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Biomedical subjects

B Giraud

Publications and source records attributed to B Giraud.

At least 37 records · Page 2Linked to original sources
PubMed1990

Node exploration in prostatic cancer.

Lymph node invasion is an important stage in the development of metastases; it is exceptional for metastases to be found in the absence of lymph node invasion. Radiological investigations have been developed, but lymphangiography, echography and scanners can only be used when invasions have attained a certain volume and they do not recognize microscopic modifications. The use of localized histological samples has been shown to be reliable and not to be as inconvenient as laparotomy, which is a relatively major operation in prostatic cancer patients, who tend to be elderly.

Humans↗
PubMed1990

Interim report of a large French multicentre study of efficacy and safety of 3.75 mg leuprorelin depot in metastatic prostatic cancer.

A study carried out in 470 patients with metastasized adenocarcinoma of the prostate confirmed the efficacy of 3.75 mg leuprorelin acetate depot given subcutaneously once monthly. Bone pain was rapidly decreased and the general condition of patients and urinary signs improved. Sexual activity was maintained in 50% of patients. After 3 months' treatment, there was no progression in 95% of patients, complete regression in 39% and partial regression in 49%; 17% of cases were stabilized. Improvement in clinical signs was directly related to a decline in amounts of prostate-specific antigen and was associated with a decline in serum testosterone concentrations within 3-4 weeks of starting treatment. Leuprorelin acetate depot was well tolerated and was easy to store and use.

Adenocarcinoma↗
PubMed1989

[Microanatomy of the female urethra].

The author presents a description of the microscopic anatomy of the bladder neck and female urethra based on reconstructions derived from microscopic sections performed in 3 planes. He describes the horizontal and vertical fibres. The horizontal fibres form 2 opposed, arched layers encircling the upper part of the bladder neck and derived from the detrusor. Inferiorly, there is a very small, annular, smooth muscle sphincter which surrounds the middle part of the urethra like a cuff. The vertical fibres arise from the detrusor mostly terminate in the periphery of the circular fibres. Several fibres also pass in the urethral lumen.

Female↗
PubMed1988

[Organ procurement. The Clermont-Ferrand experience].

The authors report the experience of a new kidney collection centre organised at Clermont-Ferrand, which rapidly became involved in the collection of multiple organs. The difficulties encountered during the collection of organs from the first 30 cadavres are presented: 19 kidneys were not grafted, sometimes for anatomical reasons, but especially because of surgical reasons (during the following period, this number fell to 3 for a series of 21 cadavres). 13 hearts and 2 livers were also removed. In conclusion, the authors stress that such organ collection centres can only be created when transplantations are also performed, because of inevitable psychological reasons affecting both the health care team as well as the population of the region.

Adolescent↗
PubMed1988

[Medical treatment of urothelial tumors of the bladder].

Intravesical chemotherapy is widely used in the management of superficial urinary bladder tumors. A complete response rate of 30 to 50% is observed in unresected tumors. Prophylactic instillations of the drugs after transurethral resection of the tumors seem able to delay recurrences. BCG can also be as effective, particularly in carcinoma in situ. Confirmation of efficacy of retinoids needs further studies. Invasive or metastatic bladder carcinoma can be responsive to systemic chemotherapy in about 40% of the cases for a period of 6 to 12 months. The value of adjuvant chemotherapy remains to be proved. Enhancement of radiation therapeutic effects by CisPlatinum in an interesting field of clinical research.

Administration, Intravesical↗
PubMed1988

[Natural history of arterial hypertension due to primary hyperreninism].

This case report deals with an eight-year duration severe high renin hypertension and its consequences. In 1975, a 13 years old girl was found to have blood pressure (BP) levels of 240/150 mmHg with bilateral papilloedema. Hypokalemic alkalosis, a 45 mm Sokolow index (SI) and very high peripheral renin activity (PRA) were also noticed. Renal vein renin sampling (RVRS) suggested secretion from the left kidney but intravenous pyelography and renal arteriography were normal. BP levels were first controlled by triple treatment but rose one year later, despite adjunction of beta-blockers. High PRA was again found, but without hormonal gradient on a second RVRS. From 1977 to 1982, BP never fell to normal levels despite quadruple treatment. In 1982, a stage II optic fundus, a 58 mm SI and 2 g/day proteinuria are noticed, so that a new complete etiologic work up is undertaken in 1983: PRA is still high, with a dramatic acute BP fall after captopril and no gradient on a third RVRS, but intravenous pyelography, tomodensitometry and selective arteriography disclose a 4 cm diameter poorly vascularized tumour on the surface of the lower pole of the right kidney. BP levels are controlled for three months by captopril + chlorothiazide. The tumour is removed in january 1984. RVRS by direct peroperative punction indicates (a posteriori) hormonal secretion from the right kidney lower pole. Histologic examination and immunofluorescence with antirenin serum corroborate the juxtaglomerular origin of the tumour. Eighteen months later, BP is permanently normal, SI is 30 mm, and there is no proteinuria.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Kidney pelvis perforation due to a Greenfield intra-caval filter].

The authors report a case of renal pelvic perforation discovered three months after insertion of a Kimray Greenfield filter on an IVP in the form of a contrast leak. This complication was favoured by the initial malposition of the filter. Computed tomography was essential in the understanding of the pathology and in the investigation of associated lesions (uric acid stone). Treatment was conservative.

Aged↗
PubMed1988

[Technic and results of lymph node excision using pelvic lymphadenoscopy].

The authors report their experience of a surgical approach to pelvic lymph nodes based on a series of 24 patients with prostatic cancer (20 patients) or bladder cancer (4 patients). After making a short iliac incision, this technique consists of detaching the peritoneum with a finger and introducing a retractor (modified Cusko speculum) allowing removal of the lymph nodes. The authors discuss the indications for this technique in comparison with other methods of investigation of lymph nodes and present their results.

Endoscopy↗
PubMed1988

[Extracorporeal lithotripsy. Apropos of 145 initial patients treated in Clermont-Ferrand].

Between April and July 1987, 145 patients (presenting with a total of 178 renal and ureteric stones) were treated by extracorporeal lithotripsy (EDAP LT 01) in the Urology Department of Clermont-Ferrand hospital. No anaesthesia was performed during the 186 sessions required, except for 1 patient who underwent neuroleptanalgesia. Fragmentation was obtained in 86% of cases; the complete success rate was 70%, the partial success rate was 16% and the failure rate was 14%.

Adolescent↗
PubMed1987

[Current role of oncostatic chemotherapy in malignant testicular tumors].

Recent results with the therapeutic strategy for malignant testicular tumors are presented. Nearly 80% of these tumors can be cured by the coordinated therapeutic efforts of a surgeon and medical oncologist. Cis-platinum chemotherapy regimens are widely used and intensive chemotherapy followed by autologous bone marrow transplantation should enable to cure poor prognosis forms in the near future.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

[Complications of abdominal hysterectomy for benign gynecologic lesions. Apropos of 1,000 cases].

The authors present a retrospective study of 1,000 total abdominal hysterectomies performed between 1969 and 1975, and they report the main complications. Early complications are dominated by: rare thrombo-embolic accidents (2.2%) since the advent of prophylactic heparin therapy; infectious complications, dominated by the abscess of the abdominal wall and asymptomatic urinary infections, and for which simple measures prevent resorting to prophylactic antibiotherapy. The role of the hysterectomy seems minimal in the occurrence of a prolapse or a stress-related urinary incontinence: prolapses after hysterectomy (1.4%) seem more related to tissue aging than to the procedure which modifies very little the supporting system of the pelvis. A post-operative urinary incontinence is, most of the time, the result of an incomplete pre-operative work-up: failure to recognize a potential stress-related incontinence, or an incontinence secondary to an unstable bladder. Prolapse and incontinence must always be treated independently. In the psychological and sexual repercussion, age, ovariectomy and the distress related to the procedure, involving the heart of womanhood, seem to be the most important factors.

Adult↗
PubMed1987

[Ureteral dosimetry during gynecological curietherapy. Possible effects on the occurrence of postoperative ureteral complications].

The dosage of radiations delivered during gynaecological brachytherapy is usually calculated for the bladder and the rectum. A new technical approach is described in order to known the dose of radiation received by the terminal portion of the ureter. During placement of the Fletcher suit one of the ureters is catheterized by a special stent which appears on the X-rays control used for dosimetry. Data of 16 pre-operative brachytherapies for carcinoma of the cervix were studied. In half of the cases, the dose debit was higher on the ureter than on the bladder and the rectum. In 7 cases, the dose delivered was also higher on the ureter rather than on the bladder and the rectum. And in 3 cases this dose was higher than 50 grays. It is concluded that the ureter is frequently the most irradiated organ in the pelvis during brachytherapy for carcinoma of the cervix. This may be a physiopathologic explanation for some ureterovaginal fistulas occurring after radical hysterectomy.

Brachytherapy↗
PubMed1986

[Treatment of epithelial cancers of the ovary in advanced stages with surgery and cisplatin chemotherapy].

Seventy-one patients with advanced epithelial ovarian carcinoma were treated at the Centre Jean Perrin between May 1979 and December 1983. Following an initial laparotomy performed for staging and maximum cytoreductive surgery, six to twelve courses of chemotherapy were delivered with cis-platinum; 43 patients underwent a second look operation (S.L.O.). The results of initial surgery, chemotherapy and S.L.O. are discussed: survival rate is 57% at 3 years for stage III. 38% complete remission induced by chemotherapy were proved by negative S.L.O. after primary surgery with residual disease. Initial complete debulking and negative S.L.O. were significant factors that improved prognosis. Improvement of survival expectancy by removal of all macroscopic residual disease at S.L.O. remains to be proved. Treatment after S.L.O. is still under discussion.

Adult↗
PubMed1986

Second-look laparotomy in managing epithelial ovarian carcinoma.

Fifty-one patients treated for an epithelial ovarian carcinoma underwent a second-look operation (SLO) from August 1979 to December 1984. Previously, an initial laparotomy had been performed for staging and maximum cytoreductive surgery. This was followed by 6 to 12 courses of combination chemotherapy including cisplatin. Findings at SLO and outcome are discussed as regards extent of initial surgery, preoperative assessment and secondary debulking procedure. In this work, the findings at SLO were often predictable, and related to the adequacy of initial surgery and to a clinical complete response. Nevertheless, after incomplete initial cytoreductive surgery, SLO appears the best procedure to assess the status of the peritoneal cavity and the efficacy of chemotherapy. Negative SLO after incomplete initial surgery assessed a complete response rate of 34% induced by the cisplatin-based chemotherapy. Survival rate of patients with a negative SLO was 93% at 3 years, which demonstrated the highly significant value of SLO in prognosis. Conversely, patient survival with positive findings at SLO was very low, whatever resection can be made. As this work and similar studies by others showed that it could improve patient survival, an attempt should be made to a secondary debulk of residual tumor, and it seems interesting to perform further such secondary resections until definite conclusions can be drawn about this procedure.

Actuarial Analysis↗