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J Aubert

Publications and source records attributed to J Aubert.

At least 19 recordsLinked to original sources
PubMed1997

Regulation by fatty acids of angiotensinogen gene expression in preadipose cells.

Adipocytes represent an important source of angiotensiongen (AT). Angiotensin II (A-II) stimulates in vitro and in vivo the formation and release of prostacyclin which acts as a potent adipogenic signal in triggering the terminal differentiation of preadipocytes into adipocytes [Darimont, Vassaux, Gaillard. Ailhaud and Négrel (1994) Int. J. Obes. 18, 783-788]. Since fatty acids have been reported to activate in preadipose cells the expression of various differentiation-dependent genes, the role of fatty acids in the regulation of AT gene expression was investigated. Long-chain natural and non-metabolized fatty acids as well as peroxisome proliferators behave as activators of AT gene expression. Accumulation of AT mRNA parallels that of the adipocyte fatty acid-binding protein gene and is primarily due to transcriptional activation of the AT gene. AT mRNA decreases after fatty acid removal (half-life approx. 8 h). Secretion of AT is also observed but appears mainly as a late differentiation-dependent phenomenon. Thus the AT gene appears to be a fatty acid-responsive gene; this regulation provides a potential link between the flux of fatty acids and the potential of adipose tissue to produce AT and possibly A-II.

Adipocytes↗
PubMed1997

Serum-to-urinary prostate specific antigen ratio: its impact in distinguishing prostate cancer when serum prostate specific antigen level is 4 to 10 ng./ml.

PURPOSE: Benign prostatic hyperplasia (BPH) was shown to be associated with high concentrations of urinary prostate specific antigen (PSA). We investigated the serum-to-urinary PSA ratio in patients undergoing prostate biopsy to assess its efficacy in enhancing serum PSA specificity in the detection of prostate carcinoma. MATERIALS AND METHODS: From November 1995 through January 1996 consecutive patients undergoing prostate biopsy were prospectively included in the study. Serum and urine PSA levels were measured at our laboratory with the Tandem-R assay. Samples were drawn 24 hours before prostate biopsy and at a distance from prostatic manipulation or ejaculation. RESULTS: We studied 73 patients with BPH and 57 with prostate cancer. Differences between BPH and prostate cancer were statistically significant considering serum PSA or serum-to-urinary PSA ratios. In the 50 patients with a serum PSA of 4.0 to 10.0 ng./ml. (35 with BPH and 15 with prostate cancer) the differences between prostate cancer and BPH were still significant only when considering serum-to-urinary PSA ratio. Receiver operating characteristic curves showed that serum-to-urinary PSA ratio was a better predictor of prostate cancer than serum PSA. CONCLUSIONS: Our results suggest that the serum-to-urinary PSA ratio may be useful in distinguishing BPH from prostate cancer, particularly in the diagnostic gray zone of serum PSA between 4.0 and 10.0 ng./ml.

Aged↗
PubMed1996

Evidence for a novel regulatory pathway activated by (carba)prostacyclin in preadipose and adipose cells.

Prostacyclin, one of the major prostanoids generated in adipose tissue, has been previously described as an autocrine/paracrine adipogenic effector, acting, in preadipose cells, by means of cAMP and free Ca2+ as cell surface receptor-mediated messengers. The present study presents evidence for the first time that its stable analogue, carbaprostacyclin, is unique among prostanoids in regulating the expression of two differentiation-dependent genes in preadipose and adipose cells in a way distinct from that elicited by its cell surface receptor. This regulation is likely mediated by some member(s) of the peroxisome proliferator-activated receptor family and suggests that prostacyclin behaves as an intracrine effector of adipose cell differentiation.

3T3 Cells↗
PubMed1996

Radiographic prognostic criteria for extracorporeal shock-wave lithotripsy: a study of 485 patients.

OBJECTIVES: We studied 485 patients treated by extracorporeal shock-wave lithotripsy (ESWL) using an ultrasound electrohydraulic apparatus in an effort to define radiographic criteria for better patient selection for ESWL. METHODS: Results were assessed according to plain x-ray nephrotomography and ultrasound. The criteria for measuring success (stone free [SF]) excluded all residual fragments. After per-criteria analysis of the results, a multivariate analysis as well as an analysis of stone composition by infrared spectroscopy were performed. RESULTS: The SF rate was 57.5% (279 of 485). Calculi that were smooth, denser than bone, located in the lower calyx, and larger than 15 mm had less satisfactory results despite a greater number of impulses. A correlation was established between the radiographic appearance of the calculus, its composition, and ESWL results. Rough, less dense calcium oxalate dihydrate yielded satisfactory results (65%), whereas smooth, dense calcium oxalate monohydrate led to less conclusive results (41%). Multivariate analysis demonstrated the predominant influence of radiographic calculus profile on the results: rough, less dense calculi yielded a 79.4% SF rate, whereas smooth, dense calculi yielded a 33.6% SF rate. CONCLUSIONS: We propose that patients with dense, smooth calculi located in the lower calyx and larger than 15 mm be treated by other techniques, such as percutaneous nephrolithotomy. This would not only increase the ESWL effectiveness rate, but would also reduce the cost of treating kidney stones.

Adolescent↗
PubMed1996

Patient acceptability of transurethral incision of the prostate under local anaesthesia.

OBJECTIVE: To determine the acceptance by patients of transurethral incision of the prostate (TUIP) under local anaesthesia. PATIENTS AND METHODS: The study comprised 30 consecutive patients who elected to undergo local anaesthesia for TUIP and were treated between December 1994 and September 1995. Twenty-two were considered a high risk for general anaesthesia and eight patients chose local anaesthesia for personal reasons. Patients were premedicated (opioid and benzodiazepine) and 1% lidocaine was infiltrated transurethrally using an endoscopic needle. The level of acceptance was determined using an immediate post-operative questionnaire which included a linear visual analogue scale (VAS) to rate pain. RESULTS: No patient required conversion to another type of anaesthesia and there were no complications related to the local anaesthesia. The mean (SE) VAS score was 3.2 (1.7) and the questionnaire results showed that 83% of the patients did not consider that general anaesthesia was necessary for the operation and that 90% would agree to undergo the procedure again under local anaesthesia. CONCLUSION: TUIP under local anaesthesia was well tolerated in motivated patients. We recommend it as the operation of choice for the relief of obstruction in high-risk patients with a small benign prostatic hyperplasia.

Aged↗
PubMed1996

Serum-to-urinary prostate-specific antigen ratio: a potential means of distinguishing benign prostatic hyperplasia from prostate cancer.

OBJECTIVE: High concentrations of serum prostate-specific antigen (PSA) may be associated with the presence of benign prostatic hyperplasia or prostatitis. We investigated the serum-to-urinary PSA ratio in patients with or without prostate cancer to assess its efficacy in enhancing serum PSA specificity. METHODS: Patients presenting abnormal findings in digital rectal examination or documented prostate carcinoma were prospectively included in the study. A control group, with no evidence of prostate disease, hospitalized in the same time interval was included. Serum and urine PSA levels were measured in our laboratory with the Tandem R assay (Hybritech). Samples were drawn twice at 2-month intervals (M1 and M3). RESULTS: Sixty-eight patients were included in the study divided into 27 cases of benign prostatic hyperplasia, 20 of prostate carcinoma, 10 of prostatitis and 11 patients in the control group. Serum and urine PSA levels were not correlated (r < or = 0.1). There was no significant difference in any group from M1 to M3 as regards urinary PSA (p > or = 0.15). Intergroup comparison showed significantly (p < or = 0.004) high urinary PSA (mean level +/- SEM 28.3 +/- 3.4 micrograms/mmol creatinine) only in the benign prostatic hyperplasia group, mean levels in the prostate carcinoma, prostatitis and control groups being 3.7 +/- 1.1, 11 +/- 2.9 and 5.2 +/- 0.9 micrograms/mmol creatinine, respectively. Differences in urinary PSA levels between the confined prostate carcinoma and benign prostatic hyperplasia groups (p = 0.0008) were further increased when considering the serum-to-urinary PSA ratio (p = 0.0003). CONCLUSION: Our results suggest that the serum-to-urinary PSA ratio may be useful in distinguishing benign prostatic hyperplasia from prostate cancer.

Aged↗
PubMed1996

[Genito-urinary injuries. Sequelae. Medico-legal aspects].

Traumatisms of the genito-urinary apparatus may be due to road or work accidents as well as mishaps occurring in surgery. Whatever be their cause, such after-effects may quite possibly not only perturb genital functioning, but also be detrimental to everyday life, if not survival itself. Such sequels are then open to legal redress, when making an estimate of the attendant damage, it behooves one to take into account the initial lesions, the gesture carried out in surgery, the evolution of such lesions as regards each particular organ and, last but not least, the way after-effects effectively impact upon the subject's everyday life. Such widespread considerations are integrally linked to equally widespread medical knowledge, to which one must necessarily add legal notions pertaining to juridical compensation for the type of corporeal injury which any surgeon, whatever be his degree of expertise, has got to know.

France↗
PubMed1995

Systematic removal of catheter 48 hours following transurethral resection and 24 hours following transurethral incision of prostate: a prospective randomized analysis of 213 patients.

The interval before removal of the catheter used in prostatic transurethral surgery depends to a great extent on the surgeon, with a frequently empirical orientation. We conducted a prospective, randomized and controlled study of 213 patients who underwent transurethral surgery for benign prostatic hyperplasia. The catheter was removed systematically 24 hours after transurethral incision and 48 hours after transurethral resection of the prostate (group 1-52 and 54 patients, respectively) or the catheterization interval was determined by each surgeon in accordance with the usual criteria (group 2-52 and 55 patients, respectively). No statistically significant differences were noted between these 2 groups in regard to complications. We conclude that systematic removal of the catheter at the aforementioned periods is cost-effective, safe and comfortable for the patient.

Aged↗
PubMed1995

[Adenocarcinoma of the rete testis. Apropos of a case].

In the light of a case report, the authors recall the clinical signs of adenocarcinoma of the rete testis and the precise histological and immunohistochemical features allowing confirmation of this very rare diagnosis. They emphasize the persistent controversies concerning the treatment of this testicular tumour.

Adenocarcinoma, Papillary↗
PubMed1995

[Hot flushes in men after surgical or pharmacologic castration].

Hormone therapy for prostate cancer is associated with a number of adverse effects including hot flushes, which constitute a significant problem as they sometimes interfere with everyday life. Every effort must be made to relieve patients complaining of this symptom. Several different therapeutic modalities are proposed.

Androgen Antagonists↗
PubMed1995

[Tumors of the Bellini collecting tubules. Apropos of a case].

Based on a personal case and a review of the literature, the authors describe the particular features of renal tumours arising from the papillary ducts of Bellini. The most remarkable feature of this rare lesion, which has a very poor prognosis, is that it arises in the medullary zone of the kidney. The histological diagnosis is often difficult to confirm and immunohistochemical techniques are essential. The possible role of adjuvant chemotherapy following nephrectomy and the type of regimens used are discussed.

Adenocarcinoma, Clear Cell↗
PubMed1995

[Simplified vesico-urethral anastomosis after radical retropubic prostatectomy for cancer. A preliminary comparative study].

The authors have done a prospective non randomized study to compare two methods of radical retropubic prostatectomy, without bladder neck preservation (Group 1 = 30 patients) or with bladder neck preservation (Group 2 = 15 patients). Anastomosis was simplified for the 15 patients with bladder neck preservation according to the Vest suture procedure. A comparative urodynamical study was performed with each group. Selection for one or the other technique was made by the personal choice or every surgeon. Results were similar for pre operative clinical staging, Gleason score with both groups. There was no significant difference in survival, progression of the disease and three month PSA level as those of the last follow-up visit (18-96 months). There was no difference between the 2 groups regarding operative time, blood loss, urethral catheterization time, drainage output and mean hospitalisation time. The only significant difference was the number of post operative transfused blood units in the Vest suture group (p < 0.001). There were no positive margin on the preserved bladder neck in group 2, even if there was finally an understaging or another apical positive margins. Complications were not significantly different in the two groups with 10 bladder neck strictures in the group 1 (33%) and only 2 in the group 2 (14.2%) (NS). Complete continence rate was 73.3% and 64.2% respectively (NS). Bladder neck incision was never followed by incontinence. On urodynamical study, 9 cases in each group were compared and both were similar but there was a tendency to a higher urethral pressure in group 2. Comments pointed out that bladder neck preservation and simplified Vest traction suture did not give more post operative nor carcinological complications than classical technique with direct separate stitches sutures. Disease progression, continence and bladder neck stricture rates were compared to literature. The urodynamical results were the same as those observed by others studies.

Aged↗
PubMed1995

[Experimental study of urinary calculi fragmentation with pulsed laser shockwave, based on their chemical composition].

OBJECTIVES: To attempt to classify the resistance of urinary calculi to shock waves according to the chemical composition of the calculi most frequently treated in clinical practice. METHOD: Seventy four urinary calculi obtained after surgery were submitted to shock waves produced by an experimental neodyme glass phosphate pulsed laser, at a frequency of 532 nanometres, delivering impulses of 4.8 Joules lasting 25 nanoseconds with a recurrence of 1 second. The calculi (25 homogeneous: 90% of one constituent, 49 heterogeneous: > 45% < 90% of one constituent) had to be fragmented down to 2 mm fragments. The total fragmentation energy (TFE) required was the parameter adopted to classify calculi and to compare the fragmentation of various chemical compositions studied by infrared spectrophotometry. The TFE of 25 homogeneous calculi were compared to a microhardness study performed on calculi with the same chemical composition. The fragmentation thresholds energy (TFE) was used to compare the fragmentation thresholds of each type of calculi. Statistical analysis by ascending multiple regression was performed to classify the various factors likely to influence fragmentation. RESULTS: Two groups were able to be significantly distinguished according to whether the TFE required to obtain 2 mm fragments was greater than 200 Joules (cystine, weddellite, brushite, uric acid) or less than 200 Joules (weddellite, carbapatite, struvite). Only cystine and whewellite significantly increased the fragmentation threshold. For the 125 homogeneous calculi, the correlation with microhardness demonstrated an inverse relationship between friability and increased microhardness. A crossover between microhardness and friability to shock waves was only observed for whewellite and cystine. For the 49 heterogeneous calculi, this study showed that when weddellite was the predominant component of a stone, the friability tended to increase. Struvite and whewellite significantly facilitated and decreased fragmentation of heterogenous calculi, respectively. CONCLUSIONS: This study allowed urinary calculi to be classified into three groups: friable (weddellite, carbapatite, struvite), intermediary (brushite, uric acid, whewellite) and resistant (cystine). Although this laser cannot be used clinically, the constants were similar to those of pulsed lasers available in clinical practice and the results of the study corresponded to those already observed empirically by other teams or observed experimentally on a single stone corresponding to each type of chemical composition. The clinical application of this study would be to prospectively compare the results with those observed in clinical lithotripsy.

Humans↗
PubMed1995

[Results of extracorporeal lithotripsy with ultrasonography-guided hydroelectric lithotriptor: study on 546 patients, prognosis factors].

OBJECTIVE: To investigate the existence of simple radiographic prognostic criteria, applicable on an outpatient basis, predictive of the result of extracorporeal lithotripsy (ECL). METHODS: This study was based on 546 patients treated by ECL using a hydroelectric apparatus. The results were evaluated on plain nephrotomographies and ultrasonography performed at the third month. Success was defined as the elimination of all residual fragments, regardless of their size, without fragments (WF). Analysis concerned 485 files after exclusion of patients lost to follow-up. Prognostic factors were evaluated criterion by criterion, and then by multiple ascending regression multivariate analysis. RESULTS: The fragment-free rate according to our criteria was 57.5%. Significantly poorer results were obtained for stones denser than bone (p < 0.001), smooth (p < 0.001, larger than 12 mm (p < 0.01), situated in the inferior calyx (p < 0.005), despite an increased (p < 0.005) number of ECL sessions and the number of shocks received. A correlation was established between the radiographic appearance of the stone, its predominant spectrophotometric nature (> or = 50%) and the results of ECL. Good results were obtained in 65% of spiculated, low-density Weddellite stones versus 41% of cases of dense, smooth Whewellite stones. Multivariate analysis of the predominant radiographic appearance of the stones showed that spiculated, low-density stones were completely eliminated in 79.4% of cases, and dense, smooth stones were completely eliminated in 33.6% of cases (p < 0.001). CONCLUSION: In this study, smooth, dense stones larger than 12 mm, situated in the inferior calyx appear to be particularly resistant to ECL. On the basis of this result, the authors propose a prospective clinical trial to compare the results of ECL and primary percutaneous nephrolithotomy in this type of stone with a high risk of failure.

Adolescent↗
PubMed1995

[Multiple myeloma of the testis].

The testis is a rare site of multiple myeloma. The authors report such a case in a patient with a 7-year history of multiple myeloma. Transinguinal castration was performed. Six months after the operation, the patient did not have any other extramedullary sites, but the disease progressed rapidly with diffuse bone pain and end-stage renal failure. The diagnosis and management are discussed in the light of a review of the literature.

Humans↗
PubMed1994

Prognostic value of histological grade and nuclear grade in renal adenocarcinoma.

We conducted a retrospective study of 237 cases of clinically localized renal adenocarcinoma treated at our department between November 1971 and December 1991 by radical nephrectomy. The parameters considered were tumor extension (pT stage), histological grading and nuclear grading. If the histological grade proved to be of little informational value in regard to survival, nuclear grade and pT stage had significant impact. On the other hand, nuclear grading considered in a given stage provided no significant influence. We conclude that nuclear grading cannot predict the outcome of patients at the same surgical stage.

Adenocarcinoma↗
PubMed1994

[The treatment of stage I malignant non-seminoma tumors of the testis without systematic lumbo-aortic dissection. Results of a study begun 20 years ago. Apropos of 21 cases].

Over a 20-year period (1971-1991), the authors have treated 75 malignant testicular tumours, corresponding to 33 seminomas and 42 nonseminomatous tumours. The latter group included 23 stage I tumours according to Peckham's classification. The authors studied the therapeutic modalities of 21 of these patgients (2 non-protocol patients excluded) treated without lumboaortic lymph node dissection. Adjuvant therapy consisted of radiotherapy alone (2 cases), radiotherapy and chemotherapy (5 cases) and chemotherapy alone (14 cases). All patients are alive in complete remission (100%) with a follow-up of at least 24 months (range: 31-222 months, mean survival: 102.2 months). In line with what they already believed in 1971, the authors consider that systematic lumboaortic lymph node dissection is not essential in the treatment of stage I nonseminomatous testicular tumours, but propose systematic adjuvant therapy. Chemotherapy (PVB or, preferably, PEB) provides a guarantee of security and good acceptability.

Adult↗