Search PubMed⌕ Search

Biomedical subjects

J Aubert

Publications and source records attributed to J Aubert.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1994

[Vesico-urethral anastomosis after radical prostatectomy in cancer: Vest-Mayo's simplified technique].

The authors describe the technique of anastomosis without vesicourethral suture after radical prostatectomy for cancer. The operative details are described with a brief analysis of the principal complications observed in the first 14 patients operated with preservation of the bladder neck. These results are compared with the in the literature concerning this old technique recently revised by the Mayo Clinic surgical team in 1988.

Anastomosis, Surgical↗
PubMed1994

[A technical device for the percutaneous extraction in monobloc of various renal calculi larger than 10 mm].

The authors present a technical device consisting of a modification of the operating channel for stone extraction by percutaneous nephrostomy. For selected stones, widening of the lips of the operating channel allows the stone to be rapidly and entirely removed without the need for ultrasound or hydroelectric fragmentation, which is always associated with a risk of leaving residual fragments. The aim of this technical device is to ensure complete absence of residual fragments with a minimum of risks for the renal parenchyma.

Calcium Oxalate↗
PubMed1993

[Inflammatory myopathy: unusual presentation of a case of Wegener disease].

The case is presented of a 66-year-old man who developed an inflammatory myopathy picture predominantly consisting in leg weakness. Wegener's granulomatosis was diagnosed on the basis of suggestive thoracic imaging, microhematuria and necrotizing arteritis with granulomas in muscular biopsy. An increasing titer of anti-neutrophilic cytoplasm auto-antibodies (ANCA) confirmed the diagnosis. Rapid resolution was obtained by classic immunosuppressor treatment (cyclophosphamide and corticoids), without worsening of renal function. In discussion we emphasize the importance of ANCA measurement for diagnosis and follow-up.

Aged↗
PubMed1993

[Prostatic cancer between 50 and 60. A more than 20-year-long retrospective study. Apropos of 65 case reports].

Sixty five 50 to 60 year old patients have been treated for prostatic cancer over a 21 year period. Twenty four had a local prostatic cancer (A1, A2, B1, B2) and 41 (63.2%) a locally advanced or metastatic (D1, D2 disease at diagnosis. The mean age was 56 years old. As being as retrospective study, miscellaneous treatments were done. The 5 and 10 years survival, analysed with the Kaplan-Meier method, was 61% and 31% respectively. According to the stage of cancer, the 10 year survival was 72% and 5% for (A-B) and (C-D) respectively. For well differentiated tumors, 5 years survival was 67% instead of 36% for undifferentiated ones. The 10 year survival was 36% for well differentiated tumors with 6 on 8 patients who survived with a mean of 11.6 ears. The authors discussed the benefit of an early diagnosis of prostatic in the 50-60 year old men group which is 4% of the total prostatic cancer diagnosed within the same period. They analysed the influence of PSA and transrectal sonography interest at this age.

Bone Neoplasms↗
PubMed1993

[Percutaneous nephrolithotomy after failure of extracorporeal shockwave lithotripsy. Indications, results, perspectives].

Eighty-one of the 579 extracorporeal lithotripsies (ECL) performed between 1987 and 1992 with an ultrasound-guided hydroelectric lithotriptor required the use of another treatment modality. 53 percutaneous nephrolithotomies (PCNL) were performed in these 81 patients after failure of ECL (21 for non-fragmentation, 32 for residual fragments). The authors analyse the factors responsible for failure in order to select the more appropriate type of treatment for different types of stones. The site of the stones, their size, their radiographic appearance, their chemical composition, the number of ECL sessions and the number of days spent in hospital were compared between the PCNL and ECL groups. Smooth, homogeneous stones denser than bone and larger than 15 mm in diameter were significantly more resistant to ECL, despite an increased number of shock waves. PCNL was successful in 92% of cases of non-fragmented stones (with no residual fragments). The success rate for multiple residual fragments was 64%. In view of the risk of complications associated with residual fragments, regardless of their size, the potential risks of ECL and cost imperatives, the authors recommend that these stones, considered to be resistant, should be treated immediately by PCNL, as the results of PCNL after ECL are less satisfactory.

Adult↗
PubMed1993

[Ectopic ureteral orifice into the seminal duct with homolateral renal agenesis: contribution of ultrasonography].

Based on an incidental case of ectopic ureteric orifice in the seminal tract associated with homolateral renal agenesis, the authors demonstrate the value of ultrasonography, particular transrectal, both for diagnosis and follow-up. Digital rectal examination is the key to the diagnosis, combined with ultrasonography and urography. The indications for surgery depend on the clinical symptoms and signs.

Abnormalities, Multiple↗