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Biomedical subjects

G Benoit

Publications and source records attributed to G Benoit.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Significance of organ donor characteristics in renal function at 1 month: reflection on the allocation of renal transplant].

In a series of 731 kidneys taken from brain-dead donors for renal transplantation, 652 were grafted, and the renal function at 1 month is known for 490 of them. The results show that some donor-related factors influence the outcome of the transplant. In particular, haemodynamic instability refractory to medical treatment is responsible for a 50 mumol increase of serum creatinine one month after transplantation and the use of UW solution during organ collection is responsible for an improvement of serum creatinine compared to other preservation solutions. Haemodynamic instability is a criterion which must be added to those already demonstrated in donors, such as the cause of death, age and sex. The authors propose that donor-related factors be taken into account in the allocation of organs in the same way as immunological factors which, at the present time, constitute the only criterion for kidney allocation.

Adolescent↗
PubMed1996

[Impact of weight difference between donor and recipient on the function of the transplanted kidney].

OBJECTIVE: The objective of this retrospective study was to determine whether the difference between the donor's weight (wd) and the recipient's dry weight (wr) could influence the function of renal transplants. METHODS: Between 1987 and 1994, 185 patients with a mean age of 43.3 years +/- 12 were transplanted with a locally harvested cadaver kidney, corresponding to 120 men (42.2 years +/- 1.4) and 65 women (45 years +/- 12.8). The weight variation between donors and recipients (wd - wr) was 0.06 for men and 0.22 for women. The serum creatinine of recipients at 1 year was 147 mumol +/- 41.7. We used analysis of variance for univariate statistical analysis and multiple linear regression for multivariate analysis. RESULTS: On univariate analysis, the serum creatinine at 1 and 2 years was significantly higher (p < 0.02 and p < 0.035 respectively) when the donor's weight was 10% lower than the recipient's weight. Multivariate analysis, taking into account the donor's age and sex and the recipient's serum creatinine, confirmed the influence of the donor-recipient weight difference on serum creatinine at 2 years (p0.03), but also the role of the donor's age at 1 and 2 years (p < 0.0001 and p < 0.0004, respectively). CONCLUSION: In our study, the donor-recipient weight difference was a factor influencing the recipient's serum creatinine at 2 years. The donor's age also influences the recipient's serum creatinine, 1 and 2 years after renal transplantation.

Adolescent↗
PubMed1996

[Multivisceral Kaposi's disease and encrusted pyelitis in a renal transplantation recipient].

Immunosuppression therapy carries inherent risks involving the occurrence of infections and neoplasms. Whereas therapeutic advancement have reduced its frequency, encrusted pyelitis reappears in kidney-transplanted patients and may lead to detransplantation. It is related to chronic urological infections and not inevitably favored by endoscopic explorations. Kaposi's sarcoma is the third cause of tumor in renal-transplanted patients. It is rarely multivisceral and develops exceptionally in the transplant. We report the case of a 60 year-old woman who developed an encrusted pyelitis and a Kaposi's sarcoma in a kidney which was transplanted 14 months earlier.

Female↗
PubMed1995

Haematogenous dissemination of prostatic epithelial cells during radical prostatectomy.

Radical prostatectomy is one treatment for organ-confined prostatic adenocarcinoma. Dissemination of malignant prostatic cells after radical prostatectomy could be partly due to prostate manipulation during dissection. We confirmed by assay of prostate-specific membrane antigen by reverse-transcription nested PCR that prostate manipulation seeded prostatic epithelial cells in the general circulation in 12 of 14 consecutive patients operated on for organ-confined prostate adenocarcinoma. Our results suggest that surgeons should approach radical prostatectomy with care to avoid seeding from the prostate gland. Antiandrogen therapy might reduce the haematogenous spread of prostatic cells during radical prostatectomy.

Adenocarcinoma↗
PubMed1995

Global energetic failure in brain-dead patients.

The objective of this prospective, clinical study of consecutive patients was to test the hypothesis of a global energetic failure in brain-dead patients by analyzing indices of peripheral oxygenation during brain-dead resuscitation. Subjects comprised 24 subjects with brain death criteria from a multidisciplinary intensive care unit. The causes of brain death were multiple: severe traumatic head injury, cerebrovascular event, cerebral anoxia, primary brain tumor, and gunshot wound to the head. Interventions used were radial and pulmonary artery catheterization. Hemodynamic and gasometric parameters and blood lactate levels were measured immediately after the diagnosis of brain death (T0) and 4 hr later (T4), while patients were receiving a therapeutic protocol (fluids, vasopressive drugs) adjusted to reach a mean arterial pressure of 75 mmHg. In 18 of our 24 patients, a blood lactate level > or = 2 mmol/L (mean +/- SD: 4 +/- 2 mmol/L) associated with an increased mean lactate to pyruvate ratio (14.4 +/- 3.2) was observed at T0, while oxygen delivery (DO2) was high (533 +/- 208 ml/min/m2) and mean arterial pressure was 76 +/- 21 mmHg. Patients were subdivided into two groups according to changes in DO2 from T0 to T4: group D comprised 14 patients (10 with hyperlactatemia and 4 with normal lactate) in whom DO2 and oxygen consumption (VO2) simultaneously decreased from T0 to T4 without significant change in lactate level; group I comprised 10 patients (8 with hyperlactatemia and 2 with normal lactate) in whom DO2 and VO2 simultaneously increased, while the blood lactate level decreased significantly from 3.5 +/- 2.5 mmol/L at T0 to 2.1 +/- 1.0 mmol/L at T4 (P < 0.05). Our results indicate that the brain-dead state was frequently associated with a global energetic failure probably due to a cellular oxygen deficit, despite blood pressure within the normal range. This energetic failure, because it is associated with high levels of DO2, could result from a defect in peripheral oxygen extraction. Aggressive therapy, achieved by producing a further increase in DO2, may reduce this global tissue oxygen deficit.

Adolescent↗
PubMed1995

[Renal graft].

After years of pioneering research and clinical applications, renal transplantation has now moved into the era of routine practice-the first line treatment for renal failure in more than 1500 new patients each year in France. Despite this success, transplantation is not a cure, it simply replaces one disease by another-immunodepression. As a result, over the next 20 years, 60% of the recipients will undoubtedly develop cancer. In addition, the life span of a transplanted kidney is shorter than that of the recipient. Consequently most of them will require a second graft 8 to 10 years after the first. Together with the development of new innovating immunology agents such as FK 506 and mycophenolate, for example, these current facts raise the challenging question of the future for renal transplantation. Will adequation between donors and recipients be achieved? Should we develop single organ transplantation units within our current nephrology-urology structures or create multiorgan units devoted solely to transplantation? And finally, will (or perhaps when will) progress in immunology completely control the problem of organ rejection? One technical point is also of interest. Being (with orthopaedic surgery) one of the rare indications where open surgery can be expected to continue over the next 20 years, renal transplantation units will play an essential role in training future surgeons.

Humans↗
PubMed1995

Intracavernous pressure changes during reflexive penile erections in the rat.

Reflexogenic penile erections have been previously described in the rat. However, exact involvement of the corpus cavernosum in reflex responses is indefinite. We report changes in intracavernous pressure (ICP) recorded in 10 awake rats by means of a telemetric device. The ICP changes and penile reflex responses (lengthening of the penile body, glans erection, cup, and flip) were recorded during ex copula tests. Each type of penile response was characterized by a specific ICP variation. Mean maximal ICP increase during lengthening of the penile body was 58.6 mmHg, during glans erection 67.3 mmHg, during cups 99.1 mmHg, and 215.2 mmHg during flips. ICP increases to 35.1 mmHg immediately preceding each cluster of penile responses. This study provides quantitative data on the involvement of the corpus cavernosum during reflexive erections. Tumescence of the corpus cavernosum was present during glans erection and suprasystolic ICP peaks occurred during flips. ICP measurements during reflexive erections should bring new insights into the analysis of their physiological mediation.

Animals↗
PubMed1995

Developmental and hormonal regulation of DNA methyltransferase in the rat testis.

Changes in DNA methylation patterns during gametogenesis have been implicated in the regulation of germ cell development and genomic imprinting. Cytosine methylation is catalyzed by the enzyme DNA (cytosine-5)-methyltransferase (DNA MTase). The objective of this study was to determine the presence and study the developmental and hormonal regulation of DNA MTase expression in the rat testis. Northern blots of RNA isolated from 10 different adult rat tissues were used to determine tissue-specific differences in transcript size and abundance of DNA MTase. The developmental regulation of DNA MTase in the rat testis was examined by use of Northern blots of testicular and isolated germ cell RNA from rats ranging in age from 7 to 91 days. For a better understanding of the hormonal regulation of DNA MTase in the rat testis, adult rats were hypophysectomized and 4 wk later (Day 0) received 24-cm testosterone silastic implants; controls were sham hypophysectomized. At Days 0, 3, 7, 14, 28, and 56, one testis from each rat (n = 4/group) was used to prepare total RNA. Examination of DNA MTase mRNA expression in different rat tissues demonstrated the existence of a single 5.2-kb transcript; up to 5-fold tissue-specific variations in the levels of DNA MTase mRNA between the tissue with the highest expression, spleen, and that with the lowest expression, prostate; and significant levels of expression in the testis (three times prostate levels). During testicular development, DNA MTase mRNA levels were highest at 7-21 days of age and decreased by 45% by Day 28; mRNA levels decreased further to reach steady adult levels by Day 42.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMed1995

Analysis of cadaver donor criteria on the kidney transplant survival rate in 5,129 transplantations.

PURPOSE: To clarify the role of donor criteria we retrospectively analyzed a series of 5,129 cadaver kidney grafts harvested from January 1, 1989 to December 31, 1991. MATERIALS AND METHODS: Graft survival was calculated and analyzed using a multifactorial approach. RESULTS: Better graft survival was obtained with donors between 6 and 50 years old (80% versus 64% at 3 years), grafts performed from male donors (74% versus 69% at 3 years), donor deaths caused by cranial injury as opposed to cerebral hemorrhage (74% versus 70% at 3 years) and negative cytomegalovirus antibodies (75% versus 71% at 3 years). CONCLUSIONS: These factors may be used for kidney allocation.

Adolescent↗
PubMed1995

Neural control of penile erection.

Filling of the sinusoidal spaces with blood due to smooth muscle relaxation results from parasympathetic neural pathway activation and probably simultaneous inhibition of sympathetic outflow. The final common pathway for proerectile fibers is represented by the cavernous nerves and fibers controlling detumescence and flaccidity originating in the sympathetic chain. The hypogastric nerve could represent an accessory proerectile pathway unmasked by a sacral spinal cord lesion. Nitric oxide, which can be colocalized with VIP and acetylcholine, is the main proerectile neurotransmitter and noradrenaline is considered to be the major antierectile agent. Reflexive erection elicited by recruitment of penile afferents involves both autonomic and somatic efferents. This reflex is mediated at the spinal cord level and modulated by supraspinal influences. Serotonergic pathways originating in the raphe nuclei may mediate inhibitory control on reflexive erections. The hypothalamic medial preoptic area is an important integrating center and dopamine may regulate penile erection at this level. Neuroendocrine regulation may vary depending on the context in which erection occurs, for example, coitus, in response to extrinsic or psychogenic stimuli, and rapid eye movement sleep.

Animals↗
PubMed1995

Enhanced detection of hematogenous circulating prostatic cells in patients with prostate adenocarcinoma by using nested reverse transcription polymerase chain reaction assay based on prostate-specific membrane antigen.

We report the development of a new sensitive nested reverse transcription-polymerase chain reaction (RT-PCR) assay, using primers derived from the prostate-specific membrane antigen (PSM) cDNA sequence, to detect an hematogenous spread of prostate adenocarcinoma cells. In 60 patients with a biopsy-proven prostate cancer, PSM and PSA RT-PCR detected circulating prostate cells in 40 and 20 patients, respectively. In pT4 M+ and pT3 M+ disease patients, nested PSM primers detected cells in 28 of 33 patients (85%), whereas nested PSA primers detected cells in 17 of 33 (51%). In patients with organ-confined cancer spread (pT2a and pT2b patients) before radical prostatectomy, nested PSM RT-PCR detected circulating prostatic epithelial cells in 6 of 17 patients (35%), which suggests that an hematogenous spread of prostate cells may occur early in prostate cancer history. Altogether, these results suggest that the detection of PSM-expressing cells in blood may predict the development of cancer in patients without clinically apparent prostate cancer. Nevertheless, the potential application and the clinical significance of detection of hematogenous prostate cells through the use of nested PSM primers need an extensive longitudinal study.

Adenocarcinoma↗