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Pierre Mongiat-Artus

Publications and source records attributed to Pierre Mongiat-Artus.

9 recordsLinked to original sources
PubMed2006

Spectrum of molecular alterations in colorectal, upper urinary tract, endocervical, and renal carcinomas arising in a patient with hereditary non-polyposis colorectal cancer.

Hereditary nonpolyposis colon cancer (HNPCC) syndrome is the most frequent hereditary cancer syndrome predisposing to cancers of various locations, especially colon, endometrium, stomach, and upper urinary tract. Carcinomas of the kidney parenchyma are not considered as an HNPCC-related tumor. HNPCC tumors are characterized by microsatellite instability (MSI) due to a defect in mismatch repair (MMR) and carry somatic frameshift mutations in mononucleotide repeats within the coding regions of key genes. We report the first case of a papillary carcinoma of the kidney in an HNPCC patient who developed carcinomas of the upper urinary tract, endocervix, and colon. Whereas the HNPCC-related tumors demonstrated MSI phenotype, loss of MSH2 protein expression, and frameshift mutations in several of the 13 target genes analyzed, the kidney cancer displayed MSS phenotype, normal MMR protein expression, and no frameshift mutation in target genes. Our observations do not support the possibility that papillary carcinomas are part of HNPCC syndrome.

Colorectal Neoplasms↗
PubMed2006

Infrequent microsatellite instability in urothelial cell carcinoma of the bladder in young patients.

OBJECTIVE: Defects in the DNA mismatch repair result in microsatellite instability (MSI), which characterise most tumours related to the hereditary non-polyposis colorectal cancer syndrome and some sporadic tumours. Several studies have reported the occurrence of MSI in urothelial cell carcinoma (UCC) of the bladder with a particularly high incidence in tumours from young patients. In this study, we have evaluated the occurrence of MSI in primary bladder UCC arising in seventeen young patients selected for being below 45 years of age at diagnosis. METHODS: Microsatellite analysis has been performed using the panel of five quasimonomorphic mononucleotide repeats (BAT-25, BAT-26, NR-21, NR-24, NR-27) recently recommended to detect MSI tumours. The original Bethesda panel including BAT-25, BAT-26 and three dinucleotide repeats (D2S123, D5S346, D17S250) has further been studied in 10 UCC samples. RESULTS: MSI has been observed in only one of the 17 bladder UCC studied. Using the original Bethesda panel, identical results were obtained, indicating that the panel of five mononucleotide markers adequately detected MSI in UCC tumours. CONCLUSIONS: Our data indicate that classical MSI affecting mono- or di-nucleotides are rarely involved in bladder UCC developing in young patients. Further studies using gold standard criteria would help clarifying the involvement of MSI in the pathogenesis of bladder UCC.

Adult↗
PubMed2006

Dosage and duration of medication for men with lower urinary tract symptoms: two questions without definitive answers.

PURPOSE OF REVIEW: In this review, the dosage and duration of medication in the management of benign prostatic hyperplasia are discussed. There is no official guideline, however, and even no professional agreement on these points. RECENT FINDINGS: Considering the dosage, dose-titration is probably not a drawback as there is a high risk of undertreatment or overtreatment when using a single dosage for every patient. Duration of treatment is a matter of concern. A quarter of patients discontinue their treatment early. For the others, a long period of treatment may be mandatory for those patients who are at risk of progression. After a course of medication (6 months to 1 year), a trial without treatment may help to decide whether treatment must be continued if symptoms relapse. SUMMARY: For men with lower urinary tract symptoms, there seems to be no definitive answer about the appropriate dosage and duration of medicine.

Adrenergic alpha-Antagonists↗
PubMed2005

Management of pelvic stones larger than 20 mm: laparoscopic transperitoneal pyelolithotomy or percutaneous nephrolithotomy?

UNLABELLED: Large pelvic stones are frequently managed with percutaneous nephrolithotomy (PCNL) but laparoscopic transperitoneal pyelolithotomy (LTP) can be an alternative. We compared PCNL and LTP for the treatment of pelvic stones >20 mm in diameter. PATIENTS AND METHODS: Between November 1999 and November 2004, 16 consecutive patients, mean age 42, with a single pelvic stone >20 x 10 mm (group I), underwent LTP as first-line treatment or after shockwave lithotripsy failure. They were compared with a similar population of 16 consecutive patients, mean age 45 (group II), who underwent PCNL for the same indication and were assessed retrospectively. We evaluated operative characteristics, complications, and results for each technique. RESULTS: There was no difference between the two groups regarding the characteristics of patients and stones. Operative time duration was significantly longer in group I (129 vs. 75 min; p = 0.001) and conversion was required in 2 patients (12%). The main postoperative complications were urinary leakage (2 patients, 12%) in group I and bleeding (3 patients, 18%) in group II, but only 1 required blood transfusion. Mean hospital stay was respectively 6.5 and 5.6 days in groups I and II (p = 0.17). Stone-free rates were assessed at 3 months and were not different between group I and group II (88 vs. 82%). CONCLUSIONS: The operative time of LTP is longer and the results of both techniques are comparable but postoperative morbidity is different. Specific indications of each technique must be determined although PCNL remains the gold standard for most large pelvic stones.

Adult↗
PubMed2005

[Double kidney transplantation].

The incidence of end-stage renal failure has been increasing for many years with a marked elevation of the mean age of kidney transplantation candidates. This situation contrasts with the shortage of kidney transplants. One solution, apart from the development of live donor kidney transplantation, is the use of so-called "borderline" cadavre kidneys. Double kidney transplantation is performed in the context of enlargement of the number of "borderline" donors. A review of the medical literature reporting the experience acquired in double kidney transplantation demonstrates a marked heterogeneity of donor selection criteria between the various teams. Recipients are generally selected from among the oldest patients waiting for transplantation. Double kidney transplantation is not associated with any excess mortality and graft survival and graft function are perfectly satisfactory, ensuring a serum creatinine close to 200 micromol/l at 3 years. These results are obtained at the price of low morbidity. Wound complications are not more frequent than after single kidney transplantation. With the exception of one team, vascular complications are not more frequent, but are even more serious than for single kidney transplantation. Ureteric strictures and fistulas are observed more frequently when the two ureters are reimplanted into a common conduit in the case of homolateral transplantation of the two kidneys. Overall, double kidney transplantation has allowed a 10% increase in the recruitment of "borderline" kidneys by all teams with satisfactory functional results and low morbidity. However, donor and recipient selection criteria for double kidney transplantation need to be more precisely defined to avoid depriving elderly patients of transplantation and to avoid using two kidneys in the same recipient when one kidney would have ensured a satisfactory functional result, Two ongoing French studies will probably allow progress in this direction by evaluating the feasibility and benefits of this technique in France.

Donor Selection↗
PubMed2004

Abarelix: the first gonadotrophin-releasing hormone antagonist for the treatment of prostate cancer.

The high incidence of prostate cancer makes it a major healthcare problem and the second leading cancer-related cause of death among men in developed countries. The hormonal treatment of prostate cancer is indicated for the palliation of symptomatic and metastatic disease in older patients, and as neoadjuvant treatment of different modalities of radiotherapy. This hormonal treatment is based on the study conducted by Huggins in 1940 and consists of androgen suppression. Since the clinical availability of the first luteinising hormone-releasing hormone (LHRH) agonist, no significant improvement has been made in the field of medical castration. Taking these data into consideration, the recent approval of abarelix by the FDA, the first gonadotrophin-releasing hormone (GnRH) antagonist, appears to be promising news. The pharmacology of the molecule and the clinical studies that led to FDA approval will be reviewed. The place of GnRH antagonists in the treatment modalities of prostate cancer will then be discussed.

Animals↗
PubMed2004

[Value of a visual analogue scale for evaluation of the severity of symptoms of benign prostatic hyperplasia (BPH). Pilot study in two urology centres].

PURPOSE: One half of French patients over the age of 50 with BPH are not diagnosed. Real difficulties are also currently encountered in the use of the I-PSS in general practice. In this context, the objective of this pilot study was to evaluate the concordance between the I-PSS score and a visual analogue scale (VAS), proposed as a new, precise and easy to use aid to the diagnosis of BPH. PATIENTS AND METHODS: Sixty five patients (mean age: 66 +/- 9 years, mean I-PSS: 13.6 +/- 7.0) recruited by two urology departments quantified their urinary symptoms by answering the question "How much difficulty do you have problems to urinate?": 7 patients used a 10 cm and a 35 cm VAS, 30 patients used a 15 cm VAS and 28 patients used a 20 cm VAS. All patients also completed the self-administered I-PSS questionnaire. RESULTS: The VAS scores were independent the patient's age. The 4 classes of I-PSS severity were also represented in the VAS groups (p=0.999). The strongest correlation with the I-PSS score was observed with the 20 cm VAS (R=0.91, p<0.0001). This coefficient was 0.26, 0.67 and 0.72 for the 10 cm, 15 cm and 35 cm VAS, respectively. A very close correlation was observed between the evaluation on the 20 cm VAS and the classes of the I-PSS score. Finally, the relationship between the I-PSS subscores and the 20 cm VAS was statistically significant (p<0.0001) with high correlation coefficients (R=0.75 and R=0.87 for irritative and obstructive symptoms, respectively). This VAS did not appear to favour one type of symptoms over another. CONCLUSION: This pilot study on a small number of patients showed that a 20 cm VAS can constitute a simple and precise aid to the detection of BPH. These results must now be validated by a large-scale study, under real general practice conditions.

Aged↗
PubMed2002

Hand-assisted laparoscopic nephrectomy.

Hand-assisted surgery enjoys the benefits of open surgery while maintaining the post-operative advantages of laparoscopy. Logical indications for its application largely include those cases that require removal of a large amount of tissue intact. Hand-assisted laparoscopic surgery may find application in complex procedures such as radical, partial and difficult nephrectomies.

Female↗