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Biomedical subjects

J M Dubernard

Publications and source records attributed to J M Dubernard.

At least 217 records · Page 12Linked to original sources
PubMed1985

[Extracorporeal shockwave destruction of urinary calculi after ultrasonic localization].

Shock waves generated by an underwater spark gap discharge, focused by an ellipsoid can destroy most urinary stones extracorporeally. A device were stones are localized by ultrasound and where the ellipsoid itself could move to be positioned in the adequate position would obviate the need for a very expensive two fluoroscopes localisation system, and patient positioning device. A regular ultrasound probe was fixed on a multijointed metallic arm. From the measurements of the angles of every point it was possible to calculate the exact coordinates X, Y, Z, of the probe. This system, thought not extremely flexible allows to perform ultrasound examination of a kidney in the bathtub and localisation of stones in vivo in good conditions. When the stone was seen on the screen, the angles given to the joints were automatically recorded and the coordinates of the stone were instantly calculated with a personal computer. The computer program was able to calculate the displacement of the ellipsoid necessary to adjust its focal point on the X, Y, Z coordinates. The ellipsoid moved through a simple 3 motors system. Destruction of the stone was performed by shock waves. Progression of the disintegration was followed by plain X-rays performed in the bath tube with a portable X-ray apparatus. This device was tested in 7 dogs with stones surgically implanted in the renal pelvis. In every case, the stone was localised and disintegrated in fragments of the order of one millimeter using 700 to 2 000.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

[Role of renal autotransplantation in the treatment of renal arterial lesions].

112 patients with hypertensive lesions of the renal artery were studied. 33 patients with stenosis of the trunk of the renal artery were operated with autotransplantation. 10 patients had lesions of the main branches of the renal artery and in these cases autotransplantation with the anastomosis of the two main renal artery branches to the two main branches of the hypogastric artery was performed. 24 patients with complex lesions of renal artery branches were treated with autotransplantation associated with extracorporeal repair of the renal artery. 45 patients, with lesions of the trunk of the renal artery were operated by aortorenal bypass. For lesions of the main renal artery, results were better in the group of patients treated by simple autotransplantation (82% of patients cured versus 46% with bypass operation). For lesions involving multiple branches of the renal artery extracorporeal replacement of the renal artery followed by autotransplantation often represents to the sole technique to prevent nephrectomy. Hypertension was cured or improved in more than 80% of cases. We believe autotransplantation to be the best operation for lesions of the renal artery in most cases.

Adult↗
PubMed1985

[Technic and results of ureteroscopy for ureteral lithiasis. Apropos of 54 ureteroscopies].

Rigid ureteroscopy has been performed 54 times in 49 patients with ureteral stones. In 72% of the cases stones were removed or disintegrated with the ultrasound or electrohydraulic probe. Best results were obtained in the pelvic ureter (96,5% success). In the lumbar ureter only 56% success was obtained. Complications were observed in 15% of the cases, however only one complication necessitated an immediate open surgical operation.

Endoscopy↗
PubMed1985

[Cancer of the prostate: role of surgery in the evaluation of lymph node extension].

None of the non surgical methods for investigations of the lymph node extension of prostate carcinoma is entirely satisfactory. However, the risk of lymphatic extension is correctly appreciated when the initial tumor is well documented by rectal examination and endo-rectal ultrasonography. Histology shows an increasing interest. IVP, CT scan are of little interest for micrometastases while the results of lymphography are improved by cytoaspiration of abnormal models. Lymphadenectomy gives the most accurate appreciation of the lymphatic extension. The reliability of frozen sections interpretation is now very satisfactory. When limited to the triangle: external iliac artery, internal iliac artery and obturator fossa, the morbidity is reduced. In case of negative lymph nodes, radical prostatectomy gives to the patients a reasonable chance of complete cure.

Biopsy, Needle↗
PubMed1984

Thirty months' experience with cyclosporin in human pancreatic transplantation.

Between September 1978 and December 1983, 33 simultaneous kidney plus pancreatic transplantations were performed in Type 1 (insulin-dependent) diabetic patients with uraemia at the Herriot Hospital, Lyon. In eight patients grafted before June 1981, immunosuppressive treatment consisted of azathioprine, steroids and a temporary course with anti-lymphocyte globulins (protocol A). Since June 1981, the immunosuppressive treatment has consisted of cyclosporin administered according to two protocols: from the day of transplantation with temporary anti-lymphocyte globulins with or without steroids (protocol B, seven patients), or after an initial course with protocol A, with or without steroids (protocol C, 18 patients). Only slight differences in patient and pancreatic graft survival between the three protocols were observed at 3, 6 and 12 months, while an improved survival rate for both patients and pancreatic grafts was observed in protocols B and C at 2 years. Moreover the incidence of pancreatic rejection as a cause of loss of pancreatic function seemed to be reduced under protocols B and C.

Adult↗
PubMed1984

Renal glucose transport after kidney transplantation.

Tubular maximal transport of glucose (TmG), plasma glucose threshold ( PGT ) and fractional maximal tubular reabsorption (TmG/GFR) were measured in fourteen kidney-grafted patients. Seven patients showed decreased PGT and normal or decreased TmG/GFR (type A or B renal glycosuria (RG) ), whereas seven other patients showed normal values. No difference was found between the two groups with respect to parameters of renal function and to clinical parameters characterizing kidney transplantation. The only difference observed between the two groups was the rate of decrease of plasma creatinine levels during the 1st week after transplantation: it was faster in the group without renal glycosuria. No difference was seen between the two groups of patients with respect to the number of rejection episodes occurred over the first 12 months.

Adult↗
PubMed1984

Revelation of AB cell surface antigens on bladder-washing specimens with the immunofluorescence technique. An approach to automated cytology.

Revelation of AB cell surface antigens is possible with the immunofluorescence technique on urothelial cells from bladder irrigation fluid. Normal urothelial cells show a heterogeneous expression varying with cell type and cell viability. However, the loss of any antigenic reactivity of some cells seems to be directly related to their neoplastic features. Flow cytometry appears to be the most appropriate technique to provide the necessary objectivity for this type of study.

ABO Blood-Group System↗
PubMed1984

[Microsurgery of the renal arteries].

The extracorporal microsurgery of renal artery branches has improved the therapeutic possibilities of complicated vascular abnormalities. Intrarenal stenoses can only be treated by this technique and excellent therapeutic conditions are rendered possible, if more than two artery branches have to be replaced. The technical results are satisfactory, if the quality of the renal parenchyma is considered, which has been abnormal in a number of cases at the moment of the surgical treatment. The results concerning the arterial hypertension and the renal function are remarkable, when considering the fact that most of the kidneys treated by this technique would have been removed some years ago.

Adult↗
PubMed1984

[Extensive venous thrombosis disclosing an aneurysm of the common iliac artery].

Although aneurysms of the common iliac artery are a rare occurrence they should be investigated routinely in patients with urinary or thrombo-embolic venous manifestations in the pelvis minor. Clinical signs are inconstant and diagnosis requires the use of abdominopelvic ultrasound tomography. Venous and urinary complications constitute warning signals suggesting the need for surgery to avoid sudden or untimely rupture. Operation in patients with a poor general condition should be performed as a function of the course of the lesion.

Aged↗
PubMed1983

Pathology of the pancreas after intraductal neoprene injection in dogs and diabetic patients treated by pancreatic transplantation.

The injection of neoprene into the pancreatic ducts of dogs has been used to destroy exocrine function prior to pancreatic transplantation. The subsequent histological changes and the evolution of lesions over a period of 3-36 months are described. Animals were sacrificed or biopsied at various intervals (3, 15 and 36 months) and the pancreases showed the disappearance of exocrine acini and changes of chronic pancreatitis. An immunoperoxidase procedure with insulin, glucagon, somatostatin and pancreatic polypeptide antisera was used to show the persistence of pancreatic endocrine cells. After the injections, sclerosis progressively increased and secondary lesions of the islets were seen, although functional islets persisted. This technique was then applied to pancreas transplantation in man. Eight transplants from seven diabetic patients were available for examination. In four cases, there were early technical failures, but four pancreatic transplants continued to function for 28-889 days until suppuration destroyed one of the grafts and the three other patients died. The persistence of endocrine cells in sclerotic tissue was observed in histological and immunopathological examinations.

Adult↗
PubMed1983

Endocrine responses of type 1 (insulin-dependent) diabetic patients following successful pancreas transplantation.

The aim of the present study was to evaluate the insulin and glucagon responses to various stimuli in patients following pancreatic transplantation. Four Type 1 (insulin-dependent) diabetic patients with end-stage renal failure who had received a cadaveric segmental, neoprene-injected, pancreas transplant, in association with kidney transplantation, were investigated. Free-insulin, pancreatic glucagon, and growth hormone concentrations were measured after both oral and intravenous glucose tolerance tests, and following tolbutamide, arginine and arginine plus somatostatin infusions. Tests were performed 1 month (three cases) and 30 months (one case) after surgery, when no insulin administration was required. Four non-diabetic kidney grafted patients, matched for duration of graft survival and immunosuppressive treatment (steroids, azathioprine and anti-lymphocyte-globulins), served as control subjects. Impaired glucose tolerance was present in all diabetic and control patients. This was possibly related to immunosuppressive treatment. In comparison with control subjects, insulin release was normal in response to arginine and tolbutamide but was reduced in response to oral and intravenous glucose, while glucagon and growth hormone release were similar in both groups. Somatostatin was less effective in diabetic patients than in control subjects in suppressing insulin and glucagon release.

Adult↗