[Our attitude in the prevention of venous thrombosis in urinary surgery].
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Biomedical subjects
Publications and source records attributed to F Pontonnier.
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A computerised study has been carried out on the general features of a clinical, biological and histological nature occurring in 124 varicocoele cases that were operated. These features were furthermore studied in correlation with the degree of varicocoele in existence and whether characteristics were found in isolation or in association with one another. The authors conclude that there were significant correlations between the degree of varicocoele present and the hormonal and histological findings. They advance a theory about the transport of testosterone in the spermatic cord which can explain the low level of testosterone found in the blood in these varicocoeles.
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Arterial embolization has been performed in 30 cases of renal tumors. Radical nephrectomy has followed renal embolization in 25 patients (10 stages I, 8 stage III, 7 stage IV). Renal embolization has been done without further operation in 5 patients with metastasis. Arterial embolization is well tolerated and useful during surgery. The best results in stage IV are seen with arterial embolization alone. Long-terme follow-up is needed for evaluation of results improvement.
Arterial hypertension is uncommon shortly after renal trauma. It is due to peri-renal hematoma following mild lesions. Transient, moderate or severe, this hypertension is hyperreninemic. Only medical treatment is justified.
The authors report a new case of signet ring cell carcinoma of bladder whose characteristic findings are the parietal infiltration and the rapidly fatal course. Based on a review of the literature, they define the histological features of this very rare tumour (less than 20 documented cases have been reported). The pluripotent behaviour of urothelial cells appears to be the essential element in the histogenesis of this tumour type, which is very similar to gastric linitis plastica.
The deleterious effects of chimio or radio-therapy on spermatogenesis of men treated for testicular cancer are well known. Retroperitoneal lymphadenectomy is a risk for ejaculation process. Semen cryopreservation seems to be obligatory before any deleterious treatment. Prophylactic measures do exist such as lead protection during x-rays therapy, drugs with less toxicity but similar efficiency, selective lymphadenectomy. Moreover, positive results were reported form realised in animals to protect spermatogenesis. In men treated for testicular cancer, 4 protective studies were reported using either GnRH analogs (3 studies) or medroxyprogesterone (one study). No protective effects were obtained in these trials, and the reasons for such failure are discussed. Finally, new potential possibilities of spermatogenesis protection are suggested supported by the results of animal experiments or the occurrence of new drugs such as use of steroids, GnRH antagonist or testicular hypothermia.
The authors study stress incontinence, symptom and not disease, an entity which is rarely found in the pure state in the 21 cases presented. After analysis of the physio-pathological factors concerning stress incontinence, they present the results of a dynamic study by flow measurement (flow-metry). This enabled division of the incontinent patients into 3 groups, depending on the amount of flow, on micturition, normal, increased, decreased. Each group has common anatomo-radiological points, perhaps permitting a new dynamic classification of symptomatic stress incontinence.