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Biomedical subjects

D Collet

Publications and source records attributed to D Collet.

At least 55 records · Page 3Linked to original sources
PubMed1991

In vitro studies of elastin-fibrin biomaterial degradation: preservative effects of protease inhibitors and antibiotics.

The degradability of a new elastin-fibrin material was tested in vitro versus human pancreatic elastase (HPE) and plasmin (PL) activities. It is shown that aprotinine Iniprol, a well-known protease inhibitor and Eglin C, a new potent inhibitor of HPE, especially when used in synergy, efficiently protected the material. A small amount of specific antibiotics was incorporated into the material. The two products will allow the material to be used in digestive surgery with improved safety.

Adsorption↗
PubMed1991

Treatment of gallstones with piezoelectric lithotripsy and oral bile acids. A multicenter study.

The efficacy of the combination of piezoelectric lithotripsy and oral bile acids in the treatment of gallbladder stones was assessed. Three hundred and sixty-three patients with symptomatic radiolucent gallstones in functioning gallbladder were treated in five medical centers using the same protocol with the EDAP LT 01 lithotripter. No anesthesia, analgesia or sedation was used. After one session of lithotripsy, fragmentation was observed in 89% of the patients, and satisfactory fragmentation (fragments less than or equal to 5 mm) in 29%. The satisfactory fragmentation rate was higher in patients with solitary stones less than or equal to 20 mm than in patients with solitary stones 21-35 mm or multiple stones (p less than 0.001). After multiple sessions (mean 1.6 session/patient, range 1-5) the overall rate of satisfactory fragmentation was 50%. After 12 months on oral bile acid therapy, complete clearance of the gallbladder was observed in 69% of patients with solitary stones less than or equal to 20 mm, 25% of patients with solitary stones 21-35 mm and 37% of patients with multiple stones. No complication was observed during the lithotripsy. During follow-up under bile acid therapy, there were five complications (1.4%): four patients had acute cholecystitis and one had mild, self-limited pancreatitis. We conclude that piezoelectric lithotripsy with the EDAP lithotripter is a safe and effective treatment which can be performed in outpatients. Satisfactory fragmentation and rapid disappearance of stones are obtained mainly in patients with solitary stones less than or equal to 20 mm.

Administration, Oral↗
PubMed1991

Laparoscopic surgery for gallbladder stones.

The radical treatment of gallstones consists of removal of the calculi and prevention of their recurrence, and cholecystectomy is at present the common solution. Since Langebuch's first operation in 1882, Calot reporting the first French case in 1889, cholecystectomy has reached a high level of technical perfection. With a small access route and complete exploration of the common bile duct, the results are well known: global mortality is less than 0.1%. Frequently, specialised teams report series of patients under 50 years of age with zero mortality. Are there other techniques that permit the removal of calculi and the removal of the gallbladder with results comparable or better than the classic cholecystectomy? We have perfected an operative technique using laparoscopy that destroys the calculi with an ultrasonic lithotriptor followed by drainage or removal of the gallbladder. Our initial results are favourable.

Adolescent↗
PubMed1990

[Treatment of gallbladder lithiasis by piezoelectric extracorporeal lithotripsy].

We report the results of extracorporeal piezoelectric lithotripsy of gallbladder stones, using the EDAP LT 01 device, in 60 patients treated without anaesthesia or analgesia. Fragmentation was satisfactory (i.e. with fragments less than 5 mm wide) in 31 patients (52 per cent) after multiple sessions (mean: 1.6). The satisfactory fragmentation rate was higher in patients with stones smaller than 20 mm (63 vs 8 per cent; P less than 0.01) and not different in patients with solitary or multiple stones (53 vs 50 per cent). After bile acid dissolution treatment during 3, 6 and 12 months, the stone-free rates were 23, 41 and 64 per cent respectively, and significantly better at 3 and 6 months in patients with satisfactory fragmentation (42 vs 4 per cent; P less than 0.05, and 71 vs 9 per cent; P less than 0.01). Fourteen patients (23 per cent) reported biliary colic, but only one required cholecystectomy. No severe complication was observed. Piezoelectric lithotripsy is safe, requires short hospitalization and gives interesting results when the stones are less than 20 mm wide.

Adult↗
PubMed1990

Laparoscopic treatment for gallbladder stones and the place of intracorporeal lithotripsy.

An ultrasonic lithotriptor (U.S. Olympus) introduced into the gallbladder under visual control of a laparoscope permits fragmentation of the stones and complete clearance of the gallbladder in one session of 10-20 min. The empty, clean gallbladder can be drained (cholecystostomy) or removed (cholecystectomy) by passing it through an 8-10 mm orifice of the abdominal wall. A series of 18 cholecystostomies and 200 cholecystectomies shows that intracorporeal lithotripsy prior to these procedures is efficient, safe, and elegant. It is the guarantee of a real laparoscopic procedure in cases of cholecystectomy.

Cholecystectomy↗
PubMed1990

[Laparoscopic surgery of gallstones--report of treatment of 157 patients].

From November 1988 to February 1990 157 patients with gallbladder stones haven been treated by a laparoscopic surgical procedure. They are 28 males and 129 females from 13 to 81 years old. 18 have had a cholecystostomy after intracorporeal lithotripsy (Lus Ultrasonic Olympus). They were placed on bue acids during 3 months. The average follow up time is 11 months. The mortality is zero and 2 mild complications occurred medically cured. 3 patients have a recurrent stone 6 months after surgery. 139 patients have had a cholecystectomy 89 after the same lithotripsy procedure seen above, 50 without prior lithotripsy. In 3 cases the laparoscopic procedure was abandoned, twice because of a sever bleeding, one for too compact surrounding adhesions. The mean follow up is 9 months. 123 were drained 1 day 16 had no drain. The mortality is zero. 2 patients without drainage developed a sub hepatic and douglas pouch abscess. They were cured by a lavage drainage laparoscopically made. 1 patient with drainages had a 7 days bile leak, which disappeared spontaneously. The 136 others have had a short stay in the hospital (2-4 days) a painless post operative time. They could go back to work and sport within 1 week. They have minimal scars and no danger of incisional herriae. The magnification of the optical system enables the dissection of the cystic duct and artery easier and safer than it is by mini laparotomy mostly in obese people. At the beginning of our experience only the patients with frequent biliary colics have been selected for the laparoscopic procedure. At that time 13 patients with subacute cholecystitis and 9 patients with stones in the commun bile duct have had a laparoscopic cholecystectomy associated with an endoscopic sphincterotomy in the last cases without complications.

Adolescent↗
PubMed1990

[Cholelithiasis. Laparoscopic treatment with intracorporeal lithotripsy followed by cholecystostomy or cholecystectomy. Personal technique].

From November 1988 to February 1990 157 patients with gallbladder stones have been treated by a laparoscopic surgical procedure. They are 28 males and 129 females from 13 to 81 years old, 18 have had a cholecystostomy after intracorporeal lithotripsy (Lus Ultrasonic Olympus). They were placed on bile acids during 3 months. The average follow up time is 11 months. The mortality is zero and 2 mild complications occurred medically cured. 3 patients have a recurrent stone 6 month after surgery. 139 patients have had a cholecystectomy 89 after the same lithotripsy procedure seen above, 50 without prior lithotripsy. In 3 cases the laparoscopic procedure was abandoned, twice because of a sever bleeding, one for too compact surrounding adhesions. The mean follow up is 9 months. 123 were drained 1 day 16 had no drain. The mortality is zero. 2 patients without drainage developed a sub hepatic and douglas pouch abscess. They were cured by a lavage drainage laparoscopically made. 1 patient with drainage had a 7 days bile leak which disappeared spontaneously. The 136 others have had a short stay in the hospital (2-4 days) a painless post operative time. They could go back to work and sport within 1 week. They have minimal scars and no danger of incisional herniae. The magnification of the optical system enables the dissection of the cystic duct and artery easier and safer than it is by mini laparotomy mostly in obese people. At the beginning of our experience only the patients with frequent biliary colics have been selected for the laparoscopic procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Traumatic rupture and aneurysm of the aortic isthmus: late results of repair by direct suture.

Between 1979 and 1986, 28 patients underwent surgery for subadventitial rupture of the aortic isthmus from blunt trauma; 16 had an acute lesion which was operated within three days after the trauma, three had a delayed repair between the first and third months, while nine had a chronic post-traumatic aneurysm (2 to 27 years after the initial accident). Transection was complete in 13 cases. A left atrium-to-descending thoracic aortic bypass or ilioiliac extracorporeal bypass were used in 14 (50%) patients whereas simple clamping was employed in the 14 remaining patients. Aortic repair was performed in 22 cases by direct suture (78.5%), more often in acute ruptures (84%) than in chronic aneurysms (66%). Five of the 16 patients operated on within three days of their accident died during the first postoperative month from associated lesions. There were no in-hospital or late deaths among the patients operated on for chronic aneurysm. All of the 23 surviving patients (82%) were followed postoperatively for six to 90 months (mean: 36 months). Of the 19 who had direct suture, 15 underwent digital subtraction arteriography which demonstrated an excellent reconstruction of the aortic isthmus. Of the techniques available for repair of traumatic aortic lesions, direct suture allows the shortest clamping time (mean: 25 minutes in our series). The long-term risks of prosthetic replacement, i.e. late infection, false aneurysm due to suture breakdown, and secondary embolism arising from mural thrombosis, can therefore be avoided.

Adult↗
PubMed1989

[Aortic valve replacement with extracorporeal circulation in a pregnant woman. Apropos of a case].

The authors report a case of surgical treatment of aortic stenosis in a pregnant woman (first pregnancy after four years treatment of sterility). The aortic valve replacement was performed at 16 weeks of amenorrhea. The valve was replaced by an Ionescu-Shiley bioprosthesis. Delivery was performed by caesarean section after 39 weeks of amenorrhea. There was no complication either for the mother or the child. Review of the literature allows analysis of the influence of aortic stenosis on pregnancy, and of the pregnancy on the tolerance of aortic stenosis. Some aspects of cardiopulmonary bypass for valve replacement in pregnant women are also analysed.

Adult↗
PubMed1989

[Tissue effects of extracorporeal lithotripsy on a model of experimental biliary calculi in dogs].

Extracorporeal shock waves represent a new method to treat gallstones. This study was designed to evaluate: 1) the effectiveness of a recently available lithotripter (EDAP LT 01) for gallstone fragmentation; 2) adverse tissue reactions after treatment; 3) the optimum conditions for use of this apparatus in man. A human cholesterol stone was surgically implanted into the gallbladder of ten 20-25 kg mongrel dogs. One dog was used as a control. The other nine animals were divided into three groups (A, B and C). Two 60 min sessions of lithotripsy were carried out twice a week. Sonographic and CT examinations were performed 9 and 16 days after operation. The animals were killed 21 days after operation. Satisfactory fragmentation was obtained in 4 of the 9 animals, and in 2 dogs no stone fragments were detected. Fragments were found in the common bile duct in 5 dogs. In 2 animals a pathologic aspect of the papilla of Vater was observed. Marked hematoma was observed in the animals treated at 5 and 10 pulses/sec. In 5 cases, hematoma was observed in the gallbladder and in one case the gallbladder was ruptured. Hematoma was also noted in the hepatic vascular bed in 3 animals. Except for microscopic hemorrhagic lesions observed at the base of the right lung, no lesions were detected in any other organ. Shock waves produced by the EDAP LT 01 are effective for fragmentation of gallstones. However, in view of the tissue reactions observed at the higher pulse rates, the pulse rate should not exceed 2.5 pulses/s for use in man.

Animals↗
PubMed1988

[Metabolic and cardiovascular effects of beta-blockers taken by the mother in newborn infants].

The effects of beta-blockers administered to mothers with arterial hypertension were investigated in 38 neonates of varying gestational age and weight. During the first 48 hours of extra-uterine life, heart rate was continuously monitored and blood pressure and glycaemia were measured every 3 hours. Left ventricular function was studied by echocardiography on the first day post-partum, once again between the 5th and 10th days. Hypoglycaemia was observed in 42% of the neonates; 47% had one or several episodes of bradycardia and 2 had arterial hypotension. Most important, a significant improvement of left ventricular function was observed between the first and the 5th-10th days. This time-related change was not found in a control group. The cardiac dysfunction was more pronounced in neonates who had an episode of bradycardia, and although it is usually asymptomatic, it probably accounts for the fortunately rare cardiovascular collapses observed in some newborn babies.

Adrenergic beta-Antagonists↗
PubMed1985

[Acupuncture in obstetrics].

Acupuncture has been used in China as a treatment modality for one thousand years and is becoming increasingly important in the western world. Through a special effect on the reticular formation, acupuncture is becoming a first choice among the various methods available to relieve pain, especially in the pregnant woman. It can be useful, in fact, during the three periods of a pregnancy: before delivery: it can effect all the functional and psychiatric problems a pregnant woman may develop; during delivery: there is a definite analgesic and oxytocic effect; after delivery: it can be beneficial in all difficulties with breast feeding. Acupoints used in obstetrics are not very numerous. There are approximately thirty which are located along the body meridians or on the ear.

Acupuncture Therapy↗
PubMed1981

[Iliac vein thrombosis with a "floating clot" at the 37th week of pregnancy. Caesarean section and the application of a clip on the inferior vena cava. A case history (author's transl)].

The authors describe a case of high venous thrombosis with floating clots at the 37th week of pregnancy. The problem of diagnosis was solved by urgent Doppler examination and by phlebograms of the legs. It is necessary to have a team of many disciplines that can be brought together at any time. These consist of: -an anaesthesist who can resuscitate with heparin and give obstetrical anaesthesia, -an obstetrician who can carry out caesarean sections, -a vascular surgeon who can carry out a partial block of the inferior vena cava. This would appear only to be possible in a special centre.

Adult↗
PubMed1979

[Thrombo-embolic disease and pregnancy. The prevention of pulmonary emboli by placing a clip on the inferior vena cava (author's transl)].

The authors, having had a case of deep pelvic phlebitis occurring in a young primiparous woman who was treated prophylactically against the occurrence of a pulmonary embolus by placing a clip on the inferior vena cava discuss: the etiology of the condition: the difficulties of the diagnosis. They point out the value of phlebo-cavography which is an essential investigation in which no more than 4 films are taken, because it is on this that the indication for surgery rests. They point out the value of anticoagulant treatment, especially that using Calciparine which permits the patient to lead a more or less normal life at home. As far as the surgical procedure is concerned, a median approach seems to them the best way to carry out the operation.

Adult↗