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Biomedical subjects

J Auvert

Publications and source records attributed to J Auvert.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Contribution of suprapubic ultrasound in prostatic hypertrophy].

After describing the technique, the authors recall the ultrasound anatomy of the prostate with the symmetrical echoes given by the seminal vesicles, the vas deferens and the ejaculatory ducts, which often allow a distinction to be made between the cranial and caudal portions of the prostate. Calculation of the volume (normally under 20 cm3) measures the enlargement (useful in determining the choice of approach), using the formula (Formula: see text) Ultrasound also often gives some idea of the nature of the lesion. The main distinction between an adenoma and a carcinoma is the fact that the adenoma is normally confined to the cranium. Carcinomas are generally asymmetrical, and their structure is non-echogenic, giving coarse echoes. Chronic prostatis, on the other hand, leads to the existence of symmetrical hyper-echogenic areas, sometimes calcified. The main contribution of suprapubic ultrasound is the information it provides concerning the repercussions on the urinary tract (residue, straining bladder, repercussions on the kidney). It can also be used to monitor developments.

Adenoma↗
PubMed1984

[Renal oncocytoma. Apropos of 9 cases].

The authors report nine cases of renal oncocytoma which were observed in a series of 220 consecutive renal cell carcinomas. They share the general view concerning the clinical latency of these tumors which are rarely hematuric, and concerning the favorable prognosis, despite signs of locoregional malignancy. On the other hand, they do not share the opinion that arteriography or CT scan can provide a reliable preoperative differential diagnosis with the normal type of renal cell carcinoma.

Adenoma↗
PubMed1984

Iridium-192 wiring after partial cystectomy as a treatment of small malignant bladder tumors.

Small tumors of the mobile portion of the bladder may be treated by means of interstitial irradiation by iridium-192 wiring. Forty-four tumors (mostly T1, but also T2 and T3) were treated by this procedure and followed over five years. Good results are attained in 66 per cent of the cases. This method has the benefit of avoiding irradiation to the surgeon's hands, and of delivering to a specific site a dose of 6,000 rads. No bladder contraction was observed. Supplementary treatment by irradiation has to be considered in view of frequent recurrences of malignant bladder tumors after transurethral resection of partial cystectomy. In small cancers slightly infiltrating the bladder wall, many attempts have been made to replace tele-irradiation by interstitial irradiation. The latter delivers specifically high rad dosage to the involved area. Radium needles has been used in France by Darget before 1951 but evaluation of accurate dosage proved difficult. This material was dangerous to the surgeon's hands, and the procedure lead frequently to bladder sclerosis. This technique is currently used by Van der Werf-Messing in Rotterdam. She strongly advises preoperative tele-irradiation (3 X: 350 rads) to prevent tumor implants in the scar. An intravesical balloon filled with fluid radioisotope of gold-198 or cobalt-60 has been used for diffuse malignant papillary epithelioma. It was discontinued because of radiation cystitis and subsequent contraction of the bladder. Recently in well-limited tumors, Bloom and Wallace have used Tantalum-182 needles which have interesting physical properties (high energy and short half-life period) (2).

Brachytherapy↗
PubMed1984

[Percutaneous nephrolithotomy in 1984. Technics, results, indications].

Percutaneous nephrolithotomy - PCNL - was made possible by technological progress, with the introduction of nephroscopes, lithotomy forceps, and mechanical, ultrasonic or electrohydraulic lithotriptors. The procedure includes four stages. First needle puncture of the inferior or middle calyx. Secondly, dilatation of the pathway and creation of a tunnel. Thirdly, investigation of the collecting system. And, finally, extraction of the stone. The results of 302 published cases show a success rate of 87 per cent, a complete failure rate of 13 per cent, and residual stones in 10 per cent of cases. The complication rate is 7 per cent, with hemorrhage and sepsis in roughly equal proportions. A few other complications are occasionally reported, such as colic wounds, perirenal collections, traumas of the ureteropelvic junction, pneumothorax, or a stone left in the lumbar wall. There was one case of death. The hospitalization period is the same as for lombotomy, but the return to work is more rapid. The best indications are pelvic and inferior calyceal stones (with a success rate of over 80 per cent). Despite their enthusiasm for this procedure, the authors feel that is still remains to be seen or whether it will in turn be superseded by ultrasound lithotripsy.

Drainage↗
PubMed1983

[Disease of branches of the renal artery. Choice of a revascularization procedure].

In situ versus extra-corporeal and microvascular reconstruction are discussed in relation to the treatment of renal branch artery disease. Ten cases are reported: 4 aneurysms, 1 atherosclerosis, 1 trauma, 1 embolism and 1 dissection. In three cases, the disease involved only the segmental artery branches and in seven cases both the main artery and the branches. An in situ procedure was performed in 5 cases and extra-corporeal surgery was necessary in 5 others. Four of the kidneys were iliac autotransplanted. Anatomical and immediate functional results were good in ten cases, but there was one postoperative death by heart failure due to a mitral disease. In our series extracorporeal and microvascular surgery were not routinely used for the treatment of renal artery branch disease. But these procedures can widen the indications for renal revascularisation, which then replaces medical treatment or a nephrectomy.

Adolescent↗
PubMed1982

[Acute renal insufficiency in spontaneous septicemia of renal origin. Analysis of a series of 17 patients].

Seventeen recent cases of spontaneous renal septicemia with acute renal failure are reviewed, confirming the need for a diagnostic and therapeutic strategy to restore the fluid balance, if necessary with the aid of an artificial kidney, and the urgency of treating local infection and the pathogenic agents involved. The case review also suggest that the high mortality rate of this infection, estimated by some observers at 50 p. cent, can be greatly reduced by early radical urological treatment.

Acute Kidney Injury↗
PubMed1982

[Late anuria in rectosigmoid cancers].

The authors discuss nine cases of anuria by local recurrence after abdominoperineal resection for cancer of the rectosigmoid, with particular emphasis on the frequency, diagnosis, prognosis, and the different methods of treating this type of anuria. The placing of a Gibbons catheter between the renal pelvis and the bladder seems to be the most suitable.

Aged↗
PubMed1982

[A review of ten cases of aldosteronoma. Diagnostic and therapeutic conclusions (author's transl)].

Ten patients with primary hyperaldosteronism resulting from a functioning adrenocortical adenoma were studied. The high incidence of hypertension and/or renal disease in the families of these patients suggests that hereditary factors play a part in the genesis of aldosteronomas. In patients with hypertension and hypokalemia the diagnosis of primary hyperaldosteronism is established by measurements of serum renin activity and serum aldosterone concentrations under normal conditions and during pharmacodynamic tests. The adenoma is demonstrated by radioactive iodocholesterol scintigraphy and computerized tomography. In nearly two-thirds of the patients, unilateral adrenalectomy is followed by complete definitive recovery.

Adenoma↗
PubMed1981

[Bilateral stenosis of the renal arteries with normal urography (author's transl)].

In theory, negative urographic findings in severe hypertension exclude a renovascular origin. However, when both renal arteries are dysplastic urography may remain perfectly normal even though arteriography demonstrates tight stenoses and these patients are cured by surgical treatment. In the case reported here the only clinical sign of stenotic renal arteries was a systolic murmur on auscultation of the abdomen.

Adult↗
PubMed1981

[Scintigraphy with technetium dimercaptosuccinic acid (99 m TC DMSA). Contribution to the functional assessment of individual kidneys (author's transl)].

Renal uptake of 99m Tc DMSA was used to evaluate the renal function of 16 healthy subjects (controls) and 115 patients with various urinary tract diseases. Scintigraphic examination was carried out 6 hours after an intravenous injection of the product. In the 16 controls Tc DMSA uptake was 25.7 +/- 2.48% in the right kidney and 24.4 +/- 2.86% in the left kidney. In 36 patients with one single hypertrophied kidney, there was a correlation (r = 0.850) between creatinine clearance and Tc DMSA uptake, which was higher than in normal subjects (39.23 +/- 9.9%). In the group of 68 patients with unilateral (31) or bilateral (37) renal disease, a significant correlation (r = 0,725) was observed between kidney-to-kidney ratios of urea clearance and Tc DMSA uptake, so that renal impairment could be quantified. Quantitative scintigraphy did not appear to be of assistance in the remaining 11 patients with obstructive uropathy, as it overestimated renal function. The results obtained with 99 m Tc DMSA scintigraphy should be helpful in choosing between nephrectomy and conservative surgery and in assessing the degree of compensatory hypertrophy in single kidneys.

Creatinine↗