[Bladder tumors: prognostic value of surface antigens and carcinoembryonic antigens. A retrospective study]. / Tumeurs de vessie: intérêt pronostique des antigènes de surface et de l'antigène carcino-embryonnaire. Etude rétrospective.

Seven patients presenting with recurrent diffuse, non-infiltrating tumors of the bladder were treated for several years by repeated endo-urethral resection, because radical exeresis was not possible. Each operative specimen was subjected to examination of the ABH blood-group antigens, pneumo-14 precursor, and carcino-embryonic antigens. The authors emphasize the prognostic interest of such studies.

[A long standing cystostomy is not a definitive infirmity in the paraplegic (author's transl)]. / Une cystostomie ancienne n'est pas une infirmité définitive chez le paraplégique

The author presents the case of a tetraplegic patient who had a cystostomy for 12 years. It was possible to abolish the infirmity by bladder closure and endoscopic resection of the striated sphincter of the urethra.

[Sub-urethral pouches in the adult female (author's transl)]. / Les poches sous-uréthrales chez la femme adulte

With reference to 15 cases, the authors carried out a diagnostic and therapeutic study of "suburethral pouches" in the adult female. They emphasize the importance of the micturition phase of intravenous pyelography and retrograde cystography. Retrograde urethrography is rarely necessary. Surgical indications must be limited by the undisputable risks of this form of surgery.

[Reno-colic fistula, spontaneous rupture of the ureter, triple urter: ureterocoele: an unusual combination (author's transl)]. / Fistule réno-colique, rupture spontanée de l'uretère, triplicité urétérale, urétérocèle: une association inusitée.

The authors report a case which is exceptional both on the basis of the association of malformations present as well as the presenting complications. Right triple ureter with ectopic implantation. Spontaneous fistulisation into the colon of a supernumerary pelvis. Rupture of a megaureter into the retroperitoneal space, the initial episode. Finally, double ureter on the left with ureterocoele. The difficulty of precise diagnosis before operation is emphasised. The latter did not permit immediate complete assessment of the lesions, the discovery and treatment of which required several operations.

[Experimental study of electro-ejaculation in the baboon (author's transl)]. / Etude expérimentale de l'électro- éjaculation chez le babouin

With the aim of applying the technique of electro-ejaculation to paraplegics, the authors perfected an apparatus which permits stimulation with an intra-rectal electrode. Out of 27 electro-ejaculations carried out on 9 monkeys, there were 5 failures and 22 successes (but 3 of these only contained coagulum). The results improved at the same time as the technique. Although the motility and the number of spermatozoa were rather reduced in comparison with normal ejaculation, the semen obtained appeared to be utilizable. Observation of the animal, rectoscopy as well as the histological investigations carried out in 3 of the animals which were sacrificed showed no complication or lesion. The apparatus and technique which subsequently proved to be applicable in the paraplegic male should enable the improvement of his possibilities of procreation.

Electro-ejaculation of a complete paraplegic followed by pregnancy.

After having experimented with electro-stimulation on monkeys, the authors have put it into practice with the paraplegic. They report observations on pregnancy of a woman with a complete paraplegic below T4 who was injured 15 years ago. Nineteen electro-stimulations and seven artificial inseminations were necessary. The electro-stimulation is easy and can be repeated at will.

[Chronic peritoneal dialysis: an alternative to iterative hemodialysis]. / La dialyse peritoneale chronique: alternative de l'hemodialyse iterative chez l'enfant.

27 children, aged 7 months to 15 years, with terminal renal failure and no available vascular access, were treated with chronic peritoneal dialysis for 3 weeks to 9 months (mean 3 months). An indwelling silicon catheter fitted with a subcutaneous dacron felt cuff was used; the average catheter life time was 10 weeks (3 to 25 weeks). Control of uremia was satisfactory with mean serum urea decreasing from 2 to 1 g/l and creatinine from 130 mg/l to 60 mg/l after 48 hours of dialysis. No uremic complications occured. Total serum protein remained stable: mean: 62 g/l prior to treatment and 60 g/l after the treatment period. Hematocrit was higher than in hemodialysed children (17% versus 15%). Three children were directly transplanted without difficulty. However, some complications did occur. There were 27 episodes of catheter obstruction leading to 12 surgical interventions. 18 episodes of peritonitis (5% of total dialyses) occured in 12 patients, and two were lethal. The frequency of complications prohibits a recommendation of chronic peritoneal dialysis over hemodialysis in children; this technique however remains very helpful in those situations where vascular access is difficult.

Improvement of the demonstration of A, B, H surface antigens in bladder tumors by a simple immunofluorescence technique.

The presence of A, B and H blood group antigens in paraffin-embedded tissue sections was demonstrated with a routine direct and indirect immunofluorescence technique. Natural and human antisera were used for 102 biopsy specimens of the various blood groups, including normal mucosa and vesical tumors. This technique allows a more precise description than the specific red cell adherence reaction of the differentiation pattern of the tumor itself and of the surrounding and distant mucosa. It may prove useful in suggesting a revised classification system, with more diagnostic and prognostic significance.

[Post-operative course in tetraplegics after urological surgers (author's transl)]. / A propos des suites opératoires des tétraplégiques en chirurgie urologique

The authors report their experience with 33 tetraplegics undergoing surgery. The operations were varied, endoscopic (resection of the bladder neck, of the prostate or striate sphincter, lithot-itiasis) or surgical (lombotomies, transintentinal cutaneous ureterostomies). The post-operative course may be dramatic or even fatal (acute hypertension with cerebral haemorrhage). Respiratory insufficiency poses no particular problem and can be controlled. Epidural anaesthesia maintained for several days makes it possible to avoid the more serious problems: -- autonomic hyperreflectivity, -- delayed resolution of ileus and digestive complication. The authors hence use epidural anaesthesia routinely and are satisfied with the technique.

[Results of radical surgery for renal cancer in adults]. / Résultats de la chirurgie radicale pour le cancer du rein chez l'adulte.

For thirteen years, between 1963 and 1976, 120/139 patients with renal cancer were operated. 45 were stage I, 20 were stage II, 45 were stage III and 12 were stage IV (Robson's classification). Of the 45 stage III cancers, 13 had lymphatic invasion and 37 had venous invasion ranging from microscopic stages to invasion of the inferior vena cava. Treatment included: preoperative teleirradiation with cobalt most often a single dose of 500 rads on the day before the operation. Wide excision with primary ligation of the vascular pedicle and node dissection via a lumbar abdominal transperitoneal route remaining the minimum strictly necessary. Sequential monthly chemotherapy over two years of Vincristine and CCNU (chloroethyl cyclo hexylnitroso urea). Postoperative mortality was considerable (14%) but involved patients with advanced cancers, poor general condition (o% stage I, 10% stage II, 22% stage III and 40% stage IV). The long range survival remains excellent in spite of the postoperative losses: 65 p. cent 5 years all stages. However, stage determines the prognosis: 85 p. cent 5 year survival stage I and II and 53 p. cent 5 year survival stage III. Severe affection of the general state of the patient carries a very poor prognosis. Fever does not indicate a worse value except in stage III tumors. In stages I and II it can have value in the paraneoplastic syndrome (terme non familier). The authors, uncertain of the efficacity of preoperative radiotherapy and postoperative chemotherapy, concluded that wide excision with node dissection is the proper fundamental treatment of renal cancer in the adult.

[Current treatment of testicular cancers]. / Les traitements actuels des cancers du testicule

The treatment and prognosis of dysembryoma of the testis have been transformed by the dissection of retroperitoneal nodes and by combination chemotherapy as early as possible. Routine retroperitoneal node dissection followed by early and prolonged chemotherapy lead to a hope of cure in more than 75% of cases of dysembryoma of the testis. Similar early chemotherapy is effective and indicate for choriocarcinoma of the testis and retroperitoneal node dissection may be of value in tumours in which the chorial element is "minor".

[Blood group ABO (H) cell surface antigens in bladder tumours invading the chorion. Prognostic value of their determination by immunofluorescence. Retrospective study of one hundred and twenty-five cases]. / Les antigènes de groupe sanguin ABO (H), dans les tumeurs de vessie infiltrant le chorion. Valeur pronostique de leur détermination par immunofluorescence. Etude rétrospective de cent vingt-cinq cas.

The authors have studied 125 stage A bladder tumours with a follow-up period of at least 5 years. The ABH cell surface antigens were collected by a double-layer immunofluorescence technique which has already been described. All the cross sections were read by the same pathologist who knew nothing about the clinical developments. The results were divided into 3 groups : (I) all the tumour cells had retained their surface antigens. (II) Only some cells had retained surface antigens. (III) All cells were negative. Study of the development of the 3 groups shows that : in group I, all the patients (11) are alive 5 years later, and only one has presented with a lesion evolving towards infiltration. In group II (32 patients), only 38 p. cent of the patients are still living 5 years later, and 65 p. cent developed towards muscular infiltration. In group III (77 patients), 27 p. cent are alive after 5 years and 80 p. cent have developed towards muscular infiltration. Homogeneous retention of the surface antigens would therefore seem to be a favourable factor in the prognosis, even in the case of a tumour which has already infiltrated the chorion. The significance of the loss of surface antigens is less clear-cut, but is on the whole adverse. The significance would, however, probably be enhanced by study of the mucosa distal from the lesion, and by marking the substances which determine the blood groups.