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J L Descotes

Publications and source records attributed to J L Descotes.

51 records · Page 3Linked to original sources

Inter-regulated balance between gelatinases and tissue inhibitor (TIMP-1) in isolated human glomeruli.

Leukocyte infiltration inside glomeruli necessitates basement membrane collagen i.v. breakdown and leads to mesangiolysis, cell proliferation and extracellular matrix synthesis during the repair process as observed in the course of acute glomerulonephritis, vasculitis and acute graft rejection. Two matrix metalloproteinases, MMP-2 and MMP-9 gelatinases, are expressed and co-secreted in balance with the tissue inhibitor of metalloproteinases-1 (TIMP-1) by activated neutrophils as well as by glomerular cells and are aimed to control basement membrane collage i.v. deposition. Using a conventional double mesh sieving method, pure populations of glomeruli were isolated from fresh human cortex specimen and maintained in short-term cultures. ELISA, zymography and immunoblotting of conditioned serum-free media revealed glomerular MMP-2, MMP-9 and TIMP-1 secretion and activity while reverse transcription-polymerase chain reaction amplification of cellular RNA demonstrated glomerular transcripts coding for these enzymes and their inhibitor. When purified neutrophils were allowed to adhere onto Transwell apparatus in contact with glomerular suspensions, neutrophil 92 kDa gelatinase seemed apparently inhibited mainly because the production of TIMP-1 was enhanced on both sides of the insert. Glomerular 72 kDa and 92 kDa gelatinases were activated shortly (1 to 6 h) after neutrophils had interacted with glomeruli and furthermore upon activation by inflammatory or vasoactive mediators such as phorbol. Decreased neutrophil MMP-9 activity together with reduced MMP-9 mRNA levels and protracted TIMP-1 transcription and secretion during cell-cell interaction could participate to cell detachment from degraded basement membranes and to increased collagen i.v. deposition leading to glomerulosclerosis after initial glomerular injury by inflammatory cells.

Cells, Cultured↗

Critical cooling and warming rates to avoid ice crystallization in small pieces of mammalian organs permeated with cryoprotective agents.

Measurements were made by differential scanning calorimetry on small pieces of rabbit kidney permeated with 2, 3-butanediol containing mainly the levo- and dextro-isomers. The critical cooling rates necessary to vitrify the pieces of organ, and the corresponding critical warming rates which are required to avoid crystallization in the vitrified samples, were determined. The dynamic method used for these determinations is described. The glass-forming tendency and the stability of the amorphous state were both greater in the kidney tissue samples than in the bulk cryoprotective solution. This result is discussed in the context of the lowering of the freezing point of water in emulsions and the promotion of supercooling in hydrogels and porous materials. In corresponding experiments with rat hearts impregnated with 1,2-propanediol, only the critical warming rate was reduced.

Animals↗

[Traumatic rupture of the bladder. Apropos of 26 cases].

26 patients were seen with ruptured bladders at Grenoble Hospital during the last 15 years. Pelvic fractures were present in 95% of the cases. Bladder injuries were extraperitoneal (58%), intraperitoneal (27%), intraperitoneal and extraperitoneal (15%). Patients were hospitalised in Urological Department (40%) or General Surgical and Intensive Care (60%). All patients with intraperitoneal bladder injury, 61% with extraperitoneal ruptures were treated by surgical repair. 4 patients died, secondary to visceral associated injuries.

Adult↗

[Kidney injuries due to skiing].

From 1974 to 1993, the authors admitted 212 patients with renal trauma to their department. A large proportion of these cases were due to skiing accidents. Based on a retrospective study of 78 patients admitted to the Grenoble urology department, the authors describe the features of this trauma. 91% of patients were males with a mean age of 27.5 years, with 9% of type III trauma. Treatment was surgical in 55% of cases. Total nephrectomy was performed in 21% of patients. Partial nephrectomy was performed in 25.5% of cases, with a morbidity of 45%, predominantly consisting of fistulas.

Adolescent↗

Pseudoneoplastic xanthogranulomatous pyelonephritis. A typical clinical presentation but unusual diagnosis and treatment.

Xanthogranulomatous pyelonephritis is a rare disease that may mimic various renal lesions, especially renal tumors, in its focal form. We report a case of pseudoneoplastic xanthogranulomatous pyelonephritis in a young woman. This case is unusual, because it was diagnosed by a percutaneous renal puncture and furthermore total renal recovery was achieved by antibiotic treatment alone.

Adult↗

[Organ cryopreservation: current status of research carried out in Grenoble].

After discussing the problem of organ cryopreservation and reviewing the current data available on this subject, the Grenoble project is presented. Physical and biological studies have been combined with experimentation of autologous renal transplantation in rabbits to assess the functional value of the retransplanted organ after treatment and cooling. Renal resistances are measured during perfusion of the kidney with the cryoprotective solution. In order to verify the homogeneity of the cryoprotector concentration in the organ, on NMR spectral imaging test has been developed. A new rapid imaging method now allows real time monitoring of concentration variations during perfusion. In addition to concentration and homogeneity, analysis of local spectra also provides information about the local temperature de the kidney.

Animals↗

[Influence of kidney procurement techniques on urologic and vascular complications of the transplantation].

Surgical complications of renal transplantation, rejection and infectious diseases are factors contributing to poor renal graft survival. Factors directly concerning the donor can be involved in graft failure: age, medical history, causes of donor brain death. Urologic or arterial anatomic variations are often the source of difficult surgical conditions during renal transplantation. Technical errors during graft procurement must be avoided such as excess of traction or coagulation. Failure in perfusion preservation. As few renal grafts are available, it is thus essential to obtain optimal conditions to avoid failure in cadaver donor graft linked to technical errors during organ procurement.

Adolescent↗

[Reconstruction of the penile skin in Fourier's gangrene: the use of a helical skin graft].

The emergency treatment of Fournier's and perineal gangrene is now well defined and is based on excision of the necrotic tissues and broad spectrum antibiotics combined with hyperbarid oxygen therapy and symptomatic resuscitation measures. However, several procedures have been described for the reconstruction of the excised zones. In the light of one case of Fournier's gangrene, the authors evaluate reconstruction of the penile skin by means of a helical split-skin graft. With a follow-up of one year, the morphological and functional result was excellent. The patient has normal erection and the suture line does not contain any retractile adhesions. The authors therefore consider that this simple, but little known procedure should be part of the urologist's therapeutic arsenal for reconstruction of the penile skin.

Gangrene↗

[Surgical treatment for ureteropelvic junction syndrome in infants and children (report of 73 cases)].

between 1982 and 1990, 73 children were operated for pyeloureteric junction syndrome (76 pyeloplasties). The authors distinguish between a group of 45 infants operated before the age of 2 years and a group of 35 children operated after the age of 2 years. 40% of these cases had been detected antenatally, which modified the management and treatment of these infants, operated at about the age of 6 months (mean: 6.6 months). Treatment was conservative (one nephrectomy out of the 41 infants operated: 2.4%). Pyeloplasty was performed according to the Anderson-Hynes-Küss resection-anastomosis technique under an operating magnifying glass. Early surgery offers the best chance of recovery. Urinary tract drainage was not systematic in these infants (50% of cases) and did not affect the long term results. Early complications and surgical revisions (3.9%) were not more frequent in the infants operated earlier. The definitive results were good in 88.5% of cases, while 7.2% of cases required further surveillance. Renal parenchymal lesions (4.3%) were related more to pyelonephritis than to failure of surgery. Overall, a conservative surgical approach is recommended, except in minor syndromes which require rigorous surveillance.

Adolescent↗

[Multiorgan procurement (MPO). Who? How? What results?].

Between 1985 and 1988, 156 organs were harvested using a multiorgan procurement technique (MPO) in the Urology Dept of Grenoble University Hospital (50 MOP). All the organs transplanted either in Grenoble or in other centers have been followed up after transplantation to try to appreciate their value and function. The surgical procedure is described, and results, organ by organ, are given. The conclusion is that the MOP technique is perfectly usable and reliable without jeopardizing any of the transplanted organs.

Adolescent↗

[Prostatic utricle in adults. Report of 4 cases].

We present here four cases of adult prostatic utricules, and discuss the endoscopic or surgical treatment. A brief embryological and clinical summary allows a better understanding of this malformation. Therapeutic indications are reviewed and transtrigonal approach is described. We think that this surgical procedure gives better results and less morbidity.

Adult↗

[Renal transplantectomy: surgical technics and results. Apropos of 60 patients].

Nephrectomy of a non-functioning renal transplant after renal transplantation is a delicate operation which the authors evaluate on the basis of a retrospective analysis of 62 patients. A review of the literature helps to more clearly define the indications, optimal time of the operation and the operative technique. A subcapsular approach, by simplifying the operation, constitutes an important factor in reducing the operative morbidity in the late forms. "Early" transplantectomies are often more serious because of the recently operated patient's fragile status and immunosuppression, responsible for frequent infectious complications. Transplantectomy should therefore not be delayed once the permanent loss of transplant function has been confirmed.

Adolescent↗