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J Corcos

Publications and source records attributed to J Corcos.

35 records · Page 2Linked to original sources
PubMed1998

[FPSUND: a pan-Canadian evaluation of a clinical classification of urinary incontinence].

Historically, urinary incontinence is divided into 3 subtypes: stress, urge and mixed. This latter group, which according to many studies can account for up to 50% of the patients, is very heterogenous. For this same reason, the reports of treatments of urinary incontinence are very difficult to analyse using this simple classification. In a attempt to clarify this situation and to help the acquisition of useful clinical information relating to urinary incontinence, were have developed a clinical classification of urinary incontinence (FPSUND) in which 6 symptoms are graded in severity from 0 to 3. In this acronym, the F stands for frequency, the P for the use of protection, the S for stress-related complaints, the U for urge-related complaints, the N for nocturia and the D for the number of daily micturitions. Urologists across Canada were sent the French or English version of the classification and used it to evaluate 148 female patients aged from 18 to 70, suffering from urinary incontinence. A second, independent evaluation, was also performed on the same patients by registered nurses or urodynamic technicians. Reproducibility between observers, as assessed by the weighted Kappa score ranged from 0.47 and 0.74 (p < 0.05), was very good. Generally, the users of the classification found it very easy to use. In summary, we propose the FPSUND clinical classification of urinary incontinence as a useful and accurate tool to classify urinary incontinence and as a means to assess treatment outcome.

Adolescent↗
PubMed1997

Rat prostate explants in serum-free organ culture: a comparison of two media and gas mixtures.

BACKGROUND: Urologists are looking for a way to easily discriminate between aggressive and very slow-growing prostate tumors. A sound way to appreciate such developing activities would be to identify an appropriate cell marker in prostate explants maintained in a defined culture system. METHODS: Different biological parameters were compared in rat prostate explants cultured for 5 days in rich CMRL or basic Leibovitz's L-15 medium, unsupplemented with serum, under a mixture of either 95% air/5% CO2 or 50% N2/45% O2/5% CO2. RESULTS: DNA synthesis was somewhat similar with the two-gas combination, but was higher in explants maintained in L-15 medium than in CMRL. Hence, L-15 medium and the 95% air/5% CO2 mixture were selected. Under these defined conditions for 5 days, cells were still able to synthesize DNA and proteins while preserving their morphological integrity and maintaining alkaline and acid phosphatase activities. CONCLUSIONS: Since the present culture system works well in a controlled environment and under such minimal conditions, it appears to be a reliable and promising model that will provide basic data and allow the study of hormones and growth factors involved in prostatic tissue growth. It might eventually permit the identification of a cell marker.

Acid Phosphatase↗
PubMed1997

The effects of insulin, transferrin and androgens on rat prostate explants in serum-free organ culture.

A model previously developed in our laboratory to culture rat prostate explants in serum-free chemically-defined medium was used to evaluate the direct influence of potential regulators. The aim of the present work was to verify the effects of insulin (I) and transferrin (Tr), two hormones considered as essential in other serum-free culture systems, and three androgenic hormones, since the prostate is known to be androgen-dependent. Explants of rat prostate were cultured for five days in serum-free Leibovitz's L-15 medium (37 degrees C, 95% air-5% CO2). The addition of Tr (50 micrograms/ml) had no effect, but I (5 micrograms/ml) significantly increased DNA synthesis. This influence was amplified by combination of the two hormones. However, protein synthesis was only slightly stimulated. Testosterone (T) or androstanediol significantly increased DNA synthesis when compared to corresponding control values at five days. In combination with I plus Tr, each hormone showed potentiated effects, particularly T with a twofold increase over day 0 values. When dihydrotestosterone was added singly, the incorporation of 3H-thymidine was stimulated by 300% over control values at five days, and by 100% over values in uncultured explants. This influence was maximal since it was not improved by I plus Tr. Protein synthesis was increased significantly by the triple combination. In addition, each androgen as well as the combination of I plus Tr had a positive influence on explant morphology. The above conditions optimize the present culture system and establish its usefulness as a valuable tool to study the direct influence of different effectors in prostate metabolism and to eventually identify putative cancer markers.

Androgens↗
PubMed1997

The effectiveness of a professionally led support group for men with prostate cancer.

PURPOSE: This study investigated the effectiveness of support groups in: (a) helping patients and significant others voice their concerns about the physical and psychosocial implications of their disease in an emotionally supportive context, (b) enhancing patients' understanding of their disease and its treatments and side effects, and (c) facilitating more active involvement in their treatment. A total of 54 men and some family members participated in seven separate groups. Patients were invited to participate with a letter describing the goals of the support groups or were referred by nurses and doctors. METHOD: The participants met for a series of 10 weekly sessions each of 90 minutes duration. The meetings were led by a nurse and a psychologist, who together provided information on the medical aspects of the disease and its treatment, focused on the psychologic reactions to a diagnosis of cancer, and encouraged participants to adopt more active, health-promoting coping strategies. RESULTS: The participants were surveyed anonymously by questionnaire at the end of the tenth session on their views and attitudes about the support groups and their overall satisfaction. The results showed that participants in the support group felt they had a better understanding of their illness and perceived themselves as more involved in their treatment. They expressed that sharing their experiences with others gave them reassurance, helped alleviate their anxiety, and provided them with a more positive outlook. CONCLUSION: It was concluded that these findings furnished evidence of the effectiveness of support groups in facilitating perceptions of enhanced coping in men with prostate cancer.

Aged↗
PubMed1996

The international prostate symptom score: physician versus self-administration in the quantification of symptomatology.

OBJECTIVES: The International Prostate Symptom Score (IPSS), originally known as the American Urological Association Score, is the most commonly used scoring system for the quantification of benign prostatic hyperplasia symptoms. One area that has remained unexplored is the stability of the questionnaire construct between different modes of administration. The objective of this study was to measure differences in IPSS when administered by the physician versus patient self-administration. The impact of order of administration was also examined. METHODS: Sixty-four patients completed two IPSS questionnaires during the same office visit, one self-administered and the other by physician interview. The influence of order of administration was examined by randomly allocating patients to either self-administration or physician-administration first. Total symptom scores (questions 1 to 7) and quality of life scores (question 8) were compared between the two modes of administration. Multivariate analysis of variance was performed to assess the effect of age, medical history (obtained from the IPSS form), order of administration, and physician (A and B) on the observed differences. RESULTS: The distribution of differences was similar between the two orders of administration. Overall, 26 patients had a higher total score with self-administration, 30 with physician-administration, and 8 had identical scores on both. Mean total symptom scores and quality of life assessments by physician- versus patient-administered questionnaires were similar (10.9 versus 10.4 and 1.8 versus 2.2, respectively). No statistically significant difference was observed. The order of administration did not show statistical significance (P > 0.05) by multivariate analysis. As well, no interaction was seen between the aforementioned variables. CONCLUSIONS: There is no difference in the information obtained if patients self-administer the questionnaire as opposed to physician administration.

Aged↗
PubMed1995

Innocuity of agents for radiocontrast enhancement of urinary tract stones.

OBJECTIVES: Mineral kidney stones are frequently difficult to detect due to their radiotranslucency. We have recently developed a method that enhances the visibility of such stones by retrograde infusions of certain heavy metal salt solutions such as cesium or lanthanide gadolinium. This report describes toxicologic studies carried out on the use of those contrast agents to introduce this technique eventually into clinical trials. METHODS: Systemic absorption was assessed in dogs through infusion of radioactive contrast agent into the renal pelvis with or without ureteral obstruction. Radioactivity in urine and blood was monitored. Local toxicity was studied in animals infused with the contrast agent at intervals up to 4 weeks. RESULTS: Reabsorption studies under high intrapelvic pressures (70 cm H2O or higher), demonstrated reabsorption of cesium. However, at normal intrapelvic pressures, only a moderate reabsorption of cesium was observed. No gadolinium reabsorption was detected even at high intrapelvic pressures. Histopathologic studies showed no major urothelial lesions but only a transient inflammatory reaction that was undetectable 4 weeks following exposure to gadolinium salts. CONCLUSIONS: Gadolinium salt solutions are good positive radiocontrast agents for mineral kidney stones without having serious toxic effects or systemic reabsorption.

Absorption↗
PubMed1993

Maturation of the external urinary sphincter: a comparative histotopographic study in humans.

The developmental anatomy of the striated urinary sphincter remains controversial and is scantly documented in children. We compared its structure and configuration in the fetus, infant and adult to determine anatomical differences among these groups. We removed 25 postmortem specimens from fetuses, infants and children, which were fixed and stained for histological study. Ages ranged from 14 weeks of gestation to 12 years postpartum. Transverse and mid sagittal sections were obtained from the bladder neck to the membranous urethra in male and the whole urethra in female subjects. At the level of the membranous urethra in male and mid urethra in female subjects the striated muscle fibers completely encircle the urethra and join behind it to form a tail-like structure that runs posteriorly towards the perineal body. This structure is mid sagittal in male and mediolateral in female subjects. At 3 to 4 months of life, at the level of the bulbourethral glands the tail disappears; the striated sphincter becomes horseshoe-shaped and its 2 branches bifurcate posteriorly to envelop these glands. The urethral striated sphincter consists of scantly dispersed muscle fibers in the fetus. In young infants it becomes well defined in both sexes with the presence of a tail-like structure that characterizes this age group. In older subjects this tail disappears and the sphincter assumes a horseshoe or omega-shaped configuration as splitting of the sphincter progresses caudo-cranially with development. We attempt to determine whether the ring configuration of the voluntary sphincter contributes to high voiding pressures that are reported to occur in some newborns and infants.

Child↗
PubMed1992

Blockade of insulin sensitive steady-state R-type Ca2+ channel by PN 200-110 in heart and vascular smooth muscle.

The effect of high K+ concentration, insulin and the L-type Ca2+ channel blocker PN 200-110 on cytosolic intracellular free calcium ([Ca2+]i) was studied in single ventricular myocytes of 10-day-old embryonic chick heart, 20-week-old human fetus and rabbit aorta (VSM) single cells using the Ca(2+)-sensitive fluorescent dye, Fura-2 microfluorometry and digital imaging technique. Depolarization of the cell membrane of both heart and VSM cells with continuous superfusion of 30 mM [K+]o induced a rapid transient increase of [Ca2+]i that was followed by a sustained component. The early transient increase of [Ca2+]i by high [K+]o was blocked by the L-type calcium channel antagonist nifedipine. However, the sustained component was found to be insensitive to this drug. PN 200-110 another L-type Ca2+ blocker was found to decrease both the early transient and the sustained increase of [Ca2+]i induced by depolarization of the cell membrane with high [K+]o. Insulin at a concentration of 40 to 80 microU/ml only produced a sustained increase of [Ca2+]i that was blocked by PN 200-110 or by lowering the extracellular Ca2+ concentration with EGTA. The sustained increase of [Ca2+]i induced by high [K+]o or insulin was insensitive to metabolic inhibitors such as KCN and ouabain as well to the fast Na+ channel blocker, tetrodotoxin and to the increase of intracellular concentrations of cyclic nucleotides. Using the patch clamp technique, insulin did not affect the L-type Ca2+ current and the delayed outward K+ current. These results suggest that the early increase of [Ca2+]i during depolarization of the cell membrane of heart and VSM cells with high [K+]o is due to the opening and decay of an L-type Ca2+ channel. However, the sustained increase of [Ca2+]i during a sustained depolarization is due to the activation of a resting (R) Ca2+ channel that is insensitive to lowering [ATP]i and sensitive to insulin.

Animals↗
PubMed1991

Radio-contrast enhancement of urinary tract stones.

Most urologists treating stone disease with any method (ESWL, PCL, URS) have encountered problems of poor stone visualization with fluoroscopy. This difficulty to localize urinary tract (UT) stones or fragments may result in incomplete stone extraction, prolonged surgery and increased risk of recurrence and post-operative complications. We have sought and found means to increase the radioopacity of mineral UT stones by a simple pre-operative perfusion technique. The capacity of radioopacification has first been demonstrated in in vitro incubations of fragments of human mineral stones with aqueous solutions of barium, of the lanthanides and of the two natural actinides. Most of the incubations led to considerable radio-contrast enhancement and heavy metal incorporation, measured by X-ray fluorescence analysis. Dogs with implanted human stone fragments were used as an in vivo model. The UT were perfused through a retrograde pyelic catheter with heavy metal salts solutions, the ensuing radioopacification of the implanted UT-stones was estimated by abdominal radiographies and the metal incorporation was measured on the retrieved stones. Considerable radioopacity enhancement together with heavy metal incorporation was observed for the following elements: Sr, Ba and the lanthanides Gd and Yb. The pathological evaluation of the urothelial linings from animals treated with lanthanide salt showed no toxic effects.

Animals↗
PubMed1991

Assisted erection follow-up with couples.

Erection obtained with a vacuum pump can be a solution for the impotent man. In this study it was proposed to and discussed with couples, eleven of whom chose it as treatment. The mean age of the men was 54 years and 8 months. The estimated etiology of their erectile disorder was: biogenic, 4, mixed, 7. A 25-item questionnaire was administered to each couple. Results show that the device was a good solution and improved the sex life of both partners. They manifested a fair degree of satisfaction with its use. The presence and the participation of the female partner should be considered in therapeutic recommendations for erectile disorders.

Erectile Dysfunction↗
PubMed1991

[Development of organ transplantation in Quebec from 1985 to January 1990].

In Québec, the first organ transplantations have been realized in 1958. Several kidney transplant programs started at that time. Cardiac, liver, pancreas and lungs programs followed and reached a full development in the eighties when Cyclosporin became available. Today, there are 4 university transplant programs in Québec (McGill, Montréal, Laval and Sherbrooke) with a total of 7 kidney, 4 liver, 4 heart, 2 pancreas and 2 lungs centers. More than 2,900 transplantations have been realized. Since 1970, organ procurement and distribution is organized by a central agency called Québec-Transplant (previously Métro-transplantation). Organ donation is done on a voluntary basis as every where in North America. More than 90% of the organs comes from cadaveric donors and more than 90% of the relatives accept organ donation. 50% of the donors have deceased from head trauma and 50% from cerebral hemorrhage. In 1989, multi-organ harvesting has been realized in 64% of the donors. Despite efforts and progresses, the number of patients awaiting an organ transplant is steadily growing and outlast the number of available organs. It is hoped that maximal utilisation of the donors and growing exchanges at a national and international level will help to solve this crucial problem.

Heart Transplantation↗
PubMed1989

Action of clonidine on micturitional reflexes in decerebrate cats.

We explored the urodynamic action of clonidine (preferential alpha 2-agonist) and yohimbine (preferential alpha 2-blocker) in decerebrate cats. These animals retain catecholaminergic fibers from the complex of the locus coeruleus to the spinal cord and have synergic and faster micturition cycles than normal cats. Twenty-nine male cats were made decerebrate at intercollicular level under ether anesthesia. Voiding, vesical, urethral and blood pressures, and the EMG of the external sphincter-pelvic floor and leg muscles were studied. Preparations with the urethrovesical junction opened and closed were used. Control activity was characterized by two types of vesical pressure waves: (1) low frequency, high intensity, and (2) high frequency, low intensity. Type-2 preceded Type-1 waves. Clonidine caused: (A) reduction of Type-1 and enhancement of Type-2 Pves waves; (B) diminution of vesical capacity; (C) facilitation of external sphincter relaxation; (D) inhibition of skeletal muscle activity; (E) systemic hypotension and bradycardia. Yohimbine inhibited clonidine's actions. When injected alone, it inhibited vesical and increased sphincteric activities. It also produced systemic hypertension and enhanced crisis of autonomic dysreflexia. The overall effect of clonidine on urodynamics in acute decerebrate cats was to bring about an active, small (normotonic) bladder with urinary frequencies. We suggest that clonidine: (1) inhibited Type-1 waves by inhibiting cellular activity in the locus coeruleus. As a result, the vesico-vesical contraction long loop reflex was abolished; (2) facilitated Type-2 waves by inhibiting inhibitory interneurons in the sacral parasympathetic center. As a result, the vesicovesical contraction short loop reflex was facilitated.

Adrenergic alpha-Agonists↗
PubMed1985

Combination of 60Co gamma-radiation, misonidazole, and maltose tetrapalmitate in the treatment of Dunning prostatic tumor in the rat.

Maltose tetrapalmitate (MTP), a synthetic nontoxic immunoadjuvant, the radiosensitizer misonidazole (MISO), and 60Co gamma-radiation, alone or in combination, were used in the management of Dunning prostatic tumor in the rat. Nine groups of 10 rats each were used to assess the efficacy of various therapeutic modalities. Tumor growth rates and animal survival times were determined for each group. Radiation was more effective when combined with MTP, but the adjuvant must be present when radiation is given for synergism to occur. MISO was as effective as MTP when used with radiation, but combining them cancels out their individual effects. In a clinical situation it would be advantageous to use separately the synergisms existing between MISO and radiation on the one hand and MTP and radiation on the other hand.

Adjuvants, Immunologic↗
PubMed1985

[Re-establishment of urinary continuity by uretero-ureterostomy in renal transplantation. Apropos of 135 cases].

Uretero-ureteral anastomosis was performed in 135 patients (40 women and 95 men) during kidney transplantation using either cadaver (120 cases) or living donor (15 cases) organs. The ureter of the retained kidney was linked proximal to the transplantation, whether or not there had been previous contemporary nephrectomy. Results were highly interesting: no mortality, no need to remove graft for urinary complications and no ureteral anastomotic stenosis. Urological complications were absent in 108 cases (80%) while 17 cases (12.6%) developed a urinary fistula, only 5 of which required surgical intervention Hematoma related to the nephrostomy occurred in 6 cases (4.4%) but operation was necessary in only 2 of these cases. Overall need for repeat surgery involved only 7 patients (5.2%) during the month following transplantation. One of 2 cases of hematoma operated upon required partial excision of the transplantation kidney due to the presence of an intraparenchymatous arteriovenous fistula. A curious finding was that of the 17 cases developing fistulae most of them had received live donor kidneys (5/15) whereas only 12 occurred in the 120 cadaver kidney transplants. Prevention of fistulae appears to be assisted by spatulation of the ureter rather than by its bevelled section, and the maintenance of a long ureteral loop to avoid traction. It is suggested that certain postoperative urine losses may be the result of a hyper-diuresis, without actual dehiscence of the anastomosis. In 4 patients with a urine output of more than 1.5 litres at the time of transplantation, the kidney proximal to the ureteral ligature became infected, and a second nephrectomy was necessary in 4 cases.

Adolescent↗
PubMedDate not supplied

Substance P and neurokinins as stimulants of the human isolated urinary bladder.

Neurokinins are active stimulants of the human isolated urinary bladder. In a preliminary study, performed on bladders taken from four donors, we attempted the characterization of neurokinin receptors. It was shown that neurokinin A is more active than neurokinin B and substance P. Neurokinin receptors selective agonists were also tested and it was found that the most active compound was the NK-A selective agonist, [Nle10]NKA 4-10: A substance P antagonist was able to reduce the effect of neurokinin A but its affinity was rather low. This suggests that the receptor mediating the contraction of the human urinary bladder to neurokinins is of the NK-A (NK2) type. The action of neurokinins on the human urinary bladder appears to be a direct one and mediated by specific receptors different from those of other agents. On the contrary, kinins were found to be active through a new mechanism which was not influenced by either anti-B1 or anti-B2 receptor antagonists.

Adult↗