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J Testart

Publications and source records attributed to J Testart.

312 records · Page 18Linked to original sources
PubMedDate not supplied

[Current status of reconstructive surgery of the sub-inguinal artery].

Saphenous vein bypass is the optimal operation for arterial reconstruction in the subinguinal region. There has been no demonstrated advantage to using a devalvulated saphenous vein in situ rather than an inverted dissected vein. Prosthetic bypass may be preferred over saphenous bypass with a vein < or = 4 mm if the lower anastomosis is situated on the upper popliteal artery, if the life expectancy is short or if on the contrary the downstream bed is normal. Permeability after percutaneous transluminal angioplasty does not last as long as after bypass surgery for obliterations, but the operation is less aggressive and does not compromise a subsequent procedure. The best indications are short stenoses in patients with a long walking distance in whom surgery would be excessive. Angiography or ultrasound angioscopy after a bypass procedure or endoluminal dilatation can check the technical quality of the operation and help improve permeability duration. Adjuvant treatment such as a venous patch on a prosthetic anastomosis or various drugs are highly important in improving the duration of permeability. A prospectively planned follow-up should be an integral part of arterial reconstruction surgery in order to identify subsequent stenoses and programme their treatment before occlusion occurs.

Arterial Occlusive Diseases↗
PubMedDate not supplied

[Superficial gastric cancer. A review of 30 cases].

Thirty cases of superficial cancer of the stomach were treated over a ten-year period from 1984 to 1993. Actuarial survival rate at 5 years was 73%. The depth of cancer invasion has a predominant effect on two prognosis factors: mucosal and submucosal involvement. Invasion of the lymph nodes is more frequent in cases with submucosal invasion. Treatment is based on gastric surgery. Nevertheless, if the diagnosis of superficial cancer is certain before operation and deep extension is clearly identified by histology and especially by echoendoscopy, more selective surgery could be justified: R1 type exeresis for cancers involving the mucosa only and R2 type exeresis for submucosal involvement.

Aged↗
PubMedDate not supplied

[From spermatid to spermatozoa : what changes are necessary for development?].

The male gamete modifications during spermiogenesis were summarized in view to answer the question : "Is it a risk for a baby conceived by fertilization with a spermatid to be different of a baby conceived with a spermatozoon?" Cytoplasmic changes in spermiogenesis mainly concern the Golgi apparatus (acrosome vesicle), centrosomal material (flagelium), mitochondria (periaxonemal ring) and ooplasm volume (drastic reduction). These changes are not necessary in case of microfertilization (ICSI) and their absence could be without consequences on post fertilization development. Nuclear changes affect chromatin with the substitution of histones by protamines to insure sperm ADN stability across male and female genital tracts. Spermatid gene transduction brings new proteins which are related to fertilization (acrosomal enzymes, flagellum proteins, protamines...) and seem no longer useful after gametes fusion. There is no report of genomic imprinting occurring during spermiogenesis in mammals. Moreover, the important sperm changes during epididymal maturation (formation of disulfure bonds, acquisition of motility and of molecules for oocyte recognition, methylation of certain genes...) were found not necessary for embryo development in case of ICSI with epididymal or testicular spermatozoa. Normal and fertile animals (mice and rabbits) were born from ICSI with spermatids originated from normal males; an animal model with sterile males delivering apparently normal spermatids is lacking. Although the risk for defectuous babies from fertilization with spermatids is highly subjective, caution is needed and requires team competence, complete informed consent by the patients and exhaustive analysis of the methods used and results obtained. Moreover the evident risk to "reproduce" the father infertility must be compared with the psychosocial injury induced by using the alternative option of donor insemination.

Animals↗