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Biomedical subjects

J Biserte

Publications and source records attributed to J Biserte.

At least 19 recordsLinked to original sources
PubMed2006

[Trauma to the anterior urethra: diagnosis and management].

Injuries to anterior urethra are uncommon, mainly due to blunt trauma, and rarely associated with pelvic fractures or life threatening multiple lesions. Straddle type injury is the most frequent lesion, in which the immobile bulbar urethra is crushed or compressed on the inferior surface to the pubic symphysis. Diagnosis of urethral injury is easy, suspected due to trauma circumstances, presence of urethrorragy or initial hematuria, and eventually difficult micturition and penile scrotal for perineoscrotal hematoma. It should always be confirmed and classified by retrograde urethro-gram, realized either immediately or after a few days. Initial acute management is suprapubic cystostomy, if possible before any attempt of urethral catheterization or miction. Urethral contusions only require this urinary diversion or urethral catheter for a few days and usually heal without any sequelae. Management of partial and complete disruptions remains controversial: suprapubic diversion only and secondary endoscopic or open surgical repair of the urethral stricture that occurs in the great majority of the cases (always after complete disruption), early endoscopic realignment and prolonged urethral catheterization (4 for 8 weeks according to the lesion), in partial disruptions, more controversial in complete disruptions; delayed (after a few days) open surgical repair (urethrorraphy) that is the preferred European and French attitude for complete disruptions. Penetrating anterior urethral trauma and urethral lesions associated with penile fracture require immediate surgical exploration and repair if possible. After anterior urethral disruption, the main morbidity is urethral stricture very often requiring surgical treatment (visual urethrotomy if the structure is short, end to end spatulated urethrorraphy, flap or graft urethroplasty if longer).

Humans↗
PubMed2005

[Imaging in the management of urinary tract infections].

This review analyzes the role of imaging in the diagnosis, follow-up and management of urinary tract infections. Uncomplicated infection of the urinary tract is frequent and usually resolves rapidly with treatment; in such cases imaging is unnecessary except to exclude dilatation or the existence of an obstacle. Progression towards complex infection often occurs in patients with predisposing factors. Imaging helps in evaluating the extent of the disease; it has a role in the selection of therapy and interventional procedures.

Chronic Disease↗
PubMed2004

[Tissue engineering in urology].

Tissue engineering refers to the techniques that are aimed at regeneration of human tissues and organs. Two elements are necessary for these techniques: matrix and cells. Matrix is the scaffold where tissues may organise. Cells are either autologous cells stimulated to regenerate in vivo, aided by implantation of matrix ("guided tissue regeneration"), or autologous cells cultured outside the body (in vitro) and later returned as auto-transplants. All types of conventional tissue reconstructive surgery need tissue engineering. These techniques have been introduced recently into the clinical practice. One of the main limitations of reconstructive surgery in genitourinary tract is the lack of autologous tissue. Two autotransplants could be distinguished: coherent tissue structure or cell suspensions. The great number of studies published in this area emphasizes the importance of the future clinical implication in urology.

Animals↗
PubMed2004

[Imaging in urinary tract infections in adults].

Uncomplicated infection of the urinary tract is frequent and usually resolves rapidly with treatment and imaging is unnecessary. Progression to complex infection often occurs in patients with predisposing factors. Imaging assists in evaluating the extent of disease, plays a role in directing therapy and guides interventional procedures if necessary. This pictorial essay reviews the role of imaging and intervention in infections of the urinary tract.

Abscess↗
PubMed2003

The inferior hypogastric plexus (pelvic plexus): its importance in neural preservation techniques.

The progress in the surgery of male neurological cancers relies on the anatomico-surgical approach to the pelvic neural structures. The objective of our study was to provide a better understanding of the inferior hypogastric plexus (IHP) and its anatomical relationships in order to spare it during radical prostatectomy. Fifteen male formalin-preserved cadavers which had no sub-umbilical scar were used. In five subjects, the superior hypogastric plexus (SHP) and the pre-sacral plexus were displayed then the IHP and its sacral afferents (pelvic splanchnic nerves or erector nerves of Eckhardt) were dissected out. Serial sections of the IHP were then studied in ten subjects. This allowed its identification on certain imaging sections obtained in pelvic tumor pathology and these made up the "reference cuts". The IHP lies within a fibro-fatty plate which is flat, rectangular, sub-peritoneal, sagittal and symmetrical. It arises at the level of the intersection between the vas deferens and the terminal pelvic ureter and follows the postero-lateral aspect and circumvolutions of the seminal vesicle, with which there is a plane of surgical cleavage. The seminal vesicle is, therefore, an essential landmark for this neural structure. The plane of this cleavage may be used in pelvic cancer surgery. The safest technical means of respecting sexual function and the integrity of the IHP is to keep it at a distance. The preservation of a lateral layer of the seminal vesicle is probably a method of limiting these complications as long as this does not conflict with the oncological clearance. An irregular communicating branch was found in one of five cases between the IHP, the sacral plexus and the pudendal nerve. This communicating branch lay immediately behind the intersection between the vas deferens and the ureter in the sacral concavity. It overhangs the IHP in the seminal vesicle. Impotence remains a frequent complication after radical prostatectomy. The methods of neural preservation at the prostatic apex are known but neural preservation should also be carried out posteriorly at the lateral pole of the seminal vesicle. The possibility of posterior neural preservation may be assessed pre-operatively by study of the "reference sections". The cleavage plane between the seminal vesicle and the IHP may be used intra-operatively to spare the IHP. The cavernous nerve in particular emerges at the antero-inferior border of the IHP before running along the postero-lateral aspect of the prostate. It therefore passes in contact with the seminal vesicle and may as a result be injured during radical prostatectomy with vesiculectomy. A proximal communicating branch between the IHP and the pudendal nerve is irregular. Such communicating branches may explain a better recovery of sexual function in curative neurological cancer surgery. The essential relationship of the IHP is with the seminal vesicle. The two are in tight contact and the seminal vesicle has a true plane of surgical cleavage with IHP. The risk of injuries to the posterior erectile mechanisms can be reduced either by using the cleavage plane between the IHP and seminal vesicle or by leaving a layer of the seminal vesicle when the oncological conditions allow. During celio-surgery, the operator must be careful to retract the little bands of the seminal vesicle and divide the fibrous and vascular tracts which tighten during this maneuver. During an abdominal approach, dissection of the seminal vesicle takes place at the bottom of a real pit. The operator must carry out the division leaving a layer of the seminal vesicle in place rather than trying to extract all the seminal vesicle by placing the forceps blindly. This maneuver is naturally dependent on the oncological situation. The anatomical confirmation of a regular or irregular proximal or distal communicating branch between the IHP and the pudendal nerve is probably an explanation for the sometimes uncertain results of new techniques of neural preservation in curative cancer surgery.

Aged↗
PubMed2002

[Urethral duplication type II in a male child: a case report].

Urethral duplication is a rare congenital anomaly, most common in male. The clinical presentation varies because of the various anatomical variant. A case of complete duplication with an accessory channel arising from a diverticulum, in a male child is reported. The clinical presentation, the imaging findings, and the management are described.

Child, Preschool↗
PubMed2001

Immunohistochemical detection of Fas and Fas ligand in sarcomatoid renal cell carcinoma.

Sarcomatoid renal cell carcinomas (SRC) are rare neoplasms associated with a very poor prognosis. The aim of this study was to evaluate biomarker expression and clinical significance in this uncommon renal cancer. Cytokeratin, epithelial membrane antigen, vimentin, desmin, smooth muscle actin, CD34, S-100 protein, MIB 1, p53, Fas and Fas ligand immunohistochemical expression was investigated in seven renal cell carcinomas with sarcomatoid changes. No significant difference between sarcomatoid and nonsarcomatoid areas was observed with the different biomarkers, excepted for Fas ligand. Fas expression was diffuse in sarcomatoid and nonsarcomatoid areas. However, Fas ligand had a higher expression in sarcomatoid in comparison to nonsarcomatoid areas. Our results showed that Fas and Fas ligand are both expressed in renal cancer. We suggest that the aggressive behavior of sarcomatoid carcinoma may be related to a higher expression of Fas ligand by tumor sarcomatoid cells. These findings may indicate that Fas ligand is a possible therapeutic molecular target for treatment of SRC.

Aged↗
PubMed2001

High-flow priapism in children: immediate treatment by selective embolization.

We present a case of a high-flow priapism related to a posttraumatic aneurysm in a ten-year-old boy treated by selective embolization. Patient history and thorough physical examination often lead to the diagnosis of high-flow priapism. Colour-coded duplex ultrasonography confirms the diagnosis, and treatment consists of angiographic embolization.

Child↗
PubMed2001

[Diagnostic methods for obstruction of the upper urinary tract: which tests are available in 2001].

The presence of upper urinary tract obstruction, its site and its nature can be determined and the most appropriate treatment can be defined in the majority of clinical cases. However, in some circumstances, non-invasive or minimally invasive methods, such as ultrasonography, intravenous urography, urography with diuretic test, conventional and diuretic nephrography and MR urography, are unable to confirm the presence of obstruction, requiring assessment of the upper urinary tract by antegrade pyelomanometry. This investigation measures the pressure in the upper urinary tract perfused at a constant rate by a percutaneous catheter and allows evaluation of the obstruction. The authors discuss the place of the various upper urinary tract investigations to confirm the definitive diagnosis of upper urinary tract obstruction.

Humans↗
PubMed2001

[Klippel-Trenaunay syndrome and multiple vesical hemangiomas: treatment with Neodymium:YAG laser].

The authors report the case of a patient presenting with bladder haemangiomas in the context of Klippel-Trenaunay syndrome treated by Neodymium:YAG laser. Klippel-Trenaunay syndrome consists of a combination of hypertrophy of a limb, cutaneous angiomas and varicose veins. Bladder haemangioma is a benign congenital vascular tumour associated with Klippel-Trenaunay syndrome in 3 to 6% of cases, especially affecting children and young adults. Its most frequent clinical manifestation is haematuria. The diagnosis is based on endoscopy. Endoscopic treatment by Neodymium:YAG (Nd:YAG) laser photocoagulation appears to be a satisfactory treatment option.

Adult↗
PubMed2000

Percutaneous nephrostomy: placement under laser guidance and real-time CT fluoroscopy.

The purpose of this paper is to present our experience with real-time computed tomography (CT) fluoroscopy guided percutaneous nephrostomy (PNT) and to describe this technique involving puncture under laser guidance. We attempted 30 placements in 25 patients: puncture was directed by laser guidance and placement of the tube was made under real time CT fluoroscopy. 25 procedures were performed in prone position and 5 procedures in the supine position. The time necessary for the procedure ranged from 10 to 45 min (mean 25 min). The average duration of CT fluoroscopy per placement was 49 seconds (range 7-110 s). The PNT placement was successful as a sole procedure including puncture and catheter placement in 24 of 30 cases; in the remainder of cases, puncture was performed under CT guidance but the catheter was definitively positioned in conventional fluoroscopy. The CT fluoroscopy technique allows routine, efficient and safe PNT placement, especially when encountering difficult access to the pelvicaliceal system.

Female↗
PubMed2000

[Therapeutic management of epidermoid carcinoma of the penis: anatomoclinical discussion and review of the literature].

The therapeutic management of penile tumours is determined by the degree of local extension of the tumour, and the presence of lymph node involvement and visceral metastases. Many published studies have tried to define the best treatment options as a function of tumour grade and stage. However, in daily practice, the treatment of penile tumours still remains highly controversial. After reviewing the literature, the authors discuss the various treatment options available to urologists as a function of tumour stage and recall the management difficulties related to lymph node staging.

Carcinoma, Squamous Cell↗
PubMed2000

[Rupture of the patellar ligament one month after treatment with fluoroquinolone].

Musculoskeletal disorders including arthralgia and myalgia are adverse effect common to all fluoroquinolones. We report a case of spontaneous rupture of the patellar ligament in a 37-year-old man participating in leisure sports which occurred one month after a three-week course of Ciprofloxacine(R). Several cases of tendon ruptures have been reported in the literature, including the patellar tendon. Unusual features in our case were the one-month delay before tendon rupture and the absence of inaugural signs. We reviewed the pathophysiological mechanisms leading to fluoroquinolone-related tendon rupture as well as the risk factors and discussed proper management. Care must be taken when prescribing fluoroquinolones for patients at risk. Close follow-up is most important.

Adult↗
PubMed2000

[Prostatic malacoplakia: report of 3 cases].

Malakoplakia is a granulomatous inflammatory disorder occurring rarely in the prostate. We report our experience with three patients aged from 54 to 75 years old. Clinical presentations were unspecific. All patients presented with a past history of urinary tract infection. Ultrasound study revealed hypoechoic peripheral zone lesions. Histological examination showed a diffuse granulomatous inflammation with numerous histiocytes containing Michaelis-Gutmann bodies. In the prostate, malakoplakia is a histological variant of granulomatous chronic prostatitis following urinary infections. Clinically and radiologically, the differential diagnosis with adenocarcinoma is difficult. The symptoms disappear with a prolongated antibiotic treatment.

Aged↗
PubMed2000

[Urothelial tumor and colonic cancer in the context of a syndrome of hereditary predisposition to HNPCC colonic cancer].

The authors report the association of ureteric tumour and colon carcinomas in the context of hereditary predisposition to HNPCC colon cancer (hereditary non polyposis colon cancer). The recall the diagnostic criteria of HNPCC syndrome and emphasize the importance of guiding the clinical interview of patients with upper urinary tract tumours in order to detect a family history and the presence of gastrointestinal tumours.

Colonic Polyps↗