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C Chatelain

Publications and source records attributed to C Chatelain.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Posterior vertical lumbar incision in the treatment of pyelo-ureteral junction anomaly: report of 71 cases].

Posterior vertical lumbar incision, described for the first time in 1869 by Simon, provides a simple access to the kidney and offers excellent exposure of the ureteropelvic junction. The technical modifications proposed by Gil Vernet facilitate access to the kidney and reduce the morbidity. The operative technique is described in detail and the authors report their retrospective experience of 71 cases of correction of ureteropelvic junction anomalies (stage 2, 3 and 4). The morbidity was low (19%). Patients returned to work by the 3rd week. 88% of good results were observed at 3 months (84% in initial stage and 4 lesions). This approach should be preferred to the lateral incision or the percutaneous approach due to the simplicity of the technique and the low complication rate.

Adolescent↗
PubMed1992

[Amplification of a circulating CD4+CD7- T lymphocytes subset in kidney transplantation].

A minor subset of CD4+ T-cells (10 +/- 4 percent) that does not express the CD7 antigen is detectable in normal individuals. These CD4+CD7- T-cells have lower proliferative capacities than autologous CD4+CD7- T-cells. We observed an expansion of CD4+CD7- peripheral T-cells in 45 kidney transplant recipients. The CD4+CD7- TL expansion (23 +/- 20 percent was observed in both short term (< 6 months, n = 20) and long term transplanted patients (> 3 years, n = 25). These results significantly differed from those observed in patients on dialysis (10 +/- 4 percent, P < 0.002). The percentages of CD4+CD7- TL in kidney recipients are significantly correlated with the percentages of CD4+CD57+ and CD8+CD57+ T-cells subsets. A three-color immunofluorescence analysis indicated that 75 percent of the CD4+CD7- TL express the CD57 molecule contrasting with those in normal individuals (0.3 percent). Purified CD4+CD7- T-cells from kidney recipients have lower proliferative responses after PHA, CD2 and CD3 stimulations than autologous CD4+CD7+ TL. The proliferative response is partially restored by the addition of anti-CD28 moAb or IL2. We have highlighted, in kidney recipients with good graft function, an expansion of CD4+CD7- T lymphocytes which could be associated with CD4+ T-cell anergy and tolerance.

Antigens, CD↗
PubMed1992

CT renal planimetry: effectiveness in the evaluation of individual renal function.

Computed tomographic (CT) renal planimetry was used to study individual renal function in 32 adult patients with urologic disease. CT results were well-correlated to reference methods (r = 0.88, P < 0.001), which were radionuclide studies (N = 9) or separate creatinine clearance (N = 23). The difference between planimetric data and reference methods did not exceed 14% in any case and was less than 10% in 26 cases.

Adult↗
PubMed1992

[Value of tomodensitometry with injection and late images for the diagnosis of urinary leaks in kidney transplants].

Between May 1985 and May 1990, 263 renal transplantations were performed in 254 patients, with 4 kidney-pancreas double grafts. 12 urinomas were observed, i.e. 4.56%. In one half of cases, clinical examination alone was able to establish the diagnosis of urinoma, but in the other 6 cases, complementary investigations were required. Post-contrast computed tomography with late images (between 6 and 24 hours after the injection) would appear to be the most useful investigation. Performed in 6 cases, this examination established the diagnosis of urinoma in 5 cases and also suggested the mechanism of the leak, which was always confirmed at operation. The positive diagnosis is based on extravasation of contrast agent which is clearly visible, even in the presence of low concentrations due to impaired renal function. This extravasation occurred early in 3 cases, but was delayed in 2 cases, emphasising the importance of late images. Other investigations appear to be less useful either because of a lack of sensitivity or because of imprecise anatomical information. The severity of urine leaks and the need for rapid treatment justify post-contrast computed tomography with late images in any case of suspected urinoma.

Adult↗
PubMed1992

[Portal hypertension: a rare cause of hematuria].

A patient with undiagnosed cirrhosis presented with massive haematuria 16 years after augmentation colonoplasty. Portal hypertension (PHT) was responsible for a portocaval collateral circulation with vesical varices detected by low pressure endoscopy performed between episodes of haematuria. A very similar case was published in 1991. Surgical haemostatis with partial or total resection of the colonoplasty was only temporarily effective in our patient, who subsequently underwent liver transplantation due to repeated episodes of hepatic encephalopathy. No recurrence of haematuria was observed six years after the diversion. This rare cause of haematuria must be considered in view of the widespread use of intestinal conduits in urology: a dozen cases have been reported after transileal cutaneous ureterostomy, occurring an average of 3 years after the operation. Direct treatment of the varices, either by surgical devascularisation or resection or be endoscopic laser sclerosis or coagulation, is only temporarily effective. Treatment of the PHT appears to be the most effective measure in the long term: beta-blockers administered in the absence of episodes of haematuria or portal by-pass surgery in the case of failure.

Hematuria↗
PubMed1992

[Primary bladder lymphoma in kidney transplant recipients: report of a case].

The authors report the case of a type B EBC (+) primary lymphoma of the bladder occurring in a renal transplant patient 14 months after the graft. The postoperative course had been marked by three episodes of early rejection, the last of which required the use of anti-CD3 antibody, then the later addition of cyclosporin. After immune labelling showing oligoclonal proliferation, the lesion was treated with CD24 and CD21 monoclonal antibodies. Ten months after treatment, the patient is in remission with renal function at 200 mumol plasma creatinine. Azathioprine and cyclosporin have been stopped. This apparently unique case provides the authors with an opportunity to review the usual characteristics of lymphocyte tumours in transplant patients and to stress the rarity of primary lesions of the urinary tract. They conclude that the new therapeutic approach based upon monoclonal antibodies is of value in comparison with the attempts at surgery, radiotherapy and/or chemotherapy used in the past.

Adult↗
PubMed1992

[The value of retrograde urethrography in the diagnosis of sub-urethral diverticula in women].

Urethral diverticulum in women is not a frequent disease. The diagnosis of this lesion is based on history and careful physical examination looking for a swelling on the anterior vaginal wall. A study of 15 cases is reported. The authors insist on investigations as a help to confirm and localise the diverticulum. A new technique of retrograde urethrography using a prehension cannula ("Bomelaer") is described. By this well tolerated and minimally invasive test, the visualisation of the urethral diverticulum was obtained in 14/15 patients. Associated with intravenous urography, it is certainly the most adapted strategy for diagnosis and management.

Contrast Media↗
PubMed1991

Legume lectins interact with muramic acid and N-acetylmuramic acid.

The inhibitory potency of both muramic acid (MurAc) and N-acetylmuramic acid (MurNAc) on various legume lectins, including Glc/Man- and Gal/GalNAc-specific lectins, was investigated by a haemagglutination inhibition technique. Data indicated that many lectins, especially those specific for Glc/Man, specifically interact with MurAc and MurNAc often to a greater extent than with other monosaccharides and their derivatives, such as N-acetylglucosamine (GlcNAc) and sialic acid. Glc/Man-specific lectins were also shown to interact with the muramyl-dipeptide MurNAc-D-Ala-D-isoGln. These interactions could explain why various lectins readily agglutinate some bacterial strains of which cell walls contain peptidoglycans with high amounts of MurNAc.

Carbohydrate Sequence↗
PubMed1991

Restoration of hearing with type V tympanoplasty.

Type V tympanoplasty with fenestration of the oval window and protection of the round window in a residual hypotympanic cavity can be considered as the last-chance procedure for rehabilitation of hearing in ears with 'canal wall down' or other conditions. The review of 64 cases suggests that restoration of hearing can be adequate in the majority of cases.

Adipose Tissue↗
PubMed1991

[Combined kidney-pancreas transplantation. Experience at the Urologic Clinic of the La Pitié Hospital].

The first attempts of pancreas transplantation were made in the middle of the 1960s and were further developed in the early 1980s with the coming of Cyclosporine. Various surgical techniques were used to carry out pancreas grafts; a total pancreatic transplantation with duodenovesical anastomosis was selected for 7 combined kidney-pancreas transplantations carried out during the past 18 months in our group. After a time lapse ranging from 18 months to 30 days, all patients were alive with functional kidney grafts. One patient only, who had lost his pancreatic graft, showed biological and histological signe of chronic rejection of his kidney graft. Five pancreas grafts are functioning, as is proved by the normal blood glucose and the normality of the markers. An immunosuppressant treatment was used in all similar cases, comprising, after an initial bolus of one gram of Methyl-Prednisolone, an initial four-drug treatment on 1/3 mg/kg/day of Prednisone, 7 mg/kg/day of Cyclosporine, 1 mg/kg/day of Imurel and, during the first fifteen days, the use of rabbit antithymocytic globulins. Ana analysis of the postoperative period revealed frequent local infectious complications, probably due to pancreatitis of the graft; however, in our experience so far, no pancreas graft was lost. The credit for this specific feature of our short series may be due to an exclusively subperitoneal approach for both the pancreas and the kidney transplantation, thus limiting the seriousness of postoperative infectious complications to a large extent.

Anastomosis, Surgical↗
PubMed1991

[The role of imaging in the diagnosis of complications in patients with artificial urinary sphincter].

The artificial urinary sphincters are implanted to treat some urinary incontinence. Abdominal plain films allow the checking of the function of the cuff; the diameter of the pressure regulating balloon can be appreciated by ultrasound or plain film. The main complications (bending of the tubules, leak, urethral erosion, rupture of the cuff) and their radiological diagnosis are described.

Bioprosthesis↗
PubMed1991

[Diagnosis of early complications of the transplanted kidney by pulsed Doppler].

Thirty four patients with advanced renal insufficiency and after kidney transplantation have been prospectively studied using pulsed wave doppler. The doppler flows were evaluated using an index of resistance. The index of resistance varies proportionally with the peripheral resistances. This study showed in 14 patients without symptoms a mean index of resistance equal to 0.71 +/- 0.087. During acute rejection, the mean index of resistance increases to 0.91 +/- 0.12 (p less than 0.01). Seven patients with acute tubular necrosis and an index of resistance equal to 1 (p less than 0.01). There is no increase of the indices of resistance in patients with cytomegalovirus infection or with overdosed cyclosporin treatment. The pulsed wave doppler has a very good sensitivity to diagnose the acute rejection (90%) and acute tubular necrosis (100%) but cannot differentiate them. However, the repetition of systematic examinations allows the early diagnosis of acute rejection and the follow-up of the vascularization of anuric kidneys related to tubulopathy.

Female↗