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Biomedical subjects

B Sastre

Publications and source records attributed to B Sastre.

At least 55 records · Page 3Linked to original sources
PubMed1995

Posttraumatic colonic polyps with skin heterotopia. Report of a case.

A case of posttraumatic colonic polyps with skin heterotopia is reported. A 35-year-old man was the victim of a grenade explosion, which caused evisceration and partial amputation of the right colon. Twenty-five months after the accident, hypochromic anemia developed because of three polyps in the ascending colon. Histology documented the presence of sebaceous glands and keratinized epithelium, suggesting a graft of skin fragments on the colonic mucosa. Such a skin heterotopia has never been reported.

Adult↗
PubMed1995

Analysis of 2166 clones from a human colorectal cancer cDNA library by partial sequencing.

Large scale sequencing of cDNAs from a tissue-specific library provides information on the functional phenotype of that tissue and the clones constitute a reservoir of biological markers. For these reasons, we have randomly sequenced 2166 clones of a cDNA library constructed with human colorectal cancer mRNAs. Database searches indicated that 1014 of the cDNAs represented known human genes or human homologs of other genes, 142 sequences corresponded to known ESTs, 119 sequences corresponded to 28S rRNA, repetitive sequences or poly(A) stretches only, and 891 corresponded to unknown transcripts representing the products of 740 new genes. Preliminary studies demonstrated that expression of some of them was altered in cancer. That cDNA collection is therefore a source of potential markers of colorectal cancer.

Animals↗
PubMed1995

Comparison of concentrations of two doses of clavulanic acid (200 and 400 milligrams) administered with amoxicillin (2,000 milligrams) in tissues of patients undergoing colorectal surgery.

The concentrations of clavulanic acid and amoxicillin were determined in sera and different abdominal tissues of 17 patients who underwent elective colorectal surgery. Patients were randomly allocated to two groups. At the time of induction of anesthesia, patients in group 1 were given 200 mg of clavulanic acid with 2,000 mg of amoxicillin and patients in group 2 received 400 mg of clavulanic acid with 2,000 mg of amoxicillin. In both groups, the initial dose was administered again after 2 h. Blood samples were collected to determine peak and trough antibiotic levels. Serial blood samples were also collected at predetermined periods (opening and closure of the abdominal cavity and surgical anastomosis). Abdominal wall fat, epiploic fat, and colonic wall tissue samples were collected simultaneously. Antibiotic concentrations were determined by high-performance liquid chromatography. Increasing the dose of clavulanic acid to 400 mg resulted in significantly higher peak and trough levels in serum (P < 0.03). Following the injection of 400 mg, mean concentrations of clavulanic acid in the fatty tissues were significantly increased at the time of opening (P < 0.02). The concentrations of clavulanic acid and amoxicillin in fatty tissues were 17 to 52% and 12 to 23% of the levels in sera, respectively. In the colonic wall, the concentrations of clavulanic acid and amoxicillin were 52 to 63% and 49 and 27% of the levels in sera, respectively. In sera, clavulanic acid given at a dose of 200 or 400 mg reached or exceeded the concentrations found to be effective in vitro to reduce the MICs of amoxicillin from the resistant to the susceptible category for 90% of the potential pathogens. In most of the tissues investigated, increased the dose of clavulanic acid to 400 mg resulted in a significantly higher number of samples with concentrations found to be effective in vitro (72 versus 11%; P < 0.05). In conclusion, increasing the dose of clavulanic acid to 400 mg resulted in higher levels in sera and improved penetration into the abdominal tissues in patients undergoing colorectal surgery.

Adipose Tissue↗
PubMed1995

Immunocytochemical study of NA+ K(+)-ATPase alpha 1 and beta 1 subunits in human and rat normal hepatocytes using confocal microscopy.

Hepatic Na+ K(+)-ATPase was recently shown to be composed of two alpha 1 and beta 1 subunits similar to that of kidney. Its localization on hepatocyte plasma membranes was not clearly established. We have studied the localization of alpha 1 and beta 1 subunits using immunocytochemical method and confocal microscopy. In accordance with previous cytochemical findings, the catalytic alpha 1 subunit was distributed in basolateral and bile canalicular membranes of hepatocytes. The beta 1 subunit was not demonstrated, due to its very low amount in the liver. The controversy about the bile canalicular localization was discussed.

Animals↗
PubMed1995

[Result of surgical treatment of exteriorized rectal prolapse in adults. Experience of 21 years].

Between 1971 and 1992, 89 patients (57 women, 32 men; mean age: 61 years) underwent surgical treatment for total rectal prolapse. 68.5% were constipated, and 12.3% had a solitary rectal ulcer, 46% were incontinent (3 grades 2, 11 grades 3, 27 grades 4). Twelve patients (21%) had been previously, but unsuccessfully operated. Manometry showed low resting pressures in the upper part of the anal canal, particularly in incontinent patients. Voluntary contraction was lower in incontinent patients. The resting anorectal angle was obtuse (113 degrees). Orr-Loygue operation (n = 53), modified rectopexy (n = 22), rectopexy to the left inguinal ligament (n = 6), Delorme operation (n = 4), and posterior rectopexy (n = 4) were performed. There was no operative mortality. Intraoperative and postoperative morbidity rates were 3.4% (n = 3) and 29%. Rectal prolapse recurred in 3 cases (3.4%). Solitary rectal ulcer healed in all patients. Only 8 patients were incontinent after operation, but control was better in 6 cases; in other both patients, preoperative electromyography showed grade III denervation. Bowel habit was postoperatively better (68.5% of patients were constipated before operation, 51.7% after operation). Resting pressures increased in preoperatively incontinent patients in the upper part of the anal canal; resting external sphincter pressures always increased. There was no change in the resting anorectal angle (112 degrees).

Adult↗
PubMed1995

[Subcutaneous cervical emphysema: complication of constipation. Review of the literature].

We report the case of a sixty-eight year old woman with chronic constipation, admitted in the emergency unit for respiratory deficiency and cervical subcutaneous emphysema. Endoscopy of the supradiaphragmatic air and digestive tracts was normal. Acutization of an abdominal syndrome required a laparotomy revealing a fissuration of the subperitoneal rectum on a fecal obstruction. This revealing complication may be explained by the topography of the cervico-thoraco-abdominal diffusion spaces.

Aged↗
PubMed1995

[Current place of thr perihepatic absorbable mesh. Apropos of a series of 105 traumas of the liver].

From October 1987 to June 1993, 105 patients with liver trauma including 71 patients with multiple trauma were admitted to the emergency unit of the Hôpital Sud in Marseilles. Mean age was 32 +/- 15 years, ranging from 16 to 77 years. 77 were male and 28 were female. 83 cases presented with closed trauma, and there were 11 by knife wounds and 11 gun shot injuries. 22 patients, including 10 with multiple trauma, were not operated. Operation was decided immediately in 38 cases for hypovolemia or during the following six hours because of unstable blood pressure after four units of blood transfusion. The absorbable perihepatic mesh was used by 3 surgeons and 3 others used classical procedures (sutures, packing). Global mortality was 15%. The morbidity (31%) was not different from other reports but was significantly lower when using the mesh (p = 0.002). This technique can achieve rapid and lasting hemostasis and bilistasis without any increase of cholestasis or hepatic cytolysis compared to conventional procedures, and without any alteration of laboratory parameters, as shown by specific laboratory tests and follow-up liver biopsies. The mesh also avoids compression of the adjacent organs, compared to packing, thereby avoiding respiratory and renal impairment and reoperation. It can be used in a septic context and in combination with all kinds of radiologic follow-up and percutaneous aspiration and drainage.

Adolescent↗
PubMed1994

[Anorectal asynchronism. Clinical, manometric and therapeutic data].

OBJECTIVES: Anorectal asynchronism is a frequent and unrecognized cause of terminal constipation. The aim of this study was to describe clinical and instrumental findings, and results of biofeedback therapy. METHODS: From 1987 to 1991, 18 patients with anorectal asynchronism were studied then treated by biofeedback training. RESULTS: We found high rates of pelvic and perineal trauma (77.7%), of psychogenic factors (6.5%), of urinary incontinence (27.8%). The manometrical study confirmed puborectalis paradoxical contraction during defecation straining, and all the patients could not expel a rectal balloon containing 50 ml of air; non-specific manometrical abnormality was found in 44.5% patients. Excessive stamp of puborectalis muscle was always found at defecography; 77.7% of the patients had incomplete rectal evacuation, and 61.1% had an associated pelvic floor disorder. Biofeedback training was successful, and 88.9% of the patients were cured by 5 or 6 sessions. There was no predictive parameter in our study, but recovery rate seemed to be lower for patients from 45 to 55 years old. CONCLUSION: The diagnosis of the anorectal asynchronism is easily made with manometry and defecography. Treatment with biofeedback gives very good results in almost all patients.

Adult↗
PubMed1994

Alterations in serum levels of insulin-like growth factors and insulin-like growth-factor-binding proteins in patients with colorectal cancer.

It has been reported that insulin-like growth factor (IGF) II is associated with human primary colorectal tumors and colon-carcinoma cell lines. Here, we examine alterations in circulating levels of IGFs and IGF binding proteins (IGFBPs) in patients with colorectal carcinoma, and compare them to age- and nutrition-adjusted references. We report (i) an increase in serum IGF-II concentrations (about 2-fold), whereas IGF-I concentrations are regarded as normal when aging is taken into account; (ii) an apparent increase in serum IGFBP-3 levels when compared to those of healthy elderly subjects, IGFBP-3 only being detected in the 150-kDa IGFBP ternary complex as in normal serum; (iii) abnormally elevated serum IGFBP-2 levels taking into account the apparent concentrations of IGFBP-3. This simultaneous elevation of IGFBP-3 and IGFBP-2 in the serum of patients with colorectal tumors appears to be unique in that it reflects a break in the inverse relationship between the serum IGFBP-3 and IGFBP-2 levels that is observed in normal and in several physiopathological conditions. Moreover, it enables a distinction to be made between 76.5% (13/17) of patients with colorectal carcinoma and normal adults, age-related healthy aged and malnourished patients. We propose that the disturbed serum IGFBP profile observed in the patients with colorectal cancer may be a consequence of oversecretion of IGF-II by the tumor cells. The usefulness of IGFs and IGFBPs as potential colorectal tumor-associated metabolic markers should be further investigated.

Aged↗
PubMed1994

Treatment of hepatic trauma with perihepatic mesh: 35 cases.

In a series of 61 trauma cases, 35 liver injuries (Moore's classes 2 to 5) were repaired using a polyglactin 910 perihepatic prosthesis. Two deaths (one coma, one avulsion of the inferior vena cava) were observed. Two centrohepatic hematomas were successfully treated by percutaneous needle aspiration. No hemobilia and no abscess of the liver occurred. Rapidly obtained hemostasis and cholestasis result in a large savings of blood. Progressive disappearance of the lesions was observed with repeat CT scanning until full recovery of the parenchyma was achieved. This was verified by biopsy and histologic examination and also by means of specific hepatic function tests.

Adult↗
PubMed1994

[Place of ampullectomy in the surgical treatment of tumors in Oddi's sphincter].

Ampoulectomy is rarely used for exeresis of tumours of the Oddi ampoula due to the risk of incomplete exeresis and postoperative complications. We performed 10 ampoulectomies between 1981 and 1990 (8 males, and 2 females: mean age 59 years). The operative procedure included wide resection followed by reimplantation of the biliary and pancreatic canals. The operative indications were based on converging evidence proficed by pathological examination of pre- and peroperative biopsies. There were 4 adenomas, 2 villous tumours, 2 ectopic pancreases, 1 somatostatinoma and 1 villous tumour with in situ carcinoma. Post-operative mortality was nil: the only post-operative complication was 1 stress ulcer. In one case, the benign nature of the tumour was infirmed by the pathological examination of the surgical specimen (invasive adenocarcinoma). This patient refused duodenopancreatectomy and died at recurrence 72 months later. For the other patients, mean post-operative follow-up was 60 months. Clinical, biological, endoscopic and pathological follow-up have not revealed relapse in any of the other patients. These results show that complete exeresis of benign Oddi tumors can be achieved by ampoulectomy without specific post-operative complications. Progress in echoendoscopy will probably lead to very precise evaluation of the local invasion of these tumours and thus to wider indications and better follow-up in operated patients.

Adenoma↗
PubMed1993

[Analgesic effect of transhiatal splanchnectomy in pain from cancer of the pancreas. Apropos of 51 operated cancers].

The greater splanchnic nerves are responsible for sympathetic innervation of the supra mesocolic viscera, and total bilateral neurotomy is efficient to relieve pancreatic pain. Their dissection is easy by a midline transperitoneal route used for pancreatic cancer surgery. The aim of this study was to evaluate the pain relief related to transhiatal bilateral splanchnicotomy in patients with pancreatic cancer. The tumor was unresectable for all the patients, and nobody was operated only to make neurotomy. Twenty two patients had single bilateral splanchnicotomy, and other had an associated biliary and/or digestive diversion. There was not postoperative specific mortality, and postoperative mortality rate was 3.9%. Specific postoperative morbidity rate was 6%. Most of the patients (83.3%) had immediate pain relief, with or without diversion (respectively 80.7% and 86.3%, p = 0.6). Our data suggest that pain recurs for some patients three months after surgery (pain control in respectively 69.2% and 72.7%), but difference was not significant (p = 0.14). Our results demonstrate that transhiatal bilateral splanchnicotomy relieves pain in patients with pancreatic cancer, with a poor specific morbidity.

Adenocarcinoma↗
PubMed1993

[Enzymatic determination of cholesterol in bile without interference of bilirubin].

The authors describe an enzymatic method for cholesterol determination in bile after elimination of bilirubin interference. During sample pretreatment, bilirubin is oxidized by hydrogen peroxide produced by adding glucose, glucose oxidase and peroxidase. Excess hydrogen peroxide is oxidatively coupled with 4-amino-antipyrine and a phenolic derivative (P-hydroxybenzoic acid). Cholesterol is then measured by use of a CHOD-PAP kinetic fixed-time method adapted to two different centrifugal analyzers (Multistat and Monarch IL). This method has a good within-run precision (CV = 1.6%) and good linearity (up to 23 mmol/l). Results have been compared to gas-liquid chromatographic (method selected by the Lipids-Lipoproteins Commission of the SFBC). The allometric regression line is: y = 1.016 x - 0.07 with r = 0.9975 (P < 0.001).

Bile↗
PubMed1993

[Tissue diffusion of amoxicillin-clavulanic acid for antibiotic prophylaxis in colorectal surgery].

Tissue penetration of amoxicillin and clavulanic acid given for antibiotic prophylaxis was studied in 15 patients. On induction of anesthesia patients were given 2 g amoxicillin and 200 mg clavulanic acid. The same dose was given two hours later. At time of surgical incision amoxicillin and clavulanate levels were 15.9 +/- 7.7 micrograms/g and 2.23 +/- 2.69 micrograms/g in abdominal wall fat and 16.6 +/- 10.5 and 1.72 +/- 1.35 micrograms/g in epiploic fat, respectively. Similar levels were measured at time of closure of the abdomen. In colonic wall, amoxicillin et clavulanate levels were 22.7 +/- 13.4 micrograms/g and 2.65 +/- 2.35 micrograms/g. By comparison with blood levels, tissue penetration of both drugs was 20 to 30 p. cent into fatty tissues and 60 to 70 p. cent into colonic wall.

Adipose Tissue↗
PubMed1993

Management of cysts and pseudocysts complicating chronic pancreatitis. A retrospective study of 143 patients.

One hundred and forty-three patients presenting with 170 cysts and pseudocysts complicating chronic pancreatitis were followed between 1980 and 1990. Thirteen patients were managed conservatively and pseudocysts spontaneously disappeared in 11 patients. Cysts were small (average 28 mm), often communicating with the ductal system without dilatation of the main pancreatic duct. Percutaneous puncture was performed in 47 patients with a low morbidity rate (5%) but a high rate of recurrence (57%). Thirteen of 39 patients (33%) who underwent percutaneous puncture as initial treatment did not require further therapy. Communication of pancreatic cysts with the ductal system was associated with poorer results after percutaneous puncture. Percutaneous drainage was performed in 9 patients with a low morbidity rate (12%). The mean duration of drainage was 10.4 days. Five patients were definitively cured. Seventy-eight endoscopic cystoenterostomies were performed in 71 patients. Complications occurred in 12 patients (15.3%) and one patient died (1.3%). Endoscopic cystoenterostomy was effective in 39 of 54 patients initially treated with this technique (72.2%). Sixty-three patients underwent surgical management, principally internal drainage (83%), with a morbidity rate of 13.2% and a mortality rate of 1.3%. Twenty-one of the 29 patients (72%) who underwent surgery as initial treatment did not require further therapy. Endoscopic cystoenterostomy is an efficient treatment of cysts and pseudocysts complicating CP when anatomical conditions are favorable. Percutaneous drainage also appears to be a satisfactory treatment modality. Surgery should be considered in cases of failure or technical impossibility of endoscopic or percutaneous approaches.

Chronic Disease↗
PubMed1993

Medial pancreatectomy for tumors of the neck of the pancreas.

BACKGROUND: The surgical treatment of benign tumors of the pancreas usually consists of enucleation or formal pancreatectomy. Nonetheless, enucleation is not always feasible, and extended pancreatectomies may result in impaired endocrine and exocrine function. METHODS: For these reasons we proposed a limited resection centered on the neck of the pancreas with complete excision of the tumor. The cephalic section was sutured, and a Roux-en-Y jejunal loop was anastomosed to the distal section of the pancreas. Fourteen patients were operated on by this technique. The tumors were mainly cystadenomas (n = 6) and endocrine tumors (n = 4). The other lesions were one epithelial cyst, one necrotic pseudocyst, one Castleman disease, and one cystadenocarcinoma diagnosed after surgery on histologic examination. RESULTS: No patients died. Two patients underwent reoperation: one for a postoperative acute pancreatitis and one for a pancreatic fistula. All patients were followed up from 4 months to 8 years. No patients had exocrine insufficiency or diabetes mellitus. CONCLUSIONS: Medial pancreatectomy does not carry a higher operative risk than formal pancreatectomy and avoids extensive pancreatic resection when enucleation is not feasible.

Acute Disease↗