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Biomedical subjects

M Legrain

Publications and source records attributed to M Legrain.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Complications and sequelae in the endoscopic follow-up of uretero-sigmoidostomies].

Progress in gastrointestinal endoscopy enables it to be used routinely in the diagnosis, treatment and follow-up of colonic tumours. The development of a tumour, especially adenocarcinoma, at the site of anastomosis of uretero-sigmoidostomy is a particular case. The endoscopic examination is delicate and confusion between the ureterocolonic junction and a polyp may have dramatic consequences when biopsy is performed. Two cases are reported: in one case, the error required nephro-ureterectomy and in the other case percutaneous nephrostomy, now a routine procedure, allowed salvage of the single kidney and preservation of the diversion with satisfactory long term function.

Colon, Sigmoid↗
PubMed1986

Isolation, physical characterization and expression analysis of the Saccharomyces cerevisiae positive regulatory gene PHO4.

The Saccharomyces cerevisiae PHO4 gene, which positively controls the expression of phosphatase genes, has been isolated by complementation of a pho4 mutation. The isolated DNA directed integration at the chromosomal PHO4 locus. The nucleotide sequence of PHO4 has a coding region of 930 nucleotides, flanked by sequences with typical transcription initiation and termination signals. The 5' region has characteristics of low-expression promoters and carries several uncommon elements, whose significance is not known. The predicted primary structure of the PHO4 protein, of 309 residues, does not show sequence elements typical of DNA-binding proteins. The transcription of PHO4 is independent of inorganic phosphate. Like other regulatory genes, PHO4 is transcribed at a very low level and the translation of its message uses preferentially several codons which are not employed for highly expressed genes.

Amino Acid Sequence↗
PubMed1986

Membranoproliferative glomerulonephritis associated with pulmonary sarcoidosis.

A 34-year-old woman with pulmonary and ganglionary sarcoidosis developed a nephritic syndrome. The renal biopsy demonstrated a type-1 membranoproliferative glomerulonephritis. Clinical and histological remission of the renal disease following indomethacin treatment was associated with the remission of sarcoidosis. Prior reports have emphasized the association of a membranous glomerulonephritis with sarcoidosis. Temporal sequence of events and biological data suggest that hypocomplementemic membranoproliferative glomerulonephritis may be linked to sarcoidosis. The role of immune complexes in the pathogenesis of the 2 diseases is also discussed.

Adult↗
PubMed1985

Early monitoring of human renal transplantations by N-acetyl-beta-D-glucosaminidase isoenzyme activities in urines.

Monitoring of variations in N-acetyl-beta-D-glucosaminidase (NAG) urinary activity, following renal transplantation, has been proposed for the early diagnosis of rejection episodes. In this study, the measurement of urinary NAG-B activity was conducted as a complement to total NAG (A + B) measurement, which is normally used alone. Selective measurement of NAG-B activity is carried out after fixation of NAG-A on ion exchanger in test tubes. Results of NAG (A + B) activity confirm that the assay of urinary NAG is a useful indicator of rejection, but a positive correlation between NAG-B and NAG (A + B) activities was observed during the various complications which can occur after transplantation. The specific measurement of this isoenzyme does not, therefore, seem to provide additional information in the early monitoring of human renal transplantations. Apart from rejection episodes, other factors are likely to produce marked NAG-B excretion, e.g. gentamicin therapy.

Acetylglucosaminidase↗
PubMed1985

[Treatment of chronic renal insufficiency in the diabetic by dialysis and transplantation].

The number of diabetics with end stage renal disease (ESRD) is growing. The best treatment at the lowest cost possible should be offered to all diabetics if therapeutic facilities are available. Such a policy requires that all dialysis methods and transplantation should be available and that transfer from one method to another should always be allowable. Results observed among insulin and non insulin-dependent diabetics are improving steadily, even in the older age group. However they are inferior to those observed in non diabetic people of the same age. Adequate medical care, including excellent control of high blood pressure and good control of blood glucose levels should reduce the frequency of severe complications including cardiac, ocular and peripheral vascular lesions. In diabetic patients under forty years of age, renal transplantation using a kidney from a cadaver or a related donor should be the first choice. However, for most patients dialysis methods are required as the only treatment or while waiting for a transplant. Very encouraging results are obtained with both hemodialysis and peritoneal dialysis. If home dialysis is considered, continuous ambulatory peritoneal dialysis (CAPD) offers the opportunity to treat many insulin-dependent or non dependent diabetics at home even those in the high risk population because of age and/or cardio-vascular instability. CAPD offers excellent control of blood glucose levels using the intraperitoneal route to administer insulin. Results obtained are discussed from data in the literature and from a survey of 124 insulin-dependent diabetic cases with ESRD treated in the Department of Nephrology of the Hospital de La Pitié from 1973 to 1984.

Diabetic Nephropathies↗
PubMed1985

[Open heart cardiac surgery in severe renal insufficiency and dialysis patients].

Surgically remediable cardiovascular complications are common in patients with renal failure treated by dialysis. 20 such patients were operated in our department (16 men and 4 women), aged 27 to 61 years (mean 44.5 years). 12 patients had undergone haemodialysis for 1 to 84 months; 4 patients were treated by peritoneal dialysis; the remaining four patients all had severe renal failure with creatinine clearances of less than 10 ml per minute. All patients were operated immediately after a session of dialysis. Particular attention was paid to preserving the peripheral arterial and venous vessels during anaesthesia and cardiopulmonary bypass. The jugular veins were used whenever possible to spare the upper limb veins and the dorsalis pedis arteries were used for the monitoring of systemic blood pressure to spare the radial arteries for eventual arteriovenous fistulae. Weight gain during the operation was limited by cardiopulmonary bypass techniques. The circuit was filled with 200 cc of B 21, 500 cc of isotonic bicarbonate solution and 800 cc of frozen plasma with potassium supplements. Mean weight gain was moderate (1.1 +/- 0.4 kg). 12 patients underwent valve replacement. The surgical indication was acute endocarditis in 6 cases. The aortic valve was replaced in 10 cases and the mitral valve in 2 cases by mechanical valve prostheses because of the high risk of calcification of bioprostheses in severe renal failure. 8 patients underwent coronary bypass graft surgery. Arterial blood pressure was maintained at over 60 mmHg and large doses of heparin were used to protect the arteriovenous shunts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Visual function, blood pressure and blood glucose in diabetic patients undergoing continuous ambulatory peritoneal dialysis.

Over the last five years, 46 insulin dependent diabetic patients (mean age 52 +/- 13 years) have been treated by continuous ambulatory peritoneal dialysis (CAPD). Fourteen patients have been on treatment for more than two years. Visual acuity assessed every six months showed that improvement has been observed in 14 eyes (19%), stabilisation in 36 eyes (46%), worsening in 17 eyes (21%), five eyes had a minimal function during the entire follow-up. Systolic blood pressure decreased from 173 +/- 42 mmHg at start of dialysis to 149 +/- 30 and 146 +/- 32 after one and two years. Mean fasting and post-prandial blood glucose assessed monthly in 36 patients treated with four daily intraperitoneal injections of insulin (660 determinations) were respectively 7.5 +/- 3.5 and 8.5 +/- 3.5mmol/L.

Adult↗
PubMed1984

Serum concentration and peritoneal transfer of aluminum during treatment by continuous ambulatory peritoneal dialysis.

The evolution of the aluminum (A1) serum levels during a 2-year follow-up and the peritoneal transfer of A1 were studied in 22 patients treated by continuous ambulatory peritoneal dialysis (CAPD), using a dialysate with a very low A1 concentration (r = 0.25 - 0.30 mumoles/liter). Patients were divided in three groups. A transfer of A1 from the patient to the dialysate was observed in all patients. In group 1, patients exclusively treated by CAPD and who have never received aluminum-containing phosphate binders (ACPB), mean level (+/- SD) of serum A1 stabilized within a safe range (0.60 +/- 0.28 mumoles/liter). In group 2 the oral administration of ACPB in patients exclusively treated by CAPD induced a slow and progressive increase of A1 serum concentration despite the increase of the A1 excretion through the peritoneal route. In group 3, patients previously treated by hemodialysis and receiving ACPB, the high serum A1 levels observed before treatment by CAPD decreased rapidly on CAPD. A1 removal through the peritoneum was higher in group 3 than in group 2 despite serum A1 levels not statistically different in both groups. A1 removal through the peritoneum is mainly influenced by serum and dialysate A1 concentration. A1 body stores could play a role in the transfer of A1 through the peritoneum. Three cases of A1 poisoning due to the accidental use of a dialysate with a high A1 content are reported.

Adult↗
PubMed1984

Dialysis treatment of insulin dependent diabetic patients: ten years experience.

From January 1973 to March 1983, 108 IDD patients with a mean age of 46 years were accepted to the dialysis program of the Hôpital de la Pitié. Since January 1973, 67 patients have been treated by hemodialysis. Since August 1978, 38 patients have been treated by CAPD. Three patients have been treated by intermittent peritoneal dialysis. Although diabetic patients remain at a higher risk compared to patients of the same age group, very encouraging results are observed including a 75% survival rate at three years among hemodialyzed patients less than 50 years old. Since 1978, CAPD, when home dialysis was possible, was selected as a first choice treatment. Some severe peritoneal complications still jeopardize the advantages of this method. Diabetics with ESRD, even in the older age group, should not be excluded from treatment. They should be offered within an integrated program all dialysis methods and transplantation.

Acute Kidney Injury↗
PubMed1983

The influence of blood transfusions on lymphocyte reactivity in man.

The effect of planned blood transfusion (BT) on lymphocyte reactivity in previously non-transfused uraemic patients has been investigated. A sustained and non-specific decrease in MLR was observed in approximately 60 per cent of the cases. Other patients had only a transient decrease, normal or increased response. Lymphocyte suspensions whose proliferation was reduced after BT suppressed the response of autologous cells taken before BT. Neither pre-BT degree of immune responsiveness nor clinical status of the patients had any influence on this phenomenon.

Blood Grouping and Crossmatching↗
PubMed1983

Is continuous ambulatory peritoneal dialysis the best dialysis choice for insulin dependent diabetics?

In the last eight years 100 insulin dependent diabetics (IDD) have been dialysed at the Hôpital de la Pitié. Since August 1978 31 have been started on continuous ambulatory peritoneal dialysis (CAPD). Cumulative duration of treatment was 336 patient months, with an average time of 10.8 months. The actuarial technique success rate was 82 per cent at one year and 65 per cent at 18 months. Causes of drop out were seven deaths and six transfers to haemodialysis. The peritonitis rate was one episode every year. For some IDD patients and within the period of observation, CAPD offers a unique opportunity to be dialysed at home with excellent clinical and biological results.

Actuarial Analysis↗
PubMed1983

[Peritonitis during continuous ambulatory peritoneal dialysis. Lavage treatment or not? A prospective study].

A prospective study. To evaluate the advantages of continuous peritoneal lavage in treating peritonitis occurring during continuous ambulatory peritoneal dialysis a prospective study was planned in one Center during a 5 months period. 32 cases of peritonitis divided in two groups were treated according to 2 different protocols, one with continuous peritoneal lavage, the other one with the standard dialysis technique using the bags. Intraperitoneal administration of antibiotics was similar in both groups. Results show no significant advantages in using peritoneal lavage. Continuous lavage should be restricted to cases whose treatment is started late as well as those with purulent dialysate and fungi infections.

Adult↗