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Biomedical subjects

J Auvert

Publications and source records attributed to J Auvert.

At least 55 records · Page 3Linked to original sources
PubMed1981

[Removal of kidneys for transplantation. Experience in a French general teaching hospital (author's transl)].

A law issued on december 22, 1976 and aimed at increasing the number of kidney transplantations in France authorizes the removal of kidneys from deceased persons of full age provided they had not expressed refusal while still alive; for decreased persons under age, removal is subject to written consent of the legal representative. In a general teaching hospital of whose than 1 000 beds, 21 kidneys donors were operated upon between January 1, 1971 and December 31, 1975 (an average of 4.2 per year). A kidney transplantation team was developed in 1976. Between January 1, 1976 and August 31, 1979, 83 kidneys donors were operated, an average of 22.6 per year. Ninety-five per cent (59/62) of the kidneys removed and transplanted in the hospital began to function (diuresis greater than 2 ml/min) within minutes of releasing the clamp, no matter how long cold ischaemia had lasted. The increase in kidney removal and transplantation may be attributed to the fact that motivation was maintained among the various units concerned (anaesthesia and intensive care, neurosurgery, neuroradiology) by sustained information and teaching.

Cadaver↗
PubMed1981

[Surgical methods of cadaver nephrectomy prior to kidney transplantation (author's transl)].

Surgical technique during donor's binephrectomy is one of the most important parameters conditioning early success after kidney transplantation. Experimental studies showed that tractions on the renal pedicle during kidney removal had a detrimental effect upon renal cortical vascularization and subsequent kidney function. Cortical vasoconstriction is equivalent to acute warm ischemia and therefore impedes prolonged kidney preservation. The means of preventing such events are: administration of large volumes of intravenous saline to the donor, renal vasodilation during surgery with furosemide (8 mg/kg I.V.) repeatedly administered, continuous I.V. infusion of dopamine (less than 10 micrograms/kg/min) and last but not least, surgical technique. Renal pedicles should never be publed. Initial dissection of inferior vena cava, aorta and both renal pedicles is mandatory. Kidney dissection takes place at the very end of the operative procedure. In case of cardiocirculatory arrest, both kidneys are cooled in situ after retrograde cannulation of the aorta above the renal arteries with an indwelling probe inserted into the femoral artery in the groin. From January, 1876 to August 31, 1979, 83 cadavers have been operated upon according to these techniques. Warm ischemic time was less than 5 minutes in all cases. 85 kidneys have been sent to other kidney transplantation centers and 19 kidneys discarded. Sixty-two kidneys have been transplanted in our institution. Cold ischemic time ranged from 2 to 43 hours. Immediate post-transplant massive diuresis (greater than 2 ml/mn) was observed in all recipients but 3 (95%).

Cadaver↗
PubMed1981

Conservation surgery of renal carcinoma: the EIRSS experience.

Seventy-two patients with renal carcinoma (RC) in a solitary kidney or bilateral synchronous tumours underwent parenchyma-sparing excision of their neoplasms. This was performed in situ in 51 and extracorporeally in 21 kidneys, with a complication rate respectively of 17 and 43%. The 5-year survival rates were 78% for unilateral disease, 48% for bilateral synchronous and 38% for bilateral asynchronous disease. Survival correlated with P category, grade and diameter of the tumour. Vascular invasion and spindle cells indicated a poor prognosis; the position of the tumour, oncocytic elements, calcification, lymphocytic infiltration or the predominance of clear cell or granular cells did not influence survival.

Adult↗
PubMed1981

[Atraumatic microsurgical nephrotomy. Experimental study on canine kidney (author's transl)].

Microsurgical transversal section and repair of canine kidney was presented as a model to study the condition required for an atraumatic nephrotomy. The investigation was carried out by two methods. In a first series five kidneys were injected by coloured resins after transection and microsurgical repair. Results were evaluated by cast examination of vascular net work. In a second series, transection and repair were made by an "ex-situ" procedure on seven dogs. The repaired kidney was autotransplanted in the opposite fossa iliaca. Long term renal function was evaluated after controlateral nephrectomy, by arteriography, biologic data and DMSA Tc 99 m scintiscan. The good results showed that microsurgery is useful in atraumatic nephrotomy and now a new tool in intrarenal access.

Animals↗
PubMed1980

[Treatment of prostatic cancer with diethylstilboestrol and detection of the vascular risk (author's transl)].

A retrospective study of immunologic behavior of patients suffering from cancer of the prostate and treated with oestrogens permits the proposal of the utilisation of a test that separates a high thromboembolic risk population due to oestrogens from a population that can benefit from this hormonotherapy. The so-called "oestrogen tolerance test" consists of seeking the presence of immune complexes by the method of precipitation of serum by 25% saturated ammonium sulphate. The group of patients where precipitates exceeds 700 micrograms/ml has a thrombo-embolic risk above 30% (41% in our series with serious complications such as pulmonary embolus and arterial thrombosis. The group of patients where precipitates are less than 300 micrograms/ml has a lower risk of arterial thrombosis (2,5%) and the observed accidents are benign. Finally, a test test when precipitate exceed 700 micrograms/ml should exclude diethylstilboestrol treatment.

Diethylstilbestrol↗
PubMed1980

Treatment of malignant bladder tumors by iridium-192 wiring.

Small tumors of the mobile portion of the bladder may be treated by means of interstitial irradiation by iridium-192 wiring. Twenty-six tumors (mostly T1, but also T2 and T3) were treated by this procedure. Good results are attained in 89 per cent of 19 cases followed over three years. This method has the benefit of avoiding irradiation to the surgeon's hands, and of delivering to a specific site a dose of 6,000 rads. No bladder contraction was observed.

Brachytherapy↗
PubMed1979

[Treatment of ureteral obstructions due to prostatic carcinoma. Prognostic value of response to medical treatment (author's transl)].

A retrospective study concerning 146 patients with prostatic cancer showed that 30 of them (20 p.cent) presented ureteral obstacles at some time during the evolution of the disease. The majority of these cases were T3-T4 tumors. When a strickly medical approach allowed to reduce the obstruction, the 1 year survived rate was 71 p.cent. When surgery became necessary due to persistent renal insufficiency, in spite of medical treatment the 1 year survival rate was 15 p.cent.

Aged↗
PubMed1979

Sequential polychemotherapy for advanced prostatic carcinoma. A preliminary cooperative study on 30 patients.

30 patients with advanced prostatic carcinomas received sequential polychemotherapy with association of vincristine (or VM 26), cyclophosphamide and 5-fluorouracil. In addition, 13 of these 30 patients received a dose of adriamycin during the first day of treatment, which did not change the results. This treatment was well tolerated and gave a good relief of bone pains.

Cyclophosphamide↗