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Biomedical subjects

C Smeesters

Publications and source records attributed to C Smeesters.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Complications of the treatment of cervix neoplasms by radiotherapy].

Of 939 patients treated by radiotherapy for carcinoma of the cervix at the hôpital Notre-Dame in Montreal, between 1979 and 1981, 275 (29.3%) had digestive, urologic, gynecologic, vascular, osseous and cutaneous complications. Surgery was necessary to treat 73 complications in 55 patients (5.9%): 42 digestive (25 occlusions, 13 fistulas and 4 perforations); 22 urologic (16 occlusions, 5 fistulas, 1 hemorrhage); 6 gynecologic (3 hemorrhage and 3 uterine necrosis); 1 cutaneous, 1 vascular and 1 osseous necrosis. No direct correlation was found between the incidence of the complications and certain predisposing factors such as the type of radiotherapy, patients' age, stage of the disease and gynecologic surgery before radiotherapy. However, there was a strong correlation between the incidence of complications and the dose of radiotherapy and the need for gynecologic surgery after radiotherapy. High morbidity was observed in the 55 patients treated surgically: they had to undergo a mean of 2.36 operations each, 2.98 general anesthetics, 1.81 hospitalizations (mean duration 75.7 days); 21 had one or more definitive stomas. The death rate was 5.45%. Surgical treatment was individualized. Limited resections were performed for occlusions, fistulas and perforations whenever it was technically feasible to treat digestive and urologic complications. A bypass procedure was used when resection would have been too extensive or dangerous. The majority of rectal lesions were treated by colostomy and a Hartmann procedure.

Adolescent↗
PubMed1986

Blood transfusions and survival after colectomy for colorectal cancer.

This study was carried out to determine the effect of perioperative blood transfusions on the survival of patients operated on for colorectal cancers. Cox's regression analysis was applied to 281 patients operated for cure of Dukes' stage A, B or C disease. Other variables studied were age, sex, tumour location, and preoperative hemoglobin, lymphocyte and albumin values. Perioperative deaths, pre- and postoperative immunodepression, neoplasia in situ, nonresections and stage D disease were excluded. It was found that the number of units of blood transfused had a strong influence on the prognosis of patients with colorectal cancer, particularly colonic cancers, but the effect could not be demonstrated when rectal cancers were studied separately, perhaps because of the small number of cases. The mechanism of action of blood transfusions seems to be independent of the other analysed variables. The authors suggest that perioperative blood transfusions may have an immunomodulatory effect in patients with colonic cancer, as already shown in recipients of transfused kidney allografts.

Aged↗
PubMed1984

Adriamycin and adriamycin-DNA nephrotoxicity in rats.

The early nephrotoxicity of free and DNA-bound adriamycin (ADR) was compared in left nephrectomized rats. Free ADR induced progressive renal failure within 3 weeks, in association with renal changes characterized by severe tubular distention and vacuolization of podocytes in glomeruli. On the contrary, renal function remained normal and renal lesions were discrete in animals treated with ADR bound to DNA. Thus, the binding of ADR to DNA seems to reduce the early nephrotoxicity of free ADR.

Acute Kidney Injury↗
PubMed1983

Beneficial effects of methylprednisolone on urinary excretion of lysosomal enzymes in acute renal ischemia.

An experimental model of canine normothermic renal ischemia was used to determine whether lysosomal urinary enzyme excretion reflects the extent of ischemic cellular injury, as assessed by subsequent renal function (serum creatinine level) and morphologic changes. The value of a lysosomal membrane-stabilizing agent (methylprednisolone) in protecting kidneys from ischemic damage by preventing lysosomal enzyme release was assessed. Results showed conclusively that urinary enzyme activities of beta-galactosidase and N-acetyl-beta-glucosaminidase are valuable indicators of renal cellular damage and functional outcome after ischemic injury, and that methylprednisolone at a dose of 30 mg/kg, given intravenously 1 hour before a 1-hour period of normothermic ischemia, protects the kidney both biologically and morphologically, by reducing the excretion of lysosomal enzymes after revascularization.

Acetylglucosaminidase↗
PubMed1983

Comparative toxicity of adriamycin and adriamycin-DNA in rats.

Adriamycin (ADR) can be linked to DNA without loss of its antitumoral activity while reducing the acute toxicity of free ADR (Deprez--DeCampeneere et al., 1979, 1980). However, the potential chronic toxic effects of both forms of ADR are poorly documented. For such a study, it is necessary to establish the sequence of treatment allowing the administration of a sufficient amount of drugs to induce chronic toxicity and a schedule leading to prolonged survival of animals. In this study, 24 Lewis rats were injected twice a week during four weeks with either free or DNA-linked ADR, and three dose levels were tested: 4, 2 and 1 mg/kg. Our results indicated that the total cumulative dose of ADR should not exceed 8 mg/kg over one month, if prolonged survival is desired. The binding of ADR to DNA seemed also to reduce the acute toxic effects induced by free ADR, in rats. However, such a beneficial effect was not observed when the chronic nephrotoxicity was considered since characteristic renal lesions were observed in all long-term survivors, whatever the dose and the form of ADR received.

Animals↗
PubMed1983

[Predictive value of preoperative acidity tests in ulcer recurrence after supraselective vagotomy].

The authors have analysed the predictive value of the basal and peak gastric acidity levels, measured preoperatively, in a series of 27 supraselective vagotomies. They recommend care in the choice of this operation for hypersecretors and they propose criteria for the preoperative selection of the candidates. They suggest determination of the preoperative basal gastric acidity level and a cimetidine suppression test to identify patients at high risk for recurrence of the ulcer.

Adult↗
PubMed1981

Effectiveness of the adriamycin-DNA complex in kidney allograft immunosuppression.

The chemotherapeutic effectiveness of the lysosomotropic Adriamycin-DNA complex has been demonstrated experimentally. This study evaluated the immunosuppressive activity of the complex on renal allografts in rats of the Buffalo-Lewis strain. Six rats receiving no treatment served as a control. Five rats received DNA along (at a dose equivalent to that in the complex), seven received the Adriamycin-DNA complex (molar ratio of DNA mononucleotide to Adriamycin, 20:1) and five were given free Adriamycin. Adriamycin, free or linked to DNA, was injected as follows: 2 mg/kg on days 2, 6 and 9 and 1 mg/kg on day 13 after transplantation. The Adriamycin-DNA complex prevented renal allograft rejection in the early postoperative period, by delaying for more than a week, the increase in serum creatinine levels in animals receiving transplants. Histologic examination of renal grafts in these rats confirmed the reduced severity of acute cellular rejection. There was also functional and morphologic evidence of reduced toxicity of Adriamycin when linked to DNA. The beneficial effect of such a drug should be attributed to its lysosomotropic mechanism of activity.

Animals↗
PubMed1976

Urinary lysosomal enzymes for detection of acute renal allograft rejection.

Six patients who received renal transplants were closely monitored to compare the sensitivity of urine levels of beta-galactosidase and N-acetyl-beta-glucosaminidase with conventional clinical and laboratory parameters in the detection of impending rejection. A rapid (60 minute), simple, accurate fluorometric assay was used to measure activities of both enzymes. Eighty per cent of ten rejection episodes were accompanied by a two- to sixfold increase in enzyme release. Parallel changes in serum creatinine levels and urinary volume occurred in six rejection episodes, but in two episodes, elevated urinary enzyme levels were observed two and four days prior to clinical evidence of rejection. It is concluded that urinary lysosomal enzyme measurements by fluorometric assay are valuable indicators of acute renal rejection, particularly when the diagnosis is not clearly established by conventional criteria that show only minimal changes. Continuing studies in a large group of renal transplant recipients are under way to evaluate the validity of this conclusion and to determine whether enzyme measurements, will, indeed, be indicative of early rejection.

Acetylglucosaminidase↗
PubMed1976

Arterial endothelial changes after ischemia and perfusion.

The effects of six hours of ischemia and six hours of perfusion with 10 per cent dextrose and water solution, Sacks' solution and Intralipid on the endothelium of common femoral arteries in dogs were examined by light and by scanning electron microscopy and compared with normal arteries. Arteries that were ischemic or perfused with 10 per cent dextrose and water solution or Sacks' solution showed a flattening of the normal linear convolutions and extensive crater formation, with fragmentation and even complete loss of endothelial cells in many areas. The more severe changes occurred in perfused vessels. Fibrin and platelets covered the luminal surface in many areas in which there was extensive injury to the endothelium. Light microscopy revealed thickening of the internal elastic membrane and intimal fibrosis. Results of biopsies performed two weeks after perfusion showed slight, although incomplete, improvement in the structure of the endothelium. Arteries perfused with Intralipid had thickening of the intima with a proliferation of plump cells orientd linearly over the surface but with an absence of craters. Results of present studies confirm the observations of other investigators that injury to endothelial cells may be produced by ischemia and that perfusion with various solutions may produce an even more severe alteration in structure of the endothelial cell which does not return to normal within two weeks. The origin of new endothelial cells is not demonstrated by this study.

Animals↗