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Biomedical subjects

B Doré

Publications and source records attributed to B Doré.

52 records · Page 3Linked to original sources
PubMed1986

[The pedicled lateral flap. Its use in the treatment of anterior hypospadias].

Many methods exist for repair of anterior penile hypospadias but one of the most commonly used is certainly Mathieu's operation. However, this procedure can give rise to different complications due essentially to necrosis of a cutaneous flap brought anteriorly to reconstitute the missing portion of urethra. Based on the pedunculated cutaneous flap described by Blandy for use in urethral shortening, a proposal is made to obtain the flap for canal reconstruction laterally, this allowing conservation of its total vascularization and thus avoiding the risk of ischemic necrosis.

Child↗
PubMed1985

[Management of isolated angiomyolipoma of the kidney].

Four patients presented isolated angiomyolipomas of kidney in the absence of any form of phakomatosis such as Bourneville's disease. The tumor was removed by partial nephrectomy in only one case, after histology of a fresh specimen confirming the presence of an angiomyolipoma without signs of cancer. In another patient it was impossible to perform conservative surgery because of dissemination of the angiomyolipoma throughout the kidney. Symptomatology suggestive of the disorder includes lumbar pain, kidney tumor and more rarely hematuria. Diagnosis is difficult despite availability of ultrasound and CT scan imaging, which has supplanted renal arteriography. Confirmation requires histology of a fresh specimen. Operative treatment is essential to avoid the risk of intra- and peri-tumoral hemorrhage, particularly during pregnancy. Partial nephrectomy or excision of tumor is possible when the diagnosis has been established, if excision involves healthy parenchyma and if after strict hemostasis at least one third of renal parenchyma remains.

Adult↗
PubMed1985

[Non-secreting malignant tumors of the adrenals. Apropos of 3 cases].

Tow of three patients seen with malignant tumor of adrenals had very large lesions and the outcome was rapidly fatal. Excision of tumor was possible in the third case and the patient is in good health two years after operation. Clinical signs are infrequent and diagnosis of an adrenal lesion is mainly dependent on combined ultrasound-scan imaging, with confirmation by histology. Differential diagnosis is necessary between adrenal cortex adenoma and pheochromocytoma. Malignancy is suspected from signs of extratumoral invasion and a tumor weight of over 100 g. Histologic findings are not always specific. Treatment is almost exclusively surgical, complementary therapy being unnecessary in non-secreting pheochromocytoma. Attempts to treat malignant adrenal cortex masses by o,p-DDD have not improved prognosis. The chance discovery of a small tumor requires either routine excision of mass to prevent progression of certain malignant tumors, or simple surveillance, particularly after 50 years of age, since many of these tumors are benign: the decision for choice of therapy is a debatable subject.

Adrenal Cortex Neoplasms↗
PubMed1985

[Pregnancy and lithiasis of the upper urinary tract. Clinical aspects and therapeutic management].

Upper urinary tract calculi can be difficult to diagnose and to treat. One has to be aware that there is a risk for the mother which is often not recognized in the long term. The authors describe 17 cases of pregnant women aged between 20 and 33 who were treated for calculi in the Urological Service in Poitiers. They were diagnosed at different stages of pregnancy and a few had a previous urological history. The women presented in different ways, several of them with urinary colic and 10 with urinary colic and fever. Urinary tract infection and septicaemia also occurred. Six patients passed the stones spontaneously. The rest had to be treated by some form of operation, either during the pregnancy or afterwards, including one case of a patient who had to have her kidney and ureter removed and another who had to have a kidney removed. One patient had to have an emergency caesarean section for fetal distress although she had had stone removed at the 20th week of pregnancy. It is not possible to know from this series the incidence of stones in the tract. Various theories of the formation of the stones, including the anatomical changes that occur in the urinary tract in pregnancy, are suggested and these include the hormonal theory of dilatation of the ureters as well as the mechanical theory of changes in the course of the ureters. There are also likely to be changes in the phosphocalcium metabolism. Pain in the lumbar and lower abdominal region is the most frequent symptom occurring in 90-100% of cases and urinary tract infection is common.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Mature retroperitoneal ganglioneuroma in the adult. A case].

Mature ganglioneuroma, a benign nervous tumor of sympathetic origin, is an uncommon diagnosis in adults, particularly when it is located in the retroperitoneal region. Embryology provides an explanation for detection of this tumor in the adrenal glands. The fortuitous discovery of a lesion of this type in a patient with a homolateral renal adenocarcinoma provoked diagnostic and therapeutic problems that are discussed and analyzed.

Adult↗
PubMed1984

[Treatment of embryonal carcinoma of the testis (stages I and IIa) without lymph node curettage. Long-term results].

Of 18 cases of embryonic carcinoma seen over the last 13 years, 10 were classified as inferior to stage III and were treated without glandular curettage: 5 by combined chemotherapy and radiotherapy, 3 by chemotherapy alone and 2 by radiotherapy alone. All patients have survived beyond 2 years (2 to 11 years). The attitude is considered as too restrictive which implies treating only when secondary recurrence occurs, since certain patients are lost to view. Moreover, curettage has a higher morbidity than chemotherapy. Routine chemotherapy without glandular curettage would appear to be indicated for stages a priori I and II.

Cobalt Radioisotopes↗
PubMed1984

[Posterior vertical lumbotomy. Its value in surgery of the kidney].

Principal technical features are described briefly based on a personal series of use of the procedure in 35 cases. The patient is placed in decubitus; a parietal approach is performed while avoiding the genitofemoral nerve; the incision can be enlarged downwards and above all upwards (subperiosteal segmental resection of 12th rib). The lateral posterior vertical lumbotomy possesses the advantage over classical lateral lumbotomy of being less disturbing to muscle, being less painful postoperatively, and never leading to eventration. It also reduces hospital stay. It presents the disadvantage, however, of providing only a narrow view of the operation zone, which limits its use to simple procedures such as exeresis of pyelic and upper lumbar ureteral calculi. It is dangerous, on the contrary, and should not be used in surgery of coralliform stones.

Adolescent↗
PubMed1983

[Lithiasis of the upper urinary tract and pregnancy].

The authors report 17 personal cases of lithiasis of the upper urinary tract discovered in the course of pregnancy. They discuss the diagnostic and therapeutic problems, taking into account the double risk of mother and foetus. The essential diagnostic sign is renal colic, with or without fever. Spontaneous excretion of these calculi is possible, but in 8 of the 17 cases, a ureteric catheter had to be passed or an operation was required. Neither the delivery nor the health of the infants delivered seemed to be harmed by this renal calculi disease. The authors recall that the most common cause of non-obstetrical abdominal pain in the course of pregnancy is in fact urinary calculi. The incidence is about 1 cases of lithiasis per 1,000 pregnancies. It appear that a physiological hyperparathyroidism of pregnancy is responsible for a hypercalciuria which could be a factor favouring the development of lithiasis during pregnancy. The important point is to know how to distinguish those forms of pyelonephritis of pregnancy which are due to a stone obstructing the upper urinary tract, as any purulent retention in the upper tract can lead to a pyonephrosis, a bacteraemia or even a septicaemia. The presence of the foetus makes interpretation of a plain abdominal film difficult. In any case, its indication is questionable, whenever the urine is septic, particularly with Proteus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Eosinophilic cystitis].

The author reports a case of severe disturbance of micturition due to a cystitis in a 17 years old adolescent. As no cause was found, a biopsy was taken by endoscopy which revealed an inflammatory process involving the full thickness of the bladder wall with a great many eosinophils. The particular interest of this case presentation resides in the effectiveness of the immuno-suppressive treatment. Three tablets of Imuran for six weeks led to the cure of this patient. The authors review the literature of this rarely published condition. They classify it into the broader group of interstitial cystitis. The authors cite their case as an argument in favour of the auto-immune origin of these interstitial cystitis. The effectiveness of immuno-suppressive therapy is the best proof.

Adolescent↗
PubMed1981

[A rare tumour: paravesical pelvic haemangiopericytoma (author's transl)].

Haemangiopericytomas are vascular tumours derived from Zimmerman's pericytes, the cells surrounding blood capillaries which correspond to the smooth muscle cells in the arterial and venous walls. This rarely observed tumour is usually found in the limbs (more than 50 p. cent of cases) or the face. Pelvic haemangiopericytomas are most frequently observed in women, and are then of uterine origin, their occurrence in men, and in the perivesical space, being exceptionally rare (seven cases reported in the publishing literature). The authors describe such a case, and review the clinical and radiological characteristics of the lesion. Diagnostic difficulties are emphasized, as confusion with a sarcoma can arise, even after histological examination. Surgical excision should be conducted routinely, but local recurrence or pulmonary metastases may occur in view of the potential malignancy of these tumours. Complementary cobalt therapy is therefore justified.

Diagnosis, Differential↗
PubMed1981

[Secondary amputation of the penis in the sequelae of local therapy with iridium 192 for carcinoma (author's transl)].

The author reports 4 cases of severe delayed irradiation complications which required partial or complete secondary amputation of the penis for sequelae of local therapy with Iridium. After reviewing the modes of spread of carcinoma of the penis and the various therapeutic possibilities in the light of these 4 cases, the author raises the question as to whether such conservative treatment by interstitial radiotherapy is well-founded. He would tend to suggest immediate surgery giving an identical result at the price of much shorter treatment and which would be free of the complications reported following radiotherapy.

Aged↗
PubMedDate not supplied

[Extra corporeal shock wave lithotripsy (ESWL) procedure in urology].

Since 1980, extra corporeal shock wave lithotripsy (ESWL) has become the first line treatment for most stones in adults and children. The indications are based on criteria depending on localization, chemical composition and size of the renal and ureteral calculi. Since the DORNIER HM 3 which remains the gold standard of first generation lithotripters, many devices of second and third generation have been built (electro hydrolic, piezo electric and electromagnetic) with fluoroscopic and ultrasound localization systems. SWL may now be performed on an out-patient basis without anaesthesia or under neuroleptic analgesia. Indications and evaluation criteria on 3 months plain abdominal X-ray are better defined since 1996. Nevertheless, comparison of reported results remains difficult due to the multiplicity of lithotripter types and the lack of consensus on efficacy criteria. Today, the third generation of mobile electromagnetic lithotripters give an average of 80% stone free rate of patients with kidney and ureteral calculi whatever the localization and size.

Analgesia↗
PubMedDate not supplied

[Correlation between chemical composition, density, and results of extracorporal lithotripsy in renal and ureteral lumbar calculi].

Based on a series of 388 patients with a total of 466 renal and lumbar ureteric stones (414 kidneys) treated between 1987 and 1990 by extracorporeal shock wave lithotripsy (ESWL) using the SONOLITH 3000* apparatus, the authors analyse the indications and results criteria for ESWL. The success criteria adopted excluded any residual fragment and considered patients lost to follow-up as failures. The success rate varied between 48.3% and 73.8% when residual fragments less than 5 mm were included and when drop-outs were excluded. A correlation was established between the radiographic appearance of the stone (dense, smooth, spiculated), its predominant spectrophometric nature and the results of ESWL: low density, spiculated Weddellite (WD) stones gave good results and very dense, smooth Whewellite (WW) stones gave less favourable results. The authors propose a refinement of the indications for ESWL in order to improve the results. Predominantly WW stones may be suitable for primary percutaneous nephrolithotomy.

Adolescent↗
PubMedDate not supplied

[Calcified renal cancers. 7 case reports].

The authors report a series of 7 patients with calcified renal cancer (5 men and 2 women with a mean age of 51 years). The calcifications had a variable appearance:arcuate (1 patient), disseminated throughout the mass (5 patients), mixed (1 patient). The distribution according to stage was as follows: T1: 1 patient, T2: 3 patients, T4: 3 patients. Five patients were treated by radical nephrectomy, but surgery was impossible in 2 patients due to the local extension of the tumour. Two patients are alive with no signs of recurrence (follow-up: +7 years and +7 months), 1 died 10 years after his nephrectomy, from myocardial infarction, 1 was lost to follow-up and 3 died within several months. These 3 patients had a spindle cell renal cancer. In the light of this series, the authors situate calcified renal cancers in relation to other calcified renal masses (of various origins) and in relation to adult renal cancers. They demonstrate that any calcified renal mass must raise the suspicion of cancer and they describe the diagnostic approach to such a hypothesis.

Adult↗
PubMedDate not supplied

[Sarcomatoid cancer of the kidney in the adult. 7 case reports].

Based on a retrospective series of 7 patients (6 men and 1 woman) with a mean age of 56.5 years, the authors describe the clinical, radiological and pathological features and the clinical course of sarcomatoid renal cancers in adults. They stress the severity of this type of tumour, due to the fact that the lesion is usually very advanced at the time of diagnosis (3 cases of Robson's stage III tumours and 4 stage IV tumours). Radiological assessment frequently reveals calcifications within the mass (4 out of 7 patients). Surgical excision is sometimes impossible and, when it can be performed, it has little influence on the prognosis or the survival.

Adenocarcinoma↗