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Biomedical subjects

J M Marechal

Publications and source records attributed to J M Marechal.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Ectopic deposits of Tamm-Horsfall protein. A psuedo-tumoral lesion].

Three cases of unusual deposits of Tamm-Horsfall protein in peripelvic and perirenal fat tissue are reported. A renal tubular rupture leads to the deposition of this protein. In the first case, the association of the deposits with epithelial structures, raised the possibility of a bladder carcinoma infiltration. These deposits simulated on the X-ray examination, a pelvis neoplasm in our second patient and a tuberculosis in the third case. However the particular microscopic appearance of Tamm-Horsfall protein, its intense staining with the periodic-acid-Schiff, and its positivity with a specific antibody led to the diagnosis.

Adipose Tissue↗
PubMed1994

[The contribution of endoscopy in the diagnosis of unilateral hematuria of renal origin and pseudotumors of the upper urinary tract].

From 1985 to 1992, 9 patients (6 males, 3 females) with a mean age of 47 years, presenting with a clinical picture suggestive of a tumour of the upper urinary tract (haematuria and/or pelvic or caliceal radiolucent filling defect), underwent retrograde (6 cases) and/or percutaneous (9 cases) endoscopic exploration of the upper urinary tract. The percutaneous examination allowed a precise diagnosis and appropriate treatment adapted to the lesion detected (papillary necrosis: 2 cases; ectopic papilla: 2 cases; hypertrophy of Brunn's nests: 1 case; papillary angioma: 1 case; haemorrhagic papillitis: 3 cases) in every case. Endoscopic exploration of radiolucent lesions of the upper tract and unexplained renal haematuria is therefore justified whenever the diagnosis of upper tract tumour is uncertain on the basis of the radiological and cytological assessment.

Adult↗
PubMed1993

[Fragmentation of urinary calculi using the Lithoclast EMS. Technique and results].

The Lithoclast is an endoscopic lithotriptor which uses the ballistic energy produced by a small hand-held apparatus, by the movement of a small metal part (the projectile) driven by a jet of compressed air. The energy is transmitted to a metal rod whose diameter is selected according to the application: 0.8 or 1 mm in the ureter; 2 mm in the bladder and kidney. We have used this apparatus to treat 40 stones in 39 patients (25 ureteric stones, 11 renal stones, 4 bladder stones). Satisfactory fragmentation was obtained for 39 of the 40 stones (97.5%). The apparatus is very easy to use in the kidney and bladder (the risk of urinary tract perforation is very low at this level). The risk of perforation of the ureteric wall by 0.8 mm or 1 mm rods is considerable (12% of cases), but these punctate lesions heal rapidly over a double J stent. Special techniques should be used in the ureter to limit the risk of pushing the stone towards the renal pelvis.

Adult↗
PubMed1991

Pancreas transplantation in Lyon: overall results.

A total of 182 pancreatic transplantations were performed between 1976 and 1990. Survival of the grafts was 45% at 5 years. Major causes of graft loss have been rejection and venous thrombosis. Death occurred in 24 patients and was usually related to vascular complications. The techniques of duodenopancreatic transplantation with enteric drainage, bladder drainage and the technique of segmental duct obstructed grafts were compared. A higher rate of surgical complications was observed with enteric drainage, whereas it is unclear from the data whether segmental grafts or duodenopancreatic grafts drained into the bladder lead to different results.

Adult↗
PubMed1991

[Pyelo-ureteral syndrome: the impact of endo-urological techniques].

The present article reports our experience with endopyelotomy, a technique we have performed at our hospital since 1985. Sixty-two patients comprise this series. Of these, 57 were evaluated more than 6 months after treatment (65 cases of ureteropelvic junction syndrome (UPJS); 26 were primary UPJS (success rate 81%) and 39 secondary UPJS (success rate 84.5%). The complication rate was low. Patients in whom endoscopic treatment had failed were submitted to open surgery with no particular difficulty. A comprehensive review of the literature highlighting the indications, techniques and results achieved with this procedure is performed.

Adolescent↗
PubMed1991

[Pancreas transplantation in 132 insulin-dependent diabetic patients].

A total of 140 pancreatic transplants have been performed in 132 insulin-dependent diabetic patients at Lyon (France). Most cases received a double pancreatic and renal transplant. The duct obstruction technique was utilized in 113 segmental transplants. A total pancreatic transplant was performed in 27 patients, with duct obstruction in 27, GI tract derivation in 14, urinary tract derivation in 11 and intraductal obstruction in 2 patients. Utilizing quadruple immunosuppression, the one year survival rate was 90% and the transplant survival was 60%.

Actuarial Analysis↗
PubMed1991

[What is the role of endoscopy in the diagnosis and treatment of tumors of the upper urinary tract?].

17 patients with upper urinary tract tumours were investigated by endoscopy. 3 patients (Group I) with fibrous or fibroepithelial polyps were treated via a retrograde approach and did not develop any recurrences. 2 patients (Group II) developed unexplained haematuria: the diagnosis of high-grade carcinoma was confirmed by endoscopy and they were treated by nephroureterectomy. 12 patients (Group III) with low grade non-invasive urothelial carcinoma, in whom radical surgical was not indicated, were treated conservatively via the percutaneous (13 tumours) or retrograde (1 tumour) endoscopic approach. The local recurrence rate was 33% (4 out of 12 tumours) for a mean follow-up of 22 months. The recurrences were treated by repeated endoscopy in 3 patients, and by nephroureterectomy in 1 patient. Endoscopic treatment of upper urinary tract tumours should be reserved for benign tumours and selected cases of low-grade, non-invasive urothelial carcinoma.

Adult↗
PubMed1991

[Long-term results of endourological treatment with and without ESWL in cystine lithiasis].

From 1984 to 1989, 15 patients with cystine calculi were treated by endourologic procedures and/or extracorporeal shock wave lithotripsy (ESWL). During this period the patients required 38 hospitalizations, a total of 74 calculi were treated localized to 61 sites: pelvic 21, caliceal 13 and 27 were multiple. The diagnosis was confirmed by a 24 hour cystinuria (3.595 muMol/24 h. average) and analysis of the stone fragments. Stone disruption was achieved in 17 of 38 cases (44.7%). ESWL as monotherapy was utilized in calculi less than 15-20 mm. in diameter; complete removal was achieved in of 18 cases. Percutaneous surgery (PC) was used alone or in combination with ESWL for large calculi or when ESWL failed to achieve stone fragmentation. Complete stones removal was achieved in 5 of 9 cases using PC as monotherapy and in 5 of 10 in combination with ESWL. There were 23 recurrences during this period; 13 patients with residual stone fragments and 10 patients that were stone-free. The present study reports our experience in the treatment of cystine calculi by PC and/or ESWL and the long-term results achieved with the respective treatment modalities.

Adolescent↗
PubMed1990

Continent cutaneous Ileostomy (Kock pouch) prior to renal transplantation.

Two patients in end-stage renal failure and with neurogenic bladders due to spina bifida complicated by myelomeningocele were considered for renal transplantation. One patient had had a right nephrectomy and urinary diversion via an ileal conduit; the other, after various external drainage procedures (cystostomy, bilateral nephrostomy), had had a tubular ileocystoplasty. Both underwent 2 surgical procedures prior to renal transplantation: in case 1 we performed a left nephrectomy and then ileal conduit removal + Kock pouch; in case 2 a bilateral nephrectomy was performed via 2 posterior incisions and then we removed the ileocystoplasty and formed the pouch. The continent ileostomy was formed according to the original technique with slight modifications. The patients have been followed up for 12 and 15 months after transplantation.

Acute Kidney Injury↗
PubMed1990

Place of luteinizing hormone releasing hormone agonists in the treatment of prostatic cancer.

Prolonged administration of a luteinizing hormone releasing hormone agonist causes a transient increase in serum testosterone concentrations, lasting a few days, followed by a long-lasting decrease in the serum testosterone concentrations, luteinizing hormone releasing hormone agonists inducing a chemical castration equivalent to surgical castration. The effect is observed whatever the agonist employed, side-effects being limited to loss of libido, impotence and hot flushes. Moreover, chemical castration is reversible and may be repeated; therefore, this new therapy appears to be of considerable interest in the treatment of prostatic cancer. The indications for luteinizing hormone releasing hormone analogues, however, are limited to metastasized adenocarcinomas which represent the stage of the disease most frequently encountered (about 75% of the cancers treated). They constitute a method of treatment that is only palliative. The use of agonists competes directly with orchidectomy but it is costly and demanding, and it derives its indications from the fact that it is reversible, does not mutilate and is devoid of toxicity.

Gonadotropin-Releasing Hormone↗
PubMed1982

[Treatment of urinary tract infections by dibekacin].

In this cooperative trial, 181 patients with various urinary tract infections were treated by dibekacin, a new hemi-synthetic aminoglycoside. Clinical and bacteriological results confirm the efficacy of dibekacin in this indication. Local and systemic tolerance, and thus renal and cochleo-vestibular, were very satisfactory.

Dibekacin↗
PubMed1979

Rectoanal pressures and rectal sensitivity studies in chronic childhood constipation.

Rectoanal pressures and rectal sensitivity studies were performed in 32 control children and 144 chronically constipated children. The rectoanal inhibitory reflex threshold, the maximal anal resting closure pressure, and the conscious rectal sensitivity threshold were studied in these children. The rectoanal inhibitory reflex threshold was increased in 6.2% of the constipated patients. Anal hypertony (increased maximal anal resting pressure) was found in 46% of the constipated children. Decreased rectal sensitivity (increased conscious sensitivity threshold) was found in 68% of the constipated children. The three parameters were found to be normal in only 13% of the constipated subjects. Thus, it appears that children with chronic constipation who do not have Hirschsprung's disease do have abnormalities at manometry in most cases.

Anal Canal↗
PubMed1978

Surgical treatment of high imperforate anus with definition of the puborectalis sling by an anterior perineal approach.

An operative technique in which the sling of the puborectalis muscle is seen through an anterior perineal approach in the treatment of high imperforate anus is described. The operation has been performed, on children with previous colostomies, and on older children with unsuccessful previous abdomino-perineal pull-through procedures. While our series of patients is still small, 24 children, operated upon sufficiently long ago for follow-up purposes, have generally shown good to excellent functional results.

Age Factors↗