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Biomedical subjects

P Thibault

Publications and source records attributed to P Thibault.

At least 145 records · Page 8Linked to original sources
PubMed1991

[Should adrenalectomy be performed systematically as part of radical nephrectomy for renal cancer? Review of 119 cases].

Systematic histological examination of 119 operative specimens of radical nephrectomies performed for renal cell carcinoma revealed adrenal invasion in 6 cases (5.04%). Preoperative computed tomography visualised the adrenal lesions with a sensitivity of 100%. Adrenal involvement was due to either contiguous invasion (3 cases) or metastatic spread (3 cases). Other visceral or lymph node metastases were detected in every case. The mean survival of patients with an adrenal lesion was 16.5 months. These data and those reported in the literature suggest the value of systematic adrenalectomy as part of radical nephrectomy.

Adrenalectomy↗
PubMed1991

[Functional analysis of micturition and continence after a Hautmann type enterocystoplasty (27 patients)].

Twenty seven patients treated by Hautmann enterocystoplasty completed a detailed questionnaire concerning the quality of their micturition and continence. The mean capacity of the neobladder was 250 cc with a diurnal interval between micturitions of about 3 hours. 79% of patients experienced an urge to micturate. The mean frequency of nocturnal micturition was 1.6. Diurnal continence was perfect in 100% of patients, while nocturnal continence was excellent in 78% of cases and good in 18% of cases, while one patient (4%) suffered from nocturnal incontinence. Hautmann enterocystoplasty is therefore an excellent technique for bladder replacement, ensuring diurnal and nocturnal continence for the great majority of patients.

Aged↗
PubMed1990

Determination of the primary structure of peptides using fast atom bombardment mass spectrometry.

The determination of the amino acid composition and sequence of a peptide, using both conventional and tandem fast atom bombardment mass spectrometry, is presented. First a list of potential empirical formulae is generated using the accurate mass and isotopic peak intensity ratios from the molecular ion cluster. The formulae are mathematically analyzed to ensure that they correspond to linear peptides composed of 19 common amino acids. Then using the ions below m/z 160 Da, which are characteristic of the amino acid content of the peptide, the formulae are decomposed into possible amino acid compositions. From each composition sequences are generated and their predicted fragment ions are compared to ions present in the mass spectrum. A score based on the intensities and the occurrence of consecutive sequence fragments is calculated. Finally sequences with the ten highest scores are retained. Analyses performed on typical peptides with molecular weights below 1500 Da indicate that identification can generally be achieved using this approach.

Amino Acid Sequence↗
PubMed1990

Cosmetic leg veins: evaluation using duplex venous imaging.

The records of 305 consecutive patients who had presented with cosmetic symptoms related to varicose and/or spider veins over a 12-month period were studied. Following clinical assessment, 250 (82%) patients were referred for duplex venous imaging. A total of 500 lower limbs were evaluated; 236 (47%) were documented to have incompetence in the superficial venous system (long or short saphenous veins). Only 6 (1%) limbs had deep venous incompetence and 45 (9%) limbs were found to have perforator incompetence. Short saphenous vein incompetence was found in 59 (12%) limbs. In the long saphenous vein there was a consistent pattern of an increasing incidence of incompetence from the saphenofemoral junction down to the below-knee segment. The duplex imaging findings were applied to determine the optimal treatment, ie, whether surgery, sclerotherapy, or a combination of both would provide the best short- and long-term results. The possible etiology and pathophysiology of spider and varicose veins are discussed in relation to these results.

Adolescent↗
PubMed1990

[Chemotherapy in cancer of the prostate].

The most classical treatment of metastatic prostatic adenocarcinoma is hormone therapy. Most often, chemotherapy is proposed only when the tumor becomes hormonally unresponsive. But evaluation of its efficacy is impaired by the diversity of inclusion criteria used and by the different criteria of response assessment. Results of randomized, comparative studies show that all cytotoxic agents currently available have a similar response rate (about 30 to 40%). Use of combined chemotherapy does not seem to significantly improve these results. Several others ways have been proposed which attempt to improve the efficacy of chemotherapy (androgen stimulation, priming chemotherapy, adjuvant or neo-adjuvant chemotherapy...) but, most probably, progress will come from the discovery of more effective and selective cytotoxic agents, and not from the increase of clinical trials with the same agents.

Antineoplastic Agents↗
PubMed1990

[Treatment of hemorrhagic cystitis caused by cyclophosphamide using intravesical instillation of potassium alum. Apropos of 5 cases].

Five patients with malignant hemopathies, including four treated by bone marrow transplantation, developed cyclophosphamide-induced hemorrhagic cystitis that failed to respond to the usual treatments. Each was treated by continuous irrigation of the bladder with potassium alum. Hematuria ceased in three patients followed up for 5 to 10 months. A review of the literature confirmed the 75% success rate of this treatment. No local side effects were recorded, but one patient had a single seizure.

Administration, Intravesical↗
PubMed1990

[Hautmann enterocystoplasty. Clinical and urodynamic study in 24 patients].

Twenty-four patients with invasive bladder cancer underwent Hautmann enterocystoplasty. A study of the urinary continence revealed 100 per cent of good results during the day and 87.5 per cent of good results at night. Urodynamic investigation after 3 months revealed that only one patient presented with peristaltic waves and that the postmicturating residual urine volume was always less than 100 cc. There was no mortality in this series. The only uncertainty concerns the long-term outcome of these patients because of the risk of incomplete emptying and distension of the neobladder.

Aged↗
PubMed1990

[Report of a case of malignant vesical pheochromocytoma. Diagnosis and therapy].

Bladder pheochromocytoma is a rare, usually benign bladder tumor. An exceptionally malignant bladder pheochromocytoma is reported with more than 5 years follow-up. The study of our case, and the review of 15 other cases reported in the literature show that surgery is the only effective therapy. Partial cystectomy with regional lymphadenectomy, when feasible is the treatment of choice. Because metastatic occurrence may be late, we emphasize the importance of long term follow-up.

Adrenal Gland Neoplasms↗
PubMed1990

[Treatment of urethral stenosis using a pedicled flap of the scrotal skin. Long-term results in 16 patients].

The scrotal skin is vascularized in part by means of the superficial perineal branch of the internal pudendal artery. This nutrient pedicle, together with the scrotal skin dependent on it, can be isolated. The urethra is approached via the perineum. The stricture is incised longitudinally right down to the healthy area. The scrotal flap and pedicle are mobilized, and then anastomosed along the edges of the urethra. From March 1983 through April 1987, sixteen patients have been operated. Postoperative results: the mean follow-up for the 16 patients is 60 months with extremes of 24 and 66 months. 13/16 patients show good results (81%). 3/16 patients show poor results with recurrence of the stricture localized at the junction of the flap and healthy urethra. Such recurrences have yielded to treatment, in two cases, by optical urethrotomy and, in the other case, by means of a new scrotal flap.

Follow-Up Studies↗
PubMed1990

[Low-pressure enterocystoplasty after prostato-cystectomy for cancer. Apropos of 13 cases].

Thirteen patients were operated for bladder carcinoma, from November 1987 to September 1988, using a Camey type II low pressure ileal bladder replacement. Clinical, radiological and urodynamic findings were studied. Diurnal continence was always acquired at three months. In terms of nocturnal continence, only 75 percent of the patients are comfortable, while two patients require oxybutinin to remain continent. Urodynamic exploration showed a low pressure in 8 patients, but a high pressure peak in 4 patients. Radiological study showed integrity of the urinary tract. This work confirmed the improvement obtained with the Camey II procedure. Nevertheless, it also shows the failure of the method with occasional high pressure peaks. We think that a more anatomical bladder reconstruction, such as Hautmann Pouch, may improve the results for nocturnal continence. This needs to be confirmed by a comparative study.

Aged↗
PubMed1989

[Accidental discovery of renal cancer by ultrasonography].

A retrospective study of 152 consecutive patients admitted for renal carcinoma between January, 1969 and August, 1987 showed that these patients could be divided into two groups, the dividing line being 1980, date of the advent of ultrasonography. Compared with the 68 patients treated between 1969 and 1980, the 84 patients treated between 1981 and 1987 had a significantly greater number of asymptomatic renal carcinomas. The asymptomatic tumours discovered incidentally by ultrasounds were less advanced than the symptomatic tumours, the difference between the 2 groups being highly significant. The diagnosis of asymptomatic renal carcinoma at an early stage suggests that these tumours might have a better prognosis. These data underline the usefulness of a systematic study of the kidney during all abdominal or vesicoprostatic ultrasonographic explorations.

Female↗
PubMed1989

Experience with the Hemasite vascular prosthesis.

A 3-year experience with the no-needle vascular prosthesis Hemasite, implanted in 10 patients who underwent hemodialysis and have a long history of multiple vascular access failures, is described. During 182 months of follow-up study, 30 thromboses occurred, while nine of 10 patients did not receive any antiplatelet aggregant treatment. Hemasite was declotted 12 times with a local infusion of urokinase and 12 more times by thrombectomy. A surgical procedure was performed only in the other cases, and the rate of surgical intervention fell from 0.18 interventions per patient per month before Hemasite implantation to 0.027 after implantation.

Adult↗
PubMed1988

Mass spectrometric determination of the inorganic carbon species assimilated by photoautotrophic cells of Euphorbia characias L.

The chemical forms of inorganic carbon, CO2 or HCO3-, incorporated during photosynthesis in photoautotrophic Euphorbia characias cell suspension cultures were determined in experiments using 13CO2 and a mass spectrometry technique. From the equations of the CO2 hydration reaction, a kinetic model was first developed, and the effect of photosynthesis on the external CO2 concentration was simulated. It was predicted from this model that CO2 and HCO3- uptakes could be differentiated by recording only the CO2 variation rate in the external medium, successively in absence then in presence of an exogenous carbonic anhydrase activity. The results obtained with either CO2-grown or air-grown photoautotrophic cells were in good agreement with the model and demonstrated that CO2 was the sole species taken up during photosynthesis. In addition no accumulation of inorganic carbon within the cells was observed in the light. Similarly, in dark, CO2 was the only species released by respiration in the external medium.

Bicarbonates↗
PubMed1988

A serious complication of vesical ether instillation: ether cystitis.

We report the fourth case of ether cystitis, which occurred after ether was used to dissolve a Foley catheter balloon. The severity of the lesions required an ileocystoplasty to preserve normal micturition. Ether dissolution of Foley catheter balloons should be replaced with mechanical disruption.

Administration, Intravesical↗
PubMed1988

[Transrenal ureteral occlusion using detachable balloons. An alternative to cutaneous ureterostomy in the treatment of vesicovaginal fistula].

The treatment of urinary fistulae is particularly delicate when they occur in the course of a neoplastic disease. The development of less invasive, but variably successful, percutaneous techniques seems essential in these advanced patients. The authors report a case of ureteric occlusion by releasable balloon allowing the simple and rapid cure of a very disabling vesico-rectal-vaginal fistula associated with recurrent pelvic tumour.

Catheterization↗
PubMed1988

[Extracorporeal lithotripsy and prophylactic antibiotic therapy].

During ESWL, bacteria which may be contained in the stone gets disintegrated. This study evaluates the role of prophylactic antibiotherapy in preventing such complications. Fifty patients whose urine culture was negative were randomized into two groups: the first group (25 patients) received a placebo, the second group received Ceftriaxone 1 g I.V. as a single injection performed 1 hour previous ESWL. There was no positive blood culture and no positive urine culture in the placebo group arm as well as in the antibiotic group. In this study, the risk of infection induced by ESWL seems to be minimal, so that prophylactic antibiotherapy does not appear to be necessary when urine before ESWL is sterile.

Bacterial Infections↗