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Biomedical subjects

J Aubert

Publications and source records attributed to J Aubert.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Cystinic lithiasis. Current aspects of the urologic treatment].

On the basis of a series of 9 patients (12 renal units) gathered over 19 years, the authors analyze the current possibilities of treatment of cystine lithiasis. They first describe the characteristics of this litiasis, which is rare but serious, being naturally prone to recurrence because it is caused by a genetic defect. The development of extracorporeal lithotripsy raised great hopes for the treatment of this lithiasis, but it was soon realized that cystine strones were hard to break. However, even the mere fragmentation of the stones improves the dissolving action of the various drugs proposed to modify the pH of urine. The authors consider that open surgery by means of posterior vertical lumbar section still is indicated for larger stones, and percutaneous nephrolithotomy seems to be a very useful technique, either exclusively or as a complement of extracorporeal lithotrity.

Adult↗
PubMed1990

[Vesicorenal reflux and ureteral duplication. Study of 62 cases].

On the basis of a series of 62 files gathered over 18 years, the authors study vesicorenal reflux in duplication of the ureters. The abnormally was bilateral in 10 cases, and a total of 206 ureters was analyzed. Clinically, fever and a urinary infection are the usual expression. While intravenous pyelography allows assessing the condition of the upper urinary tract, retrograde cystography demonstrates the reflux and indicates its degree. This study confirms that the reflux mainly occurs in the lower pelvis and that it is very marked (stage II + stage III = 62.9%). Three categories of patients should be distinguished: infants younger than age 2; children from age 2 to age 15; and adults. Purely medical treatment was disappointing, and surgery seems to by far the best solution. However, the solution is different according to whether or not another malformation is associated with duplication and reflux. In the latter case, the surgical procedure is simple, while in the former there often is a complex pathology which sometimes raises difficult surgical problems, especially in children.

Adolescent↗
PubMed1990

[Vesicorenal reflux in children under 2 years of age. Indications and results of surgical treatment].

On the basis of 133 cases, the authors analyse the clinical features and the modalities of the treatment of vesicorenal reflux in children under age 2. The number of girls is higher than that of boys. The diagnosis is most often established between 0 and 6 months of age, with a very marked peak between 0 and 1 month. The usual warning sign is a urinary infection with fever. Pyerography is normal in every second case, and retrograde cystography is the key examination, which confirms the reflux and establishes its side and degree (bilateral reflux in 53% of cases, stage II in 48% of cases). 33 children were operated at once. Another 100 first had a medical treatment, ie. urinary antibiotics, on the basis of strict criteria that are listed here. This medical treatment has been very disappointing: 20 children were lost to follow-up and 47 had secondary surgery. When surgery is necessary, advancing plasty according to Cohen's procedure yields excellent results: 98.6% of 76 operations were successful. The authors therefore think that Cohen's procedure is widely indicated, even in children under age 2.

Anti-Bacterial Agents↗
PubMed1989

Bilateral traumatic renal artery rupture: emergency surgical repair and long-term evolution.

In one case of bilateral traumatic renal artery rupture, the role of clinical and radiographic explorations is discussed to reduce the duration of renal ischemia. The diagnosis of bilateral traumatic renal artery rupture requires the performance of pyelography if the patient is oliguric or exhibits microscopic hematuria, or of conventional aortography if there is no renal secretion. Renal artery repair must be done as soon as possible, but a review of the literature shows that delay in treatment is not rare. Everything must be done to reduce this delay in order to improve renal function after surgery.

Adult↗
PubMed1989

[Flexible ureteroscopy. Diagnostic and therapeutic significance. Apropos of 15 cases].

The authors analyse the results of a preliminary report of 15 cases of ureteric stones treated by flexible ureterorenoscopy and one case of radiolucent renal stone in the left lower renal calyx. Stone fragmentation was complete in 11 cases with 1 small residual fragment in the lower ureter, 1 perforation was immediately operated without any further complication and in one case, it was impossible to advance into the ureter. Flexible ureterorenoscopy is valuable for diagnosis of filling defects in the lower calyx and for treatment of stones in the upper and middle ureter.

Adult↗
PubMed1989

[Penile metastasis disclosing cancer of the rectum. Apropos of a case].

A case report of penile metastasis from a rectal cancer in a 58 year old man is described. The authors insist on the rarity of this penile metastatic localization. Many primary tumors can be involved in this penile localization, mainly urinary tract tumors such as bladder or prostate, but rectal cancer is very rare and only 47 cases have been reported to date. The modalities of extension are analysed: direct invasion or venous extension. The prognosis of such metastases is very poor, but some long-term survivals (from 21 months to 9 years) have been seen after aggressive surgical treatment when the primary tumor was rectal cancer. Radiotherapy and are not effective.

Adenocarcinoma↗
PubMed1989

[Extracorporeal hydro-electric shockwave lithotripsy (Sonolith 2000). Analysis of 137 records of a first-year experience].

137 patients were treated by ESWL with Sonolith 2000 lithotriptor using ultrasonography localisation. 132 patients were eligible for review. Calculi were caliceal in 85, pelvic in 51, in upper ureter in 1; 26 stones were treated by the push and bang technique with an ureteric stent. Fragmentation rate was 83.9% and stone free rate at 3 months was 68.5%. Failure were reviewed: non fragmentation (16.1%) and insufficient fragmentation (15.1%). 14 calculi were analysed by infra red spectrophotometry and correlated with radiodensity on pre ESWL plain X-ray. Hardness and friability criteria are described. Calculi of different radiographic aspects respond differently to shock wave fragmentation. Some stone composition as calcium oxalate monohydrate pure or mixed with apatite and calcified uric acid are difficult to break by ESWL. Those calculi represented almost 30% of the series. This criteria of hardness has to be taken into account for the selection of patients in order to improve the results of ESWL.

Adolescent↗
PubMed1989

[Atrophicus sclerosis lichen and cancer of the glans].

Two cases of glans penis epidermoid carcinoma after lichen sclerosus and atrophicus or balanitis xerotica obliterans are discussed. Relationship between both diseases are analysed but remain not clear. Balanitis xerotica obliterans gives foreskin and urethral meatus stenosis that required circumcision. Glans carcinoma can be observed many years later even after circumcision. The knowledge of lichen sclerosus and atrophicus is important to do circumcision at the beginning of the disease with a long term follow-up of these patients to realize a glans penis biopsy if necessary. Most of lichen sclerosus and atrophicus are not recognized and the frequency would be higher than reported.

Balanitis↗
PubMed1989

[Cancer of the bladder after cystitis due to cyclophosphamide. Apropos of a case].

Since 1960, cyclophosphamide has been widely used in the treatment of solid malignant tumors, certain hematological and systemic diseases and indeed even in renal transplantation. However, while the efficacy of the product is certain, it became rapidly apparent that this molecule had a definite toxicity for urinary endothelium, in particular that of the bladder. This toxicity is due to certain metabolites of the molecule and to the fact that urine stagnates in the bladder reservoir. It is manifested principally by hemorrhagic cystitis which is always difficult to treat and which is sometimes life threatening for the patient. However, cyclophosphamide can also induce malignant bladder tumors with a poor prognosis. Since 1971, 56 cases of bladder cancer due to cyclophosphamide have been published. It is therefore a rare lesion generally manifesting itself by hematuria and sometimes occurring a long time after discontinuation of treatment. At the time of first examination, 2/3 of these tumors were widely infiltrating and despite major surgery (50% of cases required immediate total cystectomy) the prognosis was very poor due to the fact that the bladder cancer added its own degree of gravity to that of the initial disease which justified the introduction of treatment. All the authors who have studied this problem therefore stress the necessity of avoiding cyclophosphamide when another molecule may be effective and especially when it is not a malignant condition which is being considered.

Adult↗
PubMed1988

Inverted papilloma of upper urinary tract. Four case reports.

As part of urinary tract transitional cell carcinoma, inverted papilloma deserves a particular place owing to its histologic features, rarity and prognosis. These tumors are usually located in the bladder and their location in the upper urinary tract is quite exceptional. This is the reason why we were prompted to report 4 new cases.

Adult↗
PubMed1988

[Lithiasis in horseshoe kidney in children. Apropos of 6 cases].

In a 6 cases report of stones developed in horseshoe kidney in children, from 25 months old to 14 years old, diagnosis and surgical problems are analysed. Another urological malformations have to be researched mainly vesico renal reflux and pyelo ureteric junction obstruction. Diagnosis is usually made when stones give complications where septic obstruction is not rare and can be severe in children. Pre and intra-operative sonography can currently do the stone localisation. Surgical management of stones developed in horseshoe kidney seems to be done still by open surgery because new techniques as Eswl or percutaneous lithotripsy can be difficult to perform or dangerous in children on this malformation. Number of operations can often be higher than in adults, to do both treatment of the stone and associated malformation as PUJ obstruction, mainly if there are infected and septic complications.

Adolescent↗
PubMed1988

[Penile metastasis of a prostatic neoplasm. Apropos of a case. Long-term survival].

Penile metastases are uncommon lesions. They are most often secondary to a primary pelvic cancer (bladder, prostate, rectum). The appearance of a penile lesion may differ; priapism may or may not be present. The mode of dissemination is still controversial. The authors report one case and review the literature on penile metastases secondary to prostatic cancer. The essential point of their observations is the prolonged survival of their patient (7 years) whereas in the literature, the prognosis of these lesions is a rapidly fatal outcome.

Adenocarcinoma↗
PubMed1988

[Is the Gil-Vernet advancement procedure for reflux legitimate? Considerations apropos of 22 cases in adults and children].

We discuss 22 patients who have undergone surgical antireflux plasty with Gil-Vernet's technique. In 19 patients, success was obtained with an average follow-ip of 12 months. In 3 cases, a persistent reflux remains and the children have not been reoperated. This technique is very simple and has a number of advantages, such as bilateral simultaneous correction of reflux, without any lower ureteral dissection. Subsequent ureteral catheterisation is easy which is important for any further ureteroscopy. Nevertheless, a longer follow-up has to be studied to be sure of the reliability, of the technique in comparison with older but safe techniques such as Cohen's advancement.

Adolescent↗
PubMed1987

[Contusion on horseshoe kidney. Apropos of 2 cases].

Based on the personal observation of two cases and a series of 40 patients reported in the literature, the specific problems related to injuries to horseshoe kidney are evoked. The first case involved crushing of the isthmus against the spine recognized at operation on the 5th day and suggested by urography, CT scan and arteriography data. Abstention from surgery in the second case was decided on initial urography and ultrasound findings and the rapid, spontaneously favorable course. A literature review failed to provide much original data related to the anatomical anomaly, too frequently detected during emergency surgery. The only particularity is related to rupture of isthmus which may damage upper excretory pathways; this explains the interest for the authors of pyelostomy in case of conservative surgery in this context. When surgery is indicated this should be reserved to severe forms and postponed. It is important to carry out arteriography in addition to urography and a CT scan because of the particularity of the vascularization of this type of kidney: the anterior transperitoneal approach appears to be the best adapted.

Adult↗
PubMed1987

[Value of posterior vertical lombotomy in the surgical treatment of calculi of the lumbar ureter. Apropos of 42 cases].

Whereas surgery is no longer used for treatment of pyelocaliceal and lower ureter lithiasis, it remains a valid method in lithiasis of lumbar ureter poorly accessible to endoscopy. A direct approach to lumbar (or pelvic) ureter by posterior vertical lombotomy considerably reduces operation time, pain and duration of hospital stay and disability. Results in a series of 42 cases indicate that surgery remains an excellent and perhaps most effective therapy for lumbar ureter calculi, with the condition that the conventional posterolateral lombotomy be abandoned.

Adolescent↗