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Biomedical subjects

L Boccon-Gibod

Publications and source records attributed to L Boccon-Gibod.

At least 199 records · Page 11Linked to original sources
PubMed1990

Immunohistochemical markers defined by monoclonal antibodies and response to bacillus Calmette-Guérin endovesical immunotherapy for superficial bladder tumors.

As bacillus Calmette-Guérin (BCG) immunotherapy is highly effective for most but not all superficial bladder tumors, there is a need to define predictors of response to this mode of treatment. We have investigated a panel of markers defined by monoclonal antibodies, directed against tumor-associated transitional cell carcinoma antigen (G4 and E7), epidermal growth factor receptor, cytokeratin (CK) 18 and blood group antigens A, B and H, using an indirect immunoperoxidase staining on paraffin sections. Twenty superficial bladder tumors (T1) treated with intravesical BCG therapy (10 responders and 10 nonresponders) were tested with this panel. Among the responders, expression of CK18 antigen was positive in 7 and negative in 3, whereas in the nonresponder group it was positive in 2 and negative in 8. The difference was statistically significant (p less than 0.05). Loss of expression of CK18 antigenicity was associated with recurrence or progression of superficial bladder tumors following BCG therapy, indicating that changes in CK patterns should be investigated as potential predictive markers for response to BCG.

Administration, Intravesical↗
PubMed1990

[A pharmacokinetic study of diffusion in adenomatous prostatic tissue of an intravenous bolus of cefamandole].

Twenty-three patients undergoing transurethral resection of the prostate for benign prostatic hypertrophy received antibiotic prophylaxis with a second generation cephalosporin, cefamandole, administered by a single IV bolus of 2.5 g. A pharmacokinetic study was performed on blood and resection chips collected at regular intervals. Cefamandole penetrates rapidly into the prostate without any saturation threshold. It diffuses less extensively and persists for a shorter period in elderly subjects, but penetrates to an identical degree regardless of the volume of the adenoma. The prostatic concentration was always higher than the minimal inhibitory concentration for the bacteria generally encountered, except for pseudomonas. The pharmacokinetic study of cefamandole therefore demonstrated that an IV bolus of 2.5 g is perfectly suitable for antibiotic prophylaxis prior to prostatic resection.

Absorption↗
PubMed1990

[The value of ultrasound-guided multiple systematic biopsies in the early diagnosis of cancer of the prostate].

Endorectal ultrasonography using a 7 mHZ probe was performed in 99 patients with a negative history for surgery of the prostate and either findings on rectal examination suggestive of cancer (T3 stage excluded) or a serum level of prostate-specific antigen of 2.5 mg/ml or more. A biopsy gun was used to harvest 1.5 centimetre long specimens. Ultrasound-guided biopsies were performed in peripheral hypoechogeneic areas; in addition, regardless of the result of the endorectal ultrasonography, routine multiple ultrasound-guided biopsies were performed in both lobes of the prostate (3 per lobe). Morbidity consisted in two cases of prostatitis (2%). Among the 99 patients, ultrasound guided biopsies found 16 carcinomas (16.1%), and routine multiple ultrasound-guided biopsies found 32 (32.3%) carcinomas. Four patients with normal results upon rectal examination and endorectal ultrasonography were found to have carcinoma of the prostate. These findings suggest that the morbidity of routine multiple ultrasound-guided biopsies is low; that routine multiple ultrasound-guided biopsies is more sensitive than ultrasound guided biopsies, with 16/99 (16%) additional carcinomas detected in this study and 56% of carcinomas among those patients with findings upon the rectal examination suggestive of malignant disease; and that routine multiple ultrasound-guided biopsies can allow the detection of carcinomas responsible for isolated elevation of prostate-specific antigen levels without anomalies of the rectal examination or endorectal ultrasonography (8% of the carcinomas in this study).

Antigens, Neoplasm↗
PubMed1990

[Nail-patella syndrome without extra-renal lesions. A new hereditary glomerular nephropathy].

We observed an unusual glomerular disease in eight pediatric patients. Clinical features of this early, progressive renal disease included increased blood pressure in many cases, extrarenal hematologic and pulmonary symptoms, and, in one of our patients and two genetically related children, hemolytic uremic syndrome with thrombotic microangiopathy resulting in permanent renal failure. Histologic studies showed major and complex modifications of glomerular capillary walls and electron microscopy disclosed numerous bundles of fibrillar collagen within the extracellular glomerular matrix. Clinical and genetic investigations out-ruled hereditary osteo-onychodysplasia, a condition in which fibrillar collagen is found within glomerular basement membranes. In addition results of family studies were consistent with autosomal recessive transmission of this new entity.

Adolescent↗
PubMed1990

[Ambulatory urologic surgery].

Since November 1st, 1988, an outpatient clinic has been set up in our department of Urology. Patients come to the clinic on the morning of the procedure and leave in the evening after a few hours of monitoring. Eligibility for outpatient surgery is determined using strict social, surgical and medical criteria. A visit with the anesthesiologist is scheduled one week before the operation. On the day of the procedure, the patient arrives at 7 a.m., is shaved, prepared and operated on by a senior surgeon before impatient operations begin. Postoperative monitoring is carried out as usual and around 6 p.m. the surgeon and the anesthesiologist decide whether the patient can be discharged. Most patients are interviewed by telephone within one week of the procedure. From November 1988 through December 1989, 172 adults were admitted to the outpatient clinic for endoscopic surgery (85 cases), open surgery (42 cases) or other procedures including diagnostic investigations, instillations, and removal or replacement of stents (44 cases). Twenty-three patients were discharged only on the day following the procedure. One patient was readmitted for clotting in the bladder. These preliminary results show that, as compared to inpatient surgery, outpatient surgery is cost-saving, easier to cope with psychologically and less apt to be followed by nosocomial infection, without greater risk to the patient provided inclusion criteria are stringently applied.

Adolescent↗
PubMed1990

Cutaneous acquired immunodeficiency syndrome-associated Kaposi's sarcoma in pediatric patients.

Kaposi's sarcoma has only rarely been reported in children with acquired immunodeficiency syndrome. In contrast to adult patients, in whom the disease is predominantly cutaneous, among pediatric patients with acquired immunodeficiency syndrome, Kaposi's sarcoma is primarily limited to the lymphadenopathic form. We describe two children with the acquired immunodeficiency syndrome who developed diffuse nodular skin lesions of Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Infectious manifestations of AIDS in the urogenital tract].

Urogenital manifestations of AIDS appear today with an increasing incidence. Among 43 seropositive patients, seen in our department between 1985 and 1989, 19 were treated for an infection: 11 cases of epididymitis, 6 cases of prostatitis, 1 renal abscess, 1 case of extensive condylomata of the urethra. The clinical signs and follow up of these infections were straightforward in half of the cases. However, in some patients, the infection was fulminant with progression to an abscess despite the use of antibiotics or were unusual because of the pathogens isolated. Any urologist is likely to encounter cases of genitourinary complications of AIDS and should develop general measures of protection of the surgical team.

Abscess↗
PubMed1989

Tobacco and bladder cancer in males: increased risk for inhalers and smokers of black tobacco.

Relationships between risk of bladder cancer and tobacco smoking were assessed from a hospital-based case-control study conducted in France from 1984 to 1987. Smoking history was analyzed for 954 male patients (477 cases and 477 controls). The odds ratio (OR) of bladder cancer was estimated at 3.95 for all smokers vs. non-smokers. The risk increased with duration of smoking and with average daily cigarette consumption, but there was a significant interaction between these 2 parameters, since the risk only increased with average daily consumption when the duration exceeded 20 years. Black tobacco consumption and inhaling were both found to double the risk when analyzed separately, but their respective effects appeared to interact, and an elevated risk for smokers of black tobacco was only observed among inhalers. Smokers of black and blond tobacco also differed in the way in which the risk evolved with time after cessation of smoking. The OR decreased faster after cessation of smoking among smokers of black tobacco than among smokers of blond tobacco, but the residual risk was higher 15 years after cessation among the former than among the latter.

Adult↗
PubMed1989

Correlation of MDR1 gene expression with chemotherapy in neuroblastoma.

Forty-one neuroblastoma tumor specimens have been analyzed by Northern and slot blot hybridization techniques with human MDR1 gene probes. Only one of 15 (6%) tumors from patients who had not received chemotherapy exhibited high levels of MDR1 transcripts, while 11 of 26 (42%) treated tumors showed high levels of MDR1 expression (Fisher exact test: P = .03). The results indicate that the level of MDR1 mRNA expression is associated with previous chemotherapy, including drugs that select the multidrug resistance phenotype in vitro regardless of neuroblastoma tissue origin or N-myc content in the genome. For the 26 treated neuroblastomas, the number of nonresponsive tumors was found to be significantly higher among those with high levels of MDR1 mRNA.

Adrenal Gland Neoplasms↗
PubMed1989

Pelvic cancers: staging of 139 cases with lymphography and fine-needle aspiration biopsy.

One hundred thirty-nine patients with pelvic cancers (101 bladder carcinomas, 27 prostatic carcinomas, and 11 testicular tumors) considered for radical surgery were studied with lymphography and percutaneous fine-needle aspiration (FNA) biopsy, and the results were correlated with lymphadenectomy. Adequate material for FNA was obtained in 97%, 88%, and 100% of the bladder, prostatic, and testicular tumors, respectively. For bladder carcinoma, the global accuracy was 58% for lymphography and 93% for FNA; the high false-negative rate for lymphography (48%) was lowered to 25% with FNA, providing that the obturator nodes were punctured. For prostatic carcinomas, it was not possible to evaluate the true-positive rate because the patients with positive FNA results did not under-go surgery. For testicular tumors, lymphography and FNA had almost the same global accuracy (73% and 75%), but FNA had a better specificity (100%) than lymphography (86%). FNA had no false-positive results, which means that positive biopsy results obviate radical surgery; when FNA results are negative a lymphadenectomy should be performed. With its mild morbidity, FNA has a role in the preoperative staging of pelvic carcinomas.

Aged↗
PubMed1989

Systemic bacillus Calmette-Guérin infection, 'BCGitis', in patients treated by intravesical bacillus Calmette-Guérin therapy for bladder cancer.

Among 169 patients treated for supeficial bladder tumor with 150 mg Pasteur-strain bacillus Calmette-Guérin (BCG) intravesical instillation, 5 cases of 'BCGitis' were observed, i.e. a severe systemic BCG infection with bronchopulmonary lesions and granulomatous hepatitis. In 4 cases, the complications appeared at the early stage of treatment (after the 3rd, 6th, 6th and 8th instillations, respectively). In 1 case, treated with monthly maintenance therapy for 2 years, BCGitis appeared 6 months after treatment had been completed and, in addition to pulmonary basal infiltrate and granulomatous hepatitis, intramedullary granulomatosis was observed. In 3 patients, trauma must be taken into consideration as BCGitis appeared after traumatic instillation with bleeding. All patients were cured by treatment with rifampicin, isoniazid and prednisone.

Administration, Intravesical↗
PubMed1989

Bladder tumors invading the lamina propria (stage A/T1): influence of endovesical bacillus Calmette-Guérin therapy on recurrence and progression.

47 patients with transitional cell bladder carcinoma invading the lamina propria (stage A/T1) were treated from 1984 to 1986 by complete transurethral resection followed by 1-3 cycles of endovesical bacillus Calmette-Guérin instillations, and followed 14-64 months by cytology, endoscopy and bladder biopsies, 64% achieved a complete response, 36% recurred (recurrence rate/100 months/patient 2.2), 21% progressed to muscle invasion. Duration of treatment, tumor size or type (solid vs. papillary), presence of carcinoma in situ bore no relation to the final result. The preceding history of T1 bladder tumor appeared associated with a higher risk of progression although not reaching statistical significance. The results were compared to those obtained by transurethral resection in a similar group of 50 patients treated from 1982 to 1984 and followed up 12-100 months, 90% recurred and 34% progressed to muscle invasion with a recurrence rate/100 months/patient of 9.22. Keeping in mind the limits of a nonrandomized historical comparison, it appears that endovesical bacillus Calmette-Guérin therapy alters favorably the recurrence pattern of T1 bladder cancer.

Adult↗