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B Lobel

Publications and source records attributed to B Lobel.

At least 19 recordsLinked to original sources
PubMed1992

[The diagnostic value of erythrocyte polyamines (EPA) in prostatic adenocarcinoma (PA): apropos of 100 patients].

Spermidine and spermine are ubiquitous polyamines which are intensely metabolised in the prostate. Polyamines are involved in the processes of proliferation and differentiation of normal and neoplastic cells. As the erythrocyte levels of these polyamines are correlated with the intratumoral levels, we assayed EPA in 45 controls, 66 patients with benign prostatic hypertrophy and 100 patients with prostatic cancer. Erythrocytic polyamines are markers of proliferation and prostatic metastases and can be used to distinguish between hormone-sensitive and hormone-resistant patients. Although non-specific, polyamines constitute circulating markers of the state of tumour proliferation of a given patient and definitely have a prognostic value which needs to be evaluated by further studies.

Adenocarcinoma↗
PubMed1992

[The Bourne's test: a relevant contribution to the diagnosis of vesico-enteric fistulas].

Diagnostic verification of vesicoenteric fistulae is necessary in order to establish the indication for surgical therapy, but this is frequently difficult. This is because uroradiological and endoscopic methods are unreliable and the symptoms are often nonspecific. The Bourne test is a simple noninvasive screening method. If necessary, it can be supplemented by computer tomography. The problems are discussed with reference to a case report.

Adult↗
PubMed1991

[Extracorporeal lithotripsy, endocorporeal lithotripsy].

In the 1990's urologists are well equipped to treat urinary stones, using extracorporeal or intracorporeal lithotripsy, conventional surgery, ultrasounds, hydroelectric shocks, or lasers. Extracorporeal shock wave lithotripsy has revolutionized the treatment of urinary lithiasis and gradually invades all the fields of this disease. 75% of patients with calculi draw benefit from this method. However, lithotripsy cannot solve all problems, such as large stones (more than 30 mm in diameter) or ureteral stones that are impacted or difficult to locate. For this reason, intracorporeal lithotripsy and surgery remain indicated for specific cases in 20 and 6% of the patients, respectively.

Contraindications↗
PubMed1991

Preparation of spermatogenic cell populations at specific stages of differentiation in the human.

Studying biochemical events in human spermatogenesis requires separated populations of spermatogenic cells. Dissociation of these cells was performed by a Trypsin-DNAse method adapted from the technique used for rodents. Cell separation was performed by centrifugal elutriation. Seven populations were collected, one further purified by Percoll gradient centrifugation, giving nine different cell populations. The efficiency of the cell separation was evaluated by phase contrast microscopy, flow cytometric DNA analysis, and electron microscopy. Five populations were enriched in spermatids: two in round spermatids (87% and 73%), another in round (52%) and elongating (44%) spermatids, another constituted by 80% elongating spermatids, and the last by 90% elongated spermatids. Two of the four remaining populations were enriched in primary spermatocytes (74% and 54%); another population was the upper part of the Percoll gradient and constituted cytoplasmic lobes and residual bodies (89%); the last population was made up of various cells, with no specific enrichment. Electron microscopic observations revealed good preservation of the separated cells; only the flagella from elongated spermatids were lost. Furthermore, an unusual pattern of nucleoplasm distribution during stages 2-4 of spermatid differentiation was observed and its signification is discussed with regard to the shape of the human spermatozoon.

Aged↗
PubMed1991

The growth of MAT-LyLu rat prostatic adenocarcinoma can be prevented in vivo by polyamine deprivation.

The combination of inhibitors of ornithine decarboxylase and polyamine oxidase, and of antibiotics suitable for the (partial) decontamination of the gastrointestinal tract, with a polyamine deficient diet, is responsible for the almost complete inhibition of the growth of MAT-LyLu prostatic adenocarcinoma. In the tumor-bearing animals, erythrocyte spermidine levels were reduced, but spermine concentrations were increased. As has been previously observed, the increase in erythrocyte spermine level was associated with an enhancement of malignant cell death. Adriamycin administration did neither diminish tumor growth, nor potentiate the antitumor effect of polyamine deprivation treatment. Interruption of the polyamine deprivation treatment was accompanied by a significant enhancement of tumor growth. Since polyamine deprivation causes only reversible growth inhibition, it seems not appropriate as a monotherapy.

Adenocarcinoma↗
PubMed1991

Early endoscopic realignment of complete traumatic rupture of the posterior urethra.

Early primary endoscopic realignment of complete traumatic rupture of the posterior urethra is a simple, rapid and non-traumatic technique. We have recently treated 5 patients in this manner. All are continent and 4 are potent. Four patients were followed up for 1 year. One patient required no further management and had excellent urinary flow rates. The other 3 developed short secondary strictures which were managed successfully by 1 or 2 internal urethrotomies.

Adult↗
PubMed1991

[Radical prostatectomy and biologic glue].

Fibrin glue (reconstituted fibrin glue-Tissu-col-Immuno-France) was used in 24 patients following radical prostatectomy with ilio-obturator lymphadenectomy (Group II) to improve haemostasis of the operative field, to decrease or eliminate lymphatic oozing and to promote healing of the urethrovesical anastomosis. The results in terms of duration of drainage, quantity of fluid evacuated by these drains, operative complications and length of hospital stay were compared to those obtained in 24 clinically identical patients operated previously without the use of fibrin glue (Group I). Although fibrin glue is easy to use, ensures a particularly dry operative field at the end of the operation and does not induce any infectious complications (abscess, hepatitis), it increases the cost of the operation (5 ml vial = 2,500 FF) and the use of this product does not reduce the drainage time (Group I: 7 +/- 4.6 days; Group II: 8.5 +/- 5.4 days) the volume of blood or lymphatic discharge (Group I: 500 +/- 570 ml; Group II: 660 +/- 825 ml) or the length of hospital stay (Group I: 16.5 +/- 4.8 days; Group II: 17.4 +/- 5.5 days). These results argue against the routine use of fibrin glue in radical prostatectomy.

Aged↗
PubMed1991

[Bladder replacement and continent diversion: what about metabolic complications?].

During the past several years there has been increasing interest in refunctionalizing patients who have undergone radical extirpative surgery for pelvic malignancies and patients with dysfunctional bladders. To accomplish this, intestinal segments have been successfully employed in a variety of configurations. Independent of their optimal urosurgical implementation these procedures are not without potential complications, a significant portion of which involve metabolic derangements. Besides first follow-up results of patients with bladder substitution or continent urinary diversion, analysis of experimental investigations and functionally comparable clinical conditions enables an insight into potential following physiopathological interrelationships. These concern, besides the problem of chronic metabolic acidosis, disorders of bile acid and vitamin B12 metabolism as well as the potential induction of a secondary hyperoxaluria with subsequent oxalate concrement diathesis. Furthermore, there may be a malabsorption of calcium and vitamin D with development of intestinal osteopathy due to the reduction of absorptive surface. Apart from these problems of enteral loss and deficiency manifestations, several case reports and investigations suggest that bone demineralization can occur as a consequence of chronic metabolic acidosis and patients are at risk of skeletal demineralization. The pathogenesis of this association has yet to be clarified. These physiopathological interrelationships must be considered in medical attendance of patients with intestinal substitute bladders and continent supravesical pouch systems over many years. As these procedures become more popular, it becomes important to identify any metabolic changes that may occur as their consequence.

Animals↗
PubMed1991

[Male contraception].

Explore the source record for details and available documents.

Contraceptive Agents, Male↗
PubMed1991

[Intestinal motility and its variations in replacement bladder and intestine].

Urinary reservoirs replacing the bladder are made of intestine. The digestive tract motor activity is regulated by hormonal and neurologic mechanisms. The purpose of this work is the comparison of the motor activity in intact bowel with that of the new urinary reservoir during and after an oral intake. The modifications of pre- and post-prandial motor activities are recorded simultaneously in duodenum and neobladder by 4 patients with a tubular entero-cystoplasty (Camey I); standard meal (570 Kcal) triggers a similar activity in both segments. The modifications induced by an oral intake are then recorded by 14 patients with various reservoirs (ileum, ileum-cecum, cecum) and with different shapes (tubular or non-tubular). The compliance of non-tubular colic or ileocolic reservoirs appears greater than that of ileal reservoirs, even after detubularization. After oral intake, basal pressure and motor activity increase clearly in ileal bladders and much less in colic or ileocolic bladders. Nocturnal leak observed in many urinary reservoirs may be linked to the persistence of an intense motor activity in the neobladder with a marked increasing during the second part of the night.

Circadian Rhythm↗
PubMed1990

[Substitute bladders].

Following prostato-cystectomy in men or total cystectomy in women the bladder can be replaced by constructing an intestinal pouch to be connected to the urethra. This bladder replacement reservoir should possess the specific qualities of the natural bladder: it should collect and retain the urine at low pressure, protect the upper urinary tract against reflux and distension, control voluntary micturition at a socially acceptable rhythm and avoid the metabolic disorders due to the reabsorption of urine by the intestinal mucosa. Low pressure reservoirs are the ones most commonly used. They are obtained by opening the ileal or ileocaecal graft along its antimesenteric border and rearranging the intestinal tissue to form a pouch connected to the urethra. Detubulated reservoirs have a capacity and a compliance that are close to those of the urinary bladder. Daytime continence is acquired in the immediate postoperative period, and night-time continence is possible in 60 to 70 per cent of the patients. These are the main advantages of bladder replacement by tubular small intestine. The reservoirs thus constructed have few contractions, but they have not yet proved to be capable of full evacuation in the long term. Intermittent bladder catheterization might well be the price to be paid in the future for an immediate improvement in night-time continence.

Cystectomy↗
PubMed1990

[Nosocomial urinary tract infection].

Care for asepsis and the use of a closed drainage system reduce the risk of urinary tract infection with indwelling catheter. Beyond a few days, infection will still end to occur, earlier in female and diabetic patients. Local or systemic antimicrobials have neither prophylactic nor even therapeutic actual usefulness, as long as infection remain asymptomatic, which is by far the most frequent situation. Thus, repeated cultures of urine samples are needless. Treatment should be applied to symptomatic infection. The risk for infection is lower in case of intermittent catheterization, with the use of a penilex or a percutaneous bladder catheter. Some instrumental procedures of surgical techniques require short-term antimicrobial prophylaxis: prostatic endoscopic resection, transperineal or transrectal prostatic biopsy, percutaneous nephrolithotomy, prostatectomy, cystectomy, prostheses implantation.

Anti-Bacterial Agents↗
PubMed1990

Erythrocyte polyamine levels in human prostatic carcinoma.

Abnormally high red blood cell polyamine levels were found in benign prostatic hyperplasia and in prostatic adenocarcinoma patients. In prostatic adenocarcinoma patients a relationship was noted between the importance of red blood cell spermidine and spermine concentrations, and the clinical stage of the disease (Whitmore classification). Considering prostatic adenocarcinoma patient populations, patients with metastases (groups 3 and 4) statistically differed from those without metastases (group 2). Furthermore, red blood cell polyamine level determination discriminated patients in the hormonal escape group (group 4) from those usually considered as hormone responsive (groups 2 and 3). No statistically significant correlation was observed between red blood cell polyamine levels and usual tumor markers (prostatic acid phosphatase and prostate specific antigen). These results confirmed that red blood cell polyamine levels must be considered as a circulating index of cell proliferation that might be of clinical importance during the long-term followup and treatment of prostatic adenocarcinoma patients.

Adenocarcinoma↗
PubMed1989

[Microscopic hematuria. Semiologic value in urology. Management of microscopic hematuria].

Microscopic hematuria, a frequent cause for consultation, poses a problem regarding its significance. It is essential that a curable pathology is not neglected. In the absence of associated clinical data, nephrological orientation of investigations depends on the study of urinary sediments and phase contrast microscopy. Where there is a urological orientation, half the lesions involve the lower urinary tract; the use of flexible urethrocystoscopy has been a true advance in terms of its simplicity and reliability. When a lesion is demonstrated the question still remains as to whether it is in fact responsible for the microscopic hematuria. It is best to remain prudent when a poorly significant lesion is discovered. Since 20% of microscopic hematurias remain unexplained, how far should one go in the paraclinical investigation and follow up of involved patients?

Adult↗
PubMed1989

Contraception in men: efficacy and immediate toxicity. A study of 18 cases.

Ten years ago research into a reversible method of male contraception proved unsuccessful, not for any objective reasons but because volunteers failed to comply with treatment. A change in social attitudes towards contraception, a constant demand for a reversible method of male contraception and the current interest in protecting germinal cell lines by blockage of spermatogenesis during chemotherapy led the authors to reactivate the study. Eighteen volunteers received a synthetic progestogen (Norluten) and a percutaneous testosterone gel. Clinical, biological, hormonal and seminal tests were performed each month. One patient, however, had to withdraw from the trial on medical grounds (hyperlipidaemia). Ten patients achieved azoospermia which is the only guarantee of efficacy. Immediate tolerance was good but protocol compliance was poor since 8 of the 17 volunteers abandoned the trial within a year. Treatment reversibility was evaluated in 15 patients whose F.S.H. level and spermatogenesis returned to normal when contraception was ended. This additional study demonstrates that hormone contraception in males is effective and well-tolerated, but the protocol placed too great a demand on the patients and 50% withdrew from the trial within a year.

Administration, Cutaneous↗
PubMed1989

Hypofertility in males due to a secretion anomaly of the seminal vesicles and its treatment.

Between 1981 and 1986, 5,000 males with infertility were treated. Eight (0.16%) of them had hypospermia, a decrease in seminal fructose, asthenospermia without oligospermia considered as a secretion anomaly of the seminal vesicles. Artificial Insemination with the Husband's sperm (AIH) combined with vesiculo-prostatic plasma from a vasectomized donor was performed successfully in 3 couples. In this series, failures were associated with an important fertility factor in the female. AIH combined with vesiculo-prostatic plasma from a vasectomized donor is considered as an effective treatment of male hypofertility caused by vesicular dysfunction.

Female↗
PubMed1987

[Palliative urinary diversion in inoperable pelvic tumors].

The problem raised is that of the legitimacy of palliative urinary derivation in the malignant tumours of the pelvis beyond any therapeutic possibility. Between 1980 and 1985, 49 patients were referred to the department of Urology of Rennes for cutaneous ureterostomy type. 39 records were suitable for review. Bilateral ureteric obstruction in the course of carcinomas of the pelvis, regardless of the origin, is uncommon bearing in mind the prevalence of such pathology and notably in women. Recent techniques (J catheter, per-cutaneous nephrostomy) have simplified the surgical procedure of urinary bypass. They do not fundamentally change the incisions and are not always applicable. Use of the J catheter may be prevented by the impossibility of intubating the ureter or when the bladder is unusable as a reservoir, whilst the use of percutaneous nephrostomy is hazardous or possibly even insufficient to dry the perineum when there is a malignant vesicovaginal fistula. This study involved evaluation of 39 patients who underwent uni or bilateral terminal cutaneous ureterostomy, any other technique having proved to be undesirable. The mean survival of the patients was 225 days and its quality as good or satisfactory in only 25% of cases. The implantation of epidural morphine reservoirs may improve the quality of survival of these patients by suppressing pain which up to now has been an absolute contraindication to an upper cutaneous derivation procedure.

Aged↗