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Biomedical subjects

L Boccon-Gibod

Publications and source records attributed to L Boccon-Gibod.

At least 235 records · Page 13Linked to original sources
PubMed1988

[Solid tumors in the child. New advances and the importance of histological sub-classifications. II. Tumors of the peripheral nervous system, soft tissue, liver and pancreas].

According to immunohistochemical, ultrastructural features of neural cells, and identical 11; 22 chromosome translocation, at least some extra osseous Ewing's sarcoma, as well as the malignant small cell tumor of the thoracopulmonary region (Askin's tumor) are actually classified as peripheral neuroepitheliomas. Embryonal rhabdomyosarcoma, including the botryoid variant, is now, when treated with appropriate chemotherapy, a tumor of relatively favorable histology. Its prognosis is still primarily related to clinical stage and location of tumor. The alveolar subtype of rhabdomyosarcoma (including its solid variant) has a less favorable prognosis. Hepatoblastoma (epithelial or mixt variants) have the same long term survival, also mainly related to stage. Pancreatoblastoma is a tumor with well differentiated cytopathology and prolonged course, compared with other pancreatic tumors.

Carcinoma, Hepatocellular↗
PubMed1988

Hormonal consequences of orchidectomy for carcinoma of the prostate. With special reference to the measurement of free testosterone in saliva and prostatic dihydrotestosterone levels.

22 patients with metastatic carcinoma of the prostate were treated by subcapsular orchidectomy and followed by regular determinations of plasma testosterone, dihydrotestosterone, delta 4-androstenedione, dehydroepiandrosterone sulfate and testosterone estradiol-binding globulin as well as salivary testosterone, which reflects free plasma testosterone. Subcapsular orchidectomy constantly induced a dramatic and stable decrease in testicular androgens without modification of adrenal androgens or testosterone estradiol-binding globulin. Free testosterone levels vary widely for a given value of plasma testosterone, probably due to individual variations of testosterone estradiol-binding globulin. Salivary testosterone is preferable to plasma testosterone for monitoring hormonal therapy for metastatic carcinoma of the prostate. In another group of orchidectomized stage-D2 patients, obstructive symptoms motivated transurethral resection of the prostate allowing the assay of intraprostatic dihydrotestosterone which was constantly below the dihydrotestosterone level of androgen-independent tissues (below 2.5 ng/g).

Aged↗
PubMed1988

[Extracorporeal lithotripsy as the primary procedure in the treatment of large kidney calculi].

Extracorporeal shock wave lithotripsy (ESWL) as primary treatment for large renal stones has been evaluated in this clinical study of 55 patients. Patients were treated using the Dornier HM-3 lithotripter. Twenty-one (38%) patients presented with a stone burden greater than 4 centimeters. Nineteen patients had "steinstrasse", of which 8 had to undergo a secondary procedure. Sixteen (29%) patients had no residual stone, 5 had clinically non significant stones and 34 had clinically significant stones. Out of the 15 patients who underwent a second ESWL, only 2 were rendered stone-free. In this study, ESWL was not found to be a satisfactory treatment for large renal stones.

Endoscopy↗
PubMed1988

[Infantile polycystic disease. Renal pseudotumoral growth in the postnatal period].

In the most common clinical expression of infantile polycystic disease, the kidneys are greatly enlarged in the neonatal period. When the child gets older the kidneys become smaller. In this case report, both kidneys kept growing after birth causing abdominal distention and respiratory distress. The differential diagnosis was a bilateral massive nephroblastomatosis, but the renal pathology showed characteristic features of infantile polycystic disease.

Genes, Recessive↗
PubMed1988

[Technic of percutaneous anterior colpopexy under endoscopic control for orthostatic and urinary stress incontinence in women (Stamey's operation)].

Percutaneous anterior colpopexy, as described by Stamey, constitutes a simple, reliable method for treatment of orthostatic and stress incontinence of urine in women. As with all operations destined to correct this infirmity, its aim is to replace the bladder neck and initial part of urethra into spaces subject to pelvic pressure. The principle of the operation consists of solidly attaching the whole thickness of particularly the para-cervicourethral vagina fibrous layer to the anterior abdominal wall by means of two solid monofilament threads of caliber 2, scissoring on the threads being prevented by insertion of a 1 X 0.5 cm vascular prosthesis. The operation mainly involves a vaginal approach: the vaginal incision in T exposing the bladder neck. Two abdominal incisions 2 cm in length and avoiding the aponeurosis are made 1 cm above the pubis from one side of the median line to the other. These allow Stamey's needles to be passed behind the symphysis up to the vaginal incision under endoscopic control. Cystoscopy is an essential part of surgery since it allows verification of good positioning of thread exactly at the bladder neck level and of the quality of the hyperelevation of posterior lip of bladder neck obtained. As effective as other retropubic anterior colpopexies, this procedure under endoscopic control has the major advantage of avoiding opening of Retzius space, with its inevitable morbidity, and of being possible without difficulty in previously operated patients. It should undoubtedly be included in the therapeutic armament used for this frequent infirmity.

Cystoscopy↗
PubMed1988

Radical prostato-cystectomy for infiltrating bladder carcinoma using a combined abdomino-perineal approach.

Radical abdomino-perineal cystectomy was used in 23 Pts with Tis to T4 bladder tumors, 12 of whom had previously been submitted to radical Radiotherapy (salvage cystectomy). The perineal approach greatly facilitated the prostatic dissection in 10 cases, in which it was considered extremely hazardous from the abdomen. There were two post-operative deaths from acute myocardial infection in patients over 70. Prolonged drainage of the perineal wound occurred in four Pts. Abdomino-perineal cystectomy is not a routine procedure and should be considered in two settings: in the case of salvage cystectomy when Radiotherapy - induced desmoplastic reactions make the dissection of the prostate from the rectum hazardous, and when urethrectomy is mandatory and the patients status requires an expeditious procedure. Although the early cystectomies for bladder carcinoma were performed using a combined perineo-abdominal or abdomino-perineal approach (Couvelaire 1948, Hinman 1939, Wilhem 1947), this procedure has fallen into disuse since the early 1950's in favor of the suprapubic approach. Nevertheless, the combined abdomino-perineal procedure offers three advantages: 1) better exposure of the urethra, prostatoseminal pedicles, and puboprostatic ligaments, 2) total urethrectomy can be done at the same time, 3) drainage through the perineal incision is excellent. These advantages are maximized when two surgeons operate simultaneously through the perineal and suprapubic incisions (Ameline 1948, Boccon-Gibod 1979, Boccon-Gibod 1984, Crawford 1980, Pascal 1974).

Adult↗
PubMed1988

[Continent replacement enterocystoplasty using a low-pressure detubularized ileal pouch after radical prostatocystectomy].

Tubular ileal-ileo-caecal or colonic replacement enterocystoplasties induce nocturnal incontinence in more than 70% of cases, partly due to the presence of peristaltic waves responsible for pressures greater than 40 cm of water for low filling volumes. The use of debutularised intestinal grafts considerably attenuates these pressure waves, ensuring excellent diurnal continence and a dramatic reduction in nocturnal incontinence together with protection of the upper urinary tract. The detubularised ileal bladder combines the reliability of all low pressure reservoirs with a simple technique: a 30 cm ileal segment is isolated then opened 2 cm from its anti-mesenteric border. The two limbs of the loop are sutured to each other. The ureters are reimplanted at the summit of each limb according to the mucosal groove procedure and the summit of the pouch is anastomosed to the urethra. This procedure has been used in 10 patients following radical cystectomy for cancer. Seven of these patients underwent clinical, radiological and urodynamic examination 5 months after the operation: all 7 patients were continent during the day. Nocturnal continence was obtained at the cost of getting up one or twice during the night, but incontinence persisted in the other 3 patients. Cystometry did not reveal any pressure waves greater than 25 cm of water for a volume of 500 ml. The detubularised ileal bladder is simple to perform and constitutes a reasonable alternative to traditional tubular enterocystoplasties.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

Bladder tumors: when to do and what to expect from random mucosal biopsies with reference to blood group cell surface antigens.

Routine random biopsies of normal looking bladder mucosa in the evaluation of bladder tumors demonstrated a high occurrence of anomalies ranging from dysplasia to carcinoma in situ (CIS). 75 patients with a urothelial bladder tumor were submitted to 165 endoscopic procedures under anesthesia including transurethral resection of any bladder tumor and random mucosal biopsies in the 4 quadrants of the bladder. The frequency and severity of mucosal anomalies rise with the tumor grade and stage: in stage 0.Ta, the percentage of anomalies rises from 15% in grade-1 lesions to 53% in grade-3 tumors. 80% of the stage A (T1) B and C (T2, T3) tumors are associated with anomalies of the normal looking bladder mucosa characterized by CIS in 50% of the cases. These lesions which may persist in the absence of any visible tumor respond dramatically to endovesical bacillus Calmette-Guérin therapy. Simultaneous determinations of blood group antigens fail to demonstrate a clear correlation between the antigenic status of the tumor and that of random biopsies. These results may help to clarify the indications of random mucosal biopsies which should be reserved to the treatment and surveillance of grade 3-tumors, irrespective of their stage.

ABO Blood-Group System↗
PubMed1987

[Risk of infection in biopsy of the prostate].

In order to more clearly define the risk of infection of prostatic biopsy, the authors conducted an analysis of the morbidity of each method. The risk of infection, the possible forms of prophylaxis and the best indications are presented for each method.

Biopsy↗
PubMed1987

[Polycystic renal dysplasia in children].

Ultrasonography has profoundly modified the diagnostic conditions of polycystic renal dysplasia in children. Non-palpable forms, which were previously most frequently missed, can now be detected during the antenatal period. In infants, ultrasonography generally provides a definite diagnosis, which can be confirmed by aspiration-opacification of the cysts. On the basis of a series of 40 cases and a review of the literature, the authors discuss the therapeutic implications of these new data. Surgery remains essential in cases of palpable polycystic renal dysplasia, especially when it is complicated. However, in the sub-clinical forms, as the risks of malignant degeneration and the incidence of post-operative complications are minimal in the one case and undefinable in the other, surgical excision is possible but not essential.

Child↗
PubMed1987

[Anticholinergics and urination disorders].

A urodynamic assessment with an anticholinergic test has been performed on 145 patients suffering of urge incontinence or micturition frequency. Eighty per cent had a detrusor instability and in those the test has shown to be positive in three half of the cases. In this group there was also an improvement with the oral treatment. In the others groups, the anticholinergic per os was almost never usefull. Anticholinergic drugs (not always well tolerated) are usefull when there is an instability and when the test is positive but not in the other cases.

Administration, Oral↗
PubMed1987

[Ultrasonic diagnosis of non-palpable germinal tumors of the testis. Apropos of 2 cases].

The germ cell tumors are the most common type of testicular malignant tumors (90%). About 30% are revealed by metastasis usually into the retroperitoneum, with clinically normal testis. Ultrasound reveals a bright echogenic focus into the testis which is typical, considering the clinical presentation, for a regressed germ-cell tumor and guides the side of the orchidectomy which allows to suppress a still active tumoral tissue which will not be eradicated by chemotherapy. Two typical cases with sonographic guidance are reported herein and confronted with the cases previously described in the literature.

Adult↗
PubMed1987

[Cystine calculi. In vitro solubility and chemical structure].

A series of cystine stones extracted from the same subject by pyelotomy was used to study the in vitro solubility of these stones in various solutions. Isotonic bicarbonated saline presented a definite dissolving action, but the stone dissolved relatively slowly alpha-mercapto-propionyl-glycine was much more active, even when mixed urine. N-acetylcystine had the same degree of effectiveness as alpha-mercapto-propionyl-glycine. One stone in this series, which was partially covered by a coating of calcium phosphate, dissolved much more slowly than the other stones. In subjects with cystine stones, longstanding large stones are frequently mixtures of phosphates and cystine and, in 21 cases, chemical analyses and infra-red spectrography demonstrated the presence of calcium phosphate on the surface or in the inferior of these stones, associated with ammoniaco-magnesium phosphate in three cases. The presence of phosphates makes oral medical treatment ineffective, but mixed stones are more friable than pure cystine stones and are therefore easier to treat by extracorporeal lithotripsy.

Chemical Phenomena↗
PubMed1987

Hormonal consequences of orchidectomy for carcinoma of the prostate. With special reference to the measurement of free testosterone in the saliva.

22 patients with metastatic carcinoma of the prostate were treated by subcapsular orchidectomy and followed by regular determinations of plasma T, DHT, D4A Dione, SDHEA, and TeBG as well as salivary T which measures the free Testosterone. Subcapsular orchidectomy constantly induced a dramatic and stable decrease of testicular androgens or TeBG. Free Testosterone levels vary widely for a given value of plasma T, probably due to individual variations of TeBG. Therefore salivary T should be used preferably to plasma T to monitor hormonal therapy of metastatic carcinoma of the prostate.

Aged↗