Abnormal distribution of CF delta F508 allele in azoospermic men with congenital aplasia of epididymis and vas deferens.
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Biomedical subjects
Publications and source records attributed to J Biserte.
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The authors report their experience of Argon laser in superficial bladder cancer (332 tumors in 106 patients). The advantages are: unneeded anesthesia, ambulatory treatment, absence of bleeding, no gaz, no obturator nerve stimulation, limited focal reaction and unlikely complications. The disadvantages are: duration of treatment, limited pathological material (with cold cup biopsy). The limitations are: size of the tumor (less than or equal to 1 cm) and a location in an area that can be reached perpendicularly. This kind of treatment does not seem to reduce the recurrence rate.
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CT scan imaging was used to explore 215 cases of bladder tumor (48 A-B1, 55 B2, 85 C, 27 D), and findings compared with those at operation and on histopathology of specimens after total cystectomy (141 cases), partial cystectomy (13 cases) or endoscopic resection (61 cases). The radiologic technique used was that of natural contrast, evaluating the negative contrast of intravesical urine in relation to the normal or pathologic bladder wall. Analysis of scan sections, assisted by a previous pathologic and radiologic study of 14 transverse sections of pelvis, allowed definition of a certain number of semiologic criteria corresponding to the various stages of the disease. Results showed global reliability to be relatively satisfactory for assessment of local and regional extension (85%): it was obviously a more effective investigation for tumors of low invasion (A-B1: 75%, B2: 81%) than for widely infiltrating tumors (C: 94%, D: 93%). Glandular extension was less reliably evaluated, however, since global efficacy was only 65%. Failures observed can be explained by the frequent small size of the metastatic glands, the poorness in cellular and fatty tissues and, particularly, by the fact that the scanner provides data of size of glands only and not on their internal architecture. The place of the scanner among other paraclinical methods of evaluating tumoral extension has still to be determined.
Ultrasound and computed tomography imaging techniques are very reliable methods of detection and diagnosis of renal angiomyolipoma not associated with the tuberous sclerosis of Bourneville's disease: results are considerably improved when compared with conventional investigations (IVU, arteriography). The series reported included 6 patients with large angiomyolipomas and 5 with lesions less than 2 cm in diameter discovered fortuitously on ultrasonography: all tumors were partially or totally hyperechogenic. The fatty tissue was detected in 9 of the 11 cases by computed tomography imaging.
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Pyelomanometry can be used in cases of ambiguous dilatation, to measure the pressure in the upper urinary tract during constant-flow perfusion through a percutaneous catheter (Whitaker's test). After recalling the principles of this method, and the technical procedure, the authors go on to discuss twenty six cases, analyzing the results, and comparing the advantages of this procedure with other methods of exploration.
Steroid therapy has been used as a treatment for idiopathic retroperitoneal fibrosis for the past ten years and more. In 14 out of a series of 19 patients, this treatment was well-tolerated and successful. It acts quickly. The results of medical treatment compare favorably with those of surgical ureterolysis. In the authors' view, steroid therapy is therefore the treatment of choice for this complaint, and surgical management should be confined to the relatively rare setbacks of medical treatment, and to patients who do not tolerate steroids.
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The use of anterograde pyelography to assess morphological changes revealed the presence of obstruction in the upper urinary tract, previously undetected by urography, in 61 patients studied. The technique, used almost exclusively to expose the pelvis over the last year, is described. Only in very rare cases was there a failure to puncture the renal pelvis, and no complications occurred. The relative indication of anterograde and retrograde pyelography are discussed, as well as the morphological data obtained by each method in different types of obstruction: complete, severe incomplete, and partial. The main indications for this procedure are reviewed as a function of the etiology.
The authors report 3 cases of haematic cysts of the adrenal, discovered in young adults (3 female), presenting with lumbar or lumbo-abdominal pain, sometimes violent, and accompanied by fever. In each cases there was a palpable swelling in the hypochondrium and lumbar fossa. In two cases severe anaemia reflected the amount of haemorrhage which had taken place. IVU with a prolonged vascular nephrotomography time with several views and echotomography confirmed the diagnosis, avoiding the need for aortography whenever possible. The size of the cysts was such that adrenalectomy was necessary in two cases and the extent of adhesions required simultaneous nephrectomy. This is followed by a review of the literature, the dominant features being: the prevalence of haematic cysts which account for 40% of adrenal cysts, the absence of specificity of clinical symptoms and signs and the importance of radiological examinations, and finally the usual absence of any cause even though trauma may sometimes be possible.
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Renal angiomyolipomas are benign mesenchymal tumours. Whether isolated or associated with phacomatosis, they are histologically identical, but it is often difficult to distinguish an isolated angiomyolipoma from renal cancer. When it is combined with phacomatosis, it is frequently bilateral and can provoke retroperitoneal haemorrhages. These peculiarities qualify the therapeutical management which would a priori be conservative in the case of a benign tumour.
The authors report 3 new cases of fibrous polyps of the posterior urethra, all implanted very high on the posterior surface of the posterior urethra either on the veru montanum (1 case) or immediately below the bladder neck. Histologically, the benign lesion consisted of a connective tissue axis, fibrous and vascular, surrounded by a transitional type epithelium. Dysuria, bloody urethrorrhagia, initial haematuria, bladder retention and infections were the presenting features of the lesion which can be diagnosed only by urethrographic films before endoscopy. The characteristic picture is a filling defect, sometimes cervico-urethral and sometimes purely urethral, within in the most typical cases the outline of the pedicle visible. The authors treated 3 cases by opening the bladder and drawing the polyp through the bladder neck, sectioning it and ensuring haemostasis of the base. Encouraged by these good results, the authors now prefer this method to endoscopic resection. This is followed by a review of the literature and an extensive bibliography.