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Biomedical subjects

C Mion

Publications and source records attributed to C Mion.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Cannulation of the internal jugular vein with 2 silastic catheters. A new method of vascular access for hemodialysis].

The internal jugular vein cannulation (IJV) using two silastic catheters (CT) is a new vascular access method for temporary and immediate use in hemodialysis. From November 1982 to November 1984, 138 pairs of CT were used in 129 uremic patients for a mean duration of 54 days per patient (1 to 17 months) permitting to carry out more than 3000 dialysis sessions. Five complications were observed: 3 skin exit infections with 2 septicemias cured with antibiotics and CT removal, 2 vascular thrombosis treated with urokinase and anticoagulant; 1 anaphylactoid reaction at the time of insertion. IJV CT offers a convenient alternative to conventional percutaneous vascular access method that can be safely proposed in long term hemodialysis.

Anaphylaxis↗
PubMed1986

[Quantitative evaluation of low-flow rate hemodialysis with sequential use of 2 membranes of differing permeability].

Although the "low flow" dialysis has not gained large clinical experience, recent long term clinical investigation indicate that it can be an interesting alternative in the treatment of uremia. This method permits a reduction in treatment cost without impairing the quality of therapy. The interest of this 12 months cross-over and comparative study with 2 types of dialyzers (H12-10/DISCAP 110) and 2 dialysate flow regiments is twofold: it confirms the lack of morbidity linked to the low flow stage; it gives quantitative data on "dose therapy" changes during the two consecutive stages. The 50% reduction of conventional dialysate flow has a lowering effect of 11 to 18% on urea and creatinine clearances depending on which type of dialyzer used. The use of H12-10 was associated in this case with a more pronounced clearance reduction. The reduction of performances was accompanied by a significant rise in urea and creatinine plasma level without changes in protein catabolic rate while it masks a decrease in creatinine generation rate.

Acrylonitrile↗
PubMed1985

Transmission of Mycobacterium tuberculosis with renal allografts.

Disseminated tuberculosis occurred in 2 allograft recipients of kidneys procured on the same donor. Both recipients were treated by low dose prednisolone and azathioprine, and one of them was on a special protocol including antilymphocyte globulins as rejection prophylaxis. None of them experienced acute rejection. The early posttransplant period was uneventful except for the occurrence of mild viral infections in both cases (herpes simplex virus in case 1 and cytomegalovirus in case 2). 2 and 6 months after transplantation, respectively, patient 1 developed acute fever, asthenia, and disorientation while patient 2 presented with spiking fever and miliary pneumonitis. Mycobacterium tuberculosis grew in the urine of both recipients in the absence of clinical genitourinary symptoms. The two mycobacterial species had the same bacteriologic characteristics and the same antibiotic sensitivity. As the recipients had no evidence of a previous history of active tuberculosis, it is suggested, as for some other infectious agents, that mycobacterium was transmitted along with the transplanted kidneys.

Azathioprine↗
PubMed1985

Acquired multicystic transformation of kidneys.

Acquired multicystic renal transformation of diseased kidneys is a problem known since the early 19th century which has recently regained interest. Such cysts were known before dialysis was established, are seen prior to hemodialysis and in patients on peritoneal dialysis, and can therefore not be a consequence of hemodialysis. It is concluded that an increased incidence of renal cell carcinoma in such kidneys is not established, although, theoretically, several mechanisms might promote carcinogenesis in end-stage kidneys.

Adenoma↗
PubMed1985

Mycobacterium haemophilum and mycobacterium xenopi associated infection in a renal transplant patient.

The case is presented of a renal-transplant patient in Europe with a Mycobacterium haemophilum infection in association with M. xenopi infection. Clinical signs suggested the diagnosis of mycobacteriosis, which was confirmed by a skin biopsy. Despite antitubercular treatment which rapidly eliminated M. xenopi, the patient's condition did not improve until M. haemophilum was identified. Minimal inhibitory concentrations of various antimicrobial compounds showed a lack of efficacy of isoniazid, and rifampin had no clinical effect. The patient recovered only after careful surgical drainage of the lesions and the administration of minocycline. The pathogenesis of such mycobacterioses is discussed, with focus on the immunodepressive status which in our patient may have been partially induced by a cytomegalovirus reinfection.

Anti-Bacterial Agents↗
PubMed1985

[Re-establishment of urinary continuity by uretero-ureterostomy in renal transplantation. Apropos of 135 cases].

Uretero-ureteral anastomosis was performed in 135 patients (40 women and 95 men) during kidney transplantation using either cadaver (120 cases) or living donor (15 cases) organs. The ureter of the retained kidney was linked proximal to the transplantation, whether or not there had been previous contemporary nephrectomy. Results were highly interesting: no mortality, no need to remove graft for urinary complications and no ureteral anastomotic stenosis. Urological complications were absent in 108 cases (80%) while 17 cases (12.6%) developed a urinary fistula, only 5 of which required surgical intervention Hematoma related to the nephrostomy occurred in 6 cases (4.4%) but operation was necessary in only 2 of these cases. Overall need for repeat surgery involved only 7 patients (5.2%) during the month following transplantation. One of 2 cases of hematoma operated upon required partial excision of the transplantation kidney due to the presence of an intraparenchymatous arteriovenous fistula. A curious finding was that of the 17 cases developing fistulae most of them had received live donor kidneys (5/15) whereas only 12 occurred in the 120 cadaver kidney transplants. Prevention of fistulae appears to be assisted by spatulation of the ureter rather than by its bevelled section, and the maintenance of a long ureteral loop to avoid traction. It is suggested that certain postoperative urine losses may be the result of a hyper-diuresis, without actual dehiscence of the anastomosis. In 4 patients with a urine output of more than 1.5 litres at the time of transplantation, the kidney proximal to the ureteral ligature became infected, and a second nephrectomy was necessary in 4 cases.

Adolescent↗
PubMed1985

Aluminium in continuous ambulatory peritoneal dialysis and post dilutional hemofiltration.

Aluminium (Al) has been shown to be a constant contaminant of sterile apyrogenic solutions used in continuous ambulatory peritoneal dialysis (CAPD) or post dilutional hemofiltration (HF). The Al content of these solutions varied widely from 1 to 50 micrograms/l. The clinical significance of such an Al contamination was difficult to ascertain. However, the available information suggests little clinical toxicity from these low Al levels, except in those patients who ingest large amounts of aluminium hydroxide as a phosphate binder. In view of the well-known consequences of long-term Al exposure of dialysis patients, it is suggested that Al concentration in CAPD solutions and HF substitution fluids should not exceed 10 micrograms/l.

Aluminum↗
PubMed1984

[Immunological selection of donors and recipients in renal grafts: antibodies].

It appears that a wide range of antibodies must be taken into account among future recipients of renal allografts. On one hand, the hazard of hyperacute rejection induced by warm allo-antibodies directed against donor's HLA-A, B antigens is well known. It is probable that warm allo-antibodies directed against donor's Ia (HLA-DR) antigens are also harmful. On the other hand, anti-T or B lymphocytes cold auto-antibodies appear neutral, whereas some studies suggest the possibility of enhancing antibodies which may be anti-idiotypic antibodies.

Antibodies↗
PubMed1984

[Immunologic selection of renal transplant donors and recipients: blood transfusions].

Blood transfusions clearly improve the prognosis of cadaver kidney transplantation. The percentage of graft survival at one year is increased, about + 25%. Preoperative transfusions are effective, whereas peroperative transfusions are ineffective. The following technique seems to be good. Each patient should first receive 5 blood transfusions over a short time lapse, and then one unit of blood from time to time, two times per year for example. The blood must be less than three days old and must contain leucocytes. Transfusions induce, in a few hemodialysed patients, an anti-HLA immunisation. It is thus necessary to choose a donor with a negative cross-match. Transfusions induce in many patients a better tolerance for kidney transplant. This tolerance is perhaps immunologically specific. Blood transfusions are also useful for the selection of related donors HLA semi identical with recipients. The recipient is transfused several times with donor's blood. Transplantation is only performed when the cross-match remains negative and then leads to a high percentage of success.

Antibody Formation↗