[Digestive tuberculosis is not uncommon in surgery].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
C Brunet
Publications and source records attributed to C Brunet.
Monoblastic leukemia in an HIV-infected patient: absence of viral expression in RNA blasts.
A small number of patients seropositive for the human immunodeficiency virus (HIV) have been reported as developing acute non-lymphoblastic leukemia (ANLL). In the cases previously published, the authors never reported a study of the link joining HIV infection and leukemia. We describe here the case of a 41-year-old HIV positive patient who developed ANLL (FAB classification M5). Using molecular techniques, we looked for a direct link between these two co-existing diseases. We showed the absence of HIV expression in the malignant clone, suggesting that the association of ANLL and Acquired Immune Deficiency Syndrome is not a direct consequence of the myeloid precursors infection. Nevertheless a relationship may exist through a disorganization of the bone marrow micro-environment.
Adult↗
Isolation of prostatic kallikrein hK2, also known as hGK-1, in human seminal plasma.
To demonstrate the presence of kallikrein hK2 in the human prostate and seminal plasma, we used mouse monoclonal antibodies (MAb) against a recombinant hK2-fusion protein. Using one of these MAb 9D5, we detected the presence of several major immunoreactive spots of 22 kDa and minor ones of 31 and 55 kDa in prostate cytosol and seminal plasma. After ion exchange and immunoaffinity chromatography of seminal plasma proteins, the 22-kDa immunoreactive proteins were isolated along with 55- and 75-kDa proteins. The NH2-terminal amino acid sequencing permitted identification of fragments of hK2 and protein C inhibitor, respectively, in the 22- ad 55-kDa bands. Furthermore, immunoblotting experiments in one and two-D gels with two different anti-hK2 MAbs and one polyclonal anti-PCI antibody suggested that the major 55- and 75-kDa bands were covalent hK2-PCI complexes containing either the full-length hK2 chain or only its carboxyterminal fragment in the presence of mercaptoethanol. These results demonstrate for the first time the existence of kallikrein hK2 and suggest that PCI may regulate its activity in seminal plasma.
Animals↗
Congenital right hepatico-diaphragmatic venous anastomosis discovered during a liver transplant resulting in a fatal outcome.
Explore the source record for details and available documents.
Diaphragm↗
Scavenging of reactive oxygen species by letosteine, a molecule with two blocked-SH groups. Comparison with free-SH drugs.
Acute production of reactive oxygen species by polymorphonuclear neutrophils during the respiratory burst may induce tissue injuries. In this in vitro study, it was demonstrated that letosteine, a mucolytic agent containing two blocked thiol groups, had antioxidant activity, but only when it was first submitted to alkaline hydrolysis. In a cell-free system, hydrogen peroxide, hypochlorous acid and hydroxyl radical concentrations were reduced by half by letosteine concentrations of 200, 15 and 350 mumol/l, respectively. The mechanism of letosteine action may be related to the -SH group liberated in vitro by hydrolysis, which seemed to react by scavenging the reactive oxygen species in the same way as acetylcysteine and MESNA, free-thiol drugs known for their antioxidant properties. So, letosteine, a compound with blocked -SH groups which in vivo can metabolically become free, may have a therapeutic application in preventing oxidative tissue injury damage induced by the respiratory burst.
Acetylcysteine↗
[Perforated duodenal ulcer: subtotal anterior linear and posterior tuberous gastrectomy].
OBJECTIVE: To evaluate emergency surgery procedures for perforated duodenal ulcers. METHODS: Emergency surgery was performed for perforated duodenal ulcers in 25 patients (19 males and 6 females) with a mean age of 36 +/- 15 years. The procedure consisted of simple closure followed by anterior and partial posterior linear gastrectomy using a stapling device. There were 16 patients who smoked, 11 who drank and smoked, 3 who were under treatment with non-corticosteroid anti-inflammatory agents, 2 who had a history of other disease (myocardial infarction and arteritis) and 4 who were in septic shock. RESULTS: The delay in closure of perforation was less than 6 hours in 17 cases. Peritoneal leakage was confined to the supramesocolic level in 19 cases. The mean follow-up was 14 +/- 2 months with endoscopic control at 12 months. One recurrence (4%) was observed at 8 months. One patient died. Morbidity occurred in 7 patients (28%); epigastric bloating in 5 cases, subphrenic abscess in 1, abscess of the stomach wall in 1 and oesophageal reflux treated without surgery in 1. The mean duration of hospitalization was 13 +/- 3 days.
Adult↗
High-performance liquid chromatographic method for the determination of budesonide in bronchoalveolar lavage of asthmatic patients.
A simple, sensitive and selective method for the determination of budesonide in bronchoalveolar lavage (BAL) using high-performance liquid chromatography (HPLC) with UV detection was developed. BAL samples were extracted twice with methylene chloride, the extracts were centrifuged and the organic layer separated and dried under nitrogen. The samples were reconstituted in the mobile phase and 80 microliters were injected on to a Spherisorb ODS column with UV absorbance detection at 250 nm. The mobile phase was methanol-aqueous buffer (69:31, v/v). Inter-assay coefficients of variation were measured at 7.81 and 500 ng/ml with ranges of 0.89-7.31%. Average recoveries were 97% or greater. This method was successfully implemented for the analysis of BAL from asthmatics, in order to establish the amount of budesonide available to the lung and to investigate the efficacy of inhaler systems. Patients (n = 9) inhaled four puffs of 200 micrograms of budesonide and BAL was performed 10 min after the last inhalation. Only four BAL out of the nine presented detectable amounts of budesonide. The concentrations in BAL in these four patients were 13.44-84.18 ng/ml, corresponding to total amounts of 0.847-7.997 micrograms.
Administration, Inhalation↗
Popliteal artery entrapment syndrome. Anatomic and embryologic bases, diagnostic and therapeutic considerations following a series of 15 cases with a review of the literature.
We report 15 examples of popliteal artery entrapment syndrome observed in 11 patients. The anatomical causes were as follows: in one case, the popliteal artery presented an aberrant course medially to the medial head of the gastrocnemius muscle. In 5 cases, there was a small fibrous band linking the medial head of the gastrocnemius muscle to the lateral condyle and crossing behind the popliteal artery; in 5 cases this anomaly was also found in association with an abnormally high and/or internal insertion of the medial head of gastrocnemius muscle. In the last 4 cases, there was a muscular insertion anomaly associated with muscular hypertrophy causing arterial compression. Arteriography performed in the 11 patients showed evocative signs of the diagnosis in all cases where the artery was patent. Two popliteal arteries were occluded. CT scan and MRI examination of the popliteal fossa enabled us to define the muscular origin of the popliteal compression. All of the patients were operated upon; two received a reversed saphenous bypass and all of the others were treated by liberation of the popliteal artery and/or vein by a posterior approach. Follow-up in all patients at long term showed good prognosis. All of the patients were able to take up their previous physical activities without sequelae. Our review of the literature, which is based on 374 cases of popliteal artery entrapment observed in 280 patients, made it possible to define the frequency of the various anomalies observed, their symptoms and the different therapeutic possibilities. The multiple anatomical classifications as well as the arterial and muscular embryology are also described.
Adult↗
Anatomic basis of the liver for the development of a perihepatic prosthesis.
We studied specimens from 50 cadavers (27 men and 23 women) to obtain anatomical data concerning the liver and its attachments. The results allowed us to develop a polyglactin perihepatic prosthesis for compression of the injured liver. The falciform ligament and a narrowing of the hepatic parenchyma at this level allow attachment of the prosthesis. Separate prostheses were designed for each lobe. Clinical use has demonstrated that our prosthesis can be used to achieve effective control of haemorrhage and bile leakage.
Adult↗
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↗
Cytokine-induced secretion of monocyte chemotactic protein-1 by human endometriotic cells in culture. The Groupe d'Investigation en Gynécologie.
OBJECTIVE: Local secretion of chemotactic factors could contribute to the attraction of macrophages into the peritoneal cavity of women with endometriosis. The purpose of this study was to investigate the ability of endometriotic cells to produce monocyte chemotactic and activating protein-1 in response to interleukin-1 beta and tumor necrosis factor-alpha, which are found in elevated levels in the peritoneal fluid of patients with endometriosis. STUDY DESIGN: Cultures of fibroblast-like and epithelial cells isolated from endometriotic tissue were incubated with different concentrations of cytokines for varying periods of time. The de novo secretion of monocyte chemotactic protein-1 in the culture supernatants was analyzed by immunoprecipitation and electrophoresis after metabolic labeling with sulfur 35-labeled cysteine. RESULTS: The incubation of endometriotic fibroblast-like cells with interleukin-1 beta and tumor necrosis factor-alpha resulted in a time- and dose-dependent release of monocyte chemotactic protein-1 into the culture supernatant. Coincubation of the cells with tumor necrosis factor-alpha and interferon gamma resulted in a synergistic and dose-dependent increase of the monocyte chemotactic protein-1 secretion, whereas interferon gamma alone had no significant effect. Preliminary results indicate that monocyte chemotactic protein-1 is also produced by endometriotic epithelial cells in response to the same cytokines. CONCLUSIONS: Cytokine-stimulated endometriotic cells synthesize and secrete monocyte chemotactic protein-1 in culture, and they may play a relevant role in the recruitment of macrophages to the peritoneal cavity of patients by the local production of chemotactic factors.
Cells, Cultured↗
Stability, compatibility and plasticizer extraction of miconazole injection added to infusion solutions and stored in PVC containers.
The stability of miconazole in various diluents and polyvinyl chloride (PVC) containers was determined and the release of diethylhexyl phthalate (DEHP) from PVC bags into intravenous infusions of miconazole was measured. An injection formulation (80 ml) containing a 1% solution of miconazole with 11.5% of Cremophor EL was added to 250-ml PVC infusion bags containing 5% glucose injection or 0.9% sodium chloride injection, to give an initial nominal miconazole concentration of 2.42 mg ml-1, the mean concentration commonly used in clinical practice. Samples were assayed by stability-indicating high-performance liquid chromatography (HPLC) and the clarity was determined visually. Experiments were conducted to determine whether the stability and compatibility of miconazole would be compromised, and whether DEHP would be leached from PVC bags and PVC administration sets during storage and simulated infusion. There was no substantial loss of miconazole over 2 h simulated infusion irrespective of the diluent, and over 24 h storage irrespective of temperature (2-6 degrees C and 22-26 degrees C). All the solutions initially appeared slightly hazy. Leaching of DEHP was also detected during simulated delivery using PVC bags and PVC administration sets. There was a substantial difference between the amounts of DEHP released from PVC bags and from administration sets, and also between the amounts released in solutions stored in PVC bags at 2-6 degrees C and 22-26 degrees C over 24 h. At the dilution studied, miconazole was visually and chemically stable for up to 24 h. The storage of miconazole solutions in PVC bags seems to be limited by the leaching of DEHP rather than by degradation. To minimize patient exposure to DEHP, miconazole solutions should be infused immediately after their preparation in PVC bags.
Antifungal Agents↗
Secretion of monocyte chemotactic protein-1 by cytokine-stimulated endometrial cells of women with endometriosis. Le groupe d'investigation en gynécologie.
OBJECTIVE: To evaluate in vitro the production of monocyte chemotactic protein-1 (MCP-1) by endometrial cells of patients with and without endometriosis. DESIGN: Primary cultures of stromal and epithelial cells isolated from human endometrium were exposed during 24 hours to different cytokines. Monocyte chemotactic protein-1 secretion was analyzed in the culture medium. SETTING: Gynecology clinic and laboratories of endocrinology of reproduction and immunology. PATIENTS: Women presenting for infertility or pelvic pain in which endometriosis was diagnosed at laparoscopy (n = 6) and women presenting for tubal ligation without laparoscopic evidence of the disease (n = 6). INTERVENTIONS: None. MAIN OUTCOME MEASURES: De novo secretion of MCP-1 in the culture supernatant by immunoprecipitation and sodium dodecyl sulfate-polyacrylamide gel electrophoresis after metabolic labeling with 35S-cysteine. RESULTS: The incubation of endometrial epithelial cells of endometriosis women with either interleukin-1 beta or tumor necrosis factor-alpha resulted in the appearance of at least two and sometimes three bands having approximately 15, 13, and 9 kd molecular weights. These bands were identified as three distinct species of MCP-1 as their immunoprecipitation was prevented effectively in presence of an excess of cold MCP-1. In contrast, the endometrial epithelial cells of only one of six normal women produce significant levels of MCP-1 under the same stimulation conditions. The stromal cells of both groups of subjects do not secrete appreciable amounts of MCP-1 or only small quantities in two cases of endometriosis. CONCLUSIONS: Monocyte chemotactic protein-1 secretion is upregulated in cytokine-stimulated endometrial epithelial cells of women having endometriosis as compared with normal women without evidence of the disease. Such a difference at the level of eutopic endometrial cell may have a significance in the physiopathology of endometriosis.
Adult↗
[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↗
[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↗
[Occlusions by colonic cancers: emergency treatment (62 cases)].
Sixty two patients (38 men, 24 women) were operated in emergency for colic occlusion from neoplasia. The mean age was 69.6 (+/- 12.71). Fourty four (70%) had an history of cardiovascular disease. Tumor resection has been possible in 95% of cases. The mortality was 24.19% in the first two months postoperatively and 11% between the second and the fourth month. The morbidity was 32.2% and the mean length of stay in hospital was 22 days (+/- 16.6). The morbidity was less in case of right hemicolectomy (17.3 days) than for left colic resections (26 days). The postoperative mortality was not correlated to age but to lost of weight more than 10 kg (p < 0.0001) and to a mean central preoperative temperature more than 37.5 degrees C (p < 0.002). Reducing the number of surgical procedures is beneficial in patients older than 70 years.
Aged↗
Stability and compatibility studies of cephamandole nafate with PVC infusion bags.
A rapid isocratic technique was developed for the analysis of cephamandole nafate and cephamandole in parenteral solutions using high-performance liquid chromatography (HPLC) with UV detection and C18 column. The availability and compatibility of drugs from solutions infused via plastic infusion bags through plastic administration sets have been examined. No significant drugs loss was observed during simulated infusions (n = 4) for 1 h using PVC infusion bags and administration sets. No significant difference was found between infusion solutions (5% glucose or 0.9% NaCl). The stability of drugs was also studied in solution in PVC bags after storage at room temperature and at 4 degrees C without protection from light. The results show the stability of cephamandole nafate during 24 h at room temperature and 7 days storage at 4 degrees C to be satisfactory, irrespective of the infusion solution (5% glucose or 0.9% NaCl). However, an almost immediate and total transformation of cephamandole nafate to cephamandole in 5% glucose has been observed, whereas in 0.9% NaCl both forms were found in similar proportions.
Calibration↗
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↗