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Biomedical subjects

J M Dubernard

Publications and source records attributed to J M Dubernard.

At least 181 records · Page 10Linked to original sources
PubMed1987

[Ureteral stenoses after renal transplantation].

Out of 953 kidney transplantations performed in Lyon up to the end of 1984, we observed 28 (2.9%) post-operative ureteral stenoses. Most of them were diagnosed during the first year post-transplantation. Surgical reparation of the stenosis involved either ureterovesical reimplantation or pyeloureteral anastomosis with the patients' own ureter. Return to normal renal function was observed in 64.2% of our patients while in 10.7% renal function was stabilized. Actuarial postoperative graft survival was 66% at one year and 58% at two years of follow-up.

Adolescent↗
PubMed1987

[Renal failure caused by renal artery stenosis: effects of revascularization].

From 1972 to 1986, 22 patients underwent surgical treatment for severe renovascular hypertension and rapidly progressive renal failure caused by atherosclerotic disease of the renal artery or dysplasia (group A), or by post-transplant renal artery stenosis (group B). 1. Group A (n = 16): 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%. Improvement in renal function was statistically significant at 1 and 6 months postoperatively (p less than 0.05). After a mean follow-up of 31 +/- 12 months, renal function was normal in 8 patients, improved in 4, unchanged in 1 and worse in 2. At short and long-term, 81% of the patients were normotensive without medication of with an improved blood pressure (p less than 0.001). 2. Group B (n = 6): Transplant revascularisation was performed on average 10 +/- 8 months after renal transplantation. 5 patients had renal function impairment (mean serum creatinine 241 +/- 96 mumol/l, mean blood-urea 16 +/- 17 mumol/l) and 1 patient a posttransplant anuria. Resection of anastomotic (n = 2) or post-anastomotic (n = 4) lesions was carried out in all case with a new anastomosis (n = 2) or a "crossed" anastomosis (n = 4). On the 24th hour one patient underwent a second revascularization because of immediate postoperative anuria secondary to another anastomotic stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1987

[Evaluation of endorectal ultrasonography in the diagnosis of prostatic cancer using a high-frequency sectorial intracavitary probe].

Endorectal ultrasonography was evaluated in the diagnosis of prostatic cancer, using a high frequency (7,5 MHz) mechanical sectorial endocavitary probe developed by the authors. In a first study, sonograms from a series of 213 patients were interpreted retrospectively without any knowledge of the clinical or pathological findings. Specificity for the diagnosis of cancer (true non-malignant/total non-malignant) reached 79%, whereas sensitivity (true malignant/total malignant) was only 48%. Pathology was available for 132 patients. In a second study, 72 ultrasonically guided biopsies were performed in patients presenting either with a suspicious induration without nodule (47 cases) or a palpable nodule (25 cases). Good quality biopsy specimens, and absence of complication were remarkable. However, the 10 cancer cases (5 diagnosed in each group) did not show sonographically clearly different from the remaining adenoma, prostatitis and normal cases.

Evaluation Studies as Topic↗
PubMed1987

[Diagnostic value of flow cytometry of bladder lavage in the surveillance of bladder tumors].

DNA index and proliferation index (% greater than 2 n) of 125 bladder washings were studied with flow cytometry. Cystoscopy was positive in 49 patients and negative in 56 patients with a previous history of bladder cancer. There were 20 control patients with a normal bladder. Flow cytometric data was compared with cystoscopic and cytologic data. In the group of 49 patients with a positive cystoscopy, conventional cytology was suspicious or positive in 70% (34/49) whereas flow cytometry was positive in only 43% of the cases (21/49). The diagnostic sensitivity of flow cytometry increased with grade elevation: 7% of grade 1 tumors, 43% of grade 2 and 77% of grade 3 had a positive flow cytometric examination. In the group of 56 patients with a negative cystoscopy, flow cytometry was positive in 36% of the cases and cytology in 6% of the cases. The diagnostic sensitivity of flow cytometry was rather disappointing in the study on bladder washings. Flow cytometric follow-up of bladder washings should be reserved preferentially to patients with a poor prognosis, i.e., superficial bladder cancer with an aneuploid DNA content.

Cystoscopy↗
PubMed1987

[Plasma levels of cyclosporin 6 hours after its oral administration, T6: key to the surveillance of the treatment].

Clinical evolution and CsA monitoring of 65 transplanted patients (55 kidneys and 10 kidneys and pancreas) treated with CsA were analysed, retrospectively (45 patients) and prospectively (34 patients). The aim of the study was: To show that nephrotoxicity is not uncommon with low trough plasma levels of CsA, and to indicate the value of CsA pharmacokinetic studies in individual cases. To suggest that the T6 value of a CsA pharmacokinetic plasma curve (6 hours after oral drug administration) is a valid expression of a full pharmacokinetics study. To show the results in a prospective study utilizing the T6 as a monitoring tool and with dose adjustments disregarding concomitant serum creatinine levels, with the aim of maintaining a therapeutic T6 (range 150-250 ng/ml). Patients with permanent Therapeutic T6 during the follow-up period (without dose adjustments) showed a creatinine serum level of 144 +/- 6 mumol/l. Serum creatinine levels decreased when CsA dose adjustments were made related to the presence of Toxic (greater than 350 ng/ml) or under-therapeutic (less than 100 ng/ml) T6 (p less than 0.01). Kidney and pancreas patients showed a tendency to under-therapeutic T6 and required a dose of 14 +/- 0.7 mg/kg to maintain a therapeutic T6. The CsA dose of kidney grafted patients through the T6 therapeutic period was 7.03 +/- 0.5 mg/kg. During the T6 toxic period, kidney patients received 8.85 +/- 0.3 mg/kg of CsA (p less than 0.02). Kidneys and graft survival is 97.6% at 6 months follow up in the prospective study. Current serum creatinine of all patients is 180.2 +/- 8 mumol/l. No patient was switched to conventional treatment. T6 is more useful than trough plasma levels for CsA monitoring. Nephrotoxicity and CsA under-treatment can be avoided. This new monitoring tool may allow the utilization of lower doses of CsA and thus contribute to improved graft function at long term follow-up.

Administration, Oral↗