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Biomedical subjects

T Flam

Publications and source records attributed to T Flam.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Treatment of stress urinary incontinence in women using the Goebell-Stoeckel surgical method. Study of 59 operated patients. Long-term review].

Stress urinary incontinence may be treated by different techniques. This study is based on a retrospective analysis of 59 patients treated between 1985 and 1993, by the Goebell-Stoeckel technique. 48 patients were questionned by phone in March 1995 to estimate the long term results. Two groups were defined; group A: follow-up between 15-60 months and group B: follow-up between 72-120 months (Total average follow-up: 68 months). The majority of patients were elderly, menopaused (88%) and had had one or more surgical procedure for incontinence (60%). Among 59 patients, 8 developped minor early complications. The mean length of hospital stay was 14 days and the mean duration of indwelling catheterization was 6.5 days. 60% of patients have had urinary retention after catheter ablation and have required intermittent catheterization at home for a mean duration of 14 days. Continence was achieved in 84% of cases at 3 months and had persisted in 96% of cases for group A and 91.5% of cases for group B. With a mean follow-up of 68 months, 37.5% of cases had irritative symptoms, 12.5% had minor urethral obstruction. 52% of patients obtained a very excellent result (normal continence, no urgency, no dysuria), 9% obtained an excellent result (normal continence, urgency with no leaked, and/or minor dysuria); 12 obtained a moderate result (normal continence, urgency with minor leakage without toilet set, and/or minor dysuria) and 27% obtained a poor result (incontinence, urgency with leakage necessitating toilet set, and/or dysuria).

Adult↗
PubMed1994

[Electroconductive lithotripsy: experimental and clinical results with the Sonolith 4000].

Electroconductive lithotripsy uses a highly conductive liquid to bathe the electrodes rather than water. The effect is to channel energy between the electrodes and force it to pass directly from the anode to the cathode, exactly at F1. The Sonolith 4000 (Technomed Medical Systems) uses this new generation of "electroconductive" shock waves. Experimental and clinical results are presented. The typical electroconductive technique creates a linear relationship between energy level, in kilovolts, and the amplitude of the acoustic shock at F2 over a wide range of power. There is also a linear relationship between power and effectiveness of desintegration. More than 800 patients have been treated to date. Follow-up has reached 3 months in the 166 treatments reported here. Overall success rate without residual stone was 82%. The percentage of patients with residual stones smaller than 5mm was 5%. The rate of clinical success was 87%. The rate of retreatment in patients without residual stone was 10%. For 11 to 20 mm stones, the success rate (0 fragments), the rate of retreatment and the rate of auxiliary procedures were 83%, 4% and 2% respectively for stones < or = 10 mm and 78% for 11 to 20 mm stones. The electroconductive generator used in this study provided very satisfactory results, better than those generally obtained with classical generators. Tolerance was excellent.

Humans↗
PubMed1994

[Contribution of urodynamic examinations in the exploration of micturition disorders in patients with Parkinson disease].

24 men (mean age 71.2 years) with micturition disorders and parkinson disease have been studied: irritative symptoms are present in 62.5%. Urodynamics were specially usefull when obstructive symptoms (37.5%). In these cases, 3/4 had a mechanical obstruction to be treated by surgery. 3 men had a neurologic bladder and needed a pharmacological treatment. In this high risk population, urodynamics seemed to be necessary.

Aged↗
PubMed1994

[CD4 TIL (Tumor Infiltrating Lymphocytes) induce complete response in patients treated with IL-2 (Interleukin-2). Preliminary study].

This study analyzed clinical response induced by TIL in patients with renal cell carcinoma previously treated by interleukin-2. Six patients (4 men, 2 women, mean age 44.3 years) with measurable metastatic localizations have been treated by TIL reinjection (0.02 to 7.6 x 10(10) cells). TIL phenotype was a combination of CD4 and CD8 in 3 patients, predominantly CD4 in two patients and predominantly CD8 in one patient. Previous treatment by interleukin-2 induced one partial response, 2 stabilizations of the disease and 3 tumoral progressions. TIL led to an amelioration for 4 patients: 2 were in complete response, 2 were stabilized and 2 had tumoral progression and decreased. This study shows that CD4 TIL may improve an initially response induced by IL-2 therapy.

Adult↗
PubMed1994

[Circumstances of the detection of kidney cancer. Current part of accidental discoveries].

Kidney cancer accounts for 3% of all cancers, with approximately 85% of tumors arising in the renal parenchyma (renal cell carcinoma). To evaluate the part of the incidental detection of the renal carcinoma, we performed a retrospective review of the 302 patients treated for this reason in our department between April 1981 and October 1992. For the purpose of a historical comparison, 2 periods of 6 years were compared: 1981-1986 and 1987-1992. During 1981 to 1992, 71 patients (25.8%) were totally asymptomatic, with a significant improvement of the incidentally detected tumors from 1981-1986 (15%) to 1987-1992 (33.7%) (p < 0.001). Renal ultrasonography, which is responsible for 97% of the incidental diagnosis, allow for a better detection in the right kidney (60.3% vs. 39.7% in the left kidney) (p < 0.05). Primary tumor size and clinical stage (with Robson or the TNM 1992 classification) were significantly smaller (47.3 +/- 19.9 mm for the asymptomatic group vs. 71.6 +/- 34.1 mm for the symptomatic tumors) and lower respectively, in the asymptomatic group than in the symptomatic group (p < 0.001). The five-year survival rate (actuarial method) of the incidental cases tended to the better for the asymptomatic cases (87.5% vs. 39% for the symptomatic tumors) (p < 0.05). Most of the authors agree that incidental diagnosis has led to lower tumor size and stage and possibly better survival rate compared to cases where the diagnosis was suspected clinically. However, prospective studies on a large scale are needed to evaluate the role of nephron sparing surgery for incidental cancer of the kidney. Nowadays, the treatment remains radical nephectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma, Clear Cell↗
PubMed1994

[Epidermoid cyst of the testis. Apropos of a case].

The epidermoid cyst of the testis, a rare and benign tumour, continues to create problems. Its definitive diagnosis remains a histopathological one and alters the prognosis and therapy. Based on their case report and a literature review, the authors discuss the different diagnostic, prognostic and therapeutic aspects of this lesion.

Adult↗
PubMed1994

[Modified Nesbit's operation in the treatment of incurvations of the penis. Apropos of 26 cases].

Distortion of the penis can be an obstacle to normal sexual intercourse and can lead to psychological problems. Nesbit first described an operation for the correction of three cases of congenital incurvation of the penis. Several authors later proposed modifications of the original procedure, but the principle technique relies on folding the corpus cavernosum on the side opposite the deviation. We have treated 26 cases with distorted penis: 14 congenital, 3 postsurgical, 1 post-trauma and 8 due to la Peyronie's disease. Our functional results have been excellent. The risk of postoperative retraction is considerably reduced when the fold is created without removing the albugin patches. The quality of the results is directly related to rigorous patient selection.

Adult↗
PubMed1993

[TULIP: transurethral ultrasound-guided laser-induced prostatectomy. One-year clinical results].

The TULIP (transurethral ultrasound-guided laser-induced prostatectomy) system combines a real-time ultrasound transducer and a Nd:YAG laser delivery system with a 1.064 microns wavelength within a 22 F urethral probe. The goal is to produce a coagulation necrosis of the prostatic parenchyma, with a subsequent elimination of tissue in the urine. 29 patients have been included in this study, and 13 have a minimal one year follow-up. No complication occurred. 2 patients underwent a transurethral resection of the prostate secondary to the TULIP treatment. All patients complained of irritative urinary symptoms (frequency, burning on urination...) in the days or weeks following the treatment, and suprapubic catheterization tube had to be left in place for a mean duration of 13.8 days. Inclusion/exclusion criteria and evaluation modalities have been the same as in the American national study published elsewhere. At one year, our success rate for at least one criteria has been 84.6%, but only 2 (15%) out of 13 patients have been successful both in symptom score and flow rate.

Aged↗
PubMed1993

[TULIP: transurethral ultrasound-guided laser-induced prostatectomy. Clinical results after on year].

The TULIP (Transurethral Ultrasound-guided Laser-Induced Prostatectomy) system combines a real-time ultrasound transducer and a Nd:YAG laser delivery system with a 1.064 micron wavelength within a 22 F urethral probe. The goal is to produce a coagulation necrosis of the prostatic parenchyma, with a subsequent elimination of tissue in the urine. 29 patients have been included in this study, and 13 have a minimal one year follow-up. No complication occurred. 2 patients underwent a transurethral resection of the prostate secondary to the TULIP treatment. All patients complained of irritative urinary symptoms (frequency, burning on urination...) in the days or weeks following the treatment, and suprapubic catheterization tube had to be left in place for a mean duration of 13.8 days. Inclusion/exclusion criteria and evaluation modalities have been the same as in the American national study published elsewhere. At one year, our success rate for at least one criteria has been 84.6%, but only 2 (15%) out of 13 patients have been successful both in symptom score and flow rate.

Follow-Up Studies↗
PubMed1993

[Retrograde endopyelotomy in the treatment of iterative stenoses of the pyeloureteral junction].

This work is a report on our preliminary experience with the treatment of iterative stenosis of the pyeloureteral junction (JPU) through a retrograde endoscopic approach. From June, 1991, to June, 1992, we used this method to operate 6 cases of failed surgical pyeloplasty due to abnormalities of the JPU. The success of this operation depends, on one hand, on the systematic dilatation of the intramural portion of the ureter, and on the other hand, on the possible installation of a double pigtail stent a few weeks before endopyelotomy. We have noted no complication. The stay in hospital lasted 3 days in average (2 to 5 days). Clinical and radiological results include: 4 successes, 1 improvement and 1 failure. The average time elapsed is of 9 months (6 to 18 months). This technique, which has a proven feasibility, is a good alternative for this indication, in the absence of associated calculi and particularly in women. Its efficacy remains to be demonstrated by larger series with a longer follow-up.

Endoscopy↗
PubMed1993

[Does prostaglandin El (PGE1) help restoration of spontaneous erections?].

The effectiveness of intracavernous PGE1 injections for spontaneous erections has been assessed in this study. Patients with disorders of erection were treated with 6 intracavernous PGE1 injections (10 to 25 micrograms) at 15-day intervals. An exploration was undertaken in these patients to establish the cause of the disorders of erection. Spontaneous erections were compared before and after the six PGE1 injections. Thirty-five patients were studied. Their average age was 58.8 years. The cause of the disorders of erection was organic [22] or psychogenic [13]. Thirty-one patients (88%) had an erection allowing sexual intercourse after the first PGE1 injection, two had a weak erection and two had no erection. After more than one year, 24 (73%) of the 33 patients treated reported improvement of spontaneous erections, allowing intercourse; 11 (33%) occasionally received a PGE1 injection. Nine (27%) were not improved, including two psychogenic cases. The number of patients who occasionally resorted to PGE1 injections raised from 6 to 11 (33%). This study shows the effectiveness--at least temporarily--of repeated PGE1 on spontaneous erections, owing to an action on the psychogenic component of disorders of erection, but maybe also to a local, long-lasting action of PGE1 on the cavernous tissue.

Erectile Dysfunction↗
PubMed1993

[Renal oncocytoma. Retrospective study of 38 cases].

38 cases of renal oncocytoma were recognized at Cochin's hospital from 1982 to 1991. Accurate diagnosis was not possible before performing surgery. However, a benign tumor appearance on the preoperative morphologic investigations and an evocative peroperative macroscopic aspect of renal oncocytoma, allowed us to realize a conservative surgery in 4 cases. Follow-up of 27 patients (11 lost to follow-up) showed a benign clinical behaviour in all cases, de spite of invasion of the perirenal fat in 2 cases, and tumoral thrombosis of a proximal branch of the renal vein in 1 case. No metastases occurred after a mean follow-up of 32.5 months, within range from 11 to 101. Our experience as well as the literature leads us to believe that renal oncocytoma is a benign tumor. We conclude that conservative surgery must be systematically considered when peroperative histological examination assert the diagnosis of renal oncocytoma, especially when the tumoral diameter is less than 5 cm.

Adenoma↗
PubMed1993

[Association of angiomyolipoma and oncocytoma of the kidney. Apropos of two cases].

The association of an oncocytoma and of an angiomyolipoma within the same renal tumor is infrequent. The authors review the literature on the basis of two cases. Histogenesis and the clinicopathological analysis show that such an association is accidental. It makes up 0.5% of kidney tumors, and 1% of oncocytomas are associated with an angiomyolipoma. The risk to encounter a malignant tumor is of 25% in such cases.

Adenoma↗
PubMed1993

[Urinary diversion by ureteral endoprosthesis during pregnancy].

Dilatation of the renoureteral cavities during pregnancy is a common occurrence, especially on the right side. Though generally asymptomatic, this dilatation can be unfrequently complicated by pain and/or urinary infections that may cause severe infectious and obstetrical complications. In such cases, drainage of the renal cavities may be indicated in very selected cases. The authors review their experience with renal bypass through an endoureteral prosthesis during pregnancy, and specify the technical aspects and the indications of this type of bypass.

Adult↗
PubMed1992

[Cellular or atypical mesoblastic nephroma of partially cystic form. Apropos of a case in a 27 year old woman].

A case of partially cystic atypical or cellular variant of mesoblastic nephroma in a 27 year old woman is reported herein. Some of the cysts were like those seen in a cystic nephroma (solitary multilocular cyst) and others resembled ectasic vascular channels. Nephrectomy was the only treatment used. Since her operation our patient has become pregnant and given birth to a healthy daughter. The mother is well and free of disease more than 18 months after nephrectomy. We have only found 7 other reports of adult mesoblastic nephroma. Ours in the first published case of the cellular or atypical variant of mesoblastic nephroma in an adult patient. Difficulty in diagnosis and treatment particular to this type of tumor is stressed upon with reference to pediatric and adult cases described in the literature.

Adult↗
PubMed1992

[Unusual renal tumor in a young woman: cellular or atypical mesoblastic nephroma with partially cystic form].

A case of partially cystic atypical or cellular variant of mesoblastic nephroma in a 27-year old woman is reported. Nephrectomy was the only treatment. Since her operation, our patient has become pregnant and given birth to a healthy daughter. The mother is well and free of disease more than 18 months after nephrectomy. We have only found eight other reports of adult mesoblastic nephroma. Ours is the first published case of the cellular or atypical variant of mesoblastic nephroma in an adult patient.

Adult↗