PubMed HealthSearch

Biomedical subjects

B Court

Publications and source records attributed to B Court.

14 recordsLinked to original sources

[Invasive tumors of the bladder. A study of 56 cases treated at the Gustave-Roussy Institute by total cystectomy and radiotherapy].

Between July 1973 and December 1984, 56 patients with invasive bladder cancer were treated at the Gustave-Roussy Institute by total cystectomy and, generally, radiotherapy (45 patients). Four modalities of irradiation were used: preoperative flash (21 patients), preoperative flash and postoperative irradiation (9 patients), preoperative irradiation according to conventional fractionation (12 patients), postoperative irradiation (3 patients). The actuarial 5 year survival for all of the patients treated was 28%. The essential prognostic factors were depth of emboli. Analysis of the deaths revealed loco-regional recurrence in 8 patients (14%), metastases in 11 patients (20%) another cause in 14 patients (24%); treatment appeared to be directly involved in 13 cases. However, toxicity has been considerably reduced since 1980, due to more rigorous patient selection for total cystectomy, improvement in pre- and postoperative intensive care and by the use of a radiotherapy protocol no longer involving large concentrated fractions.

Adenocarcinoma

Phase II trial with D-Trp-6-LH-RH in prostatic carcinoma: comparison with other hormonal agents.

Various approaches to hormonal treatment of prostate carcinoma are discussed. Eighty-one patients with prostatic carcinoma, eight with stage B, nine with stage C, and 64 with stage D disease, were treated subcutaneously daily for 3 months with the LH-RH agonist D-Trp-6-LH-RH (Decapeptyl) in order to evaluate the incidence of remissions according to WHO recommendations for oncologic trials. The findings were compared to those obtained with other hormonal therapies of prostatic carcinoma according to the statistical method of "expected response rate" as adapted by Lee and Wesley for phase II trials. Treatment with D-Trp-6-LH-RH greatly reduced serum LH and testosterone levels without raising serum prolactin. After 1-2 weeks of therapy, there was relief of subjective symptoms and a reversal of the signs of prostatism as well as a marked decrease in bone pain. At 90 days 52 patients had complete relief of prostatism and 21 had only mild signs and symptoms. Seventy patients were experiencing no bone pain and an additional six had only mild pain. Prostatic size, evaluated by rectal examination and transabdominal ultrasonography, reverted to normal in 26.4% of patients (complete remission) and was reduced by more than 50% in an additional 17.6% (partial remission), the overall rate of complete plus partial regression of prostatic enlargement being 44%. Scans showed a major improvement of bone lesions in 14.8% of cases. This response increased to 37% after more than 6 months of follow-up. Prostatic acid phosphatase levels were decreased by more than 50% in 61% of the patients, but this test appears to be a less valid marker than the lipid-associated sialic acid (LASA). The increase in LASA before treatment and a reduction after treatment can frequently be correlated with the objective volume of the neoplasms. No flare-up of the disease was encountered, and there were no side effects except for impotence. Statistical analyses of results by the method of Lee and Wesley indicated that the incidence of complete and partial regression (CR and PR) observed with D-Trp-6-LH-RH was not significantly different from that recorded in previous studies for another LH-RH analog, Buserelin. However, CR and PR obtained with D-Trp-6-LH-RH (44%) were significantly higher than with subcapsular orchiectomy (22%). Hormonal effects and some other actions of D-Trp-6-LH-RH were compared and contrasted with those produced by castration, estrogens, antiandrogens, and progestogens.(ABSTRACT TRUNCATED AT 400 WORDS)

Acid Phosphatase

Traumatic ruptures of the urethra in children.

Considering 4 cases of urethral injuries in male children, the authors' attitude regarding pelvic factors with urethral trauma is described. They insist on the importance of intravenous urography in fresh injuries, which is very helpful to diagnose the legend of the upper and lower urinary tract. Regarding dilatation treatment of urethral injuries, resection of the urethral stenosis, followed up by direct suture of the urethra is suggested as the best treatment.

Adolescent

[Action to be taken in traumatic rupture of the urethra in boys (4 cases) (author's transl)].

On the occasion of four cases, the authors studied the problems posed by traumatic rupture of the urethra in boys. They draw a very clear distinction between fresh rupture where the urethral lesions are only one of the elements of multiple trauma. The clinical picture and the I.V.P. form the basis for the diagnosis, and the indwelling catheter when it can be placed in position remains a valid mode of treatment. At the stage where complications have arisen, a clinical as well as a radiological check-up is indispensable before taking any decision. If action must be taken, suture-resection seems to be the best solution.

Adolescent

Monitoring and treatment of minimal residual cancer of the prostate.

In manifest prostatic carcinoma, partial and complete remissions are obtained in 14-44% of patients as judged by different sets of criteria, but in up to 61% as judged by a decrease in prostatic acid phosphatase. Moreover, this decrease is poorly correlated to that of prostatic size. Prostatic acid phosphatase is therefore considered to be a relatively non-specific tumor marker. A complete remission, i.e. a stage of minimal residual disease, is obtained in about 25% of the patients. Continued endocrine treatment involves the risk of a flare-up of the disease, which is probably small. Additionally, in minimal residual disease, prolonged maintenance treatment requires minimization of side effects. D-Trp-6-LH-RH appears to lead to less gynecomastia and thromboembolism than some other forms of adjuvant therapy.

Adenocarcinoma