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Biomedical subjects

B Gattegno

Publications and source records attributed to B Gattegno.

At least 37 records · Page 2Linked to original sources

Cystectomy for severe hemorrhagic cystitis in allogeneic stem cell transplant recipients.

BACKGROUND: Hemorrhagic cystitis (HC) is a common complication following allogeneic stem cell transplantation (SCT). In rare cases, it can be severe, inducing kidney failure and sepsis, and become life-threatening. METHODS: We report three cases of severe HC in stem cell transplant recipients. Risk factors and the management of these patients were studied, as well as severe HC cases reported in the literature. RESULTS: All three patients received high-dose cyclophosphamide in addition to total body irradiation or busulfan in their preparative regimen. They underwent allogeneic SCT, one of them from unrelated cord blood. BK viruria was detected in two cases at the onset of hematuria. HC lasted for more than 3 months, resulting in urinary tract obstruction and sepsis. Ultimately, cystectomy was the last therapeutic procedure available to treat this life-threatening complication. CONCLUSION: We describe three patients, among a total of more than 1300 patients treated in our unit by allogeneic bone marrow transplantation, in whom HC was severe and long lasting enough to require cystectomy as a life-saving procedure.

Adolescent↗

Evaluation of FDG uptake by renal malignancies (primary tumor or metastases) using a coincidence detection gamma camera.

UNLABELLED: The aim of this study was to evaluate the usefulness of FDG scanning using an ordinary gamma camera equipped with coincidence detection (CDET) for 2 renal cancer indications: characterization and staging of renal masses before nephrectomy and search for recurrence after nephrectomy. METHODS: Between September 1997 and June 1998, a whole-body scan and at least 1 tomoscintigram were obtained on 23 occasions in 22 patients (fasting for at least 6 h) using a Prism XP 2000 CDET gamma camera; scanning was begun 45 min after intravenous injection of 150-250 MBq FDG. RESULTS: Postoperative histologic evidence was obtained from 13 of 16 patients who underwent FDG using a CDET gamma camera before renal surgery; 4 renal masses did not accumulate FDG (3 true-negatives, 1 false-negative), whereas 9 renal tumors accumulated FDG (8 true-positives, 1 false-positive). In the other 3 patients, only 1 extrarenal site of FDG uptake was checked and confirmed on histologic examination: a bone metastasis from renal cell carcinoma in 2 cases and lymph node metastasis from a squamous cell carcinoma (3 true-positives). The primary local and regional staging of the malignant renal tumors was accurate in the 9 patients who underwent nephrectomy (8 true-negatives, 1 true-positive). The primary distant staging was positive in 1 case (focus in the chest corresponding to a probable true-positive on follow-up). In the 7 examinations performed because of suspected recurrence of renal cell carcinoma several months after nephrectomy, metastases were visualized by FDG in 4 patients, confirmed by biopsy in 2 patients, and confirmed by conventional imaging or follow-up (or both) in 2 patients. The other 3 patients had negative FDG scans, corresponding to probable true-negative results on follow-up. CONCLUSION: FDG using a CDET gamma camera can be used effectively for the staging and restaging of renal tumors and might be useful for characterization of the primary renal tumor in doubtful cases.

Carcinoma, Renal Cell↗

Nonnephrotoxic, dynamic, contrast enhanced magnetic resonance urography: use in nephrology and urology.

PURPOSE: We assessed the value of breath-hold, gadolinium (Gd) enhanced magnetic resonance urography for diagnosing urinary tract disease. MATERIALS AND METHODS: Dynamic magnetic resonance urography was performed in 38 consecutive patients presenting with urological disease in whom excretory urography was contraindicated. Renal function was impaired in 18 cases with a serum creatinine of 140 to 400 micromol./l. Fast spoiled, gradient echo sequences were acquired during breath-holding 5, 10 and 15 minutes after intravenous injection of 10 ml. of a Gd chelate. Opacification of the collecting system was evaluated using a scale of 0 to 3. Diagnostic value of the examinations was also analyzed. RESULTS: Dynamic magnetic resonance urography was sufficient for making the diagnosis in 95% of cases. We identified 71 pathological findings and the surgical anastomosis was always well visualized. Mean image quality score was 2.34 points for renal calices, 2.86 for renal pelves and 2.48 for ureters. Image quality significantly improved after injecting a diuretic. CONCLUSIONS: Gd enhanced magnetic resonance urography provides quality dynamic imaging of the urinary tract. It is a new approach for diagnosing urinary tract disorders in patients in whom excretory urography should be avoided.

Adult↗

[Epididymal gaseous abscess after BCG treatment].

The authors report a case of unilateral epididymitis with caseous abscess after BCG-therapy for superficial bladder tumour. The severity of the lesions required orchidectomy, followed by four-agent tuberculostatic therapy.

Abscess↗