daily are observed in all cases of lithiasis in patients receiving pyridoxilate. The levels fell after cessation of the pyridoxilate treatment, and reverted to normal (30 mg/24 hours) in all but three patients. These three patients maintained levels of close to 50 mg and all three had a previous history of urolithiasis.

Aged↗
PubMed1984

[Hemostasis of the preprostatic veins in total cystoprostatectomy. Anatomical bases].

An anatomical study has enabled the authors to propose a diagrammatic description of pre-prostatic veins, the haemostasis of which is one of the difficult stages in total cystoprostatectomy for cancer. These veins are surrounded by the pubovesical ligaments but they are separated from the membranous urethra by a cleavage plane which can be used to control venous bleeding.

Hemostasis, Surgical↗