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D Jacqmin

Publications and source records attributed to D Jacqmin.

At least 37 records · Page 2Linked to original sources
PubMed1998

Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall superparamagnetic iron oxide particles--initial clinical experience.

PURPOSE: To evaluate the clinical and biologic safety of ultrasmall superparamagnetic iron oxide particles (AMI-227) as a contrast agent for magnetic resonance (MR) lymphography and to assess their efficacy for the differentiation of metastatic and benign nodes in patients with urologic and pelvic cancer. MATERIALS AND METHODS: Thirty adults suspected of having lymph node metastases underwent MR imaging before and 22-26 hours after intravenous infusion of AMI-227 (1.7 mg Fe/kg). Sixty histopathologically proved lymph nodes were analyzed on MR images, and 29 of these nodes were also analyzed quantitatively. RESULTS: AMI-227 was well tolerated with no major side effects. It allowed the detection of 10 additional nodes relative to those detected at MR imaging without AMI-227. None of the 27 metastatic nodes showed a decrease in signal intensity (SI) on AMI-227-enhanced images; nine of 27 metastatic nodes showed an increase in SI on T1-weighted images, probably resulting from altered capillary permeability in the tumor. A visually perceptible reduction in SI, indicating active AMI-227 uptake, was observed on postcontrast T2- and T2*-weighted images in 16 of 21 benign nodes. The SI ratio of benign nodes was lower than that of metastatic nodes on T2- and T2*-weighted images. The sensitivity of AMI-227-enhanced MR lymphography was 100%, and the specificity was 80%. CONCLUSION: AMI-227 is safe and may facilitate the differentiation of metastatic and benign nodes in patients with urologic and pelvic cancers.

Adult↗
PubMed1998

Single stones of the lower pole of the kidney. Comparative results of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy.

OBJECTIVE: To assess the effectiveness of extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCN) as a treatment for stones of the lower pole of the kidney and to compare their morbidity according to the stone size. METHODS: We retrospectively studied 739 patients treated for a single stone of the lower pole. Group I consisted of 666 patients treated by ESWL and group II consisted of 73 patients treated by PCN. RESULTS: These were assessed at 3 months for 587 ESWL patients (88%) and at day 1 for all PCN patients on renal tomography or ultrasonography. Respectively in groups I and II, 335 patients (57%) and 53 patients (72.6%) were stone-free (p = 0.01). For medium-size (10-20 mm) stone patients, stone-free represented 102 patients (44%) and 29 patients (72.5%) in groups I and II respectively (p = 0.001). For smaller stones (< 10 mm), stone-free represented 231 patients (69%) and 21 patients (84%) in groups I and II respectively (p = 0.12). Morbidity rate was less with ESWL than with PCN. CONCLUSIONS: PCN achieves better results than ESWL for single stone of the lower pole with statistical significance for middle-size stones but with higher morbidity.

Adolescent↗
PubMed1998

Three-month sustained-release form of triptorelin in patients with advanced prostatic adenocarcinoma: results of an open pharmacodynamic and pharmacokinetic multicenter study.

The pharmacodynamics and the pharmacokinetic characteristics of a new longer-acting formulation containing 11.25 mg of triptorelin (Decapeptyl) to be administered every 3 months were evaluated in 14 patients with advanced prostate carcinoma. After one single injection, the mean time to reach the surgical castration testosterone range is 22 days, and this effective testosterone suppression is maintained for the 3-month therapy. After a first plasma surge (35.70 ng/ml) occurring 2.5 h after injection and a rise between day 17 and day 31 (maximum on day 24: 0.32 ng/ml), the mean triptorelin plasma level is stable (0.06 +/- 0.05 ng/ml) and maintained until day 91. This new formulation was well tolerated both locally and systemically.

Adenocarcinoma↗
PubMed1998

[Therapeutic strategies in azoospermia: management].

ICSI allows use of epididymal or testicular sperm in case of azoospermia. The aim of this study is to propose an algorithm for the management of the different situations of azoospermia according to our personal experience and according to data of literature. The following points are discussed: epididymal or testicular origin of sperm, retrieval technique, contribution of freezing, interest of in vitro culture, side effects and need of a preliminary biopsy. So a therapeutic strategy adapted to both types of azoospermia obstructive and non obstructive can be proposed.

Biopsy↗
PubMed1997

Benign hyperplasia in ectopic prostatic tissue: a rare cause of pelvic mass.

Four cases of a pelvic mass due to the development of benign hyperplasia within ectopic prostatic tissue are reported. They presented a hypoechoic homogeneous or heterogeneous pattern on transrectal ultrasonography and a high signal intensity on T2-weighted spin-echo sequences on MR. On CT the density was similar to that of prostatic tissue. No recent imaging findings of this rare entity have been described in the literature. Possible aetiologies are discussed. Even if it is a rare event, the correct diagnosis can be reached. It is important for radiologists to consider the presence of this lesion because of its benign nature.

Aged↗
PubMed1997

Small pelvic lymph node metastases: evaluation with MR imaging.

The purpose of this study was to determine if lymph node asymmetry in small (< 1.0 cm) pelvic lymph nodes was a significant prognostic feature in determining metastatic disease. Two hundred and sixteen patients who presented with pelvic carcinoma underwent magnetic resonance imaging (MRI). They were correlated with pathological findings obtained at surgery. We considered the maximum diameter (MAD) of both round- or oval-shaped suspicious masses seen in the axial plane. Two different cut-off values were determined: lymph node diameter greater than 1.0 cm (criterion 1) and lymph node diameter greater than 0.5 cm with asymmetry relative to the opposite side for lymph nodes ranging from 0.5 cm to 1.0 cm (criterion 2). With criterion 1, MRI had an accuracy of 88%, a sensitivity of 65%, a specificity of 96%, a positive predictive value (PPV) of 88% and a negative predictive value (NPV) of 88% in the detection of pelvic lymph node metastasis. By considering criterion 2, MRI had an accuracy of 85%, a sensitivity of 75%, a specificity of 91%, a PPV of 71% and a NPV of 91%. Normal small asymmetric lymph nodes were present in 5.6% of cases. Normal asymmetry of pelvic lymph nodes is not uncommon. It cannot be relied on to diagnose metastatic involvement in cases of small suspicious lymph nodes.

Adult↗
PubMed1997

[Indications and results of radical prostatectomy].

Radical prostatectomy is the surgical curative treatment of localized prostate cancer. The survival is good in young patients (< 70) with T2 N0M0 tumors and more than 10 year's life expectancy. Side-effects are urinary incontinence, impotence and anastomosis stricture. Quality of life should be considered as an important factor for the choice of the patient between radical prostatectomy, radiotherapy and follow-up.

Erectile Dysfunction↗
PubMed1997

[Neuroectodermal differentiation of embryonal carcinoma of the testis].

We report here a rare differentiation of an embryonal carcinoma of the testis to a peripheral neurectodermal tumor (PNET) with lymph nodes and lung metastases. In the present case a complete remission was obtained by a PNET oriented chemotherapy combination followed by 2 courses of classical BEP.

Adult↗
PubMed1997

[Ureteroscopy for ureteral calculi. 379 cases].

OBJECTIVE: We report the experience of a centre which treated symptomatic ureteric stones exclusively by ureteroscopy. METHODS: From 1987 to 1993, 379 patients underwent ureteroscopy for ureteric stones, corresponding to 231 men and 148 women, between the ages of 8 and 80 years. The stones were situated in the pelvic ureter in 78.9% of cases, iliac ureter in 15.8%, and lumbar ureter in 5.3% of cases. An 11 F or Gautier ureteroscope was used. The only intracorporeal lithotripsy method consisted of an ultrasound transducer. Finally, our department does not possess an extracorporeal lithotripsy apparatus allowing the treatment of ureteric stones. RESULTS: The stone was eliminated immediately in 288 patients (76%), the stone was pushed back into the renal cavities in 40 patients (1.5%) and partial failures (residual fragments) or complete failures were observed in 51 patients (13.5%). 13 ureteric perforations (3.43%), treated by means of a double J ureteric stent, and one surgically drained urinoma were observed. 13 false passages of the ureteric meatus had an uneventful course by drainage with a double J stent. CONCLUSION: Ureteroscopy remains an effective method for the treatment of ureteric stones. It is associated with a definite morbidity, probably higher in a University Centre in which future urologists are trained.

Adolescent↗
PubMed1996

Assessment of painful ureterohydronephrosis during pregnancy by MR urography.

The purpose of this study was to assess the value of the fast imaging sequence called RARE (rapid acquisition with relaxation enhancement) MR urography (or RMU) in pregnant women with painful ureterohydronephrosis. A total of 17 pregnant women with an acute flank pain were examined with RMU. Results were compared with those of US, X-rays and the evolution of symptoms. The gold standard techniques used to evaluate the results of MR urography were US when it showed the entire dilated urinary tract and the nature of the obstruction (9 cases), limited intravenous urography (IVU) when performed (3 cases) or endoscopic procedure (5 cases). The accuracy of RMU in the detection of urinary tract dilatation and the localization of the level of obstruction was excellent (sensitivity 100% in our series). The determination of the type of obstruction, intrinsic vs extrinsic, was always exact. The RMU technique alone could not specify the exact nature of the obstruction. The RMU technique is able to differentiate a physiological from a pathological ureterohydronephrosis during pregnancy. It could be considered as the procedure of choice when US failed to establish the differential diagnosis.

Adult↗
PubMed1996

Genitourinary group phase II study of chemotherapy in stage T3-4 N0-X M0 transitional cell cancer of the bladder: prognostic factor analysis.

The aim of this study was to examine prognostic factors for survival of patients with invasive bladder cancer who had received neoadjuvant chemotherapy followed by further treatment. From 1986 to 1990, 149 eligible patients with T3-4 N0-X M0 bladder cancer were entered into a phase II trial of neoadjuvant chemotherapy, consisting of cisplatin and methotrexate. Patients received two or four courses of chemotherapy, depending on the absence or presence, respectively, of a major clinical response after two courses. 136 patients were evaluable for clinical response after two courses of chemotherapy, and 75 patients were evaluable for pathological response after two or four courses. A multivariate analysis, based on pretreatment variables and the post-treatment variables, clinical response and pathological response, showed that performance status, tumour size and clinical response after two courses of chemotherapy were the only independent prognostic factors for all eligible patients. A second multivariate analysis in the selected subgroup of patients, who underwent a cystectomy, showed that the G-cagetory and pathological response were the only independent prognostic factors. In conclusion, in this group of patients, the response to chemotherapy was a strong and independent prognostic factor in addition to other independent variables. However, it was not accurate or strong enough to allow an impact on the choice of locoregional therapy.

Aged↗
PubMed1996

Radical nephrectomy for renal cell carcinoma 30 mm. or less: long-term follow results.

PURPOSE: We investigated the clinical and pathological features, and long-term followup of patients with radical nephrectomy for renal cell carcinoma of 30 mm. or smaller and a normal contralateral kidney. MATERIALS AND METHODS: Between 1973 and 1993, 74 patients 29 to 83 years old (average age 60) underwent radical nephrectomy for renal cell carcinoma of 30 mm. or smaller. Average followup was 101 months (range 10 to 236). Of the 74 tumors 21 were stage pT1, 36 stage pT2 and 12 stage pT3 (all 69 stag N0 to NxM0), while 5 were stages pT1 to 3, N1 or M1. A total of 27 patients died during follow-up. Of 11 patients who died of disease progression 5 had metastatic disease initially. RESULTS: Overall survival rates were 73% at 5 years, 55% at 10 years and 38% at 20 years. Cancer-specific survival rates without the 5 patients with stage N1 or M1 disease were 91% at 5 years, and 80% at 10 and 20 years. For the group with nonmultifocal renal cell carcinoma, stage NO to Nx and/or MO, the cancer-specific survival rates were 93% at 5 years, and 81% at 10 and 20 years. For the group with multifocal renal cell carcinoma, stage NO to Nx and/or MO, the cancer-specific survival rate was 75% at 5, 10, and 20 years. There was a significant survival difference between the nonmultifocal and multifocal renal cell carcinoma groups at 5 years (p<0.05) but not at 10 and 20 years. CONCLUSIONS: Small renal cell carcinoma is definitively not a benign disease and a tumor of 30 mm. or smaller does not mean there is no risk of metastatic or multifocal disease.

Adult↗
PubMed1996

[Endovascular treatment of hemorrhagic renal angiomyolipoma with platinum microcoils].

Haemorrhage is the major complication of renal angiomyolipoma and is classically treated surgically, but embolization constitutes an alternative treatment. Improvement of catheters and embolization materials now allows highly selective embolization. The authors present a case in which the use of a variable stiffness catheter and platinum microcoils allowed highly selective embolization of a haemorrhagic renal angiomyolipoma while preserving the functional renal parenchyma.

Adult↗