Biomedical subjects
Publications and source records attributed to G Gillon.
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.
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.
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Early results of a prospective, randomized trial of active, specific immunotherapy adjunctive to nephrectomy in all stages of RCC are presented. Forty-three patients with median followup of 30 m, who were randomly allocated to either immuno-hormonotherapy arm (IMT), or hormonotherapy alone (HT), are evaluated in terms of progression-free interval (PFI) and overall survival by life table method. Immunotherapy consisted of autologous irradiated tumor cells (AITC), admixed with bacillus Calmette-Guérin (Glaxo) administered by the intradermal and endolymphatic route. Clinical results of this study show only a trend for advantage of the experimental (IMT) arm over the control (HT) arm, this trend did not reach statistical significance level: prolongation of disease free period in stages I-III with localized disease (p less than 0.1) and prolongation of survival in patients with metastatic disease (p less than 0.07). A correlation was established between induction of cutaneous delayed hypersensitivity (DTH) to AITC and prolonged PFI and survival: patients with positive DTH had a significantly better course of disease than those who could not be converted to positivity after repeated immunizations. Positive in vitro leukocyte migration inhibition against autologous tumor preparations correlates well with positive in vivo cutaneous DTH. Some immunological aspects of active immunization with autologous tumor cells are discussed.
Two cases of torsion of the testis following previous "fixation" are reported. Prompt recognition of this emergency situation and detorsion may save the ischaemic organ. The importance of adequate bilateral fixation of the testicles within the tunica vaginalis is stressed to prevent possible recurrences.
Recently more conservative surgery of renal cell carcinoma is being performed. Patients with small, low-grade and low-stage tumors can be treated by enucleation or partial nephrectomy and will have about the same cure rate as those patients who were treated before by radical nephrectomy. Six patients, who would have been candidates for chronic dialysis, underwent enucleation or partial nephrectomy. Three of them had Stage I, and three had Stage II renal cell carcinomas. Patients were followed up 6 to 52 months (average 34) after surgery, and no local recurrence or distant metastases were found. It has recently been recognized that not every patient with renal cell carcinoma requires radical nephrectomy. Renal parenchyma can be saved without a decline in effective control of the tumor or a change in prognosis.
The position and shape of the organs normally adjacent to the kidney were evaluated by computed tomography in seven patients with renal agenesis and in two patients with unilateral renal ectopy. The major findings were displacement of colonic flexures, small intestine loops, duodenum, spleen, and tail of the pancreas. The shape and position of the adrenal gland was found abnormal in cases with left-sided anomaly. Genital abnormalities such as absent seminal vesicle were frequently encountered. The presence of abnormally shaped adrenal glands in patients with left renal agenesis and ectopy is a new diagnostic radiologic sign for these conditions.
Clearance of Escherichia coli in experimental cystitis was studied in the diuresing mouse model. Urine was collected daily; sediment was isolated by cytocentrifugation and either stained or treated with fluorescent antibodies directed against mouse immunoglobulins. During the initial phase of the infection the bacteria were either free and dispersed or adhering to epithelial cells but not generally to polymorphonuclear cells (PMNs). Subsequently, the bacteria adhered to each other, to epithelial cells and to PMNs, were phagocytosed by the latter and showed strong fluorescence. It is postulated that the appearance of opsonising and agglutinating antibodies in conjunction with activity of the PMNs is involved in bacterial clearance.
This study reviews the 3- to 5-year follow-up of 35 elderly women treated by colposuspension for incontinence due to urethral sphincter incompetence (genuine stress incontinence). All patients had pre- and post-operative urodynamic studies and were followed up annually by clinical assessment and Urilos test. Thirty-two patients were subjectively cured and 31 objectively cured. Cystocele was corrected by the colposuspension. Rectocele and enterocele were frequently encountered at follow-up and prophylactic closure of the pouch of Douglas or posterior repair were recommended. Although the peak urine flow rate measurements at follow-up were reduced, no patient encountered difficulty in bladder emptying. The low operative and post-operative morbidity rate was due to careful pre-operative medical selection.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.