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Biomedical subjects

D Chopin

Publications and source records attributed to D Chopin.

At least 145 records · Page 8Linked to original sources
PubMed1989

[Orthopedic treatment of regular dorsal and dorsolumbar hyperkyphosis. New principles of active correction].

The orthopaedic treatment of hyper-kyphosis should not be unique. If the principles of treatment are different in relation with the thoracic or thoraco-lumbar localisation of the apex of the deformity, it is necessary to distinguish for the middle thoracic curve two types of patients: these in whom the kyphosis and the lordosis are balanced (the cast must diminish the lumbar lordosis and the imbalanced posterior types with a great kyphotic curve and a short compensatory lordosis which is important not to be diminish by the treatment. The principles of plaster casting are described in the two types; emphasizing on the unlucky aspect of the sternal support in the middle thoracic kyphosis and in the necessity of the thoracic modification if we wish to obtain a good result. The active expiratory reeducation is capital before and during the treatment.

Casts, Surgical↗
PubMed1988

Conservative treatment of bladder carcinoma by partial cystectomy and interstitial iridium 192.

From 1971 to 1984, 85 patients with bladder carcinoma were treated conservatively at the Henri Mondor Hospital by a combination of short course of pre-operative external pelvic irradiation, iliac node dissection, partial cystectomy, and iridium 192 implantation. There were 79 transitional cell carcinomas (G1: 12, G2: 25, G3: 36, Gx: 6) and 6 squamous cell carcinomas. By clinical stage, based on endoscopic resection, there were 43 T1, 30 T2, 5 T3, and 7 Tx. After partial cystectomy the pathologic stage distribution was: 41 pT1, 31 pT2, and 13 pT3. Crude disease-free survival at 5 years is 72% for T1 tumors and 55% for T2, but overall only 16% of patients died of bladder carcinoma. Local failures were seen in 11.5% of T1 and 0% of T2 tumors, and second bladder tumors developed at a distance from the treated site in 11.5% of T1 and 7% of T2. There is a non significant trend for intravesical recurrences (both local failures and second tumors) to occur more frequently for G1 tumors (25%) than for G2 (16%) or G3 (7%). At 5 years 95% of disease-free survivors have a functioning bladder. Regional or distant metastases occurred in 54% of patients with pT3 tumors and 10% of those with pT1 or pT2; within each stage there was no apparent influence of grade on metastatic risk. The four patients with histologically positive iliac nodes received additional post-operative external pelvic irradiation; three died of metastases and one is disease free at 10 years. No abdominal scar recurrences were seen. Late complications occurred in 6% of the population. For T1 tumors we suggest modification of the described protocol, eliminating the pre-operative irradiation and the lymph node dissection. If there is no doubt as to the pathologic stage after complete endoscopic resection, iridium 192 implantation delivering a dose of 60 Gy, without partial cystectomy, may be sufficient management. By contrast, for T2 tumors, all elements of the protocol seem important to obtain optimal results.

Adult↗
PubMed1988

[The value of the serum level of the prostate-specific antigen in prostatic pathology].

Development of serum assays for prostate-specific antigen (PSA) has provided physicians with a new marker for carcinoma of the prostate. PSA was compared to prostate acid phosphatases (PAP), the reference serum marker, in 162 patients including 54 patients with carcinoma of the prostate (CP), 84 patients with benign hypertrophy of the prostate (BHP), and 24 controls free of prostate disorders. PSA appeared more sensitive but less specific than PAP. Results showed that PSA is not suitable for routine screening in the population at large where BHP is common. In BPH, the rise in PSA concentrations parallels the size of the hypertrophy. However, in patients with CP, PSA seems more sensitive than PAP for evaluating tumor spread and response to treatment. The prognostic bearing of increased levels in patients with apparently localized carcinomas remains to be elucidated.

Acid Phosphatase↗
PubMed1988

[Cystoplasty using a resorbable polyglactin prosthesis covered by a free peritoneal flap].

The bowel is not always suitable for cystoplasty. The use of a vicryl mesh lined with a peritoneal flap was investigated as material for partial replacement of the bladder. The procedure was performed on 20 rats divided into two groups. A partial cystectomy was first performed, then a cystoplasty was done using either a free peritoneal flap (group 1) or a vicryl mesh combined with a peritoneal flap (group 2). The results were evaluated using intravenous pyelography, macroscopic examination and histological analysis within one month. In group 1 (7 cases), there was one urinary fistula. In group 2 (13 cases), no fistula was observed but stones occurred in three cases. The histological analysis revealed good reconstruction of urothelium in both groups. Partial resorption of vicryl was observed at one month with organization of neo-muscular fibers. The vicryl prosthesis was well accepted and, when covered by a peritoneal flap, provided a strong and water-tight material for bladder replacement. The vicryl mesh increased the risk of stone formation in the presence of urinary tract infection.

Animals↗
PubMed1987

[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↗
PubMed1987

[Therapy of urinary stress incontinence by the Raz-Pereyra technic. Initial results].

Needle bladder neck suspension for female urinary stress incontinence have been largely modified since the original description by A. Pereyra in 1959. The procedure utilized is known as modified Pereyra or raz bladder neck suspension. The hallmark of this operation is the blunt dissection of the endopelvic fascia, the anchorage of the periurethral fascia and the pubourethral ligament, the fixation of the sutures over the rectus muscle. Out of 40 patients, 14 are evaluable with a 6 months follow up: 12 are cured, 1 is improved and 1 is unchanged. This first experience and literature analysis suggest that this procedure is particularly useful in obese patients, in case of cytoscele or in case of other perineal surgery (i.e., vaginal hysterectomy, cure of rectocele).

Adult↗
PubMed1986

Antibodies to cultured tumor cells detected in sera of renal cell carcinoma patients by a quantitative avidin-biotin method.

Antibodies reacting with the tumor cell line RC-Pa were measured by a quantitative avidin-biotin complex method. Sera of renal cell carcinoma patients, patients with other types of cancer and healthy donors were analyzed. Of 71 sera from renal cell carcinoma patients 67 (94 per cent) were classified as showing renal cell carcinoma, while 32 of 36 sera (89 per cent) from healthy subjects were classified as showing no renal cell carcinoma. Four of 21 serum specimens (19 per cent) from individuals with other than renal cancer were misclassified. Furthermore, sera from renal carcinoma patients immunized with a mixture of autologous tumor cells and Corynebacterium parvum showed a marked increase in reactivity compared to those from patients receiving progesterone. The results indicate that this assay might become useful to detect or monitor renal cell carcinoma.

Antibodies, Neoplasm↗
PubMed1986

[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↗
PubMed1985

[Reconstructive microsurgery of the vas deferens. Experimental study of suture materials].

Microsurgery is the procedure of choice for vasectomy reversal. The aim of this study was two compare two different suture materials for vasovasectomy - a nonresorbable material (nylon 10/0 with a BV 6 needle), which is widely used, and a resorbable material (polyglycolic acid, also with a BV 6 needle), which has not yet been evaluated for this use. 28 Sprague-Dawley rats were operated on under microscope. Two groups were then compared, group A with nylon (n = 14) and group B with polyglycolic acid (n = 14). In each group, 8 animals had a vas deferens section and 6 had a previous vasectomy by ligature. Ten days postoperatively, the patency rate of the anastomosis was evaluated by the presence of sperm on both sides of the suture line. The contractility was assessed by mechanical stimulation. The existence of a sperm granuloma was considered as indicative of a non functional anastomosis. Three days later a fertility test was performed, lasting three months, and the number of litters was checked. The rats were sacrificed after three months, and each vas deferens was examined histologically or by electron microscope. The macroscopic results were: 57% patent anastomoses in group A and 77% in group B. 16% patent anastomoses after ligature in group A (n = 6) and 75% in group B (n = 6). The pregnancy rate was 54% in group A and 77% in group B. After previous ligation, the corresponding figures were 20% and 83% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1983

[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↗
PubMed1983

[Chronic renal insufficiency in urogenital bilharziasis].

Schistosoma haematobium eggs may occasionally be found in the renal parenchyma, usually with no pathological consequences, the main risk to the kidney being obstruction of the urinary tract by bilharzial lesions. Egg deposits in the submucosa and muscles of the excretory tract induce obstruction and sclerosis, mainly in the ureters. Bilateral stenosing bilharzial ureteritis results in mechanical obstruction of the renal function, sometimes, unfortunately, accentuated by sepsis and pyelonephritis. This condition is a strong indication for surgical repair of the stenotic lesions of the urinary tract, which must be performed before the onset of irreversible damage to the renal function.

Humans↗
PubMed1983

[False prosthetic aneurysms. Evaluation of etiologic factors].

There is a need for new evaluation of anastomotic aneurysms with increasing use of prosthetic material in aortoiliac reconstructive surgery. 503 lower extremity revascularisations performed between 1972 and 1978 were reviewed. 20 false aneurysms complication of synthetic grafts, operated on from 1972 to 1981 were analysed. A retrospective study on the aorto-iliofemoral prosthesis group (N = 97) was enable to compare patients with and without false aneurysm occurrence with an average follow up of 5 years (3 to 9 years). The management of false aneurysm is discussed. This study suggest that most important etiologic factors are the vascular pattern just below the revascularisation, the anastomotic level, an iterative intervention. Extensive reconstructive procedures on the anastomosis level should be avoided. On the other hand choice of anastomotic procedure (termino-terminal versus latero-lateral anastomosis) and HTA seems to have no deleterious in spite of the findings of other authors.

Aneurysm↗
PubMed1982

[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↗