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J Lepine

Publications and source records attributed to J Lepine.

13 recordsLinked to original sources
PubMed2005

[Effects of local infiltration of split thickness skin grafts donor site with ropivacaine: a prospective series of 30 patients].

AIM: The aim of this study was to evaluate the benefits and risks of local infiltration in split-thickness skin grafts donnor site with ropivacaine (Naropein. MATERIALS AND METHODS: Therefore a prospective study was conducted enrolling 30 patients assessed for split skin grafts to cover muscular flaps, burn areas or primary tumor sites. Donnor site surface ranged from 50 to 200 cm(2). Patients were randomized into two groups: with or without infiltration. Critters of inclusion were age over 18 y.o., donnor site surface below 200 cm(2), no neurological or psychiatic pathology, no contra-indication to ropivacaine. All grafts were performed under general anaesthesia, using Lagrot's razor to take 0.2 to 0.4 mm thickness skin bands. Donnor sites dressings were standardized, associating a corticoid fat dressing (Corticotulle strongly and occlusively contained with an elastic band (Elastoplast. Dressings were removed after three weeks. Immediate and late post-operative pain were evaluated using analogic visual scale (EVA) and need of analgesics during the hospitalisation in our Institution. Side-effects were collected. RESULTS: Thirty patients were enrolled in this prospective study. They were mean aged 37 years old, sex ratio was 1/1. Donor site surface was mean 157 cm(2) and graft thickness 0.35 mm. There was a significant difference in immediate and late post-operative pain between both groups. Ropivacain reduced pain for the same oral analgesics use during 36 to 48 post-operative hours. No difference was noticed after 48 hours. No side-effects were noticed. CONCLUSION: Infiltration of split skin grafts donnor site with ropivacain improves postoperative pain during 48 hours. This is a safe and efficient method to improve comfort in addition to a standardized occlusive dressing. It has become a standard routine in our Institution.

Adult↗
PubMed1987

Clonogenic hemopoietic precursors in bone marrow transplantation.

Multilineage and single-lineage hemopoietic precursors were studied in 102 bone marrow transplant recipients and their respective donors to determine their contribution to clinical outcome as measured by time to engraftment and survival. The patient population was heterogenous with respect to diagnosis and disease status. They included individuals with acute myeloid leukemia (AML), chronic myeloid leukemia (CML), acute lymphoblastic leukemia (ALL), aplastic anemia, and a few other hematopoietic malignancies. The frequency of various clonogenic precursors in the normal donor population varied considerably. The data yielded a symmetrical distribution. In contrast, most bone marrow transplant recipients presented with significantly reduced numbers of clonogenic cells before transplantation, resulting in skewed distribution profiles. Serial studies of recipients demonstrated a significantly lower than normal level of clonogenic precursors even 3 and 4 years after transplantation. The median values and distribution profiles approximated those observed before transplantation but did not return to measurements obtained for normal donors. Patients with ALL deviated from this pattern. The median values and distribution profiles of clonogenic precursors before transplantation approximated the pattern of normal donors. The frequency of clonogenic progenitors after transplantation, however, remained significantly lower than that of their respective donor or pretransplant values. Cell cycle studies performed after normalization of peripheral blood hematopoietic parameters demonstrated for most recipients that a higher than normal proportion of multipotent cells was in S-phase (P = .011). By univariate and multivariate approaches, clonogenic precursors and clinical parameters were assessed for their contributions to clinical outcome as measured by time to engraftment and survival time. The number of nucleated cells in the transplant inoculum contributed to survival independent of other risk factors. Patients with a higher cell load had a higher probability of surviving than did patients with a lower cell concentration in the transplant inoculum (P = .042). The frequency of clonogenic precursors in the transplant inoculum altered neither survival nor time to engraftment. The time to engraftment was significantly influenced by the frequency of clonogenic megakaryocyte precursors (CFU-M) observed in recipients prior to transplantation (P = .003). Patients with high values engrafted faster than did patients with a low frequency of CFU-M. This was independent of both diagnosis and disease status of the patients at time of transplantation.

Adolescent↗
PubMed1985

[Tracheal intubation after maxillofacial reconstruction using a pectoralis major flap].

From 1979 to 1984, a pectoralis major musculocutaneous flap was used in 35 patients in order to cover a maxillofacial defect following either a gunshot wound or tissue loss after cancer surgery. In 50% of the cases, one or several operations were needed. 30% of the patients showed a fixed posture of the head preventing tracheal intubation by direct laryngoscopy. The measurement of the maxillopharyngeal angle helps to predict this impossibility. In such these cases intubation by fibroscopy was done to avoid tracheotomy.

Biomechanical Phenomena↗
PubMed1984

Comparison of the ability of basement membranes produced by corneal endothelial and mouse-derived Endodermal PF-HR-9 cells to support the proliferation and differentiation of bovine kidney tubule epithelial cells in vitro.

The proliferation and morphological differentiation of bovine kidney collecting-tubule epithelial cells has been examined as a function of substrata and plasma factors. Collecting kidney tubule explant maintained in vitro gave rise to two distinct cell populations; one was composed mostly of fibroblastic cells whereas the other was epithelioid (EP cells). The proliferation of fibroblastic cells when exposed to serum-supplemented medium was best expressed when cells were maintained on a basement membrane produced by bovine corneal endothelial cells. This basement membrane has a composition, which in previous studies has been shown to favor the proliferation of mesenchymal cells. In contrast, the proliferation of EP cells was best expressed when cells were maintained on a basement membrane produced by the mouse-derived endodermal cell line PF-HR-9 (HR-9-BM). This basement membrane has a biochemical composition very similar to the basement membrane underlying the kidney tubules. Although the fibroblast confluent monolayer maintained on bovine corneal endothelial cell extracellular matrix did not undergo morphogenesis, the confluent monolayer of EP cells maintained on HR-9-BM shows hemicyst formation, suggesting that they were capable of vectorial fluid transport. They also built a complex three-dimensional kidney tubulelike network. Some tubules became grossly visible and floated into the tissue culture medium, remaining tethered to the cell monolayer at either end of the tubule. On an ultrastructural level, the tubules consisted of cells held together with junctional complexes arranged so as to form a lumen. The smallest lumen were bordered by 2-3 cells, and the largest ones by 8-15 cells. The lumens of the larger tubules did contain granular fibrillar and amorphous debris. Low-density EP cell cultures maintained on HR-9-BM could be induced to proliferate at a rate approaching that of cultures exposed to serum when they were exposed to medium supplemented with high-density lipoprotein (HDL, 750 micrograms protein/ml) and transferrin (50 micrograms/ml). When exposed to HDL concentrations equal or lower than 250 micrograms protein/ml, low-density cultures proliferated at a slow rate and readily formed tubulelike structures. This observation indicates that EP cells do not need to reach confluence to undergo morphogenesis, and that HDL, which in the presence of transferrin supports the cell proliferation, can favor their differentiation into tubulelike structures once its concentration becomes limiting for mitogenesis.

Animals↗
PubMed1984

Permissive effect of insulin on the adenosine 3',5'-monophosphate-dependent up-regulation of low density lipoprotein receptors and the stimulation of steroid release in bovine adrenal cortical cells.

Bovine adrenal cortical cells growth on extracellular matrix-coated dishes in the presence of F-12 medium supplemented with high density lipoprotein (30 micrograms protein/ml), insulin (50 ng/ml), transferrin (1 microgram/ml), and fibroblast growth factor (100 ng/ml) expressed high affinity low density lipoprotein (LDL) receptors (Kd = 2.0 X 10(-8) M) present at a density of 3 X 10(4) receptors/cell. The density of LDL receptors per cell could be increased 3-fold (9 X 10(4) receptors/cell) by incubating the cells for 24 h with cholera toxin (CT; 10 ng/ml), but not with insulin (100 ng/ml). This correlated with increased LDL internalization (10-fold) and degradation (5-fold). 11-Deoxycortisol (11 DOC) release was increased by 2.7-fold. The addition of insulin (100 ng/ml) together with CT (10 ng/ml) markedly potentiated the effects of CT on LDL binding, internalization, and degradation as well as on steroid release. Preincubation (24 h) of the cells with insulin (100 ng/ml) together with CT resulted in a 12.7-fold increase in high affinity LDL receptor density (3.6 X 10(5) receptors/cell), while LDL internalization and degradation were increased by 45- and 22-fold, respectively. This correlated with a 9.6-fold increase in the 11 DOC released into the medium. The effects of insulin on the induction of high affinity LDL receptors as well as increased internalization and degradation of [125I]LDL were both time and concentration dependent in cultures exposed to CT. Secretion of 11 DOC paralleled in a time-dependent manner the amount of internalized [125I]LDL. Exposure of the cells to chloroquine (100 microM) resulted in a 95% inhibition of [125I]LDL degradation correlating with an 80% decrease in 11 DOC released in cells preexposed to CT and insulin. The results of these studies suggest that in bovine adrenal cortex cells grown in chemically defined medium, insulin modulates steroidogenic cAMP-induced response by increasing both the LDL receptor pathway activity and 11 DOC release.

Adrenal Cortex↗
PubMed1983

Pluripotent hemopoietic progenitors (CFU-GEMM) in chronic myelogenous leukemia.

Human hemopoietic pluripotent progenitors form multilineage colonies when cultured in methylcellulose with medium conditioned by leukocytes in the presence of phytohemagglutinin (PHA-LCM) and erythropoietin (EPO). We have examined their frequency, culture requirements and proliferative activity in 20 peripheral blood and 29 bone marrow specimens from patients with CML in chronic phase. Multilineage colonies developed under regular culture conditions in approximately 50% of all samples. The frequency ranged from 1-36 per 2 X 10(5) mononuclear cells of density less than 1.077 gm/ml. The requirements for PHA-LCM and EPO varied for patients with CML when compared to normal individuals; i.e., cells from some patients gave rise to mixed colonies with substantial erythroid components in the absence of PHA-LCM or without addition of the usually required EPO concentrations. The proliferative activity of CFU-GEMM was assessed using a short-term exposure to tritiated thymidine (3HTdR) prior to plating. The plating efficiency in all bone marrow and peripheral blood samples was reduced to 40-70% of the unexposed controls. In contrast, the plating efficiency after exposure to 3HTdR in normal individuals usually ranged from 70-90% of controls for bone marrow samples and from 85-100% of controls for peripheral blood samples. Thus, an increased proliferative rate of pluripotent hemopoietic progenitors is a consistent feature of CML patients. In addition, at least in some patients, different requirements for erythropoietin or PHA-LCM were observed when compared to normal culture conditions.

Cell Division↗
PubMed1980

Properties of human pluripotent hemopoietic progenitors.

Human pluripotent hemopoietic progenitors (CFU-GEMM) from mixed colonies when cultured in methylcellulose or agar in the presence of erythropoietin and PHA-LCM. The observed frequency is low and varies for different individuals between 0 and 4 mixed colonies/O5 mononuclear cells. CFU-GEMM do not adhere to glass or plastic surfaces; their density is less than 1.077 g/ml, and their sedimentation velocity profile peaks at 4.5 mm/h. They do not form rosettes with sheep red blood cells. These physical parameters can be used preparatively to enrich for CFU-GEMM to facilitate assessment of their biological properties such as cycle state analysis and measurement of self-renewal capacity. Preliminary information suggests that some CFU-GEMM are capable of self-replication. Cycle state data are available for a larger number of patients with various clinical conditions. CFU-GEMM were found to be quiescent under steady-state conditions. They proliferate actively during bone marrow regeneration and in stem cell disorders like Polycythemia rubra vera or CML. These changes in cycle state activity were not reflected in numerical alterations of CFU-GEMM. It was thus concluded that the assay may be used more meaningfully to assess biological properties of human pluripotent progenitors rather than their frequency.

Cell Adhesion↗
PubMed1979

[Modification of septicaemias in an intensive care unit following the suppression of prophylactic antibiotics (author's transl)].

The authors after to have suppressed the preventive antibiotic therapy in their intensive care concluded after four years of this new attitude. They ascertain that this new attitude has not changed by no means the number of septicenia in their intensive care. In the other hand, the gram negative septicemia stronghly decrease, succeeding by gram positive septicemia. This results were statistically significant in the sector of intensive care where the supress of antibiotic was quick and the most completely. Thanks to this attitude, the cost of operation of the service was divided by three.

Adolescent↗