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Biomedical subjects

M Brunel

Publications and source records attributed to M Brunel.

At least 19 recordsLinked to original sources
PubMed1999

Restorative proctocolectomy for distal ulcerative colitis.

BACKGROUND: Chronic distal colitis may cause troublesome symptoms and alter quality of life. When medical treatment fails to control symptoms, patients and doctors are often reluctant to consider surgical resection because of the relatively small portion of the large bowel affected by the disease. AIM: To assess the outcome of restorative proctocolectomy (RP) in patients with distal colitis who required surgery for chronic debilitating symptoms and failed medical management. PATIENTS/METHODS: From 1986 to 1996, of 263 patients receiving RP for ulcerative colitis, 27 (16 men) were operated on for distal ulcerative colitis limited to the rectum and sigmoid colon. Bowel function and quality of life were compared before and one year after RP. RESULTS: The mean (SD) duration of ulcerative colitis was 11 (6) years. RP was performed at a mean age of 46 (10) years. All the pouches were J-shaped, and a diverting loop ileostomy was always performed. Mean (SD) hospital stay was 25 (10) days. Seven complications occurred in six patients. Previously unknown severe dysplasia was discovered on the colectomy specimen in two patients. After RP there was a significant decrease in mean (SD) daytime stool frequency (8.2 (4) v 4.7 (2), p<0.05), night-time stool frequency (2 (2) v 1 (1), p = 0.05), and the number of patients with urgency to defecate (26/27 v 1/27, p<0.001). Sex life was improved in eight patients, social life in 26, and professional life in eight. Twenty six patients were satisfied with the results, and 25 wished that they had received surgery earlier in the course of their disease. CONCLUSION: RP can improve bowel function and quality of life in patients with disabling chronic symptoms of distal ulcerative colitis.

Adult↗
PubMed1997

Fine chemical structure analysis of oligosaccharides produced by an ulvan-lyase degradation of the water-soluble cell-wall polysaccharides from Ulva sp, (Ulvales, Chlorophyta).

A marine bacterium degrading the water-soluble cell wall polysaccharides from Ulva sp. (ulvan) has been isolated. The good correlation between ulvan degradation monitored by reducing-power, UV absorbance and viscosimetry, indicated that the crude enzymatic extract contains essentially an endo-ulvan lyase activity. This activity was rapidly inhibited by the reaction products which consisted of a series of ulvanobiouronic acid A 3-sulfate [-->4)-beta-D-GlcpA-(1-->4)-alpha-L-Rhap 3-sulfate-(1-->]n with 4-deoxy-L-threo-hex-4-enopyranosiduronic acid at the non-reducing end. Other deviant repeating structures with beta-D-Xylp or alpha-IdopA replacing beta-D-GlcpA in the repeating ulvanobiouronic acid disaccharide and the presence of two consecutive (1-->4) linked beta-D-Glc pA demonstrated the great variability and complexity of ulvan chemical structure.

Carbohydrate Conformation↗
PubMed1996

Polytetrafluoroethylene grafts for carotid repair.

Polytetrafluoroethylene grafts are well established for bypassing occlusive disease in the lower limb but there are few reports which deal with the long-term results of such grafts in the neck. The present study was undertaken to evaluate the immediate and long-term results of polytetrafluoroethylene grafts for carotid repair. Between 1982 and 1991, 591 carotid operations (mostly endarterectomies) were performed by the authors. In 32 cases a polytetrafluoroethylene graft was used to replace (n = 12) or to bypass (n = 20) a stenotic lesion of the internal carotid artery. Postoperative angiography was obtained in all patients and the follow-up extended from 1 month to 9 years (mean 30 months) with clinical and duplex scan surveillance. There were no deaths within the first postoperative month. There was one acute postoperative stroke (3%) caused by plaque dislodgement and one symptomless occlusion demonstrated by routine angiography. During follow-up, seven patients died from other causes. No patient developed new neurological symptoms but routine duplex assessment showed one symptomless graft occlusion. The cumulative survival rate was 96% at 1 year and 91% at 4 years. The cumulative primary patency rate was 93% at 1 month, 89% at 1 year and 89% at 4 years. In specific situations polytetrafluoroethylene grafting is an adequate alternative to carotid endarterectomy but is not recommended by the authors as a routine procedure because of its occlusion rate (> 6.2%).

Aged↗
PubMed1986

Increase of respiratory allergy to the pollens of cypresses in the south of France.

A form of pollen allergy, which is uncommon in most parts of the world and in other Mediterranean countries where cypresses are abundant (Italy, Spain, Greece), with the exception of Israel, has become a problem since 1975 in our area. We have found 111 cases since 1975 compared with only a few cases from 1950 to 1975. The period of pollination is between mid-February and the end of March. Diagnosis has been made by skin tests and, in some instances, by RAST with good correlation. In almost all the cases, cross-reactivity has been found between the members of the Cupressaceae family with Cupressus sempervirens, the commonest cypress in the South of France, associated most often with this allergy. Clinically, allergy was of the oculo-nasal type with the association, in a few cases, of asthma or spasmodic cough. The unexpected increase of a particular allergy in a given population of atopic people raises several general problems. In this particular case it seems to us that the larger number of cypresses, which have been recently grown, is not the only explanation of the phenomenon.

Adolescent↗
PubMed1983

[Hairy cell leukemia associated with tuberculosis, disclosed by erythema nodosum].

A forty-two-year-old man presented with erythema nodosum of undeterminated etiology and pancytopenia. A bone marrow biopsy revealed extensive hairy-cell infiltration. Four months later, the diagnosis of pulmonary tuberculosis was suggested by the appearance of a pulmonary infiltrate in the left upper lobe. Despite antituberculous chemotherapy, the patient died. Post-mortem bacteriologic confirmation was given by sputum culture.

Adult↗
PubMed1983

[Hereditary osteo-onychodysplasia. Histomorphometric bone study. Apropos of a case].

The authors report on a patient with hereditary osteo-onychodysplasia (HOOD). Osteoporosis was demonstrated upon histomorphologic bone examination. HOOD is a rare inherited disorder. Typical features include dysplasia of the nails, patellae, elbows and ilium. Nephropathy occurs in 48% of patients. Numerous renal histologic studies have led to the concept that the nail-patella syndrome is an inherited metabolic disorder affecting the connective tissue. Our findings from histomorphologic bone assessment bring further evidence in support of this hypothesis.

Adult↗
PubMed1982

[Renal manifestations in Hodgkin disease. Two case-reports with a review of the medical literature (author's transl)].

The authors report on two patients in whom Hodgkin disease was revealed by renal complications: nephrotic syndrome in one patient and renal failure with enlarged kidneys secondary to malignant infiltration in the other. In comparison to other lymphomas, renal infiltration is infrequent in Hodgkin disease. Clinical manifestations of renal infiltration are delayed. Renal failure with enlarged kidneys, which is very uncommon, carries a poor prognosis and is often associated with involvement of the lungs. Nephrotic syndrome in Hodgkin disease may be secondary to one of the three following causes: renal vein compression, renal amyloïdosis, or a paraneoplastic syndrome. The latter is the most common cause and is probably ascribable to immunologic disturbances. Among the other complications, infection and the renal consequences of metabolic disorders are mentioned.

Adolescent↗