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Biomedical subjects

M A Boileau

Publications and source records attributed to M A Boileau.

At least 19 recordsLinked to original sources
PubMed2000

A self-directed home biofeedback system for women with symptoms of stress, urge, and mixed incontinence.

PURPOSE: To evaluate a self-directed home biofeedback treatment system in a group of community dwelling, otherwise healthy women with symptoms of stress, urge, and mixed urinary incontinence (UI). SETTING AND SUBJECTS: Fifty-five women, aged 25 to 81 years, participated in the study. METHODS: Initial evaluation included a self-reported continence assessment, a 24-hour bladder and fluid habits diary, severity indices for stress and urge UI, and assessment of pelvic floor strength using a pneumatic biofeedback device. Subjects completed a 16-week self-directed program. Assessment and severity index data were self-reported using a continence assessment form, a 24-hour bladder habit and fluid form, and stress and urge incontinence severity indices. Strength level of the trainer, number of digital bands lit on the screen during contraction, number of sessions, and program (starter, intermediate, advanced, or maintenance) were recorded on data sheets. INSTRUMENTS: The treatment system includes an 8-minute educational and motivational video; a journal for education, instructions, and daily documentation forms; and a home biofeedback trainer with pneumatic vaginal sensors that displays the strength of pelvic muscle contraction. RESULTS: Forty-four women completed the 16-week program. At the end of treatment, 19 (43%) were dry and 16 (36%) reported 50% or more improvement in number of leaks per day, number of voids per day, or both. Women with stress leakage experienced a significant reduction in the number of incontinent episodes per day and the mean severity index of incontinence (P < .001). Participants with urge UI experienced a significant reduction in the mean number of voids per day and mean severity index for UI (P < .001). Younger subjects were more likely to improve when compared with older participants, but no significant differences were found when comparing women who take estrogen with those who do not take estrogen or when comparing those with a history of bladder surgery with those who had no previous surgery. CONCLUSIONS: These data suggest that self-selected healthy women with symptoms of urge, stress, and mixed incontinence can improve their symptoms and lower their severity index with a minimal intervention, comprehensive, self-directed home biofeedback continence system.

Adult↗
PubMed1991

Single-dose preoperative systemic cyclophosphamide for the prevention of bladder tumor implantation in F344 rats.

An implantable rat bladder tumor model using the rat transitional carcinoma cell line 4909 was used to evaluate the effect of single-dose, preoperative, systemic chemotherapy on the risk of intravesical tumor implantation. To simulate the clinical setting in which drug levels would be present in both the tumor and the site of implantation, both tumor donor animals and tumor recipients were given a single dose of cyclophosphamide (CY) 1 h prior to tumor harvest and implantation. This protocol resulted in a significant reduction in the incidence of tumor implantation, in tumor volume, and in the incidence of nodal metastases relative to control animals. Dose-response experiments demonstrated that 10 of 139 (7%) animals treated with single doses of CY ranging from 2.5-100 mg/kg developed tumors as compared to 46 of 66 (70%) animals with tumors in the control groups (P less than 0.001). CY doses below 2.5 mg/kg were associated with an increased incidence of tumor implantation (19 of 45, 42%). No lethal toxicity was seen at doses of 50 mg/kg or less. Peak antitumor activity occurred when the CY was administered 1 h prior to tumor implantation as compared to 48 or 24 h before or 1 or 24 h after tumor implantation. Preoperative "chemoprophylaxis" may be an effective strategy for preventing bladder tumor recurrences resulting from tumor implantation.

Animals↗
PubMed1990

Combined 5-fluorouracil and irradiation for transitional cell carcinoma of the urinary bladder.

Thirty-four patients have completed treatment on a bladder-preservation protocol using primary irradiation combined with infusion 5-fluorouracil (5-FU). 4,000 cGy pelvic irradiation was delivered in 5 weeks, with 1,000 mg/m2/day of 5-FU administered as a 96 hr infusion on days 1-4 of week 1 and 4. After a 3-week rest period, patients eligible for cystectomy underwent cystoscopy and biopsy. Those with residual tumor underwent cystectomy, and those without tumor received an additional cycle of chemotherapy and irradiation. Patients ineligible for cystectomy for reasons medical, surgical, or refusal received a third cycle without the 4-week delay or re-evaluation. With a median follow-up of 18 months (range 2-45 months), and with 25/34 patients having T3 (16) or T4 (9) tumors, 17 patients are NED, 4 have died of intercurrent deaths, 7 have died with bladder cancer, and 6 are alive with tumor (2 confined to the bladder). The actuarial cancer-specific survival for the entire group of patients is 64% (+/- 12%) at 45 months, with a freedom from relapse of invasive cancer of 54% (+/- 10%). Twenty-four of the 34 patients retained intact bladders, with 20/24 reporting entirely normal voiding. Of 18 potential surgical candidates, 13/16 (81%) who underwent pathologic re-staging after 2 cycles of chemoradiotherapy had no histologic evidence of residual cancer. Of these 13 patients, 8 remain NED and 2/13 have locally recurrent non-invasive tumors only. Treatment was well-tolerated, with 28/34 patients having received 100% of the planned 5-FU and 34/34 having received greater than 80%. This regimen appears more successful than radiotherapy alone in achieving complete tumor responses, and is an attractive alternative for patients who are unable to receive more aggressive chemotherapy/radiation combinations.

Adult↗
PubMed1989

Limitations of flow cytometric DNA analysis for the diagnosis of bladder cancer.

Flow cytometric analysis was done on exfoliated urothelial cells from 11 control patients and 31 patients with transitional cell carcinoma: 9 grade I, 11 grade II, and 11 grade III. The determination of aneuploidy by DNA analysis did not provide identification of low-grade tumor cells. Other flow cytometric parameters of cellular change such as cell size, nuclear size, nuclear/cytoplasmic ratio, or cell refractivity may provide better identification of low-grade lesions.

Carcinoma, Transitional Cell↗
PubMed1988

Interstitial gold and external beam irradiation for prostate cancer.

We treated 65 patients with prostatic cancer confined clinically to the prostate or periprostatic area during an 8-year period. Seven patients had stage A2, 38 stage B and 20 stage C disease. All 65 patients underwent staging pelvic lymphadenectomy and implantation of gold grains into the prostate (mean dose 3,167 rad). A total of 64 patients then completed a course of external beam irradiation to a mean total tumor dose of 6,965 rad. Complications of therapy were mild and limited (less than 3 months in duration) in most patients, and they included radiation cystitis (32 per cent), diarrhea (31 per cent), extremity lymphedema (7.7 per cent) and wound infection (3 per cent). Two patients suffered urinary incontinence after therapy and 2 (3 per cent) had diarrhea more than 3 months in duration. The actuarial 5-year survival rate for all patients was 87 per cent and the 5-year survival free of disease was 72 per cent.

Actuarial Analysis↗
PubMed1988

Transitional cell carcinoma of the urinary bladder: histologic clearance with combined 5-FU chemotherapy and radiation therapy. Preliminary results of a bladder-preservation study.

Fourteen patients with transitional cell carcinoma of the urinary bladder were treated with 4,000 cGy of pelvic irradiation concurrent with two 96-hour infusions of 5-fluorouracil (5-FU). Three weeks after completion of this regimen, patients underwent repeat cystoscopy and deep-muscle biopsy at the site of their original neoplasms. Eight of 14 (57%) had no tumor left in the biopsy specimen, and they received an additional course of chemotherapy and radiation therapy to a total dose of 4,400 cGy to the pelvis and 6,000 cGy to the bladder. Five of the 14 had residual tumor in the biopsy specimen (one did not undergo biopsy) and went on to planned cystectomy. Two of the five had no tumor in the cystectomy specimen. Overall, ten of the 14 patients (71%) have been downstaged to a condition of P0 (no tumor) following 4,000 cGy and two courses of 5-FU. Of eight patients with retained bladders, seven remain well at a median follow-up of 7 months. At a range of follow-up of 3-21 months and a median of 7 months, 13 of 14 patients remain tumor-free. This regimen results in a greater percentage of downstaging than conventional irradiation alone, and may allow bladder preservation for those with radiation therapy- and chemotherapy-responsive tumors.

Adult↗
PubMed1988

Invasive bladder cancer. Strategies for cure and bladder preservation.

At the present time, standard therapy for invasive bladder cancer includes radical cystectomy and urinary diversion. Clearly, there is a population of patients who can be rendered tumor free by combinations of irradiation and chemotherapy, or irradiation and surgery. These patients may not require total cystectomy to be cured. Only time and experience will tell which treatment regimens can provide both cure and preservation of the urinary bladder.

Humans↗
PubMed1987

Renal cell carcinoma in a patient with situs inversus totalis.

Situs inversus occurs with a frequency of about 1 in 8,000. We present a case of renal cell carcinoma in a patient with situs inversus totalis treated with nephrectomy. Uneventful operative management was attained by adequate preoperative radiologic evaluation.

Carcinoma, Renal Cell↗
PubMed1987

Metastatic renal cell carcinoma simulating glomus jugulare tumor.

A 59-year-old man presented with jugular foramen syndrome caused by a mass with roentgenographic and histologic features highly suggestive of a glomus jugulare tumor. However, electron microscopic examination of the surgical specimen revealed features diagnostic of a previously unsuspected renal cell carcinoma. Because primary tumors of the glomus jugulare and metastatic renal cell carcinoma may present with the same clinical and roentgenographic findings and look similar histologically, careful electron microscopic examination of the tumor and urologic screening should be performed in suspected cases of glomus jugulare tumors.

Carcinoma, Renal Cell↗
PubMed1986

Evaluation of nocturnal penile tumescence with PotenTest.

PotenTest is a standardized, hygienically packaged, and reliable stamp test, useful for differentiating organic from psychogenic sexual dysfunction. Fifteen potent control patients wore a PotenTest band on three separate nights, and during a selfinduced erection, while PotenTest reliably induced nocturnal erections and penile rigidity. PotenTest and Snap-Gauge were used to evaluate pre- and postoperative potency in twelve cystectomy patients. The result with each test was essentially the same.

Erectile Dysfunction↗
PubMed1985

Comparison of specific red-cell adherence and immunoperoxidase staining techniques for ABO(H) blood-group cell-surface antigens on superficial transitional cell carcinoma of the bladder.

The presence or absence of blood-group antigens have been used to predict the clinical course of patients with superficial transitional cell carcinoma of the bladder. Antigen loss has been associated with neoplastic change. The red-cell adherence test has been the most widely accepted method of antigen determination, but this technique has inherent weaknesses. Recently, the immunoperoxidase assay has been used to detect antigens on tumor cells. We compared 30 patients using the red-cell adherence and immunoperoxidase methods on adjacent microtome cut sections. The red-cell adherence and immunoperoxidase methods performed similarly (86%) when assessing antigen presence or absence. However, the immunoperoxidase method was clearly superior in: 1) specificity for antigens on tumor cells and normal internal controls; 2) localization of antigen; 3) demonstration of cellular morphology; 4) increased objectivity of analysis; 5) ease of reproducibility; and 6) cost effectiveness.

ABO Blood-Group System↗
PubMed1985

Carcinoma in diverticulum of female urethra.

A case of carcinoma originating in a diverticulum of the urethra in a female patient is presented. A review of 143 cases of carcinoma of the female urethra treated from 1948 to 1984 at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston disclosed 6 additional patients with diverticular carcinoma. Analysis of their clinical features, treatments--various combinations of primary excision, radiotherapy, and chemotherapy--and survival results indicate that survival is primarily a function of grade. Only 40 cases of carcinoma in urethral diverticula are recorded in the world literature. The majority are adenocarcinomas, and the most frequent presenting symptoms are dysuria, frequency, and urgency. Radiotherapy successfully established long-term control of the disease with low morbidity in all of our patients who had low-grade tumors.

Adenocarcinoma↗
PubMed1985

The use of indwelling ureteral stents in managing ureteral injuries due to external violence.

Eighteen consecutive cases of ureteral injury due to external violence occurring over a 6-year period were reviewed. The diagnosis of ureteral injury was made either preoperatively on an intravenous urogram, or intraoperatively using indigo carmine. No patient had an isolated ureteral injury. Four patients with ureteral contusions were managed expectantly and needed no further therapy. Eleven patients with ureteral lacerations underwent spatulated, interrupted anastomoses of absorbable suture and placement of Silastic double-J ureteral catheters and had prompt resolution of urinary drainage and normal urograms post stent removal. Two initially nonstented patients with lacerations required delayed ureteral stent placement for massive retroperitoneal urine leakage while one patient did well with simple ureteroureterostomy without stenting. The only important complication from the use of ureteral stents was limited to a single patient, who failed to return for followup and developed a staghorn calculus on the stent. The use of Silastic double-J ureteral catheters resulted in little morbidity and allowed: relatively maintenance-free care; an extra measure of safety in multiply injured patients; and early hospital discharge.

Adolescent↗
PubMed1984

Buckshot colic.

A patient with a shotgun injury to the abdomen and kidney with delayed spontaneous ureteral passage of a shotgun pellet is reported. This rare complication "buckshot colic" usually can be treated nonoperatively. The term "buckshot colic" is clarified.

Adult↗