Search PubMed⌕ Search

Biomedical subjects

J Toubol

Publications and source records attributed to J Toubol.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Extracorporeal piezoelectric lithotripsy (EDAP LT 01) in the treatment of ureteral calculi. Apropos of a series of 143 cases].

The results for 143 cases of ureteral stones treated by EDAP LT01 were analyzed concerning stone location, ureteral manipulation and treatment position. The ureter was divided into six segments: ureteropelvic junction (UPJ), proximal ureter (PU1 and PU2), mid-ureter (MU), distal ureter (D1 and D2). The overall fracturization rate (FR) was 72%, as detailed below: UPJ (89%, 26/29), PU1 (86%, 13/15), PU2-MU (62%, 15/24), DU1 (59%, 25/42), DU2 (72%, 24/33). Anesthesia or iv sedation were never used for PEL. 24% of the patients underwent retrograde ureteral manipulation (in situ/push back = 108/35). For PU1, the FR was twice as high after retrograde manipulation (in situ/push back = 5/8). For PU2 and MU, the supine position was most common. For UPJ and PU1, it was often better to have the patient lie on his side. For DU1 and DU2, a prone position was necessary. For all stones in DU1, the bladder must be well filled; the FR was higher in DU2 than in DU1. DU2 stones appeared to adhere to the bladder wall or were intravesical (stone in the meatus). The stone-free rate for successfully manipulated ureteral calculi (3 month's follow-up) was 93% (27/29). The stone-free rate for in situ stones at 3 months was 94% (70/74). Extracorporeal piezoelectric lithotripsy combined with stone manipulation is highly efficient in the management of UPJ, PU1 and DU2 stones. The success rate of in situ PEL improves after the operator becomes skilled with the procedure. The advantages of the EDAP LT01 are the absence of pain, no need for anesthesia, and the mobility of the shock wave unit.

Adult↗
PubMed1990

[Cancer of the prostate. Computed tomography and magnetic resonance imaging in the assessment of extracapsular extension].

The stage of the tumor is commonly underestimated prior to radical prostatectomy for carcinoma. Can the growth of clinically localized carcinomas beyond their capsule be predicted with the modern medical imaging techniques (MRI and CT)? On the basis of 30 successive prostatectomies, we conclude that CT is ineffective. On the contrary, MRI seems to be an effective technique for this indication. However, no examination yet is better than clinical assessment.

Humans↗
PubMed1990

[Exclusive piezoelectric lithotripsy in the treatment of calculi larger than 30 mm (partial or complete coralliform, pyelic calculi)].

Thirty patients with partial or total staghorn stones or calculi larger than 30 mm were treated by piezoelectric lithotripsy (PEL) monotherapy using an EDAP LT-01 lithotripter with ultrasound guidance. Nineteen of these patients had pelvic stones; the other 11 had partial (9) or total (2) staghorn stones. All patients first underwent an initial lithotripsy session. No anesthesia or IV sedation was required in any case. If stone fragmentation was achieved during this first session, a double-J stent was inserted before the second lithotripsy session. Prior to the first session, 18 of 30 patients had sterile urine cultures; 12 of 30 presented major distension of the excretory tract. Results were analyzed to determine the factors influencing the outcome of this therapy. Three months after the first session, patients were considered cured if their stones had completely disappeared according to plain abdominal films (14 of 30, 46%). In seven patients (23.3%) fragmentation had occurred but residual fragments remained (1 to 3 fragments less than or equal to 4 mm). No fragmentation was obtained after the first session in nine patients (30.7%) (1 total staghorn stone, 8 pelvic stones). The mean number of treatment sessions was five (range, 1 to 15). Complications occurred in only 10% of patients (3 of 30): two steinstrassen and one acute pyelonephritis. Eighty-three percent of patients without major excretory tract distension and 55% of patients whose initial urine culture was sterile achieved a stone-free state. Therefore the best indications for PEL monotherapy for calculi larger than 30 mm are pelvic stones and partial staghorn stones and no major excretory tract dilatation in patients with sterile initial urine cultures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Can CT scanner and MRI predict capsular invasion of local cancer of the prostate? A study of 20 radical prostatectomies].

Spread beyond the capsule is a poor prognosis factor in clinically localized carcinomas of the prostate; preoperative diagnosis is difficult and clinical evaluation usually underestimates tumor spread. This prospective study was undertaken to confront results of the conventional workup (rectal examination, transrectal ultrasonography and PSA) and of CT scan and MRI findings with findings upon the pathologic study of operative specimens following radical prostatectomy. Results show that the conventional workup remains the diagnostic gold standard and that CT scan yields no additional information. Technically faultless MRI with sections in the three planes is a good means for analyzing the capsule of the prostate.

Humans↗
PubMed1990

[Extracorporeal piezoelectric lithotripsy in the treatment of calculi of the ureter. Apropos of a series of 143 cases].

The results obtained in 143 cases or ureteral stones treated by EDAP LT-01 were analysed concerning stone location, ureteral manipulation, and treatment position. The ureter was divided into six segments: ureteropelvic junction (UPJ), proximal ureter higher than the lower pole of the kidney (PU1), proximal ureter between the lower pole and the iliac crest (PU2), mid-ureter between the iliac crest and the lower end of the sacroiliac joint (MU), distal ureter between the lower end of the sacroiliac joint and the ischial spine (DU1), and the distal ureter below the ischial spine to the meatus (DU2). The overall fragmentation rate (FR) was 72%, as detailed below: (table; see text) Anesthesia or iv sedation was never used for EPL. 28% of the patients underwent retrograde ureteral manipulation (29/103). For PU1, the FR was twice as high after retrograde manipulation (push back/in situ = 5/8). For UPJ, the supine position was most common. For PU1 and PU2, it was often better to have the patient lie on his side. For DU1 and DU2, a prone position was necessary. For all stones in DU1, the bladder had to be well filled and the FR was higher in DU2 than in DU1. DU2 stones appeared to adhere to the bladder wall or were intravesical (stone in the meatus). The stone-free rate for successfully manipulated ureteral calculi (3 month follow-up) is 93% (27/29). The stone-free rate for in situ stones at 3 months is 94% (70/74). Extracorporeal piezoelectric lithotripsy combined with stone manipulation is highly efficient in the management of UPJ, PU1 and DU2 stones.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Anatomoclinical and biologic correlations in prostatic pathology. Apropos of 150 case reports].

The authors analyzed 150 patient files (16 controls with no prostatic pathology, 96 patients with benign prostatic hypertrophy (BPH), 38 prostate cancer patients) in an attempt to answer three questions: how should borderline values of PSA be interpreted in patients with BPH; is there a correlation between the Gleason grade and PSA levels in prostate cancer? Should both PSA and PAP concentrations be assayed? All patients underwent digital rectal examination and transrectal ultrasonography (TU), and were assayed for PSA and PAP. All prostate cancer patients had a bone scintigraphy (Bs). In view of the correlation coefficient of 0.391 (p less than 0.001), it can be affirmed that PSA and weight are linearly correlated in BPH (5 g BPH = 1 ng/ml PSA). This lower value of PSA is due to the overevaluation of prostate weight by TU. In contrast, the authors did not find any correlation between the PSA level and the Gleason grade in prostate cancer patients with a negative bone scintiscan. Finally, the sensitivity of PSA was markedly better than that of PAP (75% vs 50%), and no PSA false negative error was corrected by the PAP value.

Acid Phosphatase↗
PubMed1989

[Endoscopic treatment of complicated ureteroceles in adults. Apropos of 2 cases].

Usually diagnosed in childhood, ureterocele is a congenital malformation which is often revealed in adults because of a complication. Renal colic and dysuria were the clinical symptoms that led to discovery in the two patients reported here. These two women (aged 80 and 32 years) underwent transurethral meatotomy for complicated ureterocele. This procedure was sufficient for cure, with spontaneous evacuation of all stones in patient 2. There were no clinical or bacteriological (urine analyses) signs of reflux during the follow-up period (24 and 12 months). Endoscopic treatment of adult complicated ureterocele can thus be proposed as a first line procedure. Development of symptomatic secondary reflux is an indication for surgery.

Adult↗
PubMed1988

[Initial treatment of infiltrating tumors of the bladder. Combined transurethral resection and systemic chemotherapy].

From September 1983 to September 1986, 20 patients (mean age 65 years) with a muscle-infiltrating tumour of the bladder would normally have been treated by total cystectomy. Instead, they were staged by intravenous urography, pelvic and abdominal computerized tomography, physical examination under general anaesthesia and deep transurethral resection, then given neoadjuvant chemotherapy consisting of cisplatinum and 5-fluorouracil, six courses at intervals of 28 days. Results were evaluated after the 3rd and 6th courses by computerized tomography, intravenous pyelography and transurethral resection. Nine patients had a clinical complete response (6 pT2, 2 pT3, 1 pT4). The median follow-up in january, 1988 was 30 months (range 17-52 months). This protocol was objectively active and well tolerated, even by elderly subjects. Two problems remain concerning patients with complete response: the respective roles of chemotherapy and transurethral resection in the outcome, and the prevention of recurrence (5/9 complete response patients).

Adult↗
PubMed1988

Anandron (RU 23908) associated with orchiectomy in stage D prostate cancer. Preliminary results of a randomized, double-blind study.

A randomized, double-blind, multicenter trial was performed comparing the association of orchiectomy plus the nonsteroid antiandrogen Anandron (300 mg daily) to orchiectomy plus placebo in the treatment of patients with stage C or D prostate cancer. The results for 98 evaluable stage D patients with a median follow-up of 23.4 +/- 8.9 months are given. Although there was no statistically significant difference between the two treatments with regard to any parameter (subjective response, best objective response according to NPCP criteria, and progression-free interval and survival), the results were invariably in favor of the combined treatment, as already reported in other trials on Anandron.

Aged↗
PubMed1988

[Role of Chlamydia trachomatis in male urethritis. Analysis of 2,000 cases of male urethritis].

A study involving of 2,000 cases of urethritis revealed the presence of Chlamydia trachomatis in 44% of patients. Following a pathophysiological review, the strongly suggestive clinical picture of infection by this microorganism is emphasized. This study stresses two precise points by dealing with: firstly, the importance of the choice of technique for demonstration of the presence of the bacteria, and its reliability; secondly, the value of bacteriological evidence of the infection in order to treat not only the patient but also the partner(s) and to subsequently confirm the treatment as being effective.

Adult↗
PubMed1988

[Combination transurethral resection and systematic chemotherapy as primary treatment of infiltrating bladder tumors (pT2-pT4 NxM0)].

From Sept. 83 to Sept. 86, 20 patients (pts), mean age 65 yr, with a muscle-infiltrating bladder tumor would normally have been treated by total cystectomy. Pts were staged by intravenous urography, pelvic and abdominal CT, physical examination under general anesthesia, and deep TUR, then given neoadjuvant chemotherapy: cisplatinum and 5-FU. Courses were given every 28 days. Results were evaluated after the 3rd and 6th courses by CT, IVP and TUR. 9 pts had a histologically confirmed complete clinical response (pCR: 6 pT2, 2 pT3, 1 pT4). Median follow-up in Jan. 1988 was 30 mo. (17-52). This protocol was objectively active and well tolerated, even by elderly pts. Problems remain concerning pCR pts: (1) the respective roles of chemotherapy and TUR on the outcome; (2) prevention of recurrence (5/9 pCR).

Adult↗
PubMed1987

[Value of urinary time in bone scintigraphy in the evaluation of renal function. Apropos of 57 cases of cancer of the prostate].

Intravenous urography (IVU) and bone scintiscan imaging (BSI) are essential investigations during initial evaluation of prostate cancer. A study compared data provided by these two exploratory procedures in evaluation of renal function. Concordance was high (86%) between IVU and urinary images during BSI. The latter examination is non-invasive and has no contraindications. It produces indispensable oncologic information in patients with cancer of prostate and a result of the urinary secretion phase can avoid repetition of IVU during follow up.

Bone and Bones↗
PubMed1987

[Gangrenous states of the perineum and genital region].

The authors report on 13 cases of gangrene of the perineum. Eight of the patients presented with a pre-existing infectious or tumoral anorectal lesion. In two cases, gangrene was a complication of a surgically treated prostatic pathology; two other patients had Fournier's disease. The last case was termed "spontaneous" as no causative factor was found. The unexpected recrudescence of this pathology, its severe nature, our limited knowledge of the pathogenic factors involved, and the difficulties encountered in treatment make analysis of this series of cases particularly interesting; moreover, despite the apparent etiological disparity of these observations, there were common anatomic, bacteriologic, and therapeutic elements. As concerns treatment, emphasis is placed on three points: prime role of surgery, the only means of obtaining precise information on lesions, broad indications for bypass colostomy, value of treatment with hyperbaric oxygen. The mortality rate remains high: 4 of the 13 patients died.

Adult↗