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Biomedical subjects

L Boccon-Gibod

Publications and source records attributed to L Boccon-Gibod.

At least 271 records · Page 15Linked to original sources
PubMed1985

[Treatment of advanced prostatic cancer with a gonadorelin agonist, dTrp6 LHRH. 41 cases].

Forty-one patients with prostatic cancer were treated with DTrp6 LH-RH, a luteinizing hormone releasing hormone agonist. Thirty-eight of them had advanced cancer with either metastases or major local spread. In all cases with plasma testosterone levels were normal before treatment, the LH-RH agonist brought them down to values observed after surgical castration. An objective response ("improvement" or "stabilization") was obtained in 68% of the patients, but virtually all "improved" patients were those without previous hormonal treatment. As with all LH-RH agonists, the pharmacological castration produced by DTrp6 LH-RH is of considerable value in the treatment of prostatic cancer, especially since this compound, unlike estrogens, does not seem to cause cardiovascular accidents. However, transient hyperandrogenism may occur during the first days of treatment (as it did in 9 of our patients) and may be responsable for an acute flare-up of the tumoral process, as suggested by 2 of our cases. The concomitant administration of an anti-androgenic drug should perhaps be considered.

Aged↗
PubMed1985

Bladder neck reconstruction using an anterior bladder flap in post-prostatectomy incontinence.

Bladder neck reconstruction using an anterior bladder flap was used in 10 patients with total diurnal urinary incontinence, persistent 1 year after suprapubic (n = 6) or transurethral (n = 4) prostatectomy. 8 patients achieved symptomatic improvement, 6 of them with excellent or good results. Bladder neck reconstruction is undoubtedly able to correct post-prostatectomy incontinence, provided there is no residual bladder neck obstruction or alteration of the bladder musculature due to previous surgery. These cases should be considered for artificial sphincter implantation.

Aged↗
PubMed1985

Anatomical study of total cystoprostatectomy.

The authors describe an anatomical study of total cystoprostatectomy. They show that Denonvilliers' fascia is made up of many membranous layers starting at the bladder. They recall the fact that the preprostatic veins are attached at the bottom, not only to the venae dorsales penis, but also to the venae pudendae internae which runs under the levator ani muscle. These preprostatic veins lie inside a vessel-bearing blade of tissue made of muscular and collagenous tissue derived from the anterior vesical wall. This anatomical study recalls the fact that the interprostatorectal dissection line is behind Denonvilliers' fascia and that the preprostatic vein dissection line is on the anterior aspect of the membranous urethra.

Fascia↗
PubMed1985

Suprapubic ultrasonography in the follow-up of superficial bladder tumors.

40 patients with superficial (grade 1-3, stage 0) transitional cell carcinoma of the bladder were followed using urinary cytology, cystoscopy and suprapubic ultrasonography. Sonography detected tumors as small as 2.5 mm, but missed lesions that developed in the dome as well as flat anomalies associated with positive urinary cytology. Although, not a definitive alternative to cystoscopy, suprapubic ultrasonography of the bladder can, in selected cases, be used to widen the interval between endoscopic controls.

Carcinoma, Transitional Cell↗
PubMed1985

The predictive value of pre-orchidectomy serum tumor markers in non seminomatous germ cell tumors of the testis (N.S.G.C.T.T.).

A.F.P. and B.H.C.G. serum levels were measured using a radio-immunoassay in 22 patients with a N.S.G.C.T.T. before and 15 days after orchidectomy. The results were confronted to the stage of the disease as determined by R.P.L.N.D. in the absence of gross metastatic disease. 4 of 6 patients with normal tumor markers had stage II or III disease, and 2 of 7 in whom the markers returned to normal were stage II. Pre-orchidectomy A.F.P. levels over 100 ng/ml are consistent with metastatic disease as well as vascular and/or cord involvement irrespective of the markers status. These results should be born in mind when deciding a simple surveillance policy in clinical stage I N.S.G.C.T.T. Serum tumor markers, alfa foetoprotein (A.F.P.) and the B fraction of human choriogonadotropin (B.H.C.G) are commonly used to monitor surveillance as well as therapeutic response in patients with N.S.G.C.T.T. It is however well known that 30% of the patients with stage IIa, IIb, N.S.G.C.T.T. have normal post-orchidectomy serum markers (SKINNER). These false negative which may proceed from absence or undetectable tumor markers secretion by the metastases, question the safety of the wait and see policy based on serial serum markers determination as well as abdominal and thoracic C.T. Scan. Nevertheless, the level of pre-orchidectomy serum tumor markers as well as their evolution after orchidectomy may be more meaningful.

Adolescent↗
PubMed1985

[Percutaneous fine needle cytopuncture of lymph nodes opacified by lymphography, in urogenital pathology. Apropos of 174 cases].

Percutaneous fine needle puncture of lymph nodes after lymphography with contrast has been performed in 174 patients with urogenital tumors (bladder: 108, prostate: 41, testes: 25). Conducted under direct television screen control the procedure is simple to perform and provokes little discomfort for the patient, since it is painless and relatively non-traumatic. Needle puncture is a reliable technique resulting in no false positives and very few false negatives when carried out using the previously described technique (routine sampling and technical success). Combining lymphography with needle puncture is of undoubted value for detecting extension of tumor and improving choice of therapy.

Biopsy, Needle↗
PubMed1985

[Pyeloureteral duplications in the adult: diagnostic means and therapeutic indications. Apropos of 20 cases].

Complicated pyelo-ureteral duplication in the adult may be revealed by recurrent pyelonephritis or urinary leakage. The diagnosis can be performed by combined urography and ultrasound scan. The management is rarely conservative. In most cases, it consists in hemonephrectomy. The ureterectomy is partial, extending up to the pelvic brim in the case of a fine ureter. If the ureter is dilated, however, the ureterectomy must be subtotal, in order to avoid postoperative infectious recurrence.

Adult↗
PubMed1985

[What can be expected of x-ray computed tomography in the assessment of the loco-regional extension of kidney cancer?].

The authors assess the role of CT scanning in investigations for the extension of renal tumors with the aid of a series of 40 patients. A complete inventory of the lesions was obtained in 30 patients who had undergone radical surgery. Capsular damage is visualized with a high percentage of uncertainty, and, setting aside a few exceptions, it is impossible to specify the histological nature of adenomegalies. On the other hand, venous exploration can be performed with growing accuracy thanks to series of angioscans. This method of investigation would therefore not seem suitable for staging tumors on Robson's scale, but it is most useful in selecting surgical tactics in the preoperative assessment of the lesions.

Adenocarcinoma↗
PubMed1985

[Urinary incontinence following prostatectomy. Results of cervico-urethral plasty using Tanagho's tubular vesical flap].

Seven patients suffering from urinary incontinence after prostatectomy were treated by cervico-urethral plasty with a tubular vesical flap. Results were good or very good in four cases, and fairly good in one. There were two setbacks. The procedure should be reserved to patients not afflicted with vesical instability, cervico-urethral obstruction or fibrosis of the anterior surface of the bladder. Patients suffering from the last two conditions require an artificial sphincter after removal of the obstructive lesions.

Humans↗
PubMed1985

[Systemic cisplatin-based chemotherapy in the treatment of advanced bladder cancer].

Twenty one patients with advanced bladder cancer (metastases and/or loco-regional recurrences) were treated by cisplatin-based chemotherapy (cisplatin, adriamycin, cyclo-phosphamide (8 patients), cisplatin, methotrexate (8 patients) and cisplatin and radiotherapy (5 patients). The results with pure chemotherapy were, on the whole, disappointing, with a remission rate of 25% and a response rate of 50%. Only the combination of cisplatin-based chemotherapy and radiotherapy gave spectacular results with 50% complete response, but even then at the price of a high morbidity rate.

Aged↗
PubMed1985

[Calcium stones: are current metabolic studies warranted in everyday practice?].

Calcium phosphate metabolism was thoroughly investigated in twenty-four patients with calcium nephrolithiasis and hypercalciuria. Increased absorption was demonstrated in twelve cases. In two patients findings suggested normocalcemic hyperparathyroidism. Results were normal in the remaining ten cases. Metabolic investigations failed to noticeably improve the specificity of therapeutic indications over the conventional prevention by adequate fluid intake and an appropriate diet. Nevertheless continuing metabolic investigations are needed as they allow more accurate designing of studies on renal lithiasis.

Absorption↗
PubMed1985

[Bladder tumors: superiority of urinary cytology after bladder lavage].

Sixty two endoscopic examinations were performed on fifty five patients for the followup of bladder tumors. The results of urinary cytological examinations performed on voided specimens of urine, on specimens collected after introduction of the endoscope, and specimens obtained by bladder washing with saline, were compared with the results of histological examinations of the tumors, and mucosal biopsies. The results show a definite superiority of bladder washing over the other methods: the rate of non-diagnostic procedures falls from 17 to 1.5%, the detection of grade III tumors or carcinomas in situ improves from 55 to 75% and from 33 to 88% respectively. Bladder washing cytology is thus a useful adjunct to voided urinary cytology.

Cystoscopy↗