Biomedical subjects

C Brunet

Publications and source records attributed to C Brunet.

At least 109 records · Page 6Linked to original sources

PubMed1995

Anatomic basis of the liver for the development of a perihepatic prosthesis.

We studied specimens from 50 cadavers (27 men and 23 women) to obtain anatomical data concerning the liver and its attachments. The results allowed us to develop a polyglactin perihepatic prosthesis for compression of the injured liver. The falciform ligament and a narrowing of the hepatic parenchyma at this level allow attachment of the prosthesis. Separate prostheses were designed for each lobe. Clinical use has demonstrated that our prosthesis can be used to achieve effective control of haemorrhage and bile leakage.

Adult↗

PubMed1995

Posttraumatic colonic polyps with skin heterotopia. Report of a case.

A case of posttraumatic colonic polyps with skin heterotopia is reported. A 35-year-old man was the victim of a grenade explosion, which caused evisceration and partial amputation of the right colon. Twenty-five months after the accident, hypochromic anemia developed because of three polyps in the ascending colon. Histology documented the presence of sebaceous glands and keratinized epithelium, suggesting a graft of skin fragments on the colonic mucosa. Such a skin heterotopia has never been reported.

Adult↗

PubMed1995

Cytokine-induced secretion of monocyte chemotactic protein-1 by human endometriotic cells in culture. The Groupe d'Investigation en Gynécologie.

OBJECTIVE: Local secretion of chemotactic factors could contribute to the attraction of macrophages into the peritoneal cavity of women with endometriosis. The purpose of this study was to investigate the ability of endometriotic cells to produce monocyte chemotactic and activating protein-1 in response to interleukin-1 beta and tumor necrosis factor-alpha, which are found in elevated levels in the peritoneal fluid of patients with endometriosis. STUDY DESIGN: Cultures of fibroblast-like and epithelial cells isolated from endometriotic tissue were incubated with different concentrations of cytokines for varying periods of time. The de novo secretion of monocyte chemotactic protein-1 in the culture supernatants was analyzed by immunoprecipitation and electrophoresis after metabolic labeling with sulfur 35-labeled cysteine. RESULTS: The incubation of endometriotic fibroblast-like cells with interleukin-1 beta and tumor necrosis factor-alpha resulted in a time- and dose-dependent release of monocyte chemotactic protein-1 into the culture supernatant. Coincubation of the cells with tumor necrosis factor-alpha and interferon gamma resulted in a synergistic and dose-dependent increase of the monocyte chemotactic protein-1 secretion, whereas interferon gamma alone had no significant effect. Preliminary results indicate that monocyte chemotactic protein-1 is also produced by endometriotic epithelial cells in response to the same cytokines. CONCLUSIONS: Cytokine-stimulated endometriotic cells synthesize and secrete monocyte chemotactic protein-1 in culture, and they may play a relevant role in the recruitment of macrophages to the peritoneal cavity of patients by the local production of chemotactic factors.

Cells, Cultured↗

PubMed1995

Stability, compatibility and plasticizer extraction of miconazole injection added to infusion solutions and stored in PVC containers.

The stability of miconazole in various diluents and polyvinyl chloride (PVC) containers was determined and the release of diethylhexyl phthalate (DEHP) from PVC bags into intravenous infusions of miconazole was measured. An injection formulation (80 ml) containing a 1% solution of miconazole with 11.5% of Cremophor EL was added to 250-ml PVC infusion bags containing 5% glucose injection or 0.9% sodium chloride injection, to give an initial nominal miconazole concentration of 2.42 mg ml-1, the mean concentration commonly used in clinical practice. Samples were assayed by stability-indicating high-performance liquid chromatography (HPLC) and the clarity was determined visually. Experiments were conducted to determine whether the stability and compatibility of miconazole would be compromised, and whether DEHP would be leached from PVC bags and PVC administration sets during storage and simulated infusion. There was no substantial loss of miconazole over 2 h simulated infusion irrespective of the diluent, and over 24 h storage irrespective of temperature (2-6 degrees C and 22-26 degrees C). All the solutions initially appeared slightly hazy. Leaching of DEHP was also detected during simulated delivery using PVC bags and PVC administration sets. There was a substantial difference between the amounts of DEHP released from PVC bags and from administration sets, and also between the amounts released in solutions stored in PVC bags at 2-6 degrees C and 22-26 degrees C over 24 h. At the dilution studied, miconazole was visually and chemically stable for up to 24 h. The storage of miconazole solutions in PVC bags seems to be limited by the leaching of DEHP rather than by degradation. To minimize patient exposure to DEHP, miconazole solutions should be infused immediately after their preparation in PVC bags.

Antifungal Agents↗

PubMed1995

Secretion of monocyte chemotactic protein-1 by cytokine-stimulated endometrial cells of women with endometriosis. Le groupe d'investigation en gynécologie.

OBJECTIVE: To evaluate in vitro the production of monocyte chemotactic protein-1 (MCP-1) by endometrial cells of patients with and without endometriosis. DESIGN: Primary cultures of stromal and epithelial cells isolated from human endometrium were exposed during 24 hours to different cytokines. Monocyte chemotactic protein-1 secretion was analyzed in the culture medium. SETTING: Gynecology clinic and laboratories of endocrinology of reproduction and immunology. PATIENTS: Women presenting for infertility or pelvic pain in which endometriosis was diagnosed at laparoscopy (n = 6) and women presenting for tubal ligation without laparoscopic evidence of the disease (n = 6). INTERVENTIONS: None. MAIN OUTCOME MEASURES: De novo secretion of MCP-1 in the culture supernatant by immunoprecipitation and sodium dodecyl sulfate-polyacrylamide gel electrophoresis after metabolic labeling with 35S-cysteine. RESULTS: The incubation of endometrial epithelial cells of endometriosis women with either interleukin-1 beta or tumor necrosis factor-alpha resulted in the appearance of at least two and sometimes three bands having approximately 15, 13, and 9 kd molecular weights. These bands were identified as three distinct species of MCP-1 as their immunoprecipitation was prevented effectively in presence of an excess of cold MCP-1. In contrast, the endometrial epithelial cells of only one of six normal women produce significant levels of MCP-1 under the same stimulation conditions. The stromal cells of both groups of subjects do not secrete appreciable amounts of MCP-1 or only small quantities in two cases of endometriosis. CONCLUSIONS: Monocyte chemotactic protein-1 secretion is upregulated in cytokine-stimulated endometrial epithelial cells of women having endometriosis as compared with normal women without evidence of the disease. Such a difference at the level of eutopic endometrial cell may have a significance in the physiopathology of endometriosis.

Adult↗

PubMed1995

[Subcutaneous cervical emphysema: complication of constipation. Review of the literature].

We report the case of a sixty-eight year old woman with chronic constipation, admitted in the emergency unit for respiratory deficiency and cervical subcutaneous emphysema. Endoscopy of the supradiaphragmatic air and digestive tracts was normal. Acutization of an abdominal syndrome required a laparotomy revealing a fissuration of the subperitoneal rectum on a fecal obstruction. This revealing complication may be explained by the topography of the cervico-thoraco-abdominal diffusion spaces.

Aged↗

PubMed1995

[Current place of thr perihepatic absorbable mesh. Apropos of a series of 105 traumas of the liver].

From October 1987 to June 1993, 105 patients with liver trauma including 71 patients with multiple trauma were admitted to the emergency unit of the Hôpital Sud in Marseilles. Mean age was 32 +/- 15 years, ranging from 16 to 77 years. 77 were male and 28 were female. 83 cases presented with closed trauma, and there were 11 by knife wounds and 11 gun shot injuries. 22 patients, including 10 with multiple trauma, were not operated. Operation was decided immediately in 38 cases for hypovolemia or during the following six hours because of unstable blood pressure after four units of blood transfusion. The absorbable perihepatic mesh was used by 3 surgeons and 3 others used classical procedures (sutures, packing). Global mortality was 15%. The morbidity (31%) was not different from other reports but was significantly lower when using the mesh (p = 0.002). This technique can achieve rapid and lasting hemostasis and bilistasis without any increase of cholestasis or hepatic cytolysis compared to conventional procedures, and without any alteration of laboratory parameters, as shown by specific laboratory tests and follow-up liver biopsies. The mesh also avoids compression of the adjacent organs, compared to packing, thereby avoiding respiratory and renal impairment and reoperation. It can be used in a septic context and in combination with all kinds of radiologic follow-up and percutaneous aspiration and drainage.

Adolescent↗

PubMed1995

[Occlusions by colonic cancers: emergency treatment (62 cases)].

Sixty two patients (38 men, 24 women) were operated in emergency for colic occlusion from neoplasia. The mean age was 69.6 (+/- 12.71). Fourty four (70%) had an history of cardiovascular disease. Tumor resection has been possible in 95% of cases. The mortality was 24.19% in the first two months postoperatively and 11% between the second and the fourth month. The morbidity was 32.2% and the mean length of stay in hospital was 22 days (+/- 16.6). The morbidity was less in case of right hemicolectomy (17.3 days) than for left colic resections (26 days). The postoperative mortality was not correlated to age but to lost of weight more than 10 kg (p < 0.0001) and to a mean central preoperative temperature more than 37.5 degrees C (p < 0.002). Reducing the number of surgical procedures is beneficial in patients older than 70 years.

Aged↗

PubMed1994

Stability and compatibility studies of cephamandole nafate with PVC infusion bags.

A rapid isocratic technique was developed for the analysis of cephamandole nafate and cephamandole in parenteral solutions using high-performance liquid chromatography (HPLC) with UV detection and C18 column. The availability and compatibility of drugs from solutions infused via plastic infusion bags through plastic administration sets have been examined. No significant drugs loss was observed during simulated infusions (n = 4) for 1 h using PVC infusion bags and administration sets. No significant difference was found between infusion solutions (5% glucose or 0.9% NaCl). The stability of drugs was also studied in solution in PVC bags after storage at room temperature and at 4 degrees C without protection from light. The results show the stability of cephamandole nafate during 24 h at room temperature and 7 days storage at 4 degrees C to be satisfactory, irrespective of the infusion solution (5% glucose or 0.9% NaCl). However, an almost immediate and total transformation of cephamandole nafate to cephamandole in 5% glucose has been observed, whereas in 0.9% NaCl both forms were found in similar proportions.

Calibration↗

PubMed1994

Treatment of hepatic trauma with perihepatic mesh: 35 cases.

In a series of 61 trauma cases, 35 liver injuries (Moore's classes 2 to 5) were repaired using a polyglactin 910 perihepatic prosthesis. Two deaths (one coma, one avulsion of the inferior vena cava) were observed. Two centrohepatic hematomas were successfully treated by percutaneous needle aspiration. No hemobilia and no abscess of the liver occurred. Rapidly obtained hemostasis and cholestasis result in a large savings of blood. Progressive disappearance of the lesions was observed with repeat CT scanning until full recovery of the parenchyma was achieved. This was verified by biopsy and histologic examination and also by means of specific hepatic function tests.

Adult↗

PubMed1994

Stability and compatibility of cisplatin and carboplatin with PVC infusion bags.

The availability and compatibility of drugs from solutions infused via PVC infusion bags through PVC administration sets have been examined. No significant drug loss was observed during simulated infusions using PVC infusion bags and administration sets over time periods used in hospitals (cisplatin, 2 h; carboplatin, 1 h). The stability of carboplatin was studied in 5% dextrose. In 0.9% NaCl, we observed that carboplatin could be converted to cisplatin in the presence of chloride ions. With cisplatin, no significant difference was found between infusion solutions (5% dextrose or 0.9% NaCl). The stability of cisplatin (5% dextrose or 0.9% NaCl) and carboplatin (5% dextrose) was also studied in PVC bags after storage in the dark at room temperature. The results show that the drugs were stable over the 9-day storage period studied.

Biocompatible Materials↗

PubMed1994

Protective role of glutathione on alpha 1 proteinase inhibitor inactivation by the myeloperoxidase system. Hypothetic study for therapeutic strategy in the management of smokers' emphysema.

In smoking subjects with obvious emphysema, the interaction between neutrophil-derived MPO and H2O2 produced by alveolar inflammatory cells (alveolar macrophages (AM) and polymorphonuclear neutrophils (PMN)) has the ability to spontaneously inactivate, in vitro, the alpha 1 proteinase inhibitor (alpha 1PI). This inactivation can induce a desequilibrium of the protease-antiprotease balance in the lungs. In this study, we investigated the ability of glutathione to protect alpha 1PI. In a cellular model of alpha 1PI inactivation mimicking the effects of alveolar inflammatory cells present in the lower respiratory tract of smoking patients with emphysema, we demonstrated that glutathione can protect alpha 1PI against the oxidative inactivation by these activated cells. This protection has been computed in a cellular experimentation (AM and MPO-system) with a 50% inhibitory concentration of 62 microM. Moreover, glutathione has an important inhibitory effect directly on H2O2 released by PMA-stimulated AM (IC50 = 30 microM) or PMA stimulated PMN (IC50 = 70 microM). The mechanism, which governs glutathione may be a result of a scavenging effect on H2O2 as demonstrated in a free cellular experiment. With this in vitro demonstrated effectiveness, glutathione as a therapeutic antioxidant, via the aerosol, has been proposed, in order to prevent tissue damage, inflicted by an excess of activated phagocytic cells, in some lung diseases such as smoking patients with emphysema.

Glutathione↗

PubMed1994

A rapid density gradient technique for separating polymorphonuclear granulocytes.

A gradient separation technique followed by isotonic ammonium chloride haemolysis was compared with two methods for the isolation of polymorphonuclear neutrophils from blood. This technique provided a high yield, excellent purity without lymphocyte and erythrocyte contamination, and made it possible to isolate more than 50 x 10(6) human neutrophils from 15 ml of blood. The polymorphonuclear neutrophils isolated in this way were capable of generating a large amount of reactive oxygen species. This technique for the separation of polymorphonuclear neutrophils is an effective method for in vitro studies.

Cell Separation↗

PubMed1994

[Hepato-diaphragmatic venous anastomosis (report of a case)].

The authors are reporting an exceptional case of unexpected venous anastomosis between a right inferior diaphragmatic venous and a right hepatic venous discovered during a total hepatectomy before an orthotopic transplantation. Never described in the literature, this abnormality may be explained by the embryology of the transversum septum, junction of the hepatic draft and the draining tracts of the future diaphragm.

Arteriovenous Fistula↗

PubMed1994

[Anatomic problems involved in the approach to the internal carotid artery].

The portion of the internal carotid artery (ICA) located above the line joining the tip of the mastoid and the angle of the mandible is in close relation with cranial nerves VII, IX, X, XI and XII as well as the middle ear at the beginning of its intrapetrous course. Several procedures have been described for exposure of the ICA at the base of the skull. Extension of the conventional sternocleidomastoid approach by mandibular subluxation associated with division of the posterior belly of the digastric muscle and the styloid apophysis or its attached muscles allows exposure of most of the ICA. To access the last centimeter of the ICA it is necessary ot drill through the mastoid apophysis and the vaginal apophysis of the tympanic bone. This approach preserves the middle ear and the facial nerve.

Aged↗

PubMed1994

[Complications of colonic diverticulosis and emergency surgery. Prospective study of 56 cases].

Fifty six patients, 26 men (69.7 +/- 11.2 years) and 30 women (77.4 +/- 9.2 years) were admitted in the emergency unit for diverticulosis sigmoiditis. In 75% of cases an other pathology was associated. Excepted 11 extended peritonisis, 7 criterae of operation were required to operate on 17 men and 18 women (mean age = 73.7 +/- 12.5 years) in a delay less than 8 days. Reasons were: 12 occlusive forms, 9 peri-sigmoidis abcedations, 3 hemorrhages. Surgical procedures were: 11 Hartmann procedures, 21 resections with anatomosis of the sigmoid colon with 10 non protected and 3 subtotal colectomy. Postoperative mortality was been 11.4%. The global rate of complications was 28.5 and the mean hospital stay was 18.8 +/- 6.3 days. Application of operative criteriae is usefull to shorter significantly the delay of operation and then the length of evolution of the intraperitoneal infection site.

Aged↗

PubMed1994

Quantitative immune phenotyping: a new dimension for the monitoring of haemopoietic malignancies.

Quantitative data provided by flow cytometers are as yet not fully exploited due to the lack of standardization. However, fluorescence standardization systems are now available which allow the measurement of antigen density on a routine basis and the present review focuses on the interest of such quantitative techniques for the monitoring of haemopoietic malignancies. Antigen quantitation: (i) permits a more objective characterization of positivity, especially in the case of weakly expressed antigens; (ii) facilitates the analysis of complex populations, since certain antigens are expressed at different levels on different cell subsets; (iii) provides new data contributing to a more precise definition of cell differentiation; (iv) is of value to ascertain malignancy from the detection of aberrant antigen densities on putative neoplastic cells; (v) provides additional parameters suitable for the evaluation of residual disease and for the monitoring of immunological therapeutic regimens; (vi) contributes to prognosis. Quantitation of antigen densities should therefore be included in the routine study of haemopoietic malignancies.

Antigens, Neoplasm↗

PubMed1994

Pro-oxidant properties of methotrexate: evaluation and prevention by an anti-oxidant drug.

Polymorphonuclear neutrophils (PMNs) have the ability to liberate large amounts of reactive oxygen species like hydrogen peroxide. This free radicals release may have beneficial effect in chemotherapy but may also lead to cytotoxicity in case of prolongated inflammatory reaction. This in vitro study demonstrates that methotrexate (MTX), an anticancer drug, increases the amount of hydrogen peroxide released by stimulated PMNs in a dose-dependent manner with a maximum increase of 43.7% (i.e. 22 microM of hydrogen peroxide) for 500 microM of MTX. The mechanism which govern MTX reaction seems to be a result of an intracellular pro-oxidant mechanism by intervention on the oxidative metabolism of PMNs rather than a cell-free chemical interaction. Moreover, an association of MTX with mesna, an anti-oxidant drug, allowed to suppress the excess of hydrogen peroxide production. This association might be used in anticancer therapy, during oxidative burst, particularly when MTX is used in high concentrations, in order to limit toxic effects induced by free radicals.

Antioxidants↗