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Biomedical subjects

J Mouiel

Publications and source records attributed to J Mouiel.

At least 73 records · Page 4Linked to original sources
PubMed1993

Role of nonparenchymal liver cells in guinea pig to rat hepatic xenotransplantation.

This work was undertaken to investigate the role of nonparenchymal liver cells in a discordant model of hepatic xenografting. Three experimental groups were established: in group 1 guinea pig to Lew rat liver xenotransplantations were performed; in group 2 both donor and recipient were treated with dextran sulfate, a known inhibitor of the reticuloendothelial system phagocytic function; in group 3 both donor and recipient were injected with muramyl dipeptide, a synthetic immunomodulator stimulating the monocyte/macrophage axis. Survival time was assessed and xenoantibody titers 30 min before and after the intervention, Kupffer cell activity 30 min after transplantation, histology and immunoglobulin and complement deposits of the grafted liver were evaluated too. Survival time of the xenografted rats in group 1 was 6.4 +/- 0.31 h. Blockade of Kupffer cells by dextran sulfate administration significantly (p < 0.001) depressed the survival time (2.9 +/- 0.31 h) of the grafted rats, while a significant increase (p < 0.001) was observed in the muramyl dipeptide-treated group (9.3 +/- 0.52 h). A significant reduction of xenoantibody titers 30 min after intervention was observed in the muramyl dipeptide group while no reduction was observed in the dextran group. Thirty minutes after xenotransplantation sheep red blood cell 51Cr uptake was significantly depressed by dextran sulfate treatment while muramyl dipeptide administration restored the Kupffer cell activity. Histological changes worsened after dextran administration in comparison with the other groups. Immunoglobulins and complement deposits were diminished by dextran administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1993

Laparoscopic treatment of inguinal hernias. A personal approach.

Laparoscopic hernia repair has suffered from a lack of careful anatomical appreciation and the application of sound surgical principles. Key anatomical landmarks which must be clearly identified in every hernia repair are Cooper's ligament, the umbilical artery and the epigastric vessels. The preperitoneal transabdominal mesh repair is the technique advocated by the authors. Between January 1991 and February 1993, 180 hernias were repaired. One hernia has recurred. Morbidity was minimal, with no major complication. The hospital stay was 1.3 days and the majority of patients returned rapidly to full activity. The best indications for laparoscopic hernia repair are recurrent hernias, a large hernia in patients with a weak muscular abdominal wall and bilateral hernias, for which the technique is considered ideal.

Follow-Up Studies↗
PubMed1993

[Endoscopic surgery during pregnancy. A case report of cholecystectomy].

Pregnancy used to be considered a contraindication for endoscopic surgery of the digestive tract. We report a case of cholecystectomy carried out laparoscopically for complicated gall stones in a woman who was 14 weeks pregnant. There was no post-operative maternal or fetal morbidity. The mother carried on the pregnancy to term normally and gave birth to a normal infant. The same results have been reported in the literature for three other cases of cholecystectomy and six of appendicectomy. The sole technical precautions that had to be undertaken were in introducing and placing the trocars, taking into account the size of the uterus. There has been no scientific proof that CO2 is toxic for the fetus. Clinical practice shows that endoscopic surgery is possible without any obstetrical risk including thrombo-emboli, nor specific sepsis occurring in any of the three trimesters of pregnancy. The advantages of the endoscopic approach are that there is less post-operative pain and therefore less need to take analgesics. There are no complications because of an abdominal wound and the patient can both feed and walk about immediately after the operation with a reduction of the time spent in hospital. There is probably less risk of aborting when compared with classical laparotomy. The endoscopic route can be chosen when surgery is needed in the digestive tract during pregnancy.

Adult↗
PubMed1992

[Liver transplantation for hepatocellular carcinoma. Mid-term results].

The results of liver transplantation for hepatocellular carcinoma are disappointing. Thus, in 11 patients transplanted for hepatocellular carcinoma on cirrhosis, the actuarial survival rate at 3 years was 20 percent, with a postoperative mortality of 27 percent and 4 deaths caused by recurrence of the malignancy. These poor results contrast with those we obtained after liver transplantation for cirrhosis and finding of incidental hepatocellular carcinoma in the resected part of the liver. Out of 6 patients with incidental carcinoma only 1 died postoperatively (16.6 percent), and no case of recurrent malignancy was observed. These results confirm that the malignancy recurrence rate is high after transplantation for large carcinoma. On the other hand, the absence of recurrence after transplantation for incidental hepatocellular carcinoma encourages us to look for small carcinomas on cirrhosis.

Actuarial Analysis↗
PubMed1992

Endolaparoscopic palliation of pancreatic cancer.

Two patients with advanced pancreatic cancer were palliated for both duodenal and biliary obstruction without laparotomy. The techniques of endoscopic biliary stent and laparoscopic gastrojejunostomy are described. This combination achieved rapid palliation with minimum morbidity. Patients with advanced pancreatic cancer and a limited life expectancy benefit greatly from the shortened hospital stay and convalescence this manner of treatment offers.

Adult↗
PubMed1992

[Recurrence of virus B hepatitis after liver transplantation].

Thirty-three HBs antigen positive patients without signs of viral replication underwent orthotopic liver transplantation and received long term passive immunoprophylaxis with anti-HBs immunoglobulins at high doses perioperatively and then at a dose of 10,000 IU every month. All patients became negative during the first 6 months following surgery. At 34 months the survival rate was 67 percent and the actuarial recurrence rate of serum HBs antigen was 7.1 percent. Reappearance of HBs antigen was associated with evidence of HBV replication and histological alterations of the graft. In our experience, long term passive immunoprophylaxis reduces HBV reinfection of the grafted liver.

Adult↗
PubMed1992

[Orthotopic liver transplantation and hepatocellular carcinoma].

Nineteen orthotopic liver transplantations (OLT) were performed in patients with hepatocellular carcinoma, between March 1988 and December 1990, in our Department. Thirteen patients (68.4%), 10 men and 3 women, mean age 48.2 +/- 2.8 years, were clear cut neoplastic disease, six patients (31.6%), 4 men and 2 women, mean age 48.6 +/- 4.2 years, were incidental tumors. Three years survival rate was 20% in clear cut neoplastic diseases (4 patients died for neoplastic recurrence) and 66% in incidental tumors. Our results demonstrate that liver transplantation for hepatobiliary malignancy is still justified, patient selection is important in predicting outcome.

Actuarial Analysis↗
PubMed1991

A new technique of surgical treatment of chronic duodenal ulcer without laparotomy by videocoelioscopy.

We performed truncal posterior right vagotomy with lesser curve anterior gastric myotomy by videocoelioscopy on 10 patients (5 men and 5 women, ranging in age from 19 and 54 years, with a mean age of 32 years). All had a long history of chronic duodenal ulcer with a mean duration of symptoms of 3.8 years. The mean length of the operation was 60 minutes (range: 55 to 110 minutes). There was no morbidity, and all patients were discharged after 5 days. The acid secretion tests under basal conditions and under insulin stimulation preoperatively and 1 month postoperatively showed a mean decrease in the basal output of 79.3% and a mean decrease of 83.04% in the maximal output. The fibroscopic control at the second postoperative month showed a complete healing of the ulcer in nine patients and a residual ulcer scar in one. No patients had any abdominal complaints. Right truncal vagotomy and anterior lesser curve seromyotomy by videocoelioscopy is an efficient and elegant method of treating chronic duodenal ulcer, but it needs thorough experimental practice.

Adult↗
PubMed1991

The European experience with laparoscopic cholecystectomy.

A retrospective survey of 7 European centers involving 20 surgeons who undertook 1,236 laparoscopic cholecystectomies was performed. The procedure was completed in 1,191 patients. Conversion to open cholecystectomy was necessary in 45 patients (3.6%) either because of technical difficulty (n = 33), the onset of complications (n = 11), or instrument failure (n = 1). There were no deaths reported, and the total postoperative complication rate was 20 of 1,203 (1.6%), with 9 being serious complications requiring laparotomy. The total incidence of bile duct damage was 4 of 1,203. The median hospital stay was 3 days (range: 1 to 27 days) and the median time to return to full activity after discharge was 11 days (range: 7 to 42 days).

Adolescent↗
PubMed1991

Protective effects of prostaglandin E1 on normothermic liver ischemia.

Effects of treatment with prostaglandin E1 (PgE1) on normothermic liver ischemia were studied in male Lewis rats. Animals were subjected to 90 min of warm liver ischemia. Two groups of rats were constituted: group A (no treatment) and group B (PgE1 treatment). PgE1 (100 micrograms/kg) was given as a bolus 2 min before induction of ischemia and 2 min before the end of ischemia. Survival rates were assessed and, 6 h after the end of ischemia, serum transaminases, histology of the liver, Kupffer cell activity were evaluated. PgE1 treatment significantly improved survival rate (80%) in comparison with the nontreated group (40%). A significant reduction in transaminase levels was observed after PgE1 The extent of necrosis and congestion was improved by PgE1 treatment. Sheep red blood cell 51Cr liver uptake was deeply depressed 6 h after the end of ischemia in group A (6 +/- 2.3%/g tissue), and was significantly higher (p less than 0.001) after PgE1 administration in group B (32.98 +/- 11.7%/g tissue). Our results demonstrate that PgE1 is able to protect the liver from ischemic insult. The mechanism by which prostaglandins exert this beneficial effect on normothermic liver ischemia may be related to their action on hepatic macrophages.

Alprostadil↗
PubMed1991

Laparoscopic fenestration of biliary cysts.

We describe a new technique of biliary cyst fenestration using a videolaparoscopic approach. From June 1989 to October 1990, laparoscopic fenestration was performed for four symptomatic solitary cyst and one polycystic liver disease patients, without any morbidity. Mean hospital stay was short: 6.8 days (range of 3-14 days). No recurrence was observed on ultrasound controls with a mean follow-up of 6.4 months (range of 2-15 months). Laparoscopic fenestration for symptomatic biliary cysts is a simple, effective, and minimally invasive procedure.

Adult↗
PubMed1990

[Treatment of duodenal ulcer by posterior trunk vagotomy and anterior fundic seromyotomy under video-laparoscopy. Preliminary note with presentation of a film].

Posterior vagotomy associated with anterior fundic seromyotomy, as proposed by Taylor in 1979 and widely used since then, has been performed under video laparoscopic monitoring in 6 patients with inveterate chronic duodenal ulcer. The procedure described here produced no complications in the immediate postoperative period and early progress in the controlled healing of the ulcer and the reduction of acidity, which can be compared to those of the same procedure with laparotomy.

Adult↗