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Biomedical subjects

C C Abbou

Publications and source records attributed to C C Abbou.

At least 163 records · Page 9Linked to original sources

[Conservative treatment of bladder epitheliomas by partial cystectomy and iridium-192 curietherapy].

From 1971 to 1979, 55 patients were treated for bladder cancer at the Henri-Mondor Hospital using a treatment protocol combining low dose pre-operative external beam radiation followed by iliac node dissection, limited partial cystectomy (or sometimes for T1 tumors, a trans-urethral resection) and curietherapy with iridium 192. The 5 year disease free survival was 37/55 (67%). The rate of local recurrences plus second tumors within the bladder was 16% (9/55). These results are compared with other conservative modalities of treatment of bladder cancer.

Adult↗

[Demonstration of specific antibodies against diethylstilbestrol during treatment of prostatic cancer].

Antibodies against diethylstilboestrol were detected in prostatic cancer patients treated with diethylstilboestrol (DES). Direct radioimmunoassay (DRIA) was performed in 109 patients divided into three groups: a control group of 33 patients (group I), a group of 38 patients treated by DES and free of cardiovascular complications (group II), and a group of 38 patients treated by DES with cardiovascular complications (group III). Antibody count was significantly higher in group III than in the two other groups (p less than 0.05). These results suggest that DES antibodies may play a role in estrogen-associated cardiovascular toxicity. For this reason, DES should not be used in patients with a positive assay.

Adenocarcinoma↗

Treatment of bladder tumors by iridium 192 implantation. The Créteil technique.

The technique and results of a treatment protocol for bladder cancer combining low dose pre-operative external beam irradiation followed by external iliac nodal dissection, limited partial cystectomy and curietherapy with iridium 192 are described. In 55 patients treated from 1971 to 1979, 37/45 (67%) are alive NED at 5 years--23/31 pT1, 10/14 pT2, 4/10 pT3--with 9/55 bladder recurrences at 5 years--7/31 pT1, 1/14 pT2, 1/10 pT3. Only two patients (total cystectomy) have not retained a functional bladder. These favorable results have been obtained in a carefully selected population; our indications for the technique being T1, T2, T3a tumors with a total surface area not exceeding 5 cm, not involving the bladder neck and unifocal or in some cases plurifocal, but closely grouped. The advantages and precise details of each stage of the technique will be described and compared with large series in which radium 226 is utilized and results of curietherapy will be compared with other modalities of treatment employed under similar circumstances for similar patient groups. We feel that curietherapy has certain advantages over other methods in the treatment of bladder cancer and that an afterloading technique employing iridium 192 wires permits the curietherapy to proceed under optimal conditions, allowing combination with partial cystectomy, optimal placement of sources, precise radiographic control and dosimetry, dose reduction in many cases, optimal conditions of radioprotection and widening of the indications for the technique.

Brachytherapy↗

[Contribution of suprapubic ultrasound in prostatic hypertrophy].

After describing the technique, the authors recall the ultrasound anatomy of the prostate with the symmetrical echoes given by the seminal vesicles, the vas deferens and the ejaculatory ducts, which often allow a distinction to be made between the cranial and caudal portions of the prostate. Calculation of the volume (normally under 20 cm3) measures the enlargement (useful in determining the choice of approach), using the formula (Formula: see text) Ultrasound also often gives some idea of the nature of the lesion. The main distinction between an adenoma and a carcinoma is the fact that the adenoma is normally confined to the cranium. Carcinomas are generally asymmetrical, and their structure is non-echogenic, giving coarse echoes. Chronic prostatis, on the other hand, leads to the existence of symmetrical hyper-echogenic areas, sometimes calcified. The main contribution of suprapubic ultrasound is the information it provides concerning the repercussions on the urinary tract (residue, straining bladder, repercussions on the kidney). It can also be used to monitor developments.

Adenoma↗

Interstitial radiation therapy for carcinoma of the penis using iridium 192 wires: the Henri Mondor experience (1970-1979).

From 1970 to 1979, a group of 50 patients was treated for squamous cell carcinoma of the penis by interstitial irradiation using an afterloading technique and iridium 192 wires. The group included 9 patients with T1 tumors, 27 with T2 tumors, and 14 with T3 tumors. Forty-five patients presented with no metastatic inguinal nodes (N0), 3 patients with N1 nodes, and 2 patients had N3 nodes. After treatment, 11 patients (1 T1, 6 T2 and 4T3) developed local recurrences; 10 of these 11 patients underwent penile amputation which controlled the tumor in 7 of the patients. One patient refused amputation. Three patients developed post-therapeutic necrosis which necessitated partial amputation in 2 cases. Eight patients developed post-therapeutic urethral stenosis, which required surgical treatment in three of the cases. Overall, at their last follow-up examinations, 74% of the patients were free of disease with conservation of penile morphology and function. Most patients without metastatic nodes (37/45) at diagnosis did not receive prophylatic treatment of the groin. Two of these patients developed delayed metastatic nodes; one was successfully salvaged. All 5 patients presenting with metastatic nodes at diagnosis died, four with uncontrolled regional disease. Twenty-one percent of the patients died of their disease. We advocate interstitial irradiation using iridium 192 wires for the treatment of non-infiltrating or moderately infiltrating squamous cell carcinoma of the penis in which the largest dimension does not exceed 4 cm. Pre-implant circumcision and regular long-term follow-up are necessary. More extensive tumors are better managed surgically. When regular follow-up can be assured, it is reasonable to forgo prophylactic treatment of the inguinal nodes in patients presenting without groin metastasis.

Adult↗

[Renal oncocytoma. Apropos of 9 cases].

The authors report nine cases of renal oncocytoma which were observed in a series of 220 consecutive renal cell carcinomas. They share the general view concerning the clinical latency of these tumors which are rarely hematuric, and concerning the favorable prognosis, despite signs of locoregional malignancy. On the other hand, they do not share the opinion that arteriography or CT scan can provide a reliable preoperative differential diagnosis with the normal type of renal cell carcinoma.

Adenoma↗

[Percutaneous nephrolithotomy in 1984. Technics, results, indications].

Percutaneous nephrolithotomy - PCNL - was made possible by technological progress, with the introduction of nephroscopes, lithotomy forceps, and mechanical, ultrasonic or electrohydraulic lithotriptors. The procedure includes four stages. First needle puncture of the inferior or middle calyx. Secondly, dilatation of the pathway and creation of a tunnel. Thirdly, investigation of the collecting system. And, finally, extraction of the stone. The results of 302 published cases show a success rate of 87 per cent, a complete failure rate of 13 per cent, and residual stones in 10 per cent of cases. The complication rate is 7 per cent, with hemorrhage and sepsis in roughly equal proportions. A few other complications are occasionally reported, such as colic wounds, perirenal collections, traumas of the ureteropelvic junction, pneumothorax, or a stone left in the lumbar wall. There was one case of death. The hospitalization period is the same as for lombotomy, but the return to work is more rapid. The best indications are pelvic and inferior calyceal stones (with a success rate of over 80 per cent). Despite their enthusiasm for this procedure, the authors feel that is still remains to be seen or whether it will in turn be superseded by ultrasound lithotripsy.

Drainage↗

[Disease of branches of the renal artery. Choice of a revascularization procedure].

In situ versus extra-corporeal and microvascular reconstruction are discussed in relation to the treatment of renal branch artery disease. Ten cases are reported: 4 aneurysms, 1 atherosclerosis, 1 trauma, 1 embolism and 1 dissection. In three cases, the disease involved only the segmental artery branches and in seven cases both the main artery and the branches. An in situ procedure was performed in 5 cases and extra-corporeal surgery was necessary in 5 others. Four of the kidneys were iliac autotransplanted. Anatomical and immediate functional results were good in ten cases, but there was one postoperative death by heart failure due to a mitral disease. In our series extracorporeal and microvascular surgery were not routinely used for the treatment of renal artery branch disease. But these procedures can widen the indications for renal revascularisation, which then replaces medical treatment or a nephrectomy.

Adolescent↗

[Acute renal insufficiency in spontaneous septicemia of renal origin. Analysis of a series of 17 patients].

Seventeen recent cases of spontaneous renal septicemia with acute renal failure are reviewed, confirming the need for a diagnostic and therapeutic strategy to restore the fluid balance, if necessary with the aid of an artificial kidney, and the urgency of treating local infection and the pathogenic agents involved. The case review also suggest that the high mortality rate of this infection, estimated by some observers at 50 p. cent, can be greatly reduced by early radical urological treatment.

Acute Kidney Injury↗

[Scintigraphy with technetium dimercaptosuccinic acid (99 m TC DMSA). Contribution to the functional assessment of individual kidneys (author's transl)].

Renal uptake of 99m Tc DMSA was used to evaluate the renal function of 16 healthy subjects (controls) and 115 patients with various urinary tract diseases. Scintigraphic examination was carried out 6 hours after an intravenous injection of the product. In the 16 controls Tc DMSA uptake was 25.7 +/- 2.48% in the right kidney and 24.4 +/- 2.86% in the left kidney. In 36 patients with one single hypertrophied kidney, there was a correlation (r = 0.850) between creatinine clearance and Tc DMSA uptake, which was higher than in normal subjects (39.23 +/- 9.9%). In the group of 68 patients with unilateral (31) or bilateral (37) renal disease, a significant correlation (r = 0,725) was observed between kidney-to-kidney ratios of urea clearance and Tc DMSA uptake, so that renal impairment could be quantified. Quantitative scintigraphy did not appear to be of assistance in the remaining 11 patients with obstructive uropathy, as it overestimated renal function. The results obtained with 99 m Tc DMSA scintigraphy should be helpful in choosing between nephrectomy and conservative surgery and in assessing the degree of compensatory hypertrophy in single kidneys.

Creatinine↗