Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture

Purpose

We comparatively evaluated urethral stricture (US) treatment outcomes, efficacy and complications, using either holmium laser endourethrotomy (HLU) or optical internal urethrotomy (OIU) since studies such as this are scarce in literature.

Methods

During 2003?C2008, 50 men aged 17?C78?years were operated on for primary or refractory US, 32 (64%) and 18 (36%) patients, respectively. The average stricture length was 1.86?cm. Strictures were single or multiple, forty-one (82%) and nine (18%) patients, respectively, and were located in the anterior or posterior urethra in 27 (54%) and 32 (64%) patients, respectively. US were iatrogenic in 32 (64%) and idiopathic in 18 (36%). Patients were divided into two groups, grpA and grpB, each containing 25 patients who were treated using either HLU or OIU, respectively. An evaluation scale of 1?C3 was adopted and took maximum flow rate (Q_max), postvoid residual (PVR), and quality of life (QL) into consideration. A score of ??1 was very good, ??2 was good, and ??3 was poor.

Results

Treatment results were evaluated after 3, 6, and 12?months, respectively. Evaluation of grpA was as follows: five (20%), nine (36%), and seven (28%) patients scored a ??1; thirteen (52%), nine (20%), and four (16%) patients scored a ??2; and seven (28%), eleven (44%), and fourteen (56%) patients scored a ??3. Evaluation of grpB: seven (28%), ten (40%), and five (20%) patients scored a ??1; eleven (44%), seven (28%), and ten (40%) patients scored a ??2; and seven (28%), eight (32%), and ten (40%) patients scored a ??3.

Conclusions

Neither complication rate nor degree of efficacy between HLU and OIU for US revealed a significant difference. We found both laser and conventional urethrotomies to be safe and effective modes of treatment.     

Qualitative and quantitative study of the postnatal development of the rabbit claustrum

The morphometric analysis of changes occurring in the rabbit claustrum in the early postnatal period was performed by means of unbiased stereological methods. Material consisted of 40 animals aged from P2 to P180 (P-postnatal day) divided into eight groups. The volume of the claustrum, total number and numerical density of its neurons change very rapidly at the beginning of the postnatal life and stabilize by about the fourth week.From the 21st postnatal day distribution and morphology of neurons correspond to that in adults. Almost from the beginning of the postnatal life the rabbit claustrum is composed of three different parts: anterior, central and posterior. The anterior part is the largest and it consists mainly of fusiform, pyramidal and multipolar neurons. The central part is generally composed of oval neurons. The posterior part is the smallest; the distribution of its neuronal types is similar to that in the anterior one.Rapid morphological changes of the claustrum and its neurons occurring during the first postnatal month seem to point out that this structure is able to fulfill its physiological role after this critical period.     

Epidermoid cancers of the esophagus: combined chemotherapy, surgery and radiotherapy. Preliminary results in 50 cases

Fifty operable epidermoid esophageal carcinomas were treated by combined chemotherapy, surgery and radiotherapy. The post-operative mortality was 5.4% and the severe post-operative morbidity was 29%. The vindesine-5FU-platinum association and the vindesine-endoxan-platinum association gave respectively 55% and 35% objective responses (OR) after two preoperative courses without increasing the operative mortality. The patients who showed an OR had a less important tumoral extension. Thus, an objective response to the pre-operative chemotherapy is in fact a new prognostic factor. Survival without recurrence seems to be increased when chemotherapy is efficient in the curative resection group. These findings incite to promote prospective randomized studies with this kind of combined therapy.     

Retrospective study of 88 cases of cancer of the cervical esophagus and definition of a new therapeutic approach

Eighty-eight cases of cancers of the cervical esophagus were treated at the Institut Gustave-Roussy (France) between 1968 and 1980. They included 67 epitheliomas of the esophageal opening excluding those of the hypopharynx extending into the esophagus, and 21 epitheliomas of the actual cervical portion of the esophagus. Whenever possible, basic therapy was by radiotherapy (64 cases). There were no survivors after 2 years, possible explanations for this poor result being the selection criteria for treatment, the choice of radiotherapy as basic treatment, and the doses employed. A new therapeutic approach is suggested following a pathological study and an analysis of the different therapeutic possibilities available. Pre-operative chemotherapy is followed by total laryngopharyngectomy with total esophagectomy without opening of the thorax, performed under certain well defined conditions. Continuity is reestablished by gastropharyngostomy and postoperative radiotherapy is applied systematically. This therapeutic approach involving major surgery is applicable only for selected patients, others having to be treated by combined radiotherapy and chemotherapy alone.     

On some periodic toda lattices

A discrete version of Floquet's theory is developed and applied to a system of non-linear differential equations related to the periodic Toda lattice. A special solution previously found by Toda is thus seen to fit into the formalism of inverse scattering problems.     

On some isospectral second order differential operators

A method of exhibiting potentials which are uniquely determined by their spectra is discussed and illustrated in an example.     

Combination vindesine, cyclophosphamide, cis-platinum and CCNU in esophageal epidermoid cancer. Preliminary analysis of 64 cases

We have treated 64 patients with esophageal squamous cell carcinoma using a combination of Vindesine 1.4 mg/m2 on day 1-2, Cyclophosphamide 200 mg/m2 on day 2-3-4, Cis-Platin 100 mg/m2 on day 3 and CCNU. 28 of the 37 patients considered to be inoperable were evaluable. We observed three complete responses and three partial responses in this group (overall response rate 21,5%). Twenty seven patients considered to be operable received the same chemotherapy without CCNU, owing to the risk of thrombopenia. 23 of these patients were evaluable in whom we observed 35% partial responses and no complete responses. No severe toxicity related to the chemotherapy protocol was observed. The mediocre results among the group of inoperable patients suggest that other chemotherapy protocols need to be tested. On the other hand, in the group of operable patients, the preliminary results encourage us to continue this study.     

Hexosaminidase as a new potential marker for middle ear cholesteatoma

OBJECTIVES: The study aim was to investigate the activities of hexosaminidase (HEX) in cholesteatoma tissue compared with that in normal skin. DESIGN AND METHODS: The enzyme activities were determined using the Chatterjee et al. method in the modification of Zwierz et al. in cholesteatoma and skin. RESULTS: Significantly higher activity of hexosaminidase was observed in cholesteatoma tissue compared with the skin. CONCLUSIONS: Hex may be considered as a new pathogenetic factor in that destructive lesion.     

The anatomical relationships between the serotonergic afferents and the neurons containing calcium-binding proteins in the rat claustrum

Claustrum is a telencephalic structure integrating information of various modalities. Proper functioning of this structure depends on the presence of a network of intrinsic connections. This includes GABA-ergic neuronal populations that also contain calcium-binding proteins (CaBPs). The goal of this study was to analyze qualitative and quantitative the 5-HT-containing fibers in the rat claustrum and to assess the relationships between these fibers and the populations of claustral neurons expressing CaBPs. We used the methods of immunocytochemistry and morphometry. The serotonergic fibers in the claustrum are heterogeneous, both with respect to their morphology and spatial distribution. Thin varicose fibers are more numerous and are homogeneously distributed within the claustrum. Remaining fibers were thicker and possessed larger varicosities. They were present mainly in the ventral part of the claustrum. Although the serotonergic fibers are found in the vicinity of claustral cells containing CaBPs, direct contacts between these fibers and cells are rare. Other mechanisms, including volume transmission, may possibly mediate serotonergic influences.