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Biomedical subjects

P Frantz

Publications and source records attributed to P Frantz.

At least 19 recordsLinked to original sources

Acute poisonings with ethyle loflazepate, flunitrazepam, prazepam and triazolam in children.

Even though acute poisonings with benzodiazepines are extremely common, less is known of the clinical toxicity of recent derivatives, particularly in children. 1,989 cases involving ethyle loflazepate, flunitrazepam, prazepam or triazolam recorded at the Lyons Poison Center and due to 1 compound and associated with clinical symptoms were selected for study. Children less than 16-y of age accounted for 482 cases. Sleepiness, agitation and ataxia were significantly more frequent in the children. Hypotonia was seldom observed but was indicative of severe poisoning. The dangerous toxic dose of these compounds in children is suggested to be 0.78-0.90 mg ethyle loflazepate/kg, 0.26-0.29 mg flunitrazepam/kg, 7.80-9.00 mg prazepam/kg and 0.06-0.07 mg triazolam/kg. These results are in keeping with the relatively low acute toxicity of the older benzodiazepines.

Adolescent

[Analysis of 10 cases of pregnancy after renal transplantation].

Renal transplantation has changed completely the fertility of women who had been dialysed. Our study is on 10 pregnancies which we followed up in 7 women who had had renal transplants in the University Hospital of Pitié Salpêtrière (Professor Y. Darbois) between 1979 and 1985. All patients were treated by the same technique and the same methods of prevention of rejection of the transplant. The mean interval between the transplant and pregnancy was 53 months. In 3 cases there was hypertension and raised creatinine levels (more than 150 in 3 cases). In 2 cases the two conditions were associated. The prognosis is bad when a raised blood pressure or a change in renal function occurs before pregnancy starts, leading to a real deterioration in renal function during the pregnancy when such function was abnormal before the pregnancy started. As far as the infants were concerned, the most common complication was IUGR (intrauterine growth retardation) which was found in half of all cases. Blood flow studies in these fetuses are particularity interesting. There were two cases of intra-uterine fetal death. The reasons for these were not necessarily connected with the deterioration in renal function. All the deliveries were by caesarean section, for medical reasons in 7 out of 10 cases. The average duration of the pregnancy was 35 weeks of amenorrhoea. As far as the mothers were concerned, they did not have more infections than other women in spite of being immuno-suppressed (this was excluding urinary tract infections).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Specific IgM of cytomegaloviruses and primary infection in kidney transplant patients].

In 20 renal transplant recipients suffering from symptomatic CMV infection we looked if a specific IgM response was indicative of a primary infection. By an ELISA technique we investigated the specific IgG and IgM in a pair of sera taken at the time of the transplantation and later at the time of the CMV isolation. For 7 out of 8 patients exhibiting an IgM response in the late serum, the pretransplant serum did not contain either IgG or IgM specific antibodies. Therefore the specific IgM response was associated in 7 out of 8 patients with a primary CMV infection. Nevertheless in 6 other primary infected patients no specific IgM response was detected. Otherwise rheumatoid factors appeared in each primary infected patient developing a specific IgG response, with or without specific IgM response.

Antibodies, Viral

[Restoration of urinary tract continuity in a non-functioning bladder after renal transplantation].

The restoration of the continuity of the urinary tract after renal transplantation in anuric patients, an increasingly frequent situation, raises a number of theoretical problems: is it possible to use a bladder which has been non-functioning, sometimes for many years (20 years)? What should be performed during pre-operative assessment? Which surgical technique should be used? The authors try to answer these questions on the basis of their experience of 116 transplanted anuric patients. Anuria, even of long duration, does not prevent the use of the bladder, provided that the bladder was originally normal and is not infected. The pre-operative assessment is the same as for other patients and urodynamic investigations are not required. The optimal reimplantation technique is the Leadbetter-Politano open bladder technique and every effort should be made to obtain abundant diuresis immediately. Under these conditions, reimplantation into these non-functioning bladders is not associated with more complications than in the case of normal bladders.

Adult

[Responsibility of the left renal vein and inferior vena cava in certain cases of myelitis and syringomyelia. Value of ligation of the venous reno-spinal trunk. Apropos of 30 cases].

Certain diffuse forms of myelitis may be due to raised intra-spinal venous pressure resulting in veritable "varicose veins of the spinal cord". The origin of this increased pressure is often multifactorial, but may be due to venous reflux of blood from the left kidney into the intraspinal plexuses via the reno-spinal trunk. Ligation of this trunk results in a considerable and often complete improvement in the neurological syndrome. This operation was performed for the first time by our team in 1973 and since then has been successfully performed on 30 occasions for 21 cases of myelopathy and 9 cases of syringomyelia.

Adult

Early monitoring of human renal transplantations by N-acetyl-beta-D-glucosaminidase isoenzyme activities in urines.

Monitoring of variations in N-acetyl-beta-D-glucosaminidase (NAG) urinary activity, following renal transplantation, has been proposed for the early diagnosis of rejection episodes. In this study, the measurement of urinary NAG-B activity was conducted as a complement to total NAG (A + B) measurement, which is normally used alone. Selective measurement of NAG-B activity is carried out after fixation of NAG-A on ion exchanger in test tubes. Results of NAG (A + B) activity confirm that the assay of urinary NAG is a useful indicator of rejection, but a positive correlation between NAG-B and NAG (A + B) activities was observed during the various complications which can occur after transplantation. The specific measurement of this isoenzyme does not, therefore, seem to provide additional information in the early monitoring of human renal transplantations. Apart from rejection episodes, other factors are likely to produce marked NAG-B excretion, e.g. gentamicin therapy.

Acetylglucosaminidase

Early anuria prevention in human kidney transplantation. Advantage of fluid load under pulmonary arterial pressure monitoring during surgical period.

In human kidney transplantation, a high blood flow established through the graft immediately upon clamp release is usually associated with immediate satisfactory renal function. One hundred consecutive kidney transplant patients were thus provided with a large volume of fluid during surgery. To avoid pulmonary edema, fluid load was given under mean pulmonary arterial pressure (PAP) monitoring, and controlled ventilation was maintained during the early postoperative period. Whether initial PAP value was within normal range or elevated, all patients required an equivalent fluid load to reach the best hemodynamic condition upon clamp removal. The mean intraoperative fluid load consisted of 2406 +/- 968 ml of water with 22.8 +/- 9.4 g of sodium chloride, 5.9 +/- 1.8 units of albumin, and 2.6 +/- 1.8 units of packed red blood cells. Immediately before clamp release patients were given furosemide and mannitol. During the postoperative period, i.v. infusions consisted of water and sodium chloride (6 g/liter) to match urine output, provided that diuresis was equal to or above 400 ml/hr. If diuresis remained or decreased below this level, diuresis replacement was associated with PAP-controlled infusion of saline, albumin, and red blood cells if needed. Furosemide was eventually given if diuresis did not increase above 400 ml/hr with fluid loading. With this protocol a good early diuresis was established in 95% of the cases. Ten patients required dialysis before the 5th postoperative day, one of them because of fluid overload and anuria. Concurrently, a decreased mortality rate and an increased graft survival rate were observed.

Adolescent

Augmentation mammoplasty, irradiation, and breast cancer. A case report.

A case report is presented of mammary adenocarcinoma in association with a Silastic prosthesis and earlier irradiation exposure. Causative relationships of these two variables are discussed. Recommendations for management of the breast cancer patient with a mammary prosthesis are suggested.

Adenocarcinoma

[Renal-rachidian venous trunk. Replacement of the left renal vein. A danger for the spinal cord (author's transl)].

In two cases of paraplegia due to an inondation of the intrarachidian plexus by venous blood from the left venal vein, we studied the frequency with which the renal-rachidian trunk connected the left renal vein and the intrarachidian plexus. We show in these rare cases how it is possible, with a simple procedure, the ligature of the renal-rachidian trunk, to bring about a marked regression in the paraplegia. This procedure has been carried out five times, and it should be seen within the wider framework of a serie of procedures on the cava system, which are now practised for more than forty years.

Constriction, Pathologic

[Cis-platinum in the treatment of disseminated testicular neoplasms resistant to classical chemotherapy].

Seven patients with advanced testicular tumors, resistant to existing chemotheurapeutic agents, were treated with a new antitumor agent, the Cisplatinum (associated to mannitol induced hyperdiuresis). There were 3 objective remissions (1 complete and 2 partial). Major toxicity was gastrointestinal. There was little renal and hematologic toxicity in our serie. The drug may have use in combination therapy in advanced non seminomatous testicular tumors.

Adult