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Biomedical subjects

A Gelet

Publications and source records attributed to A Gelet.

At least 109 records · Page 6Linked to original sources
PubMed1987

[Revascularization of the renal artery in renovascular hypertension with progressive renal insufficiency].

Sixteen patients underwent surgical treatment for severe renovascular hypertension with rapidly progressive renal failure. These patients were assessed preoperatively with the measurement of serum creatinine and blood-urea levels (means 271 +/- 204 mumol/l and 15.6 +/- 10.3 mmol/l respectively), and renal clearances. 5 patients underwent aorto-renal bypass (bilateral in one case) and 11 patients were treated by autotransplantation of the kidney. Operative mortality was 6.2%. Early results were assessed at 1 and 6 months postoperatively. Renal function was normal in 8 patients, improved in 5 (p less than 0.05), unchanged in 1 and worse in 1 by aorto-renal bypass thrombosis. At long-term with a minimum follow-up of 12 months (mean 31 +/- 12 months), the initial improvement in renal function remained steady in 12 patients whilst 1 patient has gone on to hemodialysis. At middle and long-term, 81% of the patients were normotensive without medication or had improved blood pressure (p less than 0.001). These good results confirm the reversibility of renal ischemic lesions and support an aggressive attitude towards the use of revascularization in the surgical treatment of such patients with renovascular hypertension and renal failure.

Acute Kidney Injury↗
PubMed1986

[Extracorporeal lithotripsy by shock waves. Initial results (322 cases)].

Results of 322 patients treated with extracorporeal shock wave desintegration are reported (277 patients treated with the Dornier lithotripter, 45 patients treated with Solonithe using ultrasonic stone location). Lesions treated included 168 caliceal, 111 pyelic, 23 ureteral and 21 coralliform calculi. 45 patients presented multiple and 28 bilateral renal lithiasis. Stones were mainly between 10 and 20 mm in diameter (157 patients) but were less than 10 mm in size in 110 cases and more than 20 mm in 55. For poorly opaque stone, lithotripsy was performed after ultrasound localization with the Sonolithe apparatus. The Dornier machine was used to treat 277 patients during 308 sessions, equivalent to an 11% repeat rate. Fragmentation was excellent in 84% of cases after a single session, and 5% of stones could not be fragmented and required complementary therapy. Out of 200 patients reviewed after 3 months, only 8% had residual fragments (92% success rate), 5% having to undergo auxillary endoscopic manoeuvres: stenting ureteral catheter (4 cases); percutaneous nepholithotomy (3 cases); ureteroscopy (7 cases). Septic complications (6 patients) responded well to antibiotic treatment. Renal colic or pain was recorded in 25% of cases. One kidney was non-functional at 3 months due to distal ureteral obstruction without subsequent dilatation of the collecting system. Out of 45 patients treated with the Sonolithe, 3 (6.6%) were failures of fragmentation and 85% had satisfactory results. After a minimum follow up of 3 months, 20/22 patients were free of residual calculi, and there were no complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Metabolic control of type I (insulin dependent) diabetes after pancreas transplantation.

A study was conducted of the circadian hormonal and metabolic patterns of 10 type I (insulin dependent) uraemic diabetic patients after pancreas and renal transplantation. A single 24 hour profile was obtained in each patient following as closely as possible his or her normal daily routine two to 15 months after transplantation. None of the patients were using insulin at the time of the study. Compared with a group of six normal subjects the transplant recipients had mildly raised blood glucose concentrations, hyperinsulinaemia between meals and at night, delayed postprandial insulin peaks, mild hyperketonaemia, and normal blood lactate and plasma glucagon concentrations. The findings showed that successful pancreas transplantation results in disappearance of the need for insulin and return to normal or near normal of the metabolic abnormalities of diabetes. The minor differences observed in comparison with normal hormonal and metabolic homoeostasis were probably due to intrinsic (reduced islet mass, denervation, peripheral hormone delivery) and environmental (immunosuppression, relatively impaired renal function) factors.

3-Hydroxybutyric Acid↗
PubMed1985

Extracorporeal replacement of the renal artery: techniques, indications and long-term results.

Extracorporeal repair of the renal artery was done in 24 patients for complex lesions extending to branches of the renal artery (9 dysplasias, 5 atheromas and 10 aneurysms). The renal artery and its branches were replaced by a hypogastric branched autograft in 20 patients and a saphenous vein graft in 4. Indications for an extracorporeal operation were hypertension, preservation of renal function against progressive deterioration and extension of the lesion to more than 2 branches of the renal artery. Of 76 peripheral anastomoses 68 were patent postoperatively. Two secondary nephrectomies were performed. Mean followup was 54 months. Hypertension was cured in 19 patients and improved in 2, while 2 failed treatment and 1 died. An extracorporeal operation may represent the best alternative for treatment of renal arterial lesions involving more than 2 branches.

Adult↗
PubMed1985

Aneurysms of the renal artery: surgical management with special reference to extracorporeal surgery and autotransplantation.

27 patients underwent surgical arterial reconstruction for renal artery aneurysms. Hypertension was present in 21 cases. The indication for surgery was the prevention of hemorrhagic rupture in association with hypertension. Extracorporeal surgery was performed 13 times for complex aneurysms involving several branches of the renal artery. Simple autotransplantation was performed 3 times for aneurysms located on the main renal artery. In situ surgery was performed on 11 patients (5 aneurysmectomy-arteriorrhaphies and 7 bypass operations). Results on high blood pressure showed that 10 of the 14 hypertensive patients operated by extracorporeal surgery and/or autotransplantation were cured. 1 delayed nephrectomy was performed in this group and 1 death was observed. 39 of the 46 peripheral anastomoses were patent postoperatively. All patients treated with aneurysmectomy-arteriorrhaphy were cured. In patients treated with bypass operations, 3 thromboses of the bypass and 2 failures on hypertension were observed. Aneurysmectomy and simple arterioplasty are preferred for simple renal artery aneurysms. For complex lesions involving several branches and of an intrarenal location, extracorporeal surgery and autotransplantation represent an effective treatment on hypertension and preservation of kidney function.

Adolescent↗
PubMed1985

[Ultrasonic high frequency probes in urology].

The authors report on their experience with Ultrasonic high frequency ultrasonography probes. The endorectal and the endourethral probes were designed and developed by the authors. High resolution imaging, easy handling of the probes with a range of several scanners are the major qualities of this material.

Humans↗
PubMed1985

Renal autotransplantation versus bypass techniques for renovascular hypertension.

From 1972 to 1983, 78 patients underwent surgical treatment for renovascular hypertension caused by a lesion limited to the trunk of the renal artery. Forty-five of these patients underwent aortorenal bypass (24 saphenous grafts and 21 arterial hypogastric grafts); 36 patients (80%) had either a relief of the hypertension or were improved. Graft closure occurred in five cases. Thirty-three patients were treated by autotransplantation of the kidney. After resection of the lesion, the renal artery was anastomosed end-to-end to the hypogastric artery or end-to-side to the common iliac artery and the renal vein and side-to-side to the iliac vein or the origin of the vena cava. In this group all patients but one (97%) had relief of the hypertension or were improved. No thrombosis was observed. Late angiography was performed 5 years after surgery in 19 patients (nine autotransplantations and 10 bypass operations): patients who underwent autotransplantation had no alteration of the renal vessels whereas four patients who underwent bypass operations had dilatation of the saphenous vein bypass. Renal autotransplantation was superior to the bypass technique in the surgical treatment of renovascular hypertension caused by lesions of the trunk of the renal artery and may represent a better alternative in the surgical treatment of this condition.

Adolescent↗
PubMed1985

[Extracorporeal shockwave destruction of urinary calculi after ultrasonic localization].

Shock waves generated by an underwater spark gap discharge, focused by an ellipsoid can destroy most urinary stones extracorporeally. A device were stones are localized by ultrasound and where the ellipsoid itself could move to be positioned in the adequate position would obviate the need for a very expensive two fluoroscopes localisation system, and patient positioning device. A regular ultrasound probe was fixed on a multijointed metallic arm. From the measurements of the angles of every point it was possible to calculate the exact coordinates X, Y, Z, of the probe. This system, thought not extremely flexible allows to perform ultrasound examination of a kidney in the bathtub and localisation of stones in vivo in good conditions. When the stone was seen on the screen, the angles given to the joints were automatically recorded and the coordinates of the stone were instantly calculated with a personal computer. The computer program was able to calculate the displacement of the ellipsoid necessary to adjust its focal point on the X, Y, Z coordinates. The ellipsoid moved through a simple 3 motors system. Destruction of the stone was performed by shock waves. Progression of the disintegration was followed by plain X-rays performed in the bath tube with a portable X-ray apparatus. This device was tested in 7 dogs with stones surgically implanted in the renal pelvis. In every case, the stone was localised and disintegrated in fragments of the order of one millimeter using 700 to 2 000.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

[Role of renal autotransplantation in the treatment of renal arterial lesions].

112 patients with hypertensive lesions of the renal artery were studied. 33 patients with stenosis of the trunk of the renal artery were operated with autotransplantation. 10 patients had lesions of the main branches of the renal artery and in these cases autotransplantation with the anastomosis of the two main renal artery branches to the two main branches of the hypogastric artery was performed. 24 patients with complex lesions of renal artery branches were treated with autotransplantation associated with extracorporeal repair of the renal artery. 45 patients, with lesions of the trunk of the renal artery were operated by aortorenal bypass. For lesions of the main renal artery, results were better in the group of patients treated by simple autotransplantation (82% of patients cured versus 46% with bypass operation). For lesions involving multiple branches of the renal artery extracorporeal replacement of the renal artery followed by autotransplantation often represents to the sole technique to prevent nephrectomy. Hypertension was cured or improved in more than 80% of cases. We believe autotransplantation to be the best operation for lesions of the renal artery in most cases.

Adult↗
PubMed1985

[Technic and results of ureteroscopy for ureteral lithiasis. Apropos of 54 ureteroscopies].

Rigid ureteroscopy has been performed 54 times in 49 patients with ureteral stones. In 72% of the cases stones were removed or disintegrated with the ultrasound or electrohydraulic probe. Best results were obtained in the pelvic ureter (96,5% success). In the lumbar ureter only 56% success was obtained. Complications were observed in 15% of the cases, however only one complication necessitated an immediate open surgical operation.

Endoscopy↗
PubMed1985

[Cancer of the prostate: role of surgery in the evaluation of lymph node extension].

None of the non surgical methods for investigations of the lymph node extension of prostate carcinoma is entirely satisfactory. However, the risk of lymphatic extension is correctly appreciated when the initial tumor is well documented by rectal examination and endo-rectal ultrasonography. Histology shows an increasing interest. IVP, CT scan are of little interest for micrometastases while the results of lymphography are improved by cytoaspiration of abnormal models. Lymphadenectomy gives the most accurate appreciation of the lymphatic extension. The reliability of frozen sections interpretation is now very satisfactory. When limited to the triangle: external iliac artery, internal iliac artery and obturator fossa, the morbidity is reduced. In case of negative lymph nodes, radical prostatectomy gives to the patients a reasonable chance of complete cure.

Biopsy, Needle↗
PubMed1984

Thirty months' experience with cyclosporin in human pancreatic transplantation.

Between September 1978 and December 1983, 33 simultaneous kidney plus pancreatic transplantations were performed in Type 1 (insulin-dependent) diabetic patients with uraemia at the Herriot Hospital, Lyon. In eight patients grafted before June 1981, immunosuppressive treatment consisted of azathioprine, steroids and a temporary course with anti-lymphocyte globulins (protocol A). Since June 1981, the immunosuppressive treatment has consisted of cyclosporin administered according to two protocols: from the day of transplantation with temporary anti-lymphocyte globulins with or without steroids (protocol B, seven patients), or after an initial course with protocol A, with or without steroids (protocol C, 18 patients). Only slight differences in patient and pancreatic graft survival between the three protocols were observed at 3, 6 and 12 months, while an improved survival rate for both patients and pancreatic grafts was observed in protocols B and C at 2 years. Moreover the incidence of pancreatic rejection as a cause of loss of pancreatic function seemed to be reduced under protocols B and C.

Adult↗