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Biomedical subjects

C Chatelain

Publications and source records attributed to C Chatelain.

At least 109 records · Page 6Linked to original sources

[Comparative study of MRI and CT x-ray in evaluating the extension of kidney cancer in adults].

The assessment of the extent of kidney cancers with MRI and CT is compared in 40 patients. The appearance of the tumor with MRI is very variable but always heterogeneous. Specific MRI features (tumoral pseudocapsule) provide a higher overall reliability (OR) than with CT for the detection of expansion beyond the capsule and into the kidney: 80% for 60%. Although the overall reliability of MRI is similar to that of CT (92% for 86%), MRI has proved its superiority for the assessment of the limits of endovenous tumoral expansion because of natural flow/thrombus contrast and of the multiple incidences of exploration. There is no significant difference between MRI (OR = 91%) and CT (OR = 88%) or the detection of lymph node involvement. Invasion of neighboring organs is better assessed with multi-incidence MRI. According to Robson's classification, the OR of MRI (77%) is not significantly higher than that of CT (65%). MRI is still a time-consuming and expensive technique, which should be reserved for cases in which iodine is contraindicated and used as a second-intention technique after CT to confirm the invasion of the capsule if partial nephrectomy is indicated, or the better delineate venous or regional invasion which CT could not assess properly.

Adrenal Gland Neoplasms↗

[The uretheral syndrome in men or prostatodynia].

Based on the results of the clinical and urodynamic investigation of 15 patients, presenting with functional genitourinary symptoms, the authors report the efficacy of treatment with alpha-blockers. They stress the importance of the clinical history and of static sphincterometry in this type of patient.

Adult↗

Identification of a light density murine megakaryocyte progenitor (LD-CFU-M).

Murine bone marrow cells were separated on discontinuous Percoll gradients and assayed for their ability to give rise to megakaryocyte colonies. Ninety-one percent of the megakaryocyte progenitors (CFU-M) sedimented at densities between 1.070 and 1.080 g/mL. Six percent of CFU-M were found at densities between 1.060 and 1.070 g/mL, 2% between 1.050 and 1.060 g/mL, whereas less than 1% had a density either lower than 1.050 g/mL or higher than 1.080 g/mL. The number of doublings and endomitoses achieved by progenitors of density classes higher than 1.050 g/mL were similar. However, colonies derived from CFU-M of densities less than 1.050 g/mL (LD-CFU-M) had a higher probability of polyploidization and a lower probability of cell division in vitro. The inverse correlation found between the number of cells per colony and their DNA content was invariate regardless of the density class of the progenitors. The heterogeneity of the ploidy of cells within colonies increased continuously with increasing cell numbers per colony. The study if a short-period exposure of LD-CFU-M to acute thrombocytopenia could modify the ploidy of their progeny, mice were given rabbit antimouse platelet serum while control animals received normal rabbit serum. Twenty-four hours after injection, marrow was cultured. After a five-day culture period, no change in the number of colonies, doublings, ploidy, and heterogeneity of ploidy were observed between control and thrombocytopenic animals. The data suggests that LD-CFU-M are a distinct category of CFU-M, perhaps more mature than the common CFU-M.

Acute Disease↗

[Preventive antibiotic therapy and endoscopic resection. A randomized study of 52 patients].

In an open randomised comparative study, the efficacy of perioperative treatment with pivmecillinam (from the evening before the operation to the day after removal of the catheter) in urinary tract endoscopic surgery complicated by a serious uronephrological history was evaluated in 27 subjects versus a control group of 25 subjects. 80% of patients in this group had an uncomplicated postoperative course compared with only 40% of the subjects in the control group (p less than 0.010). The authors conclude on the value of this type of prophylaxis.

Amdinocillin↗

[Priapism induced by heparin. A more serious prognosis?].

Between 1973 and 1985, 31 patients were treated in the Urology Department of La Pitié hospital for priapism. Analysis of the aetiologies, determined in 25 cases, revealed a particularly high incidence of heparin as an aetiological factor for priapism. Surgical treatment was proposed in 28 patients. Independently of the type of surgical treatment performed and with a comparative preoperative delay, priapism as a complication of heparin therapy appears to be functionally more severe than priapism due to other aetiologies. Although the frequency, mechanism and prognosis of this complication of heparin therapy remain poorly understood, analysis of the 10 cases in this series and a review of the literature nevertheless provide certain answers.

Adult↗

[Restoration of urinary tract continuity in a non-functioning bladder after renal transplantation].

The restoration of the continuity of the urinary tract after renal transplantation in anuric patients, an increasingly frequent situation, raises a number of theoretical problems: is it possible to use a bladder which has been non-functioning, sometimes for many years (20 years)? What should be performed during pre-operative assessment? Which surgical technique should be used? The authors try to answer these questions on the basis of their experience of 116 transplanted anuric patients. Anuria, even of long duration, does not prevent the use of the bladder, provided that the bladder was originally normal and is not infected. The pre-operative assessment is the same as for other patients and urodynamic investigations are not required. The optimal reimplantation technique is the Leadbetter-Politano open bladder technique and every effort should be made to obtain abundant diuresis immediately. Under these conditions, reimplantation into these non-functioning bladders is not associated with more complications than in the case of normal bladders.

Adult↗

[Transurethral surgery and persistent urinary infection: effect of a single preoperative dose of cefuroxime].

To evaluate the efficacy of cefuroxime, a second generation cephalosporin, in minimizing the risk of per and postoperative infection complications in patients with urinary tract infection undergoing transurethral surgery, 86 patients (ASA I, II) with persistent urinary tract infection despite antibiotic therapy were studied. A double blind protocol was followed. Patients were randomly assigned to receive 10 minutes before surgery either I.V. cefuroxime (1.5 g) (group C, n = 39) or placebo (group P, n = 47) the incidence of positive peroperative systematic blood cultures was lower in group C (9.7%) than in group P (25.2%) (p less than 0.001). The incidence of postoperative blood cultures taken when clinical septic signs were present, was significantly lower in group C (0%) than in group P (21.7%) (p less than 0.05). However neither the incidences of both postoperative urinary tract infection at the 48th postoperative hour and the clinical signs of bacteraemia including fever nor the average length of hospitalization were significantly different in the 2 groups. This lack of significant clinical benefit was not explained by the pharmacokinetic properties of this antibiotic. Thus, preoperative administration of a single dose of cefuroxime, reduces the incidence of per and postoperative bacteraemias in ASA I-II patients with persistent urinary tract infection.

Adolescent↗

[Prevention of anuria in uretero-sigmoidostomy without catheter].

The development of anuria following catheter-less uretero-sigmoidostomy performed between 1977 and 1982 has led to a modification of the intra-operative and post-operative intensive care. During the period 1983 to 1985, the systematic intra-operative administration of furosemide immediately after performing the uretero-colonic anastomosis, the use of intra- and post-operative filling with control of filling pressures by a pulmonary arterial catheter, resulting in considerable diuresis, have been able to prevent anuria following this type of surgery.

Anuria↗

[Complications and sequelae in the endoscopic follow-up of uretero-sigmoidostomies].

Progress in gastrointestinal endoscopy enables it to be used routinely in the diagnosis, treatment and follow-up of colonic tumours. The development of a tumour, especially adenocarcinoma, at the site of anastomosis of uretero-sigmoidostomy is a particular case. The endoscopic examination is delicate and confusion between the ureterocolonic junction and a polyp may have dramatic consequences when biopsy is performed. Two cases are reported: in one case, the error required nephro-ureterectomy and in the other case percutaneous nephrostomy, now a routine procedure, allowed salvage of the single kidney and preservation of the diversion with satisfactory long term function.

Colon, Sigmoid↗

[Results of treatment of postoperative urinary incontinence in men by implantation of an AS 800 artificial sphincter. Apropos of 15 cases].

Fifteen men were treated for postoperative urinary incontinence by implantation of an AS 800 artificial sphincter between May 1984 and May 1986. Follow up for at least 6 months and in some cases for more than 2 years has shown perfect day and night continence in 11 of the 15 patients and almost perfect continence in the remaining 4 who consider nevertheless that their quality of life has been transformed. These findings plead in favor of the implantation of this type of material.

Aged↗

[Rare testicular tumors. Apropos of 15 cases].

In a series of 141 patients treated over the last ten years for testicular tumour, 15 presented lesions considered to be rare: 9 Leydig cell tumours, 3 epidermoid cysts, 1 leiomyoma, 1 primary testicular lymphoma and one testicular localisation of a known leukaemia. The clinical, endocrine and histological features of these different tumours are reviewed on the basis of the present series and a wider discussion of other rare testicular tumours. Leydig cell tumours, epidermoid cysts, mature benign teratomas and testicular lymphomas are the most frequent. Leiomyomas, metastatic tumours and connective tissue tumours are exceptional. Sertoli cell tumours are rare and are similar to Leydig cell tumours in that they raise problems concerning their possible endocrine activity and the evaluation of their malignant potential. The general therapeutic rule of radical orchidectomy for any testicular tumour is still valid.

Adolescent↗