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Biomedical subjects

J M Dubernard

Publications and source records attributed to J M Dubernard.

At least 91 records · Page 5Linked to original sources
PubMed1996

[Simultaneous allotransplantation of the adrenal gland and the kidney].

Thirteen months after a bilateral nephrectomy for a synchronous bilateral renal cell carcinoma involving both adrenal glands, a 46 years-old man underwent a simultaneous adrenal and kidney allotransplantation. The left renal allograft was harvested together with a ipsilateral adrenal gland using a common aortic patch. Maintenance immunosuppression was based on azathioprine, antilymphocyte globulin cyclosporine and prednisolone. Kidney allograft function remained stable for 5 years until the patient died from multifocal pancreatic metastases. Clinical, biochemical, radiological and histological arguments demonstrated the function of adrenal allograft. To our knowledge, it is the first report of a simultaneous kidney and adrenal gland allotransplantation in a therapeutic intent. An adrenal gland allotransplantation is only justified when the adrenal insufficiency exists with an end stage organ failure requiring transplantation and therefore immunosuppressive drugs.

Adrenal Gland Neoplasms↗
PubMed1996

[Renal and adrenal involvement in von Hippel-Lindau disease: clinical features and therapeutic strategies].

OBJECTIVES: We report our experience of renal and/or adrenal manifestations of von Hippel-Lindau disease and propose a practical approach. METHODS: Eight patients (mean age: 43 years) presented with predominant renal and adrenal lesions in 6 cases and 2 cases, respectively. RESULTS: All patients are alive with a mean follow-up of 8.1 years. A local recurrence after partial nephrectomy was observed in two cases. Two patients are in renal failure and are treated by dialysis and two patients require hormone replacement therapy for adrenal insufficiency. CONCLUSIONS: The predegenerative nature of simple renal was not observed. Conservative renal surgery is adapted to small renal tumours, with a low cytological grade and without any distant lesions in the same kidney. Radical nephrectomy is reserved for large lesions (greater than 5 cm) with a high cytological grade. The presence of pheochromocytoma must be systematically excluded. Preservation of the adrenal gland in the case of homolateral renal surgery for cancer is recommended. The reliability of the genetic test allows early diagnosis of this disease.

Adrenal Gland Diseases↗
PubMed1995

[Lymphoma with bladder involvement and renal transplantation].

Based on the case of a renal transplant recipient who developed a monoclonal B cell lymphoma with plasma cell differentiation, arising in the bladder, the authors discuss the responsibility of intensive immunosuppressant protocols in the development of post-transplantation lymphoproliferative syndromes. The Epstein-Barr virus favours the development of these lymphomas. The bladder is a rare site. Diagnosis was based on endoscopic resection with immunohistochemical analysis. The prognosis depends on the stage at the time of diagnosis. At an early stage, resection of the tumour combined with reduction of immunosuppressant therapy may be sufficient, but more aggressive treatment is required for more advanced stages. Anti-B lymphocyte monoclonal antibodies (CD21, CD24) give good results, especially in polyclonal forms and Epstein-Barr virus primo-infections. Anti-CD38 monoclonal antibodies are currently being investigated and appear to be very promising. Conventional radiotherapy and chemotherapy are disappointing.

Herpesviridae Infections↗
PubMed1995

[First clinical trials of a new endoscopic lithotriptor with ballistic energy (Waltz EL 25 Combilith)].

The Waltz Combilith EL 25 is an endoscopic lithotriptor equipped with an electrohydraulic and ballistic function. The device which generates the ballistic energy is a hand-piece in which a projectile, driven by an electromagnet, strikes a metal rod which transmits the energy to the stone. The diameter and length of the rod are adapted to the site of the stone (bladder + kidney: 1.7 mm rod; ureter: 0.8 mm rod). 29 stones in 25 patients with a mean age of 43 years (range: 25-72) were treated using ballistic energy: 22 ureteric stones (mean dimensions: 9 x 6 mm), 2 renal stones (mean dimensions: 20 x 30 mm) and 5 bladder stones (mean dimensions: 15 mm). Satisfactory stone fragmentation was obtained for 26 of the 29 stones (89.6%) with a mean fragmentation time of 142 seconds. One minimal ureteric perforation was observed (cure without sequelae after drainage by a double J stent). The Combilith EL 25 presents an excellent efficacy/safety ratio and can be used throughout the urinary tract.

Adult↗
PubMed1995

[Endoscopic treatment of intermittent vesico-ureteral reflux in women. Apropos of 40 cases].

UNLABELLED: To evaluate the clinical efficacy of endoscopic treatment of intermittent vesicoureteric reflux in adult females. METHODS: Forty women presenting with recurrent urinary tract infection related to intermittent vesicoureteric reflux, underwent subureteric Teflon injection according to the O'Donnell procedure (mean volume of Teflon 1 cc). Thirty patients required one injection, while nine patients needed two injections. Meatostomy or urethral dilatation were associated in 29 cases (72.5%). RESULTS: No complication occurred. Clinical results were evaluated using a questionnaire. The mean follow-up was 33.5 months (range 12-72), complete disappearance of infection was obtained in 31 out of 40 cases (77.5%). Recurrent urinary infection occurred in 9 cases. After complementary Teflon injection, urinary infection disappeared in 5 patients and finally a complete cure was obtained in 36 out of 40 cases (90%). CONCLUSION: Intermittent vesicoureteric reflux could be easily cured by an endoscopic procedure. This minimally invasive technique is simple and well adapted to this relatively benign disease.

Adolescent↗
PubMed1994

Normothermic preservation of "multiple organ blocks" with a new perfluorooctyl bromide emulsion.

To evaluate the efficiency of fluorocarbon emulsions as oxygenating media for the normothermic preservation of organs (multiple organ blocks, MOB), a new perfluorooctyl bromide (perflubron) emulsion was compared with a mixture of modified Krebs solution and blood. The fluorocarbon emulsion used (90% w/v of fluorocarbon) contained a low amount of egg yolk phospholipid (EYP, 2% w/v) and was stabilized by a mixed fluorocarbon-hydrocarbon amphiphile C6F13C10H21 (F6H10). Blood of 4 rat MOBs was replaced with a 36% w/v fluorocarbon emulsion which has been complemented with albumin and electrolytes (EMOBs). 5 MOBs were perfused with a mixture of blood and albumin-containing Krebs solution (KBMOBs). Lactate, amylase and creatine kinase were lower (p < 0.05) at 60 and 120 min in EMOBs than in KBMOBs,

Animals↗