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Amelot A, Terrier LM, Mathon B, Joubert C, Picart T, Jecko V, Bauchet L, Benard F, Castel X, Chenin L, Cook AR, Emery E, Figarella-Branger D, Gauchotte G, Graillon T, Jouvet A, Kalamarides M, Knafo S, Lazard A, Lubrano V, Mokhtari K, Rigau V, Roualdes V, Rousseau A, Seizeur R, Uro-Coste E, Voirin J, Metellus P, Pallud J, Zemmoura I. Natural Course and Prognosis of Primary Spinal Glioblastoma: A Nationwide Study. Neurology 2023; 100:e1497-e1509. [PMID: 36690453 PMCID: PMC10104612 DOI: 10.1212/wnl.0000000000206834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/05/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Primary spinal glioblastoma is extremely rare. The dramatic neurological deterioration and unresectability of primary spinal glioblastoma makes it a particularly disabling malignant neoplasm. Since it is a rare and heterogeneous disease, the assessment of prognostic factors remains limited. METHODS Primary spinal glioblastomas were identified from The French Brain Tumor Database and the Club de Neuro-Oncologie of the Société Française de Neurochirurgie retrospectively. Inclusion criteria were age ≥ 18 years at diagnosis, spinal location, histopathological diagnosis of newly glioblastoma according to the 2016 World Health Organization classification, and surgical management between 2004 and 2016. Diagnosis was confirmed by a centralized neuropathological review. The primary outcome was overall survival. Therapeutic interventions and neurological outcomes were also collected. RESULTS Thirty-three patients with an histopathologically confirmed primary spinal glioblastoma (median age 50.9 years) were included (27 centers). The median overall survival (OS) was 13.1 months (range 2.5-23.7) and the median progression-free survival was 5.9 months (range 1.6-10.2). In multivariable analyses using Cox model, ECOG PS at 0-1 was the only independent predictor of longer OS [Hazard Ratio: 0.13, 95%CI 0.02-0.801; p=0.02], whereas a Karnofsky PS score <60 [Hazard Ratio: 2.89, 95%CI 1.05-7.92; p=0.03] and a cervical anatomical location [Hazard Ratio: 4.14, 95%CI 1.32-12.98; p=0.01] were independent predictors of shorter OS. The ambulatory status (Frankel D-E) [Hazard Ratio: 0.38, 95%CI 0.07-1.985; p=0.250] was not an independent prognostic factor while the concomitant standard radiochemotherapy with temozolomide (Stupp protocol) [Hazard Ratio: 0.35, 95%CI 0.118-1.05; p=0.06] was at the limit of significance. DISCUSSION Preoperative ECOG PS, Karnofsky PS score and the location are independent predictors of overall survival of primary spinal glioblastomas in adults. Further analyses are required to capture the survival benefit of concomitant standard radiochemotherapy with temozolomide.
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Affiliation(s)
- Aymeric Amelot
- Department of Neurosurgery, CHRU de Tours, Tours, France
| | - Louis-Marie Terrier
- Department of Neurosurgery, Clairval Private Hospital, Ramsay Generale de Sante, Marseille, France
| | - Bertrand Mathon
- Department of Neurosurgery, CHU Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France
| | | | - Thiebaud Picart
- Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - Vincent Jecko
- Department of Neurosurgery A, CHU Pellegrin, Bordeaux, France
| | - Luc Bauchet
- Department of Neurosurgery, Hôpital Saint Eloi - Gui de Chauliac, Montpellier, France
| | - Florian Benard
- Department of Neurosurgery, CHU d'Angers, Angers, France
| | - Xavier Castel
- Department of Neurosurgery, CHU de St-Etienne, St Etienne, France
| | - Louis Chenin
- Department of Neurosurgery, CHU Amiens-Picardie, Amiens, France
| | - Ann-Rose Cook
- Department of Neurosurgery, CHRU de Tours, Tours, France
| | - Evelyne Emery
- Department of Neurosurgery, CHU de Caen, Caen, France
| | | | | | - Thomas Graillon
- Aix Marseille Univ, INSERM, APHM, MMG, UMR1251, Marmara Institute, La Timone Hospital, Neurosurgery departement, Marseille, France
| | - Anne Jouvet
- Department of Pathology, Cancer University Institute of Toulouse Oncopole, CHU Toulouse, Toulouse, France
| | - Michel Kalamarides
- Department of Neurosurgery, CHU Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France
| | - Steven Knafo
- Department of Neurosurgery, le Kremlin-Bicêtre, AP-HP, Kremlin-Bicêtre, France
| | - Arnaud Lazard
- Department of Neurosurgery, CHU Grenoble-Alpes, Grenoble, France
| | | | - Karima Mokhtari
- Department of Neuropathology, Pitié-Salpêtrière, AP-HP, Paris, France
| | - Valérie Rigau
- Department of Neuropathology, CHU Gui de Chauliac, Montpellier, France
| | | | | | - Romuald Seizeur
- Department of Neurosurgery, CHU de la Cavale Blanche, Brest, France
| | - Emmanuelle Uro-Coste
- Department of Pathology, Cancer University Institute of Toulouse Oncopole, CHU Toulouse, Toulouse, France
| | - Jimmy Voirin
- Department of Neurosurgery, Pasteur Hospital, HCC, Colmar, France
| | - Philippe Metellus
- Department of Neurosurgery, Clairval Private Hospital, Ramsay Generale de Sante, Marseille, France
| | - Johan Pallud
- Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, Paris, France
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Pourbabaee B, Patterson MH, Patterson MR, Benard F. SleepNet: automated sleep analysis via dense convolutional neural network using physiological time series. Physiol Meas 2019; 40:084005. [PMID: 31349239 DOI: 10.1088/1361-6579/ab3632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In this work, a dense recurrent convolutional neural network (DRCNN) was constructed to detect sleep disorders including arousal, apnea and hypopnea using polysomnography (PSG) measurement channels provided in the 2018 PhysioNet Challenge database. APPROACH Our model structure is composed of multiple dense convolutional units (DCU) followed by a bidirectional long-short term memory (LSTM) layer followed by a softmax output layer. The sleep events, including sleep stages, arousal regions and multiple types of apnea and hypopnea, are manually annotated by experts, which enables us to train our proposed network using a multi-task learning mechanism. Three binary cross-entropy loss functions, corresponding to sleep/wake, target arousal and apnea-hypopnea/normal detection tasks, are summed up to generate our overall network loss function that is optimized using the Adam method. Our model performance was evaluated using two metrics: the area under the precision-recall curve (AUPRC) and the area under the receiver operating characteristic curve (AUROC). To measure our model generalization, 4-fold cross-validation was also performed. For training, our model was applied to full night recording data. MAIN RESULTS Finally, the average AUPRC and AUROC values associated with the arousal detection task were 0.505 and 0.922, respectively, on our testing dataset. An ensemble of four models trained on different data folds improved the AUPRC and AUROC to 0.543 and 0.931, respectively. SIGNIFICANCE Our proposed algorithm achieved the first place in the official stage of the 2018 PhysioNet Challenge for detecting sleep arousals with an AUPRC of 0.54 on the blind testing dataset.
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Schaffer P, Benard F, Vuckovic M, Zeisler S, Anazodo U, Romsa J, Cross M, Foster S, Gleeson F, Hayashi K, Hook B, Kumlin J, Buckley K, Schlosser J, Wilson K, Dodd M, Hanemaayer V, Kovacs M, Mcdiarmid S, Prato F, Ruth TH, Valliant J. Cyclotron-based production of Tc-99m and other metals. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30209-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lenferink A, Baardsnes J, Sulea T, Wu C, Acchione M, Jaramillo M, McDonald P, Benard F, Dedhar S. PO-033 Identification and functional evaluation of monoclonal antibodies specifically targeting human carbonic anhydrase IX. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lacroix-Poisson F, Benard F, Wilson D, Adam M, Yapp D, Ho C, Laskin J. P1.03-020 Detection of Hypoxia Using EF5 PET/CT in 10 Patients with Advanced NSCLC Receiving Chemotherapy with and without Bevacizumab. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lefebvre-Lacœuille C, Lacœuille F, Rousseau C, Courbon F, Benard F, Couturier OF. 16α-[18F]-fluoro-17ß-oestradiol ([18F]FES): A biomarker for imaging oestrogen receptor expression with positron emission tomography (PET). Médecine Nucléaire 2015. [DOI: 10.1016/j.mednuc.2015.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Buckley K, Benard F, Kovacs M, Hanemaayer V, Hook B, McDiarmid S, Zeisler S, Dodd M, Corsaut J, Vuckovic M, Cockburn N, Economou C, Harper R, Valliant J, Ruth T, Schaffer P. Large-scale cyclotron production of 99mTc. Nucl Med Biol 2014. [DOI: 10.1016/j.nucmedbio.2014.05.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hanemaayer V, Benard F, Buckley KR, Klug J, Kovacs M, Leon C, Ruth TJ, Schaffer P, Zeisler SK. Solid targets for 99mTc production on medical cyclotrons. J Radioanal Nucl Chem 2013. [DOI: 10.1007/s10967-013-2626-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kosztyla R, Moiseenko V, Reinsberg S, Ma R, McKenzie M, Wilson D, Benard F, Vertinsky T, Toyota B, Nichol A. TH-C-141-06: Estimating Cell Density Using Fractional Anisotropy From Postoperative Diffusion Tensor Imaging of High-Grade Gliomas. Med Phys 2013. [DOI: 10.1118/1.4815774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Shukla T, Nichol G, Wells G, Garrard L, Guo A, Davies R, Haddad H, Duchesne L, Freeman M, Gulenchyn K, Racine N, Humen D, Benard F, deKemp R, Chen L, Ruddy T, Chow B, DaSilva J, Beanlands R. 577 The role of fluorodeoxyglucose positron emission tomography guided management in improving quality of life amongst patients with ischemic left ventricular dysfunction. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Hou X, Grimes J, Benard F, Ruth TJ, Celler A. MO-F-110-08: Yields and Dosimetry Estimates for Radioisotopes Produced in Proton-Induced Reactions on Enriched Molybdenum Targets. Med Phys 2011. [DOI: 10.1118/1.3613030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kosztyla R, Hsu F, Wilson D, Zhang S, Moiseenko V, Ma R, McKenzie M, Benard F, Nichol A. WE-G-214-08: Interobserver Volume Variations in the Target Delineation of High-Grade Gliomas Using Magnetic Resonance Imaging and 18F-FDOPA Positron Emission Tomography. Med Phys 2011. [DOI: 10.1118/1.3613429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Savage KJ, Connors JM, Klasa RJ, Hoskins P, Shenkier TN, Gascoyne RD, Bhimji S, Pickles T, Benard F, Wilson D, Sehn LH. The use of FDG-PET to guide consolidative radiotherapy in patients with advanced-stage Hodgkin lymphoma with residual abnormalities on CT scan following ABVD chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Porter C, Walz J, Gallina A, Jeldres C, Kodama K, Gibbons R, Correa R, Perrotte P, Benard F, Saad F, Karakiewicz P. 634 NATURAL HISTORY OF BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY FOR PROSTATE CANCER. EUR UROL SUPPL 2007. [DOI: 10.1016/s1569-9056(07)60632-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Benard F, Campistron I, Laguerre A, Laval F. Influence of silica fillers during the electron irradiations of DGEBA/TETA epoxy resins, part I: Study of the chemical modification on model compounds. Polym Degrad Stab 2006. [DOI: 10.1016/j.polymdegradstab.2006.01.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Benard F, Campistron I, Laguerre A, Vigier G, Laval F. Influence of silica fillers during the electron irradiation of DGEBA/TETA epoxy resins, part II: Study of the thermomechanical properties. Polym Degrad Stab 2006. [DOI: 10.1016/j.polymdegradstab.2006.01.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Karakiewicz PI, Perrotte P, Valiquette L, Benard F, McCormack M, Menard C, McNaughton Collins M, Nickel JC. French-Canadian linguistic validation of the NIH Chronic Prostatitis Symptom Index. Can J Urol 2005; 12:2816-23. [PMID: 16274517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION The NIH Chronic Prostatitis Symptom Index (CPSI) is recommended in the clinical evaluation of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, its use is not possible in French speakers, as it has not been validated in this population. We performed a linguistic validation of the CPSI. METHODS Linguistic translation followed the forward-backward-forward technique and relied on professional medical translators, bilingual health professionals, and patient input. Along with the SF-12, the translated version was administered to a convenience sample of men presenting for pre-vasectomy visits (controls) and to consecutive patients with established CP/CPPS (cases). Men with CP/CPPS were subsequently asked to complete a 14-day retest questionnaire. Psychometric testing addressed standard reliability and validity characteristics. RESULTS Thirty-six cases and 38 controls with respective mean ages of 46.5 and 44.0 years participated and 33 (91.2%) cases completed the retest questionnaire. Pain (p<0.001), urinary (p<0.001) and quality-of-life (QOL) scale (p<0.001) score means differed between cases and controls. For the same scales, Cronbach's alphas for cases were respectively 0.70, 0.72 and 0.79 versus 0.80, 0.57, and 0.88 for controls. The retest product-moments were 0.83 for pain, 0.55 for urinary, and 0.83 for QOL scales. In cases, strong correlation was noted between QOL and pain scales (r=0.7), and between urinary and pain scales (r=0.6), versus moderate correlation between QOL and urinary scales (r=0.4). Negative correlation was recorded between CPSI scales and SF-12 scales, which ranged from -0.2 to -0.4. CONCLUSIONS When applied to CPPS and control subjects, the French Canadian CPSI translation demonstrates excellent discriminant properties. Moreover, its reliability and validity characteristics confirm the qualities of the CPSI as a standard evaluative tool for men with CPPS.
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Affiliation(s)
- P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Montreal Health Center, Montreal, Quebec, Canada
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Heaton JP, Lording D, Liu SN, Litonjua AD, Guangwei L, Kim SC, Kim JJ, Zhi-Zhou S, Israr D, Niazi D, Rajatanavin R, Suyono S, Benard F, Casey R, Brock G, Belanger A. Intracavernosal alprostadil is effective for the treatment of erectile dysfunction in diabetic men. Int J Impot Res 2001; 13:317-21. [PMID: 11918246 DOI: 10.1038/sj.ijir.3900760] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The efficacy and safety of intracavernosal alprostadil was evaluated for the treatment of erectile dysfunction in men with type I or type II diabetes mellitus. This was an open-label, flexible dose-escalating study involving 336 men (77% of whom were Asian/Oriental) enrolled by 15 centres in Australia, Canada and seven countries in Asia. The effective alprostadil dose, ie the dose producing penile rigidity adequate for intercourse and lasting up to 60 min, was established by titration at the clinic prior to entry into the 6 month self-treatment home phase. All men were fully trained in the self-injection technique before entry into the home phase. Efficacy and safety were assessed using patient and partner diaries and by interview at clinic visits during the titration phase and after 1, 3 and 6 months of treatment. An effective home dose was established by titration for 94% of the 336 men (median dose 20 microg, range 2.5-60 microg). Of 278 (83%) men who entered the home phase, 277 men (247 with type II diabetes and 30 with type I diabetes) had evaluable data for alprostadil dosage and clinical response. During the home phase, a satisfactory erectile response was achieved after 99% of injections, and the median alprostadil dose remained unchanged. The initial home dose and clinical response were similar in type I and type II diabetic men. Treatment was generally well tolerated with a low incidence of penile pain (24%) In conclusion, intracavernosal alprostadil was effective and well tolerated in type I and type II diabetic men with erectile dysfunction of mixed aetiology.
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Abstract
A 77-year-old man with stage IIB squamous cell carcinoma of the lung underwent right upper lobectomy. One month later he was examined for right chest pain, dyspnea, cough, and weakness. A roentgenogram showed nondiagnostic diffuse opacification of his right lung cavity. An F-18 FDG positron emission tomographic (PET) study revealed extensive uptake in the right pleural area, left adrenal gland, right axilla, and soft tissues consistent with extensive local recurrence and metastatic disease. Biopsy of a right chest soft tissue lesion showed spindle cell carcinoma, a rare variant of squamous cell carcinoma.
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Affiliation(s)
- J Verreault
- Service of Nuclear Medicine, Centre Universitaire de Santé de l'Estrie, University of Sherbrooke, Quebec, Canada.
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Mandel SJ, Shankar LK, Benard F, Yamamoto A, Alavi A. Superiority of iodine-123 compared with iodine-131 scanning for thyroid remnants in patients with differentiated thyroid cancer. Clin Nucl Med 2001; 26:6-9. [PMID: 11139058 DOI: 10.1097/00003072-200101000-00002] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Iodine-123 is a pure gamma emitter and has excellent characteristics for imaging with modern scintillation cameras. The goal of this study was to compare the performance of I-123 and I-131 as imaging agents for whole-body scanning in patients with differentiated thyroid cancer undergoing ablation for thyroid remnants after initial surgery. METHODS Fourteen patients with differentiated thyroid cancer who had undergone near-total thyroidectomy and had serum thyroid-stimulating hormone levels greater than 40 mU/I underwent diagnostic scanning 5 hours after administration of 48 to 56 MBq (1.3 to 1.5 mCi) I-123 and 48 hours after administration of 111 MBq (3 mCi) I-131. After receiving ablative I-131 therapy, they also underwent whole-body planar imaging 7 days later. The diagnostic I-123 and I-131 scans were compared with each other and with the post-therapy images by two nuclear medicine physicians and one endocrinologist. RESULTS The diagnostic scans revealed 35 foci in the thyroid bed and neck. The I-123 images showed all 35 foci, but only 32 of the 35 foci (91 %) were seen on the I-131 scans. The findings of pre- and post-therapy scans were concordant in 11 of 13 patients, and the same general sites of uptake (left and right thyroid bed, midline) were revealed on both sets of images. In one patient, a focus seen on the diagnostic I-123 and I-131 images was not visualized on the post-therapy scan and was thought to represent possible stunning. An additional area of uptake in the lower right neck and upper mediastinum was present on the post-therapy scan of another patient, but it was not seen on diagnostic images. CONCLUSION These results show improved quality of imaging with 50 MBq (1.5 mCi) I-123 compared with 111 MBq (3 mCi) I-131 for whole-body scanning in patients with differentiated thyroid cancer undergoing thyroid remnant ablation. I-123 imaging may prove to be the preferred procedure in such settings in patients with differentiated thyroid cancer.
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Affiliation(s)
- S J Mandel
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia 19104, USA
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Shiue C, Shiue GG, Benard F, Visonneau S, Santoli D, Alavi AA. N-(n-Benzylpiperidin-4-yl)-2-[18F]fluorobenzamide: a potential ligand for PET imaging of breast cancer. Nucl Med Biol 2000; 27:763-7. [PMID: 11150709 DOI: 10.1016/s0969-8051(00)00161-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
N-(N-Benzylpiperidin-4-yl)-2-[(18)F]fluorobenzamide (2), a potential ligand for PET imaging of sigma receptor, has been found to be a potential agent for detection of breast cancer. In vivo studies in severe combined immunodeficient (SCID) mice bearing MDA-MB231 tumors showed that the uptake of compound 2 in these tumors was high (3.8%/g); the ratios of tumor/muscle and tumor/blood were 6.2 and 7.0, respectively, at 1 h postinjection. Pretreatment of SCID mice with haldol increased the uptake of compound 2 in blood, muscle, and other well-perfused organs while decreasing its uptake in tumors. The ratios of tumor/muscle and tumor/blood decreased from 6.2 and 7.0 to 1.3 and 1.1, respectively, at 1 h postinjection. At 2 h postinjection, the ratios of tumor/muscle and tumor/blood decreased from 4.9 and 7.8 to 1.4 and 1.4, respectively. The tumor uptake of compound 2 in SCID mice bearing primary tumor explants from a human breast cancer patient was lower than that in MDA-MB231 tumors (1.66%/g versus 3.78%/g), and the ratios of tumor/muscle and tumor/blood were 3.5 and 3.7, respectively, at 1 h postinjection. These results suggest that compound 2 may be a potential ligand for PET imaging of breast cancer.
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Affiliation(s)
- C Shiue
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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Hustinx R, Smith RJ, Benard F, Bhatnagar A, Alavi A. Can the standardized uptake value characterize primary brain tumors on FDG-PET? Eur J Nucl Med 1999; 26:1501-9. [PMID: 10552096 DOI: 10.1007/s002590050487] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of this study was to evaluate the usefulness of measuring the standardized uptake value (SUV) in primary brain tumors on fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) scans. Two groups of patients were studied. Whole-brain glucose cerebral metabolic rates (wCMRs) and SUVs were obtained in 20 normal subjects. Twenty-seven patients with histology-proven malignant primary CNS tumors (high-grade gliomas n=22, primitive neuroectodermal tumors n=3, ependymomas n=2) were also studied. The degree of FDG uptake was assessed by visual inspection and thereafter regions of interest were placed over the lesion, the contralateral cortex and white matter and the whole brain. Average (avg) and maximum (max) pixel values were determined in each site. Based on these measurements, SUV, tumor to cortex (T/C) and tumor to white matter (T/WM) activity ratios were calculated. There was no correlation between wCMRs (4.55+/-0.36 mg min(-1) 100 g(-1)) and wSUVs (5.41+/-0.43) in the normal subjects (r=0.18, P=0.45). In the second group, 17 lesions were described as definitely and seven as probably malignant. However, SUVs in these tumors and in the contralateral cortex were not significantly different. Although the SUVs were generally higher in the tumor than in the contralateral white matter, there was a significant overlap between the values. The range of the SUVs was wide: 2.54-11.8 for the tumors, 2.98-9.96 for the cortex and 1.87-6.76 for the white matter. SUVs in the normal cortex were negatively correlated with blood glucose level at the time of the injection. SUVs in the whole brain and in the cortex were lower in patients previously treated by irradiation, even months after completion of the treatment. No correlation was detectable between any of the SUVs and the age of the patients, tumor type, time post injection, use of dexamethasone, patient weight, dose injected and visual score. With cutoff levels of 1.5 for T max/WM and 0.6 for T max/C, the sensitivity of the activity ratios was 74% and 96% respectively. In conclusion, SUVs do not correlate with CMRs across subjects and appear to be of limited value in characterizing brain tumors. Visual assessment and measurement of the activity ratios currently remain the most reliable methods of analysis.
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Affiliation(s)
- R Hustinx
- Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
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Hustinx R, Smith RJ, Benard F, Rosenthal DI, Machtay M, Farber LA, Alavi A. Dual time point fluorine-18 fluorodeoxyglucose positron emission tomography: a potential method to differentiate malignancy from inflammation and normal tissue in the head and neck. Eur J Nucl Med 1999; 26:1345-8. [PMID: 10541835 DOI: 10.1007/s002590050593] [Citation(s) in RCA: 201] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) studies imaging FDG PET imaging is used to detect and stage head and neck cancers. However, the variable physiologic uptake of FDG in different normal structures as well as at inflammatory sites may either obscure a tumor focus or be falsely interpreted to represent tumor activity. Twenty-one patients (9 men, 12 women, median age 59) were scanned serially at two time points, one at 70 min (range 47-112) and the second at 98 min (77-142) after the intravenous injection of 4.3 MBq/kg of FDG. The mean interval between emission scans was 28 min (13-49). Transmission scans were performed and regions of interest (ROIs) were overlayed on the fully corrected images. Standardiued uptake values (SUVs) were generated for the cerebellum, tongue, larynx, every lesion, and a matched contralateral site. Follow-up and pathologic studies revealed 18 squamous cell carcinomas and nine inflammatory or infectious lesions. Tumor SUVs were 4.0+/-1.6 (mean +/- SD) for the first scan and 4. 5+/-2.2 for the second scan. Contralateral SUVs were 1.2+/-0.5 and 1. 1+/-0.5 for the two scans. Tumor SUVs increased by 12%+/-12% as compared with a 5%+/-17% decrease for contralateral sites (P<0.05). SUVs for inflammatory sites (2.0+/-0.7 and 2.0+/-0.9), cerebellum (4. 2+/-1.3 and 4.3+/-1.4), tongue (1.8+/-0.4 and 1.9+/-0.5) and larynx (1.5+/-0.6 and 1.5+/-0.6) remained constant over time (+0.6%, +2.8%, +1.4%, and -2.4%; P<0.05 when compared with tumor SUV changes). The ratio tumor/contralateral SUV increased by 23%+/-29% over time while this ratio for inflamed sites increased by only 5%+/-15% (P=0.07). The time interval between scans correlated with increase in SUV for tumors (r=0.55, P<0.05) but not for any of the other ROIs. Separation was superior when studies were performed more than 30 min apart (P<0.05). These preliminary data suggest that dual time point imaging compatible with a clinical study protocol is helpful in differentiating malignant lesions from inflammation and normal tissues, especially when separated by a sufficient time interval.
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Affiliation(s)
- R Hustinx
- Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Donner Building Room 110, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Farber LA, Benard F, Machtay M, Smith RJ, Weber RS, Weinstein GS, Chalian AA, Alavi A, Rosenthal DI. Detection of recurrent head and neck squamous cell carcinomas after radiation therapy with 2-18F-fluoro-2-deoxy-D-glucose positron emission tomography. Laryngoscope 1999; 109:970-5. [PMID: 10369292 DOI: 10.1097/00005537-199906000-00024] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES/HYPOTHESIS Fluorodeoxyglucose positron emission tomography (FDG-PET) has been proposed as a sensitive method to diagnose and stage various malignancies. We assessed the efficacy of FDG-PET imaging in distinguishing tumor persistence/recurrence from posttreatment changes following radiation therapy for squamous carcinomas of the head and neck STUDY DESIGN Retrospective analysis of FDG-PET results compared with biopsy results or outcome, or both. METHODS Twenty-eight patients who had undergone radiation therapy with or without surgery for treatment of squamous cell carcinoma were studied with FDG-PET imaging. There was clinical suspicion for recurrence in each patient, but no obvious mass or lesion to biopsy was found on physical examination or anatomic imaging. The results of FDG-PET imaging were compared with those of biopsy or clinical follow-up of at least 6 months, or both. RESULTS FDG-PET imaging was positive in 13 patients, and the presence of active disease was confirmed in 12. Two thirds of the 12 received further cancer treatment. There were 15 negative FDG-PET images. Thirteen of these were confirmed true-negative images, but two studies were false-negative images. The sensitivity and specificity of FDG-PET were 86% and 93%, respectively, with positive and negative predictive values of 92% and 87%, respectively. The overall accuracy was 89%. CONCLUSION FDG-PET imaging is a useful modality to distinguish tumor persistence/recurrence from radiation-induced tissue changes in the neck following treatment for head and neck cancer. FDG-PET can identify patients who may benefit from further treatment, and may lead to improved outcome for individual patients.
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Affiliation(s)
- L A Farber
- Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA
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Bedigian MP, Benard F, Smith RJ, Karp JS, Alavi A. Whole-body positron emission tomography for oncology imaging using singles transmission scanning with segmentation and ordered subsets-expectation maximization (OS-EM) reconstruction. Eur J Nucl Med 1998; 25:659-61. [PMID: 9722421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Shiue CY, Shiue GG, Zhang SX, Wilder S, Greenberg JH, Benard F, Wortman JA, Alavi AA. N-(N-benzylpiperidin-4-yl)-2-[18F]fluorobenzamide: a potential ligand for PET imaging of sigma receptors. Nucl Med Biol 1997; 24:671-6. [PMID: 9352539 DOI: 10.1016/s0969-8051(97)00097-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Four nitro- and fluorobenzamides (1-4) have been synthesized in good yields from nitro- and fluoro-substituted benzoyl chloride with 4-amino-1-benzylpiperidine. In vitro studies showed that these compounds have high affinities to sigma receptors. N-(N-Benzylpiperidin-4-yl)-2-fluorobenzamide (3), in particular, bound to sigma receptors with high affinity (Ki = 3.4 nM, guinea pig brain membranes) and high selectivity (sigma-2/sigma-1 = 120). It was, therefore, labeled with 18F and evaluated as a sigma receptor radioligand. N-(N-Benzylpiperidin-4-yl)-2-[18F]fluorobenzamide (3a) was synthesized in one step by nucleophile substitution of the 2-nitro precursor (1) with [18F]fluoride in DMSO at 140 degrees C for 20 min followed by purification with HPLC in 4-10% yield (decay corrected). The synthesis time was 90 min and the specific activity was 0.4-1.0 Ci/mumol. Tissue distribution in mice revealed that the uptakes of 3a in the brain, heart, liver, lungs, spleen, kidneys and small intestine were high, and the radioactivity in these organs remained constant from 60 to 120 min post-injection. The radioactivity in the bone did not significantly increase, suggesting in vivo defluorination may not be the major route of metabolism of 3a in mice. Blocking studies with haloperidol in rats indicated that the uptake of compound 3a in the rat brain was selective to haloperidol-sensitive sigma sites. These results suggest that compound 3a is a potent sigma receptor radioligand and may be a potential ligand for PET imaging of sigma receptors in humans.
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Affiliation(s)
- C Y Shiue
- Department of Radiology, University of Pennsylvania, Philadelphia 19104, USA
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Derrick M, Krakauer D, Magill S, Mikunas D, Musgrave B, Okrasinski JR, Repond J, Stanek R, Talaga RL, Zhang H, Mattingly MCK, Anselmo F, Antonioli P, Bari G, Basile M, Bellagamba L, Boscherini D, Bruni A, Bruni G, Bruni P, Romeo GC, Castellini G, Cifarelli L, Cindolo F, Contin A, Corradi M, Gialas I, Giusti P, Iacobucci G, Laurenti G, Levi G, Margotti A, Massam T, Nania R, Palmonari F, Pesci A, Polini A, Sartorelli G, Garcia YZ, Zichichi A, Amelung C, Bornheim A, Crittenden J, Deffner R, Doeker T, Eckert M, Feld L, Frey A, Geerts M, Grothe M, Hartmann H, Heinloth K, Heinz L, Hilger E, Jakob HP, Katz UF, Mengel S, Paul E, Pfeiffer M, Rembser C, Schramm D, Stamm J, Wedemeyer R, Campbell-Robson S, Cassidy A, Cottingham WN, Dyce N, Foster B, George S, Hayes ME, Heath GP, Heath HF, Piccioni D, Roff DG, Tapper RJ, Yoshida R, Arneodo M, Ayad R, Capua M, Garfagnini A, Iannotti L, Schioppa M, Susinno G, Caldwell A, Cartiglia N, Jing Z, Liu W, Parsons JA, Ritz S, Sciulli F, Straub PB, Wai L, Yang S, Zhu Q, Borzemski P, Chwastowski J, Eskreys A, Jakubowski Z, Przybycień MB, Zachara M, Zawiejski L, Adamczyk L, Bednarek B, Jeleń K, Kisielewska D, Kowalski T, Przybycien M, Rulikowska-Zarębska E, Suszycki L, Zając J, Duliński Z, Kotański A, Abbiendi G, Bauerdick LAT, Behrens U, Beier H, Bienlein JK, Cases G, Deppe O, Desler K, Drews G, Flasiński M, Gilkinson DJ, Glasman C, Göttlicher P, Große-Knetter J, Haas T, Hain W, Hasell D, Heßling H, Iga Y, Johnson KF, Joos P, Kasemann M, Klanner R, Koch W, Kötz U, Kowalski H, Labs J, Ladage A, Löhr B, Löwe M, Lüke D, Mainusch J, Mańczak O, Milewski J, Monteiro T, Ng JST, Notz D, Ohrenberg K, Piotrzkowski K, Roco M, Rohde M, Roldán J, Schneekloth U, Schulz W, Selonke F, Surrow B, Tassi E, Voß T, Westphal D, Wolf G, Wollmer U, Youngman C, Zeuner W, Grabosch HJ, Kharchilava A, Mari SM, Meyer A, Schlenstedt S, Wulff N, Barbagli G, Gallo E, Pelfer P, Maccarrone G, Pasquale S, Votano L, Bamberger A, Eisenhardt S, Trefzger T, Wölfle S, Bromley JT, Brook NH, Bussey PJ, Doyle AT, Saxon DH, Sinclair LE, Utley ML, Wilson AS, Dannemann A, Holm U, Horstmann D, Sinkus R, Wick K, Burow BD, Hagge L, Lohrmann E, Poelz G, Schott W, Zetsche F, Bacon TC, Brümmer N, Butterworth I, Harris VL, Howell G, Hung BHY, Lamberti L, Long KR, Miller DB, Pavel N, Prinias A, Sedgbeer JK, Sideris D, Whitfield AF, Mallik U, Wang MZ, Wang SM, Wu JT, Cloth P, Filges D, An SH, Cho GH, Ko BJ, Lee SB, Nam SW, Park HS, Park SK, Kartik S, Kim HJ, McNeil RR, Metcalf W, Nadendla VK, Barreiro F, Fernandez JP, Graciani R, Hernández JM, Hervás L, Labarga L, Martinez M, Peso J, Puga J, Terron J, Trocóniz JF, Corriveau F, Hanna DS, Hartmann J, Hung LW, Lim JN, Matthews CG, Patel PM, Riveline M, Stairs DG, St-Laurent M, Ullmann R, Zacek G, Tsurugai T, Bashkirov V, Dolgoshein BA, Stifutkin A, Bashindzhagyan GL, Ermolov PF, Gladilin LK, Golubkov YA, Kobrin VD, Korzhavina IA, Kuzmin VA, Lukina OY, Proskuryakov AS, Savin AA, Shcheglova LM, Solomin AN, Zotov NP, Botje M, Chlebana F, Engelen J, Kamps M, Kooijman P, Kruse A, Sighem A, Tiecke H, Verkerke W, Vossebeld J, Vreeswijk M, Wiggers L, Wolf E, Woudenberg R, Acosta D, Bylsma B, Durkin LS, Gilmore J, Li C, Ling TY, Nylander P, Park IH, Romanowski TA, Bailey DS, Cashmore RJ, Cooper-Sarkar AM, Devenish RCE, Harnew N, Lancaster M, Lindemann L, McFall JD, Nath C, Noyes VA, Quadt A, Tickner JR, Uijterwaal H, Walczak R, Waters DS, Wilson FF, Yip T, Bertolin A, Brugnera R, Carlin R, Corso F, Giorgi M, Dosselli U, Limentani S, Morandin M, Posocco M, Stanco L, Stroili R, Voci C, Zuin F, Bulmahn J, Feild RG, Oh BY, Whitmore JJ, D’Agostini G, Marini G, Nigro A, Hart JC, McCubbin NA, Shah TP, Barberis E, Dubbs T, Heusch C, Hook M, Lockman W, Rahn JT, Sadrozinski HFW, Seiden A, Williams DC, Biltzinger J, Seifert RJ, Schwarzer O, Walenta AH, Zech G, Abramowicz H, Briskin G, Dagan S, Levy A, Fleck JI, Inuzuka M, Ishii T, Kuze M, Mine S, Nakao M, Suzuki I, Tokushuku K, Umemori K, Yamada S, Yamazaki Y, Chiba M, Hamatsu R, Hirose T, Homma K, Kitamura S, Matsushita T, Yamauchi K, Cirio R, Costa M, Ferrero MI, Maselli S, Peroni C, Sacchi R, Solano A, Staiano A, Dardo M, Bailey DC, Benard F, Brkic M, Fagerstroem CP, Hartner GF, Joo KK, Levman GM, Martin JF, Orr RS, Polenz S, Sampson CR, Simmons D, Teuscher RJ, Butterworth JM, Catterall CD, Jones TW, Kaziewicz PB, Lane JB, Saunders RL, Shulman J, Sutton MR, Lu B, Mo LW, Bogusz W, Ciborowski J, Gajewski J, Grzelak G, Kasprzak M, Krzyżanowski M, Muchorowski K, Nowak RJ, Pawlak JM, Tymieniecka T, Wróblewski AK, Zakrzewski JA, Żarnecki AF, Adamus M, Coldewey C, Eisenberg Y, Hochman D, Karshon U, Revel D, Zer-Zion D, Badgett WF, Breitweg J, Chapin D, Cross R, Dasu S, Foudas C, Loveless RJ, Mattingly S, Reeder DD, Silverstein S, Smith WH, Vaiciulis A, Wodarczyk M, Bhadra S, Cardy ML, Frisken WR, Khakzad M, Murray WN, Schmidke WB. Measurement of theF 2 structure function in deep inelastice + p scattering using 1994 data from the ZEUS detector at HERA. ACTA ACUST UNITED AC 1996. [DOI: 10.1007/s002880050260] [Citation(s) in RCA: 132] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Leblanc B, Paquin JM, Valiquette L, Perreault JP, Faucher R, Mauffette F, Benard F. [Ureteroscopy versus in situ extracorporeal shockwave lithotripsy in the treatment of calculi of the distal ureter]. Prog Urol 1996; 6:535-8. [PMID: 8924928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In a retrospective study from a unique center (St. Luc Hospital, Montreal) stone clearance of 88 consecutive distal ureteral calculi (below pelvic brim) treated by extracorporeal shock wave lithotripsy in situ were compared to a group of 94 distal ureteral calculi treated by ureteroscopy during the same period. Our results show 84% success rate for ureteroscopy which is clearly superior than 58% stone clearance rate at 3 month follow-up for ESWL Success rate was influenced by stone size in the ESWL group but not in the ureteroscopy group. This study reveals similar success rate for calculi smaller than 6 mm but for larger calculi, success rate of ureteroscopy is significantly superior.
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Affiliation(s)
- B Leblanc
- Départment de Chirurgie, Université de Montréal, Montréal, Canada
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Abstract
OBJECTIVE To investigate the cause of erectile dysfunction after nerve-sparing radical prostatectomy for clinically localized adenocarcinoma of the prostate (stage A or B). PATIENTS AND METHODS Erectile function was evaluated in 20 patients, mean age 65 years (range 44-74), both pre-operatively and 1 year after surgery by intracavernosal injection of a vasoactive agent (papaverine hydrochloride or prostaglandin E1) and pulsed Doppler ultrasonography. The degree of erection, the size of the cavernosal artery and penile arterial blood flow velocity were assessed. RESULTS Results revealed that the decreased response to intracavernosal injection of a vasoactive agent was associated with a significant reduction in both the diameter and velocity of blood flow within cavernosal arteries in 40% of patients after surgery. The pathological stage of the tumour did not correlate with the degree of vascular injury. CONCLUSION We conclude that post-prostatectomy impotence is multifactorial but vascular injury plays a substantial role.
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Affiliation(s)
- S Aboseif
- Department of Urology, University of California School of Medicine, San Francisco
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Stief CG, Benard F, Bosch R, Aboseif S, Wetterauer U, Lue TF, Tanagho EA. Calcitonin gene-related peptide: possibly neurotransmitter contributes to penile erection in monkeys. Urology 1993; 41:397-401. [PMID: 8470332 DOI: 10.1016/0090-4295(93)90608-d] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The distribution of calcitonin gene-related peptide (CGRP) immunoreactivity in the cavernous tissue and the erectile response to intracavernous injection of CGRP was investigated in 7 monkeys. Intracavernous CGRP increased cavernous arterial flow and induced cavernous smooth muscle relaxation and venous outflow occlusion. Intracavernous injection of CGRP antibody did not significantly change the erectile response to cavernous nerve stimulation. Histologic staining for CGRP immunoreactivity showed nerve fiber-like staining within the cavernous arterial wall and the cavernous smooth muscles. These data suggest that CGRP may contribute to penile erection in monkeys.
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Affiliation(s)
- C G Stief
- Department of Urology, University of California, San Francisco
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Takahashi Y, Aboseif SR, Benard F, Stief CG, Lue TF, Tanagho EA. Effect of intracavernous simultaneous injection of acetylcholine and vasoactive intestinal polypeptide on canine penile erection. J Urol 1992; 148:446-8. [PMID: 1635155 DOI: 10.1016/s0022-5347(17)36625-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We investigated the effects of intracavernous injection of a combination of acetylcholine (ACh) and vasoactive intestinal polypeptide (VIP) on the erectile response in eleven adult male dogs. The minimum dose of ACh which increased the intracavernous pressure in eight dogs varied from 0.2 to 40 micrograms, and the minimum dose of VIP varied from 0.2 to 5 micrograms. When the minimum doses of ACh and VIP were injected simultaneously, a strong increase of intracavernous pressure (the mean increase was 102 cm. H2O from the baseline level) and a sustained erection (mean 5 min.) were observed in all eight dogs. The effect of simultaneous injection of both drugs was not additive but synergistic. Pretreatment with VIP-antibody and atropine intracavernously suppressed the erectile response induced by cavernous nerve stimulation. VIP may increase the affinity of muscarinic receptors for ACh in canine corpus cavernosum because pretreatment with atropine alone before the simultaneous injection of ACh and VIP completely abolished the effect of the combination. We conclude that ACh and VIP may play a cooperative role in canine penile erection.
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Affiliation(s)
- Y Takahashi
- Department of Urology, University of California School of Medicine, San Francisco
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Ravanat JL, Berger M, Benard F, Langlois R, Ouellet R, Lier JEV, Cadet J. PHTHALOCYANINE AND NAPHTHALOCYANINE PHOTOSENSITIZED OXIDATION OF 2'-DEOXYGUANOSINE. Photochem Photobiol 1992. [DOI: 10.1111/j.1751-1097.1992.tb08528.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bosch RJ, Benard F, Aboseif SR, Schmidt RA, Tanagho EA. Perineal pudendal neurotomy versus selective neurotomy of the S2 somatic contribution to the pudendal nerve. Effects on sacral-root-stimulated bladder and urethral responses in the dog. Urol Int 1992; 48:48-52. [PMID: 1598735 DOI: 10.1159/000282296] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In 10 dogs that underwent bilateral electrode implantation on the S2 ventral root, 5 then underwent a bilateral total perineal neurotomy of the pudendal nerve (group A) at 3 months and 5 bilateral division of the S2 somatic contribution to the pudendal nerve (group B). The effects of these 2 types of neurotomy on the bladder and urethral responses to electrostimulation were compared after another 3 months. In group A, the proximal and mid-urethral responses decreased significantly [69.1% (p = 0.004) and 79.6% (p = 0.002), respectively]. A decrease in bladder response [26% (p = 0.089)], although not significant, was also found. In group B, the decrease in the proximal urethral response was significant [67.8% (p = 0.012)]; the mid-urethral response (56.8%) was not statistically significant (p = 0.134). The bladder response decreased by 73.6% (p = 0.034). Thus, although pudendal neurotomy can be effective in reducing the outlet resistance, the pudendal nerve may have an important role in the regulation of micturition in the dog. Preoperative testing of the effect of a pudendal neurotomy by temporary nerve blocks is warranted to avoid undesirable side effects such as a decrease in bladder excitability.
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Affiliation(s)
- R J Bosch
- Department of Urology, University of California School of Medicine, San Francisco
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Abstract
In 22 dogs in which erection was induced by cavernous nerve stimulation, we analyzed the intracavernous pressure changes during detumescence without and with acute clamping of the aorta or electrostimulation of the lumbar sympathetic chains. Additionally, the degree of venous outflow obstruction was assessed by saline perfusion of the cavernous body during aortic occlusion. Detumescence had three distinct phases: an initial phase exhibiting a small pressure increase; a second phase showing a slow pressure decrease; and a third phase in which a fast decrease occurred. The first phase was abolished by aortic clamping, whereas the other phases were not significantly affected. Sympathetic stimulation abolished or prevented the second phase. Perfusion of the cavernous body during the second phase resulted in a pressure rise to off-scale values; however, when initiated during the terminal phase or in the nonstimulated penis, the pressure increase was slight. Our study indicates that the arterial flow rate influences the duration of the first phase of detumescence and that venous drainage is completely restored in the third phase. Furthermore, sympathetic stimulation causes an almost immediate full restoration of venous drainage, as cavernous perfusion initiated with an intracavernous pressure about twice as high as without sympathetic stimulation failed to increase pressure to off-scale values.
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Affiliation(s)
- R J Bosch
- Department of Urology, University of California, San Francisco
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Abstract
The effects of the lumbar and pelvic sympathetic system on penile erection were studied in a canine model. Erection was induced by cavernous nerve stimulation and detumescence by sympathetic trunk stimulation. Erection induced by cavernous nerve stimulation normally subsides slowly. After discontinuation of electrical stimulation the intracavernous pressure drops within a mean of 291 s to 50% and after a mean of 372 s to 10% of the highest level. However, stimulation of the sympathetic trunk at the level of L4-S1 applied directly after discontinuation of cavernous nerve stimulation accelerated this drop of intracavernous pressure significantly: to 50% after a mean of 19 s and to 10% after a mean of 36 s. If stimulation of the sympathetic trunk was initiated 20 s before cavernous nerve stimulation, the pressure rise was aborted completely. Neurostimulation of the hypogastric nerves alone or in combination with cavernous nerve stimulation did not change the intracavernous pressure. These results were not altered after neurotomy of the pudendal or hypogastric nerves. The main pathway of the fibers from the sympathetic trunk to the penis seems to run via the pelvic plexus. The stimulation voltage and frequency to induce erection or detumescence were equivalent. Our results suggest that an elevated central sympathetic tone may be one of the causes of psychogenic impotence.
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Affiliation(s)
- W Diederichs
- Department of Urology, University of California, School of Medicine, San Francisco
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Huguet C, Bona S, Nordlinger B, Lagrange L, Parc R, Harb J, Benard F. Repeat hepatic resection for primary and metastatic carcinoma of the liver. Surg Gynecol Obstet 1990; 171:398-402. [PMID: 2173159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
During the last 15 years, 19 patients underwent repeated hepatic resections for malignant lesions of the liver. The first hepatic resection had been performed four to 40 months earlier for treatment of hepatocellular carcinoma (nine patients) or hepatic metastases (ten patients), eight of which were of colorectal origin. Repeat resection was an extensive hepatectomy in six, a segmentectomy in six and a local excision in seven. In one patient, three wedge resections and, finally, hepatic transplantation were subsequently performed after an initial extended right lobectomy. The operative mortality rate was 5.2 per cent. The three year actuarial survival rate was 64 per cent after the second resection.
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Affiliation(s)
- C Huguet
- Department of Surgery, Centre Hospitalier Princesse Grace, Principality of Monaco
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Bosch RJ, Aboseif SR, Benard F, Stief CG, Schmidt RA, Tanagho EA. Synchronized electrical stimulation of the sympathetic and parasympathetic innervation of the bladder: facilitation of the initiation of micturition in the dog. J Urol 1990; 144:1252-7. [PMID: 2231911 DOI: 10.1016/s0022-5347(17)39714-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To improve the quality of bladder contractions induced by parasympathetic stimulation and to facilitate the initiation of voiding, we investigated the effect of sympathetic stimulation on the parasympathetic innervation of the bladder in 12 dogs. For the sympathetic system, the lumbar sympathetic trunks were electrically stimulated; for the parasympathetic system, either the pelvic nerve or the ventral root of S2 was stimulated. With voltages at or just above the threshold for achieving a measurable effect on bladder pressure, stimulation of the sympathetic system or the pelvic nerve alone did not lead to voiding, and sacral root stimulation alone elicited voiding in only 7.4 per cent of stimulations. However, when the same stimulus parameters were used for synchronous stimulation, the voiding process was facilitated when sympathetic stimulation was begun five to 10 seconds before parasympathetic stimulation. When the pelvic nerve was used, voiding resulted in 77.7 per cent of stimulations and the bladder was emptied by a mean of 68.7 per cent; with S2 ventral root stimulation, voiding resulted in 83.3 per cent of stimulations and the bladder was emptied by 59.7 per cent. The facilitory effect of sympathetic stimulation was not abolished when the sympathetic trunks were cut centrally to the point of stimulation, but was absent when the hypogastric nerves were transected. We feel that sympathetic stimulation modulates the parasympathetic innervation of the bladder.
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Affiliation(s)
- R J Bosch
- Department of Urology, University of California School of Medicine, San Francisco 94143
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Baskin LS, Kogan BA, Benard F. Treatment of infants with neurogenic bladder dysfunction using anticholinergic drugs and intermittent catheterisation. Br J Urol 1990; 66:532-4. [PMID: 2249125 DOI: 10.1111/j.1464-410x.1990.tb15004.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The use of anticholinergic drugs in infants with neurogenic dysfunction has not been well documented. In this study, 35 neonates at risk of upper urinary tract damage from neurogenic dysfunction were treated from infancy with anticholinergics, in combination with clean intermittent catheterisation. None of the patients showed upper urinary tract deterioration with follow-up ranging from 6 to 72 months, although 2 required vesicostomy--1 due to difficulty with catheterisation and 1 due to possible anticholinergic side effects. Only 2 (6%) have had clinical pyelonephritis. Twenty-five (76%) are virtually dry between catheterisation. We conclude that anticholinergics are safe and effective, even in the neonatal period, when used in combination with clean intermittent catheterisation for the treatment of neonates with neurogenic bladder dysfunction.
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Affiliation(s)
- L S Baskin
- Department of Urology, University of California School of Medicine, San Francisco
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Aboseif SR, Wetterauer U, Breza J, Benard F, Bosch R, Stief CG, Lue TF, Tanagho E. The effect of venous incompetence and arterial insufficiency on erectile function: an animal model. J Urol 1990; 144:790-3. [PMID: 2388351 DOI: 10.1016/s0022-5347(17)39593-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We designed an animal model to elucidate the effect of venous leakage and arterial insufficiency on erectile function. In 10 dogs, electrodes were implanted around the cavernous nerves for electroerection and blood flow in the internal pudendal artery was recorded. Venous leakage was mimicked by inserting needles of varying gauges (30 to 16G) into the corpus cavernosum and the erectile response to neurostimulation was recorded before and after the creation of the leak. The relationship between the size and the amount of the venous leakage, the changes in the intracavernous pressure (peak and drop), and the changes in the peak and maintenance arterial blood flow were documented. Arterial blood flow was then reduced by 25 and 50 per cent by means of a screw clamp on the terminal aorta. The erectile response to neurostimulation was again determined, with the same electrical parameters, first with reduced blood flow alone, then in combination with leakage of varying size. Our results showed that minor cavernous vein leakage in the presence of normal arterial flow and a healthy sinusoidal system had a minimal effect on erectile function owing to a compensatory increase in penile blood flow. However, when reduction of arterial blood flow was superimposed on venous leakage, even of a minor degree, the erectile response to neurostimulation was markedly impaired.
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Affiliation(s)
- S R Aboseif
- Department of Urology, University of California School of Medicine, San Francisco 94143
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Stief CG, Benard F, Bosch RJ, Aboseif SR, Lue TF, Tanagho EA. A possible role for calcitonin-gene-related peptide in the regulation of the smooth muscle tone of the bladder and penis. J Urol 1990; 143:392-7. [PMID: 1967661 DOI: 10.1016/s0022-5347(17)39972-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We investigated the effect of calcitonin-gene-related peptide (CGRP) on bladder contractions and penile erection in 12 dogs. In a system in which the arteries were tied bilaterally to ensure delivery of high drug levels to the bladder, arterial injections of CGRP significantly reduced the peak intravesical pressure of bladder contractions induced by pelvic nerve stimulation or arterial injection of carbachol. When given intravenously, CGRP had no effect on bladder contractions consequent to neural stimulation. Intravesical instillation of CGRP, however, reduced the bladder contractions significantly. Histologic staining showed CGRP-immunoreactive nerve fibers within the smooth muscle layers of the bladder wall. Intracavernous CGRP increased cavernous arterial flow and induced cavernous smooth muscle relaxation and venous outflow occlusion. Muscarinic blockade had no effect on the canine intracavernous pressure response to intracavernous injection of CGRP. Histologic staining for CGRP-immunoreactivity showed nerve-fiber-like staining within the cavernous arterial wall, the nerves running near the cavernous arteries, and the cavernous smooth muscles. Our results suggest a possible role for CGRP in the regulation of the smooth muscle tone of the bladder and penis.
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Affiliation(s)
- C G Stief
- Department of Urology, University of California School of Medicine, San Francisco 94143
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Aboseif SR, Breza J, Bosch RJ, Benard F, Stief CG, Stackl W, Lue TF, Tanagho EA. Local and systemic effects of chronic intracavernous injection of papaverine, prostaglandin E1, and saline in primates. J Urol 1989; 142:403-8. [PMID: 2746759 DOI: 10.1016/s0022-5347(17)38773-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
To compare the local and systemic effects of chronic intracavernous injection of papaverine, prostaglandin E1, and saline on erectile tissue, eight pigtail monkeys underwent 75 injections over a nine-month period. Monkeys were divided into three groups; each group received papaverine (10 mg.), prostaglandin E1 (20 micrograms.), or saline (one ml.). The erectile response was closely observed for two hours after each injection to monitor the onset, degree, and duration of erection. Liver function tests were performed every three months to detect early systemic metabolic changes. After sacrifice, the simian penises were perfused in situ and examined histologically with both light and electron microscopy. Papaverine resulted in an initially strong erectile response, but this was maintained throughout the length of the study in only two monkeys. In contrast, prostaglandin E1 resulted in tumescence that was maintained in all monkeys over the nine-month period. In addition, the papaverine group had elevated liver enzymes and significant histologic changes with loss of normal architecture on both light and electron microscopy. The other two groups showed only minimal histologic changes or none.
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Affiliation(s)
- S R Aboseif
- Department of Urology, University of California School of Medicine, San Francisco 94143
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Abstract
We investigated the erectile response to intracavernous injection of increasing doses of acetylcholine (0.5 to 500 micrograms.) in 10 monkeys. To differentiate between nicotinic (ganglionic) and muscarinic (parasympathetic postganglionic) effects, acetylcholine was likewise administered after 1.6 mg. trimethaphan camsylate and 0.1 mg. atropine, alone or sequentially. Erections were induced by cavernous nerve stimulation before and after atropine. Acetylcholine induced a dose-dependent, triphasic erectile response: a first tumescence phase followed by contraction and a subsequent second phase of tumescence. Atropine reduced but did not abolish the erectile response to acetylcholine: attainment of maximal intracavernous pressure after neurostimulation was both delayed and reduced (mean 25 cm. H2O). Only after combined nicotinic and muscarinic blockade was the erectile response to acetylcholine completely abolished. Histologic staining for acetylcholinesterase in five additional monkeys that had not received acetylcholine showed dense staining within the cavernous erectile tissue and around the cavernous arteries. Our data suggest that acetylcholine is a possible neurotransmitter for penile erection in monkeys.
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Affiliation(s)
- C Stief
- Department of Urology, University of California School of Medicine, San Francisco
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Stief C, Diederichs W, Benard F, Bosch R, Aboseif S, Lue TF, Tanagho EA. Possible role for acetylcholine as a neurotransmitter in canine penile erection. Urol Int 1989; 44:357-63. [PMID: 2576164 DOI: 10.1159/000281540] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In 15 adult dogs, the possible role of acetylcholine as a parasympathetic neurotransmitter in canine penile erection was investigated. Intracavernous injection of increasing dosages of acetylcholine (0.1-100 micrograms) induced a dose-dependent erectile response with increased arterial flow, cavernous smooth muscle relaxation, and venous occlusion. This erectile response was completely abolished after muscarinic blockade by intracavernous injection of 0.1 mg atropine. After cavernous nerve stimulation, atropine injection significantly reduced the pudendal arterial flow (by 25%) and likewise caused a significant reduction in cavernous outflow restriction. Histologic staining showed acetylcholinesterase-positive fibers around the cavernous arteries and within the cavernous erectile tissue.
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Affiliation(s)
- C Stief
- Department of Urology, University of California School of Medicine, San Francisco
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Abstract
To refine the diagnostic method for opacification of aberrant venous drainage in venogenic impotence, an experimental study was done in eight monkeys. In all monkeys, cavernosography after induction of erection by saline perfusion showed significant drainage via the cavernous veins. However, when cavernosography was performed after neurostimulation or papaverine injection, no cavernous drainage was visualized, even when the intracavernous pressure had been significantly lowered by creation of an artificial cavernous leak. Because erection can result from saline perfusion only when the volume perfused exceeds the venous outflow capability, cavernosography during saline-induced erection will always demonstrate the entire venous system and, thus, is of no diagnostic value. Pharmacocavernosography imitates the physiologic venous occlusive mechanism and should therefore be used to identify the abnormally draining veins in venogenic erectile dysfunction.
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Affiliation(s)
- C G Stief
- Department of Urology, University of California, San Francisco 94143
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Abstract
In an attempt to refine the diagnosis of venogenic impotence, we evaluated different techniques of cavernosometry in 10 dogs. Saline was perfused intracavernously in five dogs to induce erection. Regardless of the amount required for induction, a mean flow rate of 23.4 ml./min. was necessary to maintain an intracavernous pressure level of 110 cm. H2O. In seven dogs, a leak was created by intracavernous insertion of a 19-gauge needle. When erection was induced by either cavernous nerve stimulation or a combination of papaverine injection and saline perfusion, the mean flow through the needle was significantly less than when erection was induced by saline perfusion alone (1.73, 1.78, and 8.77 ml./min., respectively). Sympathetic trunk stimulation at the level of L5 could reduce the intracavernous pressure by 90% in erections induced by neural stimulation or papaverine plus perfusion but had no effect on erection induced by saline perfusion alone. Our findings show that cavernosometry after intracavernous injection of papaverine will provide more valuable information in patients in whom venogenic impotence is suspected.
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Affiliation(s)
- C G Stief
- Department of Urology, University of California, San Francisco 94143
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Benard F, Chiotasso P, Legrand G, Lazorthes F. [Inguinal hernia. The Shouldice parietal repair]. Presse Med 1986; 15:1276-80. [PMID: 2945183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Parietal repair according to the Shouldice technique consists of a double line of sutures on each of three musculo-aponeurotic layers of the groin, i.e. successively: plicature of the transverse muscle and attachments; aponeuroplasty by back-to-back suture of the internal and external oblique muscles, and plicature of the aponeurosis of the external oblique muscle. Parietal repair of this kind is only possible after wide dissection of the inguinal region. It can be performed under local anaesthesia during a short hospitalization period. Normal activity is rapidly resumed, and in the experience of those who favour this technique, the recurrence rate is a mere 1%.
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Ravanat JL, Berger M, Benard F, Langlois R, Ouellet R, Lier JEV, Cadet J. PHTHALOCYANINE AND NAPHTHALOCYANINE PHOTOSENSITIZED OXIDATION OF 2'-DEOXYGUANOSINE: DISTINCT TYPE I AND TYPE II PRODUCTS. Photochem Photobiol 1984. [DOI: 10.1111/j.1751-1097.1984.tb08389.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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