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M Carretier

Publications and source records attributed to M Carretier.

At least 19 recordsLinked to original sources
PubMed1998

Anomalous pancreatico-biliary ductal union with cystic dilatation of the bile duct.

We report, in an adult, an asymptomatic association between cystic dilation of the bile duct (type IV A in Todani's classification) and anomalous pancreatico-biliary ductal union (APBD) with stones in a long common channel. In APBD, the connection between the common bile duct and the main pancreatic duct is located outside the duodenal wall andis therefore not under the influence of the sphincter of Boyden. An abnormally long common channel is in excess of 15 mm. Two types of convergence anomalies are defined according to whether the bile duct opens into the main pancreatic duct (BP) or the main pancreatic duct into the bile duct (PB). In APBD, there is probably a reverse pressure gradient between the bile and pancreatic ducts, with regurgitation of pancreatic juice into the bile duct, repeated attacks of cholangitis, stenosis and cystic dilatation. A long common channel is associated with a higher incidence of carcinoma of the gall bladder of the bile duct.

Adult↗
PubMed1998

Lipid peroxidation after cold storage and normothermic reperfusion: the effect of trimetazidine.

Ischemia reperfusion injury is still a leading cause of early graft dysfunction after transplantation. Trimetazidine (TMZ) has been postulated to be protective against renal damage from oxygen free radicals. The aim of this study was to assess the effect TMZ during cold storage (CS) and normothermic reperfusion in an isolated perfused pig kidney model. Three groups were studied: control group, immediately perfused (G0), 48 h CS in Euro-Collins solution (G1), and 48 h CS in Euro-Collins solution plus TMZ (G2). Glomerular filtration rate (GFR) and fractional sodium reabsorption (FRNa+) were calculated during reperfusion from urine and perfusate samples. Lipid peroxidation was determined by the renal tissue level of Schiff bases (SB) and malondialdehyde (MDA) after reperfusion. A histological evaluation was performed after reperfusion. Renal function was significantly improved and lipid peroxidation reduced after preservation in Euro-Collins solution plus TMZ. Functional data were closely related to histological damage. In conclusion, TMZ is a useful protective agent against renal damage induced by CS.

Animals↗
PubMed1998

Effects of trimetazidine on lipid peroxidation and phosphorus metabolites during cold storage and reperfusion of isolated perfused rat kidneys.

This study was undertaken to evaluate the effect of trimetazidine (TMZ) during cold storage (CS) and the consequence during normothermic reperfusion in an isolated perfused rat kidney model (IPK). IPK was used to assess the rate of perfusion flow, the ratio of ATP to inorganic phosphate (ATP/Pi) as a reflection of the energetic status during reperfusion, intracellular pH (pHi), tissue water content and malondialdehyde (MDA) tissue levels in four different preservation solutions after 48-hr preservation at 4 degreesC and 2-hr reperfusion at 37.5 degreesC: EuroCollins (EC), University of Wisconsin (UW), EC plus TMZ (10(-)6 M) (EC + TMZ) and UW plus TMZ (10(-)6 M) (UW + TMZ). When TMZ was added to the preservation solutions, perfusion flow rate (PFR) was significantly improved during reperfusion. Tissue water content, which reflected tissue edema, was significantly lower in TMZ groups than in groups without TMZ during both CS and reperfusion conditions. In TMZ groups, ATP/Pi ratio was also significantly improved during CS and reperfusion. In addition, TMZ lowered the pHi both during preservation and after reperfusion. MDA renal tissue level significantly decreased with TMZ both during the preservation period and after reperfusion. These overall results strongly suggested that TMZ contributes to renal protection from cold ischemia-reperfusion injury in this IPK model, especially when TMZ was added to UW solution and during prolonged hypothermic ischemia.

Adenosine Triphosphate↗
PubMed1998

[Renal cancer and late pancreatic metastases. Apropos of 3 cases and review of the literature].

Renal cell carcinoma is a malignant epithelial tumour which can always give rise to metastases, usually situated in the lungs, bone and liver. In contrast, pancreatic metastases are exceptional and can occur late. The authors report three cases of metachronous pancreatic metastases, 1, 4 and 10 years after nephrectomy. The procedures performed consisted of Whipple procedure, tumour excision and total duodenopancreatectomy. Although rare when isolated to the pancreas, these metastases can justify even audacious pancreatic resection.

Adenocarcinoma, Clear Cell↗
PubMed1997

Trimetazidine prevents renal injury in the isolated perfused pig kidney exposed to prolonged cold ischemia.

BACKGROUND: Ischemia caused by cold storage (CS) and reperfusion of the kidney is often responsible for delayed graft function after transplantation. Significant attention has been focused on the cascade of events involved in ischemia-reperfusion injury, with the objective of identifying drugs to ameliorate the functional damage that occurs. METHODS: The purpose of this study was to evaluate the renal function of isolated perfused pig kidneys after 48 hr of CS with Euro-Collins (EC) solution plus trimetazidine (EC+TMZ), standard EC solution, or University of Wisconsin (UW) solution. Normothermic isolated perfused pig kidneys were randomized into five experimental groups: (A) control group (cold flush with cold heparinized saline and immediately reperfused; n=6); (B) cold flush with cold heparinized saline with TMZ (10(-6) M), n=6; (C) 48 hr of CS with EC and reperfusion (n=8); (D) 48 hr of CS with EC+TMZ alone and reperfusion (n=8); (E) 48 hr of CS with UW and reperfusion (n=8). Proton nuclear magnetic resonance spectroscopy and biochemical studies were performed for the functional evaluation during reperfusion. Lipid peroxidation was also determined. Histological examination (optical and electron microscopy) was performed after CS and reperfusion. RESULTS: Using TMZ, the renal perfusate flow rate as well as the glomerular filtration rate and proximal tubular function were significantly improved. This improvement of renal function during reperfusion was correlated with a less significant cellular and interstitial edema. In addition, tubular injury markers were significantly lower in the group preserved with EC+TMZ, and TMZ reduced lipid peroxidation dramatically during reperfusion. CONCLUSIONS: The addition of TMZ to the EC solution increased the preservation quality and renal tubular function, and gave protection from reperfusion injury better than EC alone or UW. These results strongly suggest that TMZ has a cytoprotective effect and may therefore be useful for kidney preservation.

Adenosine↗
PubMed1997

Evaluation of normothermic ischemia and simple cold preservation injury in pig kidney by proton nuclear magnetic resonance spectroscopy.

The isolated perfused pig kidney (IPK) model was used to mimic the non-heart-beating donor situation. This model was performed to assess initial renal functions after normothermic ischemia, cold flush, and 24 hr cold-storage preservation (CSP) with Euro-Collins and to determine normothermic ischemia and reperfusion impairment by biochemical, histological, and proton nuclear magnetic resonance (NMR) spectroscopy analysis. Twenty-four pig kidneys were used. There were three experimental groups: Group 1 (G1), control kidneys flushed with cold heparinized saline and immediately perfused; Group 2 (G2), cold flush followed by 24 hr CSP and reperfusion; and Group 3 (G3), 30 min of normothermic ischemia followed by cold flush and 24 hr CSP and reperfusion. Kidneys were perfused for 2 hr at 37.5 degrees C for functional evaluation. Perfusate flow rate is significantly different for G3 (P < 0.01). Glomerular filtration rate is less in G3 (P < 0.05). Fractional reabsorptions of sodium (FRNa+) and glucose (Glc) excretion in urine are different in G3 (P < 0.01 and P < 0.05, respectively). Amino acid excretion in NMR spectroscopy was higher in G3 (P < 0.05). Elevated levels of trimethylamine-N-oxide (TMAO) and lactate (Lac) were detected by proton NMR spectroscopy in G2 and particularly G3. A peak is present in G3 and related with poor glomerular and tubular functions and worse histological data. Malondialdehyde tissue level was higher in G3. This study shows that the IPK with proton NMR spectroscopy may be a useful method in the evaluation of kidneys after cold ischemia and transplantation. This model might be suitable for a variety of experimental protocols, particularly to improve functional performance after ischemia and reperfusion.

Animals↗
PubMed1997

Evaluation of injury preservation in pig kidney cold storage by proton nuclear magnetic resonance spectroscopy of urine.

The isolated perfused kidney (IPK) model from pig was used to assess initial renal functions after cold flush and a 24- and 48-hour cold storage preservation (CSP) with Euro-Collins (EC) and to determine ischemia reperfusion (IR) impairment by biochemical, histological and proton nuclear magnetic resonance (NMR) spectroscopy of urine analysis. Eighteen pig kidneys were used. There were three experimental groups: Group 1--control kidneys flushed with cold heparinized saline, Group 2--cold flush followed by 24-hour CSP and reperfusion, Group 3--cold flush followed by 48-hour CSP and reperfusion. Kidneys were perfused for 2-hour at 37.5C for the determination of exogenous creatinine clearance (CCr), perfusion flow rate (PFR) and tubular function. Functional parameters and histological data are very poor after prolonged cold ischemia. Levels of tubular injury markers determined by proton NMR spectroscopy analysis were significantly higher with a longer ischemic time correlating well with the increased degree of renal functional and anatomic impairment. A new peak detected only in the 48-hour ischemic group was identified. In this model, proton NMR spectroscopy may be a useful technique in the evaluation of both new preservation solutions or methods.

Animals↗
PubMed1997

[Technique for protecting the liver graft less tolerant than the small bowel to heat-induced ischemia in experimental liver + small bowel transplantation in swine].

Multivisceral and orthotopic liver/small bowel transplantations have been performed to treat patients with intestinal failure associated with liver failure induced by parenteral nutrition. The aim of this experimental study was to determine the experimental liver-small bowel harvesting and transplantation technique that achieves the best compromise between liver and intestine ischemia times in pigs. Initial portal revascularization of the liver which reduces the hepatic warm ischemia time after cold ischemia preparation of the graft immersed in lactated ringer's solution at 4 degrees C, reduce the risk of primary non function of the graft.

Animals↗
PubMed1996

Pharmacokinetics of lidocaine with epinephrine in piglets following epidural anaesthesia.

The time course of arterial plasma lidocaine concentration, following an epidural anaesthesia via the sacrococcygeal or the S4-S5 trans-sacral approach, was studied in nine healthy piglets (7.8 +/- 1.3 weeks). Plasma lidocaine concentrations were measured for up to six hours after administration (5 mg/kg). Peak plasma concentration was 1.83 +/- 0.17 mg/l. Pharmacokinetic parameters determined from an independent compartment model were not different from those observed after an epidural administration of lidocaine via the sacrococcygeal space in children, except for a wide variability in the time taken to reach the maximum concentration (27.3 +/- 7.4 min) and a shorter half-life of elimination (82.8 +/- 7.0 min). The total body clearance of lidocaine was similar in piglets (17.3 +/- 1.6 ml/min/kg) to that in children. The shorter half-life of elimination was therefore attributed to a smaller volume of distribution in piglets (2.0 +/- 0.2 l/kg).

Anesthesia, Epidural↗
PubMed1994

Anatomic and radiologic bases of combined transplantation of liver and small intestine in the pig.

In order to assess the tolerance induced by hepatic transplantation in a multivisceral graft, a model of a transplant combining the liver and small intestine was developed in the pig, using animals of Large White Isogroup O, typed in the system of major incompatibility as "Swine lymphocyte antigen" (SLA), whose weight varied from 30 to 40 kg. In order to limit the duration of warm ischemia, dissection of the graft was performed on the donor animal with respect for the following anatomic features: absence of intestinal attachment to the posterior parietal peritoneum, anti-clockwise torsion of 360 degrees of the intestine around the superior mesenteric a. with the small intestine convolutions on the right and the colonic helix on the left. The bifid pancreas follows this rotation and its resection must respect the vascularisation of the proximal small intestine; the hepatic a. arises from a common trunk with a gastrosplenic branch of the aorta between the crura of the diaphragm and travels sagittally from behind forward toward the liver pedicle, which it reaches ar the upper border of the duodenum; the hepatic a. and its branches are dorsal in relation to the portal vein; the hepatic arterial distribution follows a right-left and antero-posterior systematisation for the six hepatic lobes of this quadruped animal.

Anastomosis, Surgical↗
PubMed1994

[Arterial risks in celiosurgery].

It is important to recognize exceptional vascular events in celiosurgery because of their gravity. Most occur during pneumoperitoneal manoeuvres using a Palmer needle and rarely at the insertion of the first trocar. We performed a tomodensitometric study in 200 subjects free of abdominal pathology in order to determine the distance from the umbilicus to the aortic bifurcation, their projection over the spine and the superficial relations of the large vessels to the cutaneous umbilical cover. Generally, the projections of the umbilicus, and also the aortic bifurcation, lie over L4. The distance between the skin and the large retroperitoneal vesses is generally equal to one-third of the antero-posterior abdominal diameter. In thin subjects with a flat abdomen however, this distance may be smaller, even less than 3 cm. These findings emphasize the importance of "safety" manoeuvres during celiosurgery, especially during the learning period.

Adolescent↗