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J Y Soret

Publications and source records attributed to J Y Soret.

At least 19 recordsLinked to original sources

[Pelvic lipomatosis. A case with ureteral and venous obstruction].

The authors report a case of pelvic lipomatosis in a 62 year old man associated with venous obstruction (third case reported in the literature), diagnosed after bilateral ureteric obstruction, and review of the literature on this subject. The diagnosis was suggested by the radiological triad of hyperlucency of the pelvis on plain abdominal X-ray, "hot air balloon" appearance of the bladder on IVU and a rigid and ascended rectosigmoid on barium enema, and was confirmed by CT and MRI. Treatment combining corticosteroids and urinary tract disinfection was partially effective. A double J ureteric stent resolved the problem of persistent right ureteric obstruction.

Cystoscopy

[Substitute bladders].

Following prostato-cystectomy in men or total cystectomy in women the bladder can be replaced by constructing an intestinal pouch to be connected to the urethra. This bladder replacement reservoir should possess the specific qualities of the natural bladder: it should collect and retain the urine at low pressure, protect the upper urinary tract against reflux and distension, control voluntary micturition at a socially acceptable rhythm and avoid the metabolic disorders due to the reabsorption of urine by the intestinal mucosa. Low pressure reservoirs are the ones most commonly used. They are obtained by opening the ileal or ileocaecal graft along its antimesenteric border and rearranging the intestinal tissue to form a pouch connected to the urethra. Detubulated reservoirs have a capacity and a compliance that are close to those of the urinary bladder. Daytime continence is acquired in the immediate postoperative period, and night-time continence is possible in 60 to 70 per cent of the patients. These are the main advantages of bladder replacement by tubular small intestine. The reservoirs thus constructed have few contractions, but they have not yet proved to be capable of full evacuation in the long term. Intermittent bladder catheterization might well be the price to be paid in the future for an immediate improvement in night-time continence.

Cystectomy

Total androgen blockade with Zoladex plus flutamide vs. Zoladex alone in advanced prostatic carcinoma: interim report of a multicenter, double-blind, placebo-controlled study.

A double-blind, placebo-controlled, randomized, multicenter study was undertaken to investigate the effects of Zoladex plus flutamide vs. Zoladex plus placebo in patients with advanced prostatic cancer. Interim analysis has revealed no differences between the 2 groups in objective or subjective responses at 6 months' follow-up or in overall survival and time to disease progression at 15 months' follow-up.

Aged

[Long-term results of urethrectomy following termino-terminal urethrorrhapy for urethral stenosis. A study of 18 cases].

Urethrectomy followed by terminoterminal urethrorraphy is one of the oldest surgical techniques for treating short urethral stenoses, regardless of their location. Eighteen patients managed by this technique were followed-up for at least ten years. Results were satisfactory in four out of every five cases and success was nearly immediate. No delayed deteriorations were seen. These limitations are mainly related to the length of the lesion.

Adult

The usefulness of prostate-specific antigen and prostatic acid phosphatase in clinical practice.

A comparative study was performed on the usefulness of prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) in control subjects (69), benign prostatic hypertrophy (BPH) patients (150), and patients with prostatic carcinoma (113) in a urology department. We establish, as others, the greater clinical sensitivity of PSA and its effectiveness as a prognostic tool in the evaluation of prostatic cancer therapy and in the early detection of residual tumor following radical prostatectomy. However, patients are admitted to our department with more severe and complicated benign prostatic pathology and urinary dysfunctions, which decreases the specificity of the PSA test to 30% (N = 2.7 ng/ml). A cutoff threshold of 50 ng/ml becomes necessary to maintain a 90% positive predictive value. The combination of PSA sensitivity (96%) and PAP specificity (95%) enabled a better definition of the high-risk subpopulation among noncancer patients and, in addition, was a help for differential diagnosis, confirmation of advanced stages of prostatic cancer, and selection of low-stage prostatic cancer candidates undergoing radical prostatectomy. Routine serum PSA measurements in the population of patients consulting a urology department will no doubt bring about a new approach to the management of prostate cancer.

Acid Phosphatase

[The value of preoperative perineal rehabilitation in radical prostatectomy and replacement entero-cystoplasty. Preliminary results].

Radical surgery of the prostate and replacement entero-cystoplasty are associated with varying degrees of risk of diurnal or nocturnal incontinence, which is always poorly tolerated by the patient. In order to reduce this discomfort, perineal reeducation, commenced before the operation, appears to be a valuable aid. A survey of sphincter function easily detects patients at risk and postoperative sphincter disorders can be prevented to a large degree. The authors analyse their preliminary results in 14 patients undergoing radical prostatectomy and in another 10 patients undergoing replacement entero-cystoplasty.

Aged

[Prognostic value of cytofluorometry in bladder tumors].

Bladder lavage fluid was examined using flow-cytometry (FCM) in 112 patients with transitional cell carcinoma seen over 30 months. FCM investigates the entire mucosa, furnishes indications as to the possible existence of dysplasia or carcinoma in situ, and thus provides for a more accurate evaluation of the evolutive potential of the "bladder disease". FCM consists in the automated assay of the DNA content of epithelial cells. The test is positive when "tumorous" diploid or aneuploid cells are demonstrated. The diagnostic sensitivity of FCM is comparable to that of cytologic diagnosis on bladder lavage specimens, but FCM has the additional advantage of detecting those patients at high risk for disease progression by measurement of the DNA index. Grade 1 and 2 tumors are diploid in 70% of patients, against only 14% for grade 3 tumors and carcinomas in situ. Follow up of 25 grade 2 patients and determination of the recurrence index clearly establishes the prognostic significance of the degree of tumorous ploidy. Furthermore, the effectiveness of endovesical chemotherapy can be monitored using FCM measurement of the aneuploidy index.

Aged

[Reproducibility and prognostic value of Gleason's and Gaeta's histological grades in prostatic carcinoma].

Two histopathologic grading systems for prostatic adenocarcinomas are reevaluated: the Gleason system and the Gaeta system. Two pathologists reviewed 234 specimens to assess reproducibility. Exact agreement is achieved in 88% with the Gaeta system, in 65% with the Gleason system. Nevertheless, agreement to within one score unit is achieved in 94% with the Gleason grading. One pathologist's autoreproducibility exceed 80% with either system. Actuarial survival curves and mortality index (deaths per patient-year of follow-up) provided evidence of their predictive value. Regardless of the clinical stage these two grading systems select groups of patients sharing a good, intermediate or bad prognosis but none can predict a given patient's accurate survival. The Gleason system would allow a better discrimination between poorly and highly aggressive tumors of intermediate grade.

Adenocarcinoma

[The anterior and transperitoneal approach in the surgery of the kidney and ureter].

Because of the variety of situations encountered in surgery of the kidney and ureter, the methods of approach to these organs need to be diversified. In this context, the authors discuss the place of the anterior and transperitoneal approach, based on a series of 573 cases. Its principal indications are: excision of large kidney tumours or pseudo-tumours, conservative treatment of hydronephrosis, removal of pelvic calculi, staged operations or operations on bilateral lesions, re-operations resulting in secondary nephrectomy or repair of the collecting system. The modalities, advantages and disadvantages are discussed and the authors stress the complications which may result from opening of the peritoneum. Overall, the anterior and transperitoneal approach, in the situations in which it is indicated, is an easy and safe operative technique, superior to the usual sub-peritoneal approaches. Its results are very satisfactory; they should overcome reservations which have surrounded this technique for so long and should give it a definite place beside the classical approaches, which nevertheless remain supreme.

Abdomen

[Prostatic carcinoma: histoprognosis, prognostic value of Gleason's index].

This paper recalls the definition of the Gleason index and describes the five architectural types that enable a calculation of the index. The conditions of the practical application of the index are defined, with a discussion of reproducibility of results based on current literature and the author's experience. The index allows appreciation of the developmental potential of prostatic cancer and distinguishes between patients with a high risk of metastases and death from the cancer and those with low potential development. While the Gleason index cannot predict the course of the tumour in any given patient, it can be considered a useful element among the clinical and biological factors assessed in the prognosis of prostatic carcinoma.

Adenocarcinoma

[Value of x-ray computed tomography in the study of the inferior vena cava in urologic practice].

The CT scan provides a reliable evaluation of the inferior vena cava, especially since the development of second and third generation scanners. It can readily detect congenital malformations and obstructive anomalies complicating renal cancer and it is also able to determine the tumoral or thrombotic nature of the venous obstruction. This excellent definition of the vessel reduces the indications for caval angiography to a few exceptional cases.

Humans

[Multifocal fibrosclerosis (retroperitoneal, mediastinal, mesenteric and pelvic involvement) associated with vasculitis and revealed by a livedo: clinical, histopathological and ultrastructural study in a case (author's transl)].

A 22-year-old male patient was seen with vasculitis and subcutaneous nodules on arms and legs. Discret thoracic venous dilations were noticed and venography demonstrated obstruction of the superior vena cava. Clinical and biological examination, roentgenograms revealed no sign of immunological disease but led to the diagnosis of mediastinal and retroperitoneal idiopathic fibrosis. No drug could be incriminated. Right hydronephrosis obliged to a surgical bilateral ureterolysis combined with systemic steroid therapy. Histological and ultrastructural examinations on retroperitoneal biopsies showed dense collagenous fibrosis, with vasculitis. Perivascular infiltrate was mainly composed of extravased erythrocytes and lymphocytes. Fibrin deposits were seen around implicated vessels. Direct immunofluorescence investigations were negative. These morphological features seem to be in agreement with the physiopathological hypothesis of sclerosis. No retroperitoneal or mediastinal fibrosis extension occurred three years after surgical procedure, and under corticosteroid therapy. Similar vasculitis with mediastinal and retroperitoneal idiopathic fibrosis have previously been reported in only one case by R. W. Carton and R. Wrong. Multifocal fibrosclerosis is the generic term currently used, since Comings et al. (1967), to describe a group of fibrosing conditions which affect separate organ systems. Findings suggest that retroperitoneal fibrois, mediastinal fibrosis, sclerosing cholangitis, Riedel's thyroiditis and pseudotumors of the orbit may be different manifestations of a single disease whose pathogenesis remains obscure.

Adult