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J Hubert

Publications and source records attributed to J Hubert.

At least 55 records · Page 3Linked to original sources
PubMed2002

[Preoperative evaluation of renal carcinoma using multi-detector CT].

When laparoscopic nephrectomy is performed, the limited visibility of many anatomical structures requires additional pre-operative information. However, most of this information can be highlighted by Multislice-CT which depicts all the vascular structures while providing an essential road mapping for the surgeon. Besides underlining arterial abnormalities, this technique allows to depict venous pathways and tumoral invasion. This review illustrates the various potential applications of Multislice-CT in the evaluation of renal tumors.

Humans↗
PubMed2002

[Imaging of upper urinary tract tumors].

Urothelial tumors of the upper urinary tract are mainly represented by transitional cell carcinomas. They are usually multifocal, synchronous or metachronous. Patients most often present with hematuria. Histological staging is according to the degree of cellular anaplasia (grade) as well as to the degree of wall invasion (stage). Accurate and differential diagnosis are by excretory urography (EU) and/or by computed tomography (CT) associated with EU. EU and endoscopic investigations assess tumoral extension. The most appropriate treatment is radical nephroureterectomy with a cuff of bladder. Early and high recurrence is common; therefore a regular follow-up is required and depends on the initial treatment and the tumoral aggressiveness. This follow-up is performed by imaging, endoscopic and cytologic investigations.

Aftercare↗
PubMed2001

Prevalence of anthelmintic resistance in gastrointestinal nematodes of dairy goats under extensive management conditions in southwestern France.

The occurrence of benzimidazole (BZ) and levamisole resistance was investigated in 18 randomly selected dairy goat herds located in southwestern France and characterized by extensive management. On each of the 18 farms, 45 adult goats were randomly allocated into three groups of 15 animals each: an untreated control group, a group that was orally administered fenbendazole (10 mg kg(-1) body weight) and a group that received orally a levamisole drench (12 mg kg(-1) body weight). Individual faecal egg counts and pooled larval cultures were done 10 days after anthelmintic treatment. Naive lambs were infected with larvae obtained from control and fenbendazole treated groups and were necropsied 35 days after infection for worm recovery. Faecal egg count reductions (FERC) were calculated for fenbendazole and levamisole and, when less than 95 per 100, were considered as indicative of anthelmintic resistance. An in vitro egg hatch test (EHT) was conducted with thiabendazole on eggs isolated from pooled faeces of fenbendazole treated goats in nine farms. Faecal egg count reductions indicated the occurrence of benzimidazole resistance in 15 out of 18 farms. Among these farms, nine had EHT values above 0.1 microg thiabendazole ml(-1) confirming the benzimidazole resistance status. Levamisole resistance was detected in two farms through FECR. Based on necropsy results, the prevalence of benzimidazole resistance was higher in Trichostrongylus colubriformis, medium in Haemonchus contortus and lower in Teladorsagia circumcincta. In nine farms the benzimidazole resistance was monospecific whereas multispecific resistance was found in the six remaining farms. A negative relationship was found between FECR for fenbendazole and the average number of anthelmintic treatments given per year on the farm. Despite extensive management including a low number of treatments, the prevalence of benzimidazole resistance was very high suggesting that the repeated and sometimes exclusive use of benzimidazole drugs, even at low frequency, is probably the main cause in developing nematode resistance in dairy goat herds. The importance of other factors such as under-dosing or buying animals already carrying resistant nematodes are discussed.

Animals↗
PubMed2001

[Role of multiarray scanner in the choice of therapeutic strategy in kidney cancer. Report of a case of kidney tumor with double thrombus in inferior vena cava].

Renal cancer with caval thrombus is a disease which requires precise preoperative assessment, in order to adapt the surgical technique to the stage and extent of the disease. Recent developments in CT imaging, spiral acquisition and, more recently, the multiarray technique, allow a high quality evaluation. In the light of a case of right renal tumour with bifocal caval extension, the authors discuss the valuable contribution of this imaging modality in the staging assessment and evaluation of arterial (single or multiple artery, anatomical situation in relation to the left renal vein, presence of early bifurcations, etc.), and venous structures (renal vein, genital vein, extension of the thrombus, lumbar vein and hepatic vein). Improvements in CT imaging constitute a major progress in the staging of renal cancers with caval thrombus and make a considerable contribution to the choice of treatment strategy.

Aged↗
PubMed2001

[Kidney cooling during multi-organ harvesting. Descriptive study].

OBJECTIVE: To describe kidney cooling during multi-organ harvesting (MOH) from brain-dead donors and to evaluate harvesting practices. MATERIAL AND METHOD: The temperature of 12 kidneys (6 left and 6 right kidneys) was monitored continuously during MOH from brain-dead donors. After in situ cooling, the kidneys were separated on the table and washed for several minutes with UW preservation solution. The kidney temperature was studied as a function of the main phases of the operative procedure. RESULTS: The mean minimum kidney temperature of 10.8 degrees C (3.7 degrees C to 16.6 degrees C) was reached at the beginning of mobilization of the liver, i.e. an average of 20 minutes (13 to 37 min) after cannulation. The mean cooling rate was 1.37 degrees C/min (0.73 to 2.19 degrees C/min). The mean temperature of the UW cooling solution was 9.4 degrees C (3.8 degrees C to 14 degrees C). For hepatic followed by renal dissection, the kidneys slowly reheated at a mean rate of 0.20 degree C/min (0.12 to 0.37 degree C/min) to reach a mean temperature of 21 degrees C (13.5 degrees C to 26.3 degrees C) at the time of resection. The mean kidney temperature at the time of placement in the container was 17.5 degrees C (13.2 degrees C to 22 degrees C). CONCLUSION: The course of kidney temperature during MOH has not been previously described. This study, performed under usual harvesting conditions, demonstrated sometimes imperfect cooling that could be harmful to he kidneys, but which could be improved by simple measures: rapid dissection of the liver and kidneys and correct application of contact cooling.

Adolescent↗
PubMed2000

Localization and migration of benzimidazole resistant and susceptible adult Cooperia curticei in the small intestine of sheep after treatment with thiabendazole.

Four groups of three lambs per group were experimentally infected with Cooperia curticei susceptible (two groups) or resistant (two groups) to benzimidazoles, and distributions of adult worms in the small intestine were studied. For each Cooperia isolate, one group was treated with thiabendazole (TBZ) (5 or 50mg/kg bodyweight) 28 days after infection. In the two untreated groups, the population of C. curticei were present from the second to the tenth meter of intestine from the pylorus with a maximum in the sixth meter for both isolates. After treatment with TBZ, the size of the resistant worm population did not significantly decrease but a large number of worms were found towards the proximal sections of the intestine. In contrast, the susceptible population was reduced by about 40% but the surviving worms remained at this same site of predilection after treatment. Measurements of the concentration of TBZ and 5OH-thiabendazole (5OH-TBZ) in the intestinal segments do not indicate a clear relationship between the localization of worms and TBZ or 5OH-TBZ concentrations at least 12h after the anthelmintic treatment. The hypothesis of an enhanced expression of the mechanisms of resistance in the first few meters of small intestine is suggested.

Animals↗
PubMed2000

Successful surgical thrombectomy of renal allograft vein thrombosis in the early postoperative period.

We report the successful surgical treatment of two cases of renal vein thrombosis, each occurring early after kidney transplantation. Prompt intervention was a result of accurate diagnosis by color Doppler ultrasonography. Invasive radiological procedures were not useful. Although recent advances in thrombolytic therapy have created several alternatives to open surgery, the rationale for surgical exploration in these cases was to remove the thrombus quickly, to avoid the postoperative bleeding complications of thrombolytic therapy, and to correct any technical or anatomic problems.

Adult↗
PubMed2000

[Bladder candidosis after renal transplantation: contribution of ultrasonography].

Candidosis of the ureter and the bladder is an infrequent complication after renal transplantation. A case occurring early after kidney transplantation is reported in a patient presenting with candiduria. Ultrasound examination detected several fungal bezoars, presenting as a proliferating, avascular lesions, located within the ureter and the bladder. It allowed to demonstrate the rapid extension of lesions, in spite of a medical treatment, leading to a successful endoscopic removal of fungus balls.

Aged↗
PubMed2000

[Carcinomatous degeneration of augmentation enterocystoplasty].

Augmentation enterocystoplasties are performed increasingly frequently and their indications are no longer exclusively limited to small tuberculous bladders. One of the most serious complications of these procedures is malignant transformation, as reported in the present case. Carcinomatous degeneration is uncommon and usually occurs more than ten years after enterocystoplasty. Patients treated by this operation must be submitted to annual cystoscopy combined with guided biopsies at the slightest doubt. This surveillance should be started between the 5th and the 10th postoperative year.

Adenocarcinoma↗
PubMed1999

High-grade inflammation in prostate cancer as a prognostic factor for biochemical recurrence after radical prostatectomy. Pathologist Multi Center Study Group.

OBJECTIVES: To assess the prognostic value of prostatic stromal inflammation in surgically treated localized prostate carcinoma for biochemical recurrence-free survival. METHODS: Stromal prostatic inflammation grading was studied in 161 patients who underwent radical prostatectomy for prostate cancer without involvement of the lymph nodes and who did not receive preoperative or postoperative radiotherapy or hormonal therapy until recurrence occurred. Inflammation was graded as high-grade inflammation if confluence of inflammatory cell infiltrate and/or glandular epithelium disruption associated with interstitial inflammatory infiltrate were present and as low-grade inflammation otherwise. Each specimen was graded separately first in the stroma surrounding nonmalignant glands and second in the stroma surrounding malignant glands. Biochemical recurrence based on serum prostate-specific antigen (PSA) level was defined as two successive PSA measurements greater than 1 ng/mL. RESULTS: Malignant tissue was significantly less involved in high-grade inflammation than benign adjacent tissue (9.3% and 19.9%, respectively; P <0.01). In a univariate Kaplan-Meier analysis, the 5-year recurrence-free survival rate for patients with high-grade and low-grade classified prostates was 61.0% and 66.7% in benign tissue and 27.0% and 65.3% in malignant tissue, respectively, with a significant difference between grades only in malignant tissue (P <0.02). In a multivariate analysis controlling for Gleason grade, preoperative serum PSA, pathologic stage, and inflammation grade in malignant tissue, the latter factor remained significantly predictive of biochemical recurrence (P = 0.03). CONCLUSIONS: Patients with high-grade inflammation surrounding malignant glands in radical prostatectomy specimens had significantly more postoperative biochemical recurrence than patients with low-grade inflammation.

Aged↗
PubMed1999

Science education partnership between the University of Colorado and a Denver High School.

The authors describe a partnership, begun in 1997, between Manual High School, a school in which about 85% of the students are African, American or Hispanic, and the University of Colorado Health Sciences Center in Denver. There are three partnership goals: help teachers transform a lecture-based curriculum into an inquiry-based curriculum, help students build their science knowledge, and give students opportunities to learn--and become excited--about careers in medicine. The current emphasis of the partnership is at the ninth-grade level. The first unique aspect of the partnership is the Medical Explorers program. One portion of the program begins when a hypothetical teenage car-crash victim arrives at the emergency room; over the next six weeks, practicing health care professionals dramatize their medical responsibilities to this patient and discuss the academic training necessary to fulfill those responsibilities. In addition, the Medical Explorers students travel to the Health Sciences Center, where they tour laboratories and clinics, help conduct experiments, and explore computer-based surgical simulations. The second unique program is a service learning project in which ninth-grade students assist with an activity that gives elementary school students a chance to participate in the process of scientific inquiry and to discover the wonder of real hearts and lungs; the ninth-graders assist with logistics (e.g., they distribute newspapers), and, more important, interact with the younger students by asking thoughtful questions of them. The partnership plans to incorporate the elementary and middle schools that graduate their students to Manual High School in order to encourage the implementation of inquiry-based science curricula and to provide sustained support to teachers throughout the entire K-12 educational pathway. If medical colleges can help teachers provide a consistent classroom draw for student fascination in science and medicine, then the colleges are more likely to help create a rich diversity of students who pursue careers in medicine.

Adolescent↗
PubMed1999

Bereavement and grief in adults with learning disabilities. A follow-up study.

BACKGROUND: This paper reports on the follow-up of a cohort of parentally bereaved adults with learning disabilities. AIMS: To investigate whether significant psychopathology, present up to 2.1 years after the death, had resolved five years later. METHOD: Of an original sample of 50 adults with learning disabilities, 41 were reassessed. The Aberrant Behaviour Checklist and the Psychopathology Instrument for Mentally Retarded Adults were re-administered to carers. RESULTS: At follow-up, there was a small increase in the measures of aberrant behaviour. Measures of psychopathology showed improvement, and in particular there was a reduction in anxiety. CONCLUSIONS: The response to bereavement by adults with learning disabilities is similar in type, though not in expression, to that of the general population. Learning disability is a significant predictor of mental health problems following bereavement. Participants adapted more easily when basic emotional needs had been constructively met by carers.

Adult↗
PubMed1999

[Conformal radiotherapy].

Conformal radiotherapy is a new irradiation technique made possible by technological improvements, especially progress in imaging and 3D dosimetry. By conforming the volume irradiated as closely as possible to the clinical anatomical target volume, conformal radiotherapy is designed to deliver a higher dose to the tumour volume, while more effectively sparing the adjacent tissues from the adverse effects of irradiation. Conformal radiotherapy may therefore constitute a progress comparable to the contribution of high-energy radiotherapy in the 1960s or the impact of computer-assisted dosimetry in the 1970s. Evaluation of the results, definition of its indications, standardisation of practices, and study of the impact of dose escalation require further studies in the field of prostate cancer, as the superiority of this new technique over conventional radiotherapy has not been formally established due to the limited follow-up.

Humans↗