PubMed Health⌕ Search

Biomedical subjects

T Flam

Publications and source records attributed to T Flam.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Morbidity of radical prostatectomy for localized cancer of the prostate. Apropos of 100 cases].

Adenocarcinoma of the prostate is the most frequent cancer of male over 60 years of age. Radical prostatectomy is one of the preferred modes of treatment for localized stages. Surgical morbidity decreases with experience and consists mainly in bleeding and rectal injury. Delayed morbidity comprises loss of erection, anastomosis stricture, incontinence. A retrospective study of 100 patients is reported.

Aged↗
PubMed1992

[Localized transrectal hyperthermia in the treatment of obstructive manifestations of prostatic adenoma. Review of the literature and personal experience].

For about the last 10 years, transrectal hyperthermia has been used to treat obstructive manifestations of adenoma of prostate. This procedure induces interstitial edema and acts preferentially on the fibrous elements of the prostate. Several therapeutic regimens have been used successively by different teams, after objective and subjective inclusion screening programmes. Results published up to the present show about 45% of objective responders (against 3% in a placebo group) with improvement sustained in 3 out of 4 cases. Morbidity rate (infection and urinary retention) was 3%. Data from a retrospective study of a series of personally treated patients was w used to determine those with the greatest chance of a successful outcome, even though this is never comparable with that of surgical treatment.

Adenoma↗
PubMed1992

[Treatment of urinary stress incontinence in women by percutaneous cervico-cystopexy. Gitte's operation: contribution of intraoperative ultrasonography. Apropos of 47 patients].

Between March 1988 and February 1991, 47 patients with urinary stress incontinence (USI) were treated by Gittes' operation, suspension thread traction being determined by perioperative ultrasonography in 31 of these cases. All patients were re-examined on February 1992 after a mean follow-up of 26 months (range 12 to 24 mths). The global success rate (recovery and improvement) was assessed as 72% at 3 months and 56% at follow-up. Rated as a function of closure pressure (CP), the success rate at evaluation was 62% with normal CP, 42% with CP low for age, and 33% with CP < 30 cm H20. For the 31 patients with perioperative ultrasonography examination the success rate was 80% at 3 months and 70% at follow up. As a function of CP the rate was 83% at follow up with a normal CP, 50% with a CP low for age, 37.5% with a CP < 30 cm H20. Although Gittes' operation is a simple, fairly non-aggressive intervention, results diverge widely from those obtained with "classical" techniques. Optimization of indications is essential, therefore, only patients with pure USI without hypotonia of the sphincter obtaining maximum benefit from the intervention, carried out preferably under perioperative by control ultrasonography.

Adult↗
PubMed1992

[Resection of a pyelonephritic small kidney by celiosurgery].

The authors report about the exeresis of a pyelonephrictic left small kidney with laparoscopic surgery. First a ureteral tube was inserted to facilitate detection of the ureter by laparoscopy possible after reclining the colon. Dissection of the ureter was taken up to the hilum and pedicle, which was severed between rows of clamps by means of the endoscopic GIA stafler. The operation lasted 4 hours and 30 minutes. The blood loss was minimal and the stay in hospital was of three days.

Adult↗
PubMed1991

[Adenocarcinoma of the prostate: pathological stage C. 2: Treatment].

The discovery of a pathological stage C after radical prostatectomy with a curative aim for a clinically localized cancer of the prostate raises the question of a possible adjuvant therapy. The indications and modalities of such a therapy still remain controversial. Our review sums up our knowledge and uncertainties on this point.

Adenocarcinoma↗
PubMed1991

[Is dysuria an objective or subjective concept?].

A prospective study was carried out in 100 consecutive male patients coming to consultation in the department. These men, whose average age was 65 years (32-82), and who had come for various reasons, answered a questionnaire on the quality of their urine flow, which was rated on a scale ranging from 1 to 4. The results of flow rate measurements were classified in 4 categories according to the maximum flow rate and to the volume of micturation, which always was greater than 150 ml. The comparison of the subjective appreciation and of the objective value showed frequent discrepancies (over- or under-evaluation). These results were analysed according to various parameters, and in particular to the patients' age. It thus appears that one third of the patients only have an accurate appreciation of the quality of their micturation.

Adult↗
PubMed1991

[Treatment of calculi of the lumbar ureter. Apropos of a series of 118 patients].

118 patients suffering from a calculus in the lumbar ureter were treated from January, 1987 to January, 1990. The treatment of 91 patients combined an initial internal ureteral drainage, followed by extracorporeal lithotrity (ECL): 40 calculi were driven back into the kidney and 51 were treated within the ureter. 69 patients (76%) no longer have any calculus; 17 (19%) retain residual fragments smaller than or equal to 3 mm in the lower calyces. We therefore count 5 failures, including 3 in which a second-intention surgical ureterotomy was performed. The ascent of the probe failed in 9 cases at the beginning of the series (6 ureterotomies and 3 percutaneous nephrostomies + ECL). 11 patients were treated with probeless in situ ECL. The others were treated with ureteroscopy (4), percutaneous nephrostomy + ECL (1) and nephrectomy (2). There is not one single treatment for the calculi of the lumbar ureter, and they require associating several therapeutic procedures.

Drainage↗
PubMed1991

[Low pressure bladder replacement after total cysto-prostatectomy. Apropos of a series of 40 patients].

The results of 40 consecutive patients who underwent bladder replacement following cystoprostatectomy for invasive bladder cancer are reported. A 30 cm detubularized ileal segment was used to make the neobladder. Mean follow-up was 19 months (over 2 years in 17 patients). All patients achieved diurnal continence. Nocturnal continence was obtained in 70.5% of patients: 41% had no leakage and nocturia less than 2, while 29.5% had some occasional leakage. Urodynamic evaluation showed the average peak flow to be at 18.3 ml/s and an average neobladder capacity of 410 ml. Six patients had spontaneous contractions of the enteric bladder of greater than 40 cm H20, always associated with elevated urethral pressure. Post-void residue was smaller than 100 cc in all cases. This procedure is simple to do, and led to an excellent diurnal continence, although it cannot assure nocturnal continence in every single patient.

Aged↗
PubMed1991

[Conservative treatment of a recurring retroperitoneal liposarcoma. Apropos of a case followed over 27 years].

We report about the case of a patient who, over 27 years, presented with seven local recurrences of a retroperitoneal liposarcoma. This evolution seems to characterize differentiated (adult and myxoid) forms of liposarcoma, for which metastatic expansion is less frequent that in the undifferentiated, pleiomorphic or round-cell forms. The treatment of these tumors is mainly surgical. Adjuvant radiation therapy might reduce the frequency of local recurrence.

Combined Modality Therapy↗
PubMed1990

Clinical experience with a new pulsed dye laser for ureteral stone lithotripsy.

We treated 45 patients (46 ureteral stones) with a new pulsed dye laser. A 250 mu. fiber was used through a rigid (40 stones) or flexible (6) ureteroscope. Stones were in the upper (5 cases), middle (5) or lower (36) third of the ureter. Stone composition was calcium oxalate dihydrate (34 patients) or monohydrate (7), struvite (2) or uric acid (2). Of the calculi 36 (78%) were fragmented, including 14 that also required simultaneous basket removal of fragments. Ten stones were not fragmented: 6 because of the pure monohydrate composition and 4 due to malfunction of the laser. No damage to the ureteral wall was noted. Retrograde rigid ureteroscopy with laser lithotripsy was effective for lower and middle third ureteral stones. Flexible ureteroscopy with laser lithotripsy was effective (impacted stones) but difficult for upper third ureteral stones.

Endoscopy↗
PubMed1990

Clinical experience with a new pulsed dye laser for ureteral stone lithotripsy.

Forty-five patients with 46 ureteral stones were treated using a new pulsed dye laser (Pulsolith, TMI). A fiber of 250 micrometers was used through rigid (40 cases) or flexible (6 cases) ureteroscopes. Stones were located in the upper third (5 cases), middle third (5 cases), or lower third (36 cases) of the ureter. Stone composition was calcium oxalate dihydrate or monohydrate, struvite, or uric acid in 34, 7, 2, and 2 patients, respectively. Thirty-six stones (78%) were fragmented, including 14 cases that required basket removal of fragments at the same time. Ten stones were not fragmented, 6 because of the pure monohydrate composition and 4 due to a laser breakdown. No damage to the ureteral wall was noted. Retrograde rigid ureteroscopy with laser lithotripsy was effective for lower and middle third ureteral stones. Flexible ureteroscopy with laser lithotripsy was effective (impacted stones) but difficult for upper third ureteral stones. Laser lithotripsy was not effective for pure calcium oxalate monohydrate stones.

Calcium Oxalate↗
PubMed1990

Genitourinary tumors and HIV1 infection.

4 patients with solid genitourinary tumors and HIV1 infection have been treated in our institution over the last 2 years. Two patients had seminoma, 1 renal adenocarcinoma and 1 renal angiosarcoma. All had deeply impaired immunity with a low CD4 level. 3 had or developed a true AIDS syndrome according to the WHO and CDC criterias of 1988. The remaining patient was seropositive and died less than 3 months following the diagnosis of renal angiosarcoma. He is the first reported case of renal sarcoma in a patient infected with HIV1. 2 patients were homosexuals, and the 2 others were drug addicts. Along with other reported cases, our cases underline the association between the depression of immunity due to HIV and the onset of solid genitourinary tumors.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Epidemiology of prostatic cancer.

The worldwide incidence of prostatic cancer derived from data published by the Union Internationale contre le Cancer and the International Red Cross Committee has been estimated to be 200,000 new cases each year. Cases occur predominantly in the USA (75 per 100,000) and in northern Europe (40 per 100,000), whereas the incidence is low in Asia. Comparison of clinical series and autopsies confirms the high incidence of cancer in older age groups, although not all cases are seen clinically. Mortality increases more slowly than the incidence of the disease, indicating that diagnosis and treatment are increasingly effective. Aetiological factors remain the subject of much discussion, without any criteria appearing to be dominant.

Africa↗