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Biomedical subjects

G Gillon

Publications and source records attributed to G Gillon.

At least 19 recordsLinked to original sources
PubMed2001

Model-based estimation of male urethral resistance and elasticity using pressure-flow data.

To assess urethral resistance and changes in the urethral elasticity during voiding, a lumped parameter model of the urethra was developed. The model uses pressure and flow measurements to estimate time-dependent resistance and elasticity factor. The model includes a resistance that has a function of the cross-section and urethral elasticity. Two resistivity types are compared in the constricted flow-controlling zone of the urethra: Poiseouille resistance and the Bernoulli effect. Using real pressure-flow data sets, the model was used to estimate urethral resistance and changes in urethral elasticity during voiding. Estimation of the elasticity show that in a normal patient relaxation of the urethra is a process that continues until the end of voiding. This has important implications with regard to the present methods that are used in the clinic to assess urethral obstruction or constriction. The resistance as calculated by this model, may be a useful indicator of urethral constriction and obstruction, since it is especially independent of the bladder function. Changes in the urethral elasticity during voiding which are estimated by the model add a new diagnostic parameter to pressure-flow studies.

Algorithms↗
PubMed2001

The effect of cholinergic enhancement during filling cystometry: can edrophonium chloride be used as a provocative test for overactive bladder?

PURPOSE: Overactive bladder, a highly prevalent disorder, is suspected of having a low detection rate due to the lack of sensitive diagnostic tools. Recent studies imply the involvement of the cholinergic system in the pathophysiological mechanism underlying overactive bladder. We determined whether in vivo enhancement of cholinergic activity with edrophonium chloride, a potent cholinesterase inhibitor, would serve as a provocative maneuver to increase the sensitivity of filling cystometry. MATERIALS AND METHODS: A total of 27 patients underwent a multichannel video urodynamic evaluation, followed by filling cystometry with the intravenous administration of 10 mg. edrophonium chloride. The response to edrophonium was defined as a significant change in sensation and decreased bladder capacity, the induction or amplification of involuntary detrusor contractions, or significantly decreased detrusor compliance. Findings were compared in responders and nonresponders. RESULTS: We identified 11 responders and 16 nonresponders. A response was noted in 78% of the patients with the symptomatology of overactive bladder but in none with no specific complaints suggesting bladder overactivity. In 7 of the 12 responders (64%) baseline cystometry was interpreted as normal. In 6 of the 11 responders (54%) uninhibited urinary leakage was observed in response to edrophonium. There were no serious adverse reactions to the drug. CONCLUSIONS: This preliminary study implies that edrophonium may serve as a novel, practical and safe drug for provocative cystometry. By significantly increasing cystometry sensitivity the drug would facilitate the identification of the subset of patients with overactive bladder who are currently classified with sensory urgency.

Adult↗
PubMed1998

Management of renal angiomyolipoma: analysis of 15 cases.

OBJECTIVE: We present our experience with 15 patients with renal angiomyolipoma warranting intervention. METHODS: The medical records and radiological studies were reviewed for patient age and sex, tumor location and size, association with tuberous sclerosis, and treatment approach. All patients were regularly followed by ultrasound and computed tomography scan. RESULTS: Presenting symptoms were retroperitoneal bleeding in 9 patients and flank pain in 6. Excluding cases of tuberous sclerosis (mean tumor diameter 11 cm), the mean diameter of the two tumors that bled was 5.4 cm, similar to those in the patients presenting with flank pain. Two patients with retroperitoneal bleeding had tumors < 3 cm. Angioinfarction was performed in 7 patients, partial nephrectomy in 3, and total nephrectomy in 4. One patient with tuberous sclerosis, who was observed only, died of bleeding and sepsis. The mean follow-up period of 4.3 years revealed stable creatinine levels and no recurrent hemorrhage. CONCLUSIONS: The management approach of angiomyolipoma should be aimed at parenchymal preservation which can be effectively accomplished by limited surgery or preferably by selective embolization. Preventive embolization may be feasible even for small tumors. However, any doubt about the diagnosis of angiomyolipoma should be clarified by surgery.

Adult↗
PubMed1997

Enhancing the phonological processing skills of children with specific reading disability.

The present study evaluated the benefits of phonological processing skills training for children with persistent reading difficulties. Children aged between 9-14 years, identified as having a specific reading disability, participated in the study. In a series of three experiments, pedagogical issues related to length of training time, model of intervention and severity of readers' phonological processing skills deficit prior to intervention, were explored. The results indicated that improvement in poor readers' phonological processing skills led to a dramatic improvement in their reading accuracy and reading comprehension performance. Increasing the length of training time significantly improved transfer effects to the reading process. Children with particularly severe phonological processing skill deficits benefited from an extended training period, and both individual and group intervention models for phonological processing training proved successful. Implications for speech and language therapists are discussed.

Adolescent↗
PubMed1996

Dismembered pyeloplasty in children with and without stents.

OBJECTIVES: To assess the benefit of performing nonstented pyeloplasty in infants. METHODS: Forty-eight consecutive pyeloplasties were performed by two surgeons using different techniques, from 1987 to 1992. One used stents in all cases (23) and the other performed a nonstented anastomosis with external drainage (25 cases). Patients with specific indications for internal drainage, i.e. poor renal function, extreme pyelocaliectasis, were excluded from the study. Parameters of cost and complications were assessed. RESULTS: The group with stents had more febrile episodes, needed more antibiotics and were hospitalized twice as long as the nonstented group. Pre- and postoperative renal function was similar in both groups. CONCLUSIONS: Performing pyeloplasties in children without stenting the anastomosis is safe and cost-effective.

Adolescent↗
PubMed1996

[Surgery for women with urethral diverticulum].

Urethral diverticulum in the female is an acquired lesion following infection of the para-urethral glands. Its symptoms are often nonspecific and only by increased awareness of this condition can delay in diagnosis be avoided. Radiologic imaging of the urethra allows diagnosis of this lesion and determination of its location, extent and the number of lesions. Complete surgical excision is the optimal therapy. In recent years 8 women with this condition were admitted aged 21-52 years. It had been an average of 11 months before their lesions were diagnosed. All had complete surgical excision without perioperative complications. In 5 a Martius labial fat pad was used to facilitate prompt healing of the urethral defect. 6 have been followed for over a year and are completely symptom-free. Judicious choice of surgical technique is required to reduce the rate of complications in the management of these lesions.

Adult↗
PubMed1994

Effect of improved diagnosis of renal cell carcinoma on the course of the disease.

The impact of the improved diagnosis of renal cell carcinoma (RCC) on the course of the disease was evaluated in 188 patients who were diagnosed and treated at a single medical center. Sixty-seven patients (group A) who had undergone nephrectomy between 1979 and 1983 for RCC initially diagnosed by intravenous pyelography (IVP) were compared with 121 patients (group B) who had undergone nephrectomy between 1983 and 1989, diagnosed by ultrasound and/or computed tomography (CT) scan. Incidental asymptomatic tumors were found in 18 of 67 (26.9%) group A patients and in 57 of 121 (47.1%) group B patients (P < 0.001). The incidence of small tumors of < 5 cm in diameter was significantly lower in group A compared to group B (25.4% vs. 47.9%, respectively, P < 0.01). The disease-free 5-year survival rate for group A was 40% compared to 80% for group B. It is concluded that the introduction of modern imaging techniques has improved the survival of patients with RCC and decreased the progression rate of the disease.

Carcinoma, Renal Cell↗
PubMed1993

[Repeated self-catheterization of the bladder].

41 adults with urinary retention of various etiologies (including 10 after cystoplastic surgery) were treated by clean, intermittent, self-catheterization (CISC) for a mean of 37 months. Most learned the technique in the outpatient clinic. 4 needed assistance in performing CISC by family members. None stopped the treatment. In 72% there was no discomfort or only mild discomfort. 39% had acute UTI in the preceding year. We conclude that emptying the bladder by CISC is effective and easy to learn. Although patients are initially reluctant, most adapt well to the technique and morbidity is relatively low.

Humans↗
PubMed1992

Risk factors and their effect on the results of Burch colposuspension for urinary stress incontinence.

Forty patients with urinary stress incontinence were studied and the results of Burch colposuspension evaluated. Combined detrusor instability and stress incontinence were found in 22.5% of the patients. The results of surgery showed that 87.5% of the patients (35/40) were cured of incontinence. None of the contributing risk factors of incontinence had a significant role in the outcome of surgery. In view of this, all patients with surgically amenable urinary incontinence should be considered for surgical resolution of this condition.

Adult↗
PubMed1989

The dissolution of urinary mucus after cystoplasty.

Three agents have been tested for mucolytic activity to prevent or treat difficulties in bladder emptying following augmentation and substitution cystoplasty, particularly in patients emptying by intermittent self-catheterisation. Carbocysteine produced precipitation of mucus, which was found not to be helpful. N-acetylcysteine and urea both dissolved mucus, but urea proved to be more effective.

Acetylcysteine↗
PubMed1989

Results and relevance of urodynamic studies in the management of urinary incontinence in women over eighty.

Urinary incontinence among the elderly is a major problem that is often neglected. The results of urodynamic studies in a group of 32 women greater than 80 years old with incontinence revealed that detrusor instability was the primary cause of incontinence in 23 (72%), while 9 (28%) patients demonstrated signs of sphincter incompetence. Urodynamic study results were normal in four patients. Medical treatment on a self-regulated dose and bladder training were effective in controlling incontinence in 25 (78%) of the study group. It is suggested that, although detrusor instability is the major cause of incontinence in elderly women, urodynamic studies should be performed for accurate diagnosis to ensure optimal therapeutic results.

Aged↗
PubMed1988

Bladder diverticula in elderly females with urgency, dysuria and incontinence.

Bladder diverticula are usually encountered in the male. Their occurrence in women is scarcely appreciated. The association of bladder diverticula with urinary tract infection, dysuria, urgency and incontinence is reported in a series of 11 elderly female patients. The etiology of this finding is discussed based on urodynamic evaluation of these patients.

Aged↗
PubMed1988

Sequential study of macrophage migration inhibition factor in renal cell carcinoma patients.

Preliminary investigation of cell-mediated immunity (CMI) in 49 patients harboring renal cell carcinoma (RCC) by the migration inhibition factor (MIF) tests as compared to 47 patients with simple renal cysts or normal kidneys established the specificity (85%) and reproducibility of this test. A retrospective analysis of the results of the MIF test was conducted in 35 patients followed for a minimum 20-month period. A marked difference was observed between the group of patients with localized disease who remained disease free and those with metastatic lesions and disease progression. The first group sustained their positive response of the MIF tests for a longer time during the study period, while the latter had a decrease of the MIF test response shortly after surgery. This difference may indicate that immune response as reflected in the positive MIF test has a role in RCC patients' defense mechanism.

Aged↗