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Biomedical subjects

M Jemni

Publications and source records attributed to M Jemni.

At least 19 recordsLinked to original sources
PubMed2001

[Abdominoscrotal hydrocele].

The abdominoscrotal hydrocele (ASH) is a rare variant of hydrocele of the tunica vaginalis with fluid accumulation into the abdominal cavity passing through the inguinal canal. The etiology of ASH is not clear. The positive diagnosis depends on the clinical data (hydrocele + abdominal mass). It is confirmed by means of echography and or by TDM. The treatment is surgical complete resection of the vaginalis with ligation of the peritoneal cavity. This report concerns the observation of a huge ASH, so far described in a literature review. We try to distinguish the diagnostic and therapeutic elements of this exceptional pathology.

Abdomen↗
PubMed2001

[Urachal cyst. Report of 3 cases].

The authors report three cases of cyst of the urachus, one of which was complicated by infection. This diagnosis is only rarely established clinically. The current performance of ultrasonography allows very precise analysis of the anterosuperior surface of the bladder, which may reveal the diagnosis. The authors discuss the problems raised by cysts of the urachus and emphasize the importance of clinical history, physical examination and complementary investigations, particularly CT which should allow the diagnosis of this disease, which needs to be treated surgically.

Adult↗
PubMed2001

[Evolution of the physiological profile of gymnasts over the past 40 years. A review of the literature].

Authors illustrate the evolution of the physiological profile of gymnasts over the past 40 years. Gymnasts are demonstrating increased anaerobic power. Maximal power output measured by the Wingate test in high level male gymnasts is currently between 12 and 14 W x kg(-1). Female gymnasts show maximal power between 10 and 12 W x kg(-1). In spite of an increase in the number of training hours, they have a low aerobic aptitude. It is still adequate and sufficient for their practice. Maximal heart rate values measured during gymnastic exercises have mirrored technical and acrobatic demands of increasing difficulty. Currently, exercise heart rates exceed 190 beat x min(-1) as compared to 135 to 151 beat x min(-1) in the seventies. Measurement of higher blood lactate values suggests that anaerobic glycolysis has increased in importance. Glycolytic contributions differ between apparatuses. Data from energy cost studies demonstrate that gymnastics energy demands are greater now than in the seventies.

Adaptation, Physiological↗
PubMed1999

[Results of the treatment of renal lithiasis by percutaneous nephrolithotomy: apropos of 115 cases].

OBJECTIVES: The objective of this study was to analyse the results of percutaneous nephrolithotomy (PCNL), which was recently introduced into Tunisia, in order to determine its place among the treatment options for renal stones. MATERIAL AND METHODS: Our retrospective study was based on 115 consecutive PCNL procedures performed between April 1994 and November 1997. The stone was a single pelvic stone in 13 cases, lower caliceal in 15 cases, lower pyelocaliceal in 28 cases, partial staghorn in 20 cases, total staghorn in 16 cases and multiple pyelocaliceal in 23 cases. In our series, ultrasound lithotripsy constitutes the procedure of choice for renal stone fragmentation. RESULTS: A good result was obtained immediately in 67% of cases. This figure is lower than that published in the literature because of the complexity of the stones and the high failure rate due to the learning curve, involving 6 members of the team. In the case of failure, the procedure was converted to conventional surgery under the same anaesthetic in 20 patients. Residual stones, observed in 23 patients, were successfully treated by extracorporeal shock-wave lithotripsy (ESWL) in 79% of cases. By combining PCNL and ESWL, the good result rate was 80%. The mortality rate of this series was 0.8% and the morbidity rate was 7.5%. Complications were generally rare and often minor. CONCLUSION: PCNL occupies an important place in the treatment of renal stones. The results depend on the site, size and number of stones and on the operator's experience.

Adolescent↗
PubMed1998

[Results of BCG in the treatment of pTa and pT1 bladder tumors. Evaluation of a long protocol using 75 mg of Pasteur strain BCG].

OBJECTIVES: Evaluation of a protocol of intravesical BCG therapy using 75 mg of Pasteur strain BCG with 2 years of maintenance treatment, and a follow-up of up to 60 months. MATERIAL AND METHODS: 189 patients treated by transurethral resection (TUR) for a pTa (N = 80) or pT1 (N = 109) bladder tumour were included in the study. The local and general safety was excellent. We retrospectively compared this series to a group of patients treated by TUR alone (N = 42) another group treated with TUR and Mitomycin C (MMC) (N = 81). The 3 groups were statistically comparable. RESULTS: At 48 months, 62% of patients treated with BCG were recurrence-free, versus only 18% for patients treated with TUR alone and 38% for patients treated with TUR and MMC (p = 0.001). At 42 months, 11% of pT1 tumours treated with BCG had progressed to invasive carcinoma, and this progression occurred during the first 18 months in every case. In comparison, this progression was observed in 25% of pT1 tumours treated by TUR alone and 21% of tumours treated with TUR and MMC. CONCLUSIONS: Our study confirms the efficacy of our BCG protocol ro reduce the potential for recurrence and progression of superficial bladder tumours, despite reduction of the dose to 75 mg. It also suggests the superiority of BCG compared to MMC in terms of recurrence and progression.

Actuarial Analysis↗
PubMed1997

[Urinary fistula after transplantation: eleven cases].

OBJECTIVES: To specify the anatomical features of urinary fistulas and to evaluate the results of percutaneous and surgical treatment of post-transplantation urinary fistulas. PATIENTS AND METHODS: 11 urinary fistulas were observed after 160 renal transplantations, corresponding to an incidence of this complication of 6.8%. Urinary fistulas were treated percutaneously in three cases and surgically in eight cases. THE FOLLOWING COMPLICATIONS WERE OBSERVED DURING SURGICAL TREATMENT: extensive necrosis of the urethra in four cases, rupture of the sutures in two cases, a punctate pelvic fistula in one case. RESULTS: The incidence of fistula was 5.8% for Leadbetter reimplantation and 8.1% for Lich-Gregoir extravesical reimplantation. We obtained one success in three patients treated percutaneously and one death and seven successes out of eight patients treated surgically. We performed ureteropelvic anastomosis with the native ureter in the case of extensive necrosis of the ureter (4 cases), a new reimplantation in three cases and suture of the pelvic fistula in one case. CONCLUSION: More than one half of post-transplantation urinary fistulas observed in our department are secondary to ischaemic necrosis of the ureter. We emphasize the value of preservation of the ureteric blood supply during organ harvesting. Post-transplantation urinary fistulas must be treated surgically, as soon as possible, to avoid infectious complications.

Follow-Up Studies↗
PubMed1995

[Ureteral stenoses and fistulas after kidney transplantation].

We report a retrospective study of 100 renal transplants, the majority using kidneys from related live donors. We saw 6 ureteric stenoses and four fistulas. Three relatively small stenoses and two limited fistulas were treated percutaneously, all of them successfully. The transplant had to be removed in two patients with a ureteric fistula. Four stenoses and one fistula were treated successfully by open surgery. Actuarial survival of grafts with a urological complication was significantly shorter than that of transplants free of such lesions.

Actuarial Analysis↗
PubMed1995

[Renal transplantation from related live donors. Results and survival].

We report a retrospective study of 91 renal transplants from related live donors carried out at the Charles Nicolle Hospital, Tunis, between 1986 and 1993. There were 27 HLA-identical and 64 semi-identical. Classical immunosuppression based upon corticosteroids and azathioprine was used in the majority of cases. Surgical complications occurred in 15.4% of cases. 56% of patients had at least one acute rejection attack. There were 4 deaths, 3 related to infection and one to septic arterial rupture. Return to hemodialysis was related to chronic rejection in 5 cases and to recurrence of the initial nephropathy in one case. 5-year actuarial survival was 94% for recipients and 81% for grafts. In this series, acute rejection had no negative influence on graft survival and the difference between graft survival between HLA-identical and semi-identical patients was not statistically significant.

Actuarial Analysis↗
PubMed1995

[Vascular complications of kidney transplantation].

We report a retrospective analysis of 100 renal transplantations, mainly from related living donors. The rate of vascular complications was 9%: one arterial hemorrhage due to partial suture failure; one lymphocele; two arterial thrombi, one in the inferior artery leading to fistulization by ureteral necrosis and death following septic rupture of the artery, and one in the renal artery requiring graft removal; and five arterial stenoses, one which regressed spontaneously, one treated by endoluminal angioplasy, one treated surgically, one controlled by medical treatment and one which could not be treated due to secondary hemodialysis after graft rejection. In this series of 100 transplantations, vascular complications were the cause of 16.5% of deaths and 12.5% of post-graft hemodialysis.

Adolescent↗
PubMed1995

[Trans-symphyseal approach in the treatment of cervico-urethro-vaginal fistulas. Apropos of 2 cases].

We opted for a symphysiotomy approach in the management of cervico-urethro-vaginal fistulae in two patients. This approach offers an excellent exposure of the region of the bladder neck. After section of the symphysis pubis with a Gigli's wire saw, the anterior wall of the bladder was taken down to the fistulae and we excised the fistulous tract. Longitudinal closure of the fistulae and the bladder followed. Results were satisfactory and there were no urinary incontinence.

Adult↗
PubMed1995

[Female hypospadias. Apropos of 3 cases].

Female hypospadias (FH) is a rare congenital abnormality caracterised by total or partial agenesy of uretero-vaginal septum. We report there cases of this anomaly. In one case, FH was isolated. In the others two, it was associated with other genital abnormalities. The diagnosis was established in adult age. Urinary incontinence is the most constant revealing symptom. Treatment consists of an uretral reconstruction using the anterior wall of vagina. In one case, associated vaginal atresia was treated during the same operation. Perfect continence and good bladder emptying was noted in two cases. One patient had been reoperated to perfect the continence.

Adult↗
PubMed1994

[Extra-renal retroperitoneal angiomyolipoma].

Angiomyolipoma is a benign kidney tumour. Its extrarenal, retroperitoneal site is exceptional. The authors report a case and emphasise the value of ultrasonography and computed tomography in the diagnosis of these tumours with a marked fatty component, without neglecting the contribution of arteriography which can be useful in the diagnosis of the origin of very large retroperitoneal tumours.

Angiomyolipoma↗
PubMed1994

[The treatment of ureteroceles complicated by calculi].

In a series of 13 adults with calculi in ureteroceles, 10 cases underwent endoscopic meatotomy associated with endoscopic lithotripsy. In 2 bulky ureteroceles with calculi, the authors performed excision of the ureterocele and reimplantation of the ureter. In one case, the authors successfully performed extracorporeal lithotripsy. The authors obtained good results in all cases. Endoscopic meatotomy with lithotripsy is a very useful procedure for treatment of small or medium sized ureteroceles with calculi in adults.

Adult↗