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M Meurisse

Publications and source records attributed to M Meurisse.

At least 55 records · Page 3Linked to original sources
PubMed2001

Seventy-two hours hypothermic intestinal preservation study using a new perfluorocarbon emulsion.

We investigated the effect of a perfluorocarbon emulsion (FC) added to the University of Wisconsin (UW) solution on hypothermic (4 degrees C, 12-72h) preservation of rat small bowel grafts. The FC was 90%w/v perfluorooctylbromide, 2%w/v egg yolk phospholipids and 1.4%w/v mixed fluorocarbon-hydrocarbon molecular dowels. Four groups were defined: [1] UW flush and UW storage; [2] UW flush and FC storage; [3] flush with FC diluted 2 times with UW (FU) and FU storage; [4] FU flush and storage in oxygenated FU. Preservation was estimated with a histological score based on villus epithelium adhesion, on villus sloughing and on crypt cell adhesion to the basal membrane. Antioxidant potential was estimated by measurement of total thiol functions (SH) and activities of glutathione-peroxidase (GSH-P), superoxide dismutase (SOD) and catalase. FC in flush improved preservation during the first 24h (p<0.01). Storage in FC appeared superior to UW for the first 24h (p<0.01). Oxygenation (100% O2) of the storage medium yielded superior results at 12h and 24h (p<0.01 and p<0.001 versus group [1] respectively). After 72h, SOD and catalase activities increased in groups [3] and [4], and SOD decreased in group [1] (p<0.05). SH progressively decreased in group [1] (p<0.05) and GSH-P increased at 24 and 48h in groups [3] and [4] (p<0.01). The increase of O2 in the perfusion flush or storage medium ameliorated the preservation status and protected the antioxidant potential of the small bowel.

Animals↗
PubMed2001

[Update on pancreatic transplantation].

Pancreas transplantation significantly improves the quality of life as well as the survival of the diabetic patient. It is also associated with stabilization and reversal of secondary diabetic complications. Improvements in organ preservation, surgical techniques and immunosuppression have achieved one-year graft survival of more than 90% for combined kidney-pancreas transplant and 80% for isolated pancreas transplantation. Recipient evaluation must weigh the benefits of the procedure with the risk associated with surgery and chronic immunosuppression. Combined kidney-pancreas transplantation appears today as the best treatment for the diabetic patient with end stage renal disease. Isolated pancreas transplantation is reserved to non-uremic patients with severe diabetic complications or with brittle glycaemic control and severe impairment of quality of life.

Humans↗
PubMed2001

[Alpha-1-antitrypsin deficiency. An indication for pediatric liver transplantation].

Alpha-1-antitrypsin deficiency is the most common inborn error of metabolism leading to liver transplantation, and the second cause of liver transplantation in children after biliary atresia. The authors report the case of a 6-year-old girl, who was suffering from end-stage liver disease secondary to alpha-1-antitrypsin deficiency. She was successfully treated by whole liver transplantation, the hepatic graft coming from a 3-year-old donor. Three months later she went back to school. The authors discuss the pathogenesis and the natural history of this frequent cause of liver transplantation in children.

Child↗
PubMed2001

[Lung transplantation and mitochondrial function].

The mechanisms of cellular lesions induced by lung ischemia and reperfusion are not fully understood and, in particular, the consequences of pulmonary ischemia and reperfusion injury on mitochondrial function have not been previously investigated. Therefore, we studied the respiratory function of isolated pulmonary mitochondria in a swine model of lung ischemia and reperfusion. We demonstrated that prolonged hypothermic (4 degrees C) ischemia induces significant lesions of the mitochondrial respiratory chain, particularly if ischemia is followed by normothermic reperfusion. These results should be integrated in the cellular alterations induced by the ischemia-reperfusion injury. In another swine model mimicking controlled non-heart beating donors, we demonstrated that thirty minutes of cardiac arrest do not promote significant alteration of the mitochondrial respiratory function. In contrast, forty-five minutes of cardiac arrest, induced significant mitochondrial lesions. This pulmonary tolerance to normothermic cardiac arrest might be explained by the presence of air in the lung airways, allowing some aerobic metabolism after circulatory arrest. These results suggested that lung grafts might be harvested from non-heart beating donors after thirty minutes of cardiac arrest, significantly increasing the pulmonary graft pool.

Animals↗
PubMed2000

Organ donors with primary central nervous system tumor.

Patients with primary central nervous system (CNS) tumor have been accepted for organ donation because these tumors very rarely spread outside the CNS. However several case reports of CNS tumor transferral with organ transplantation recently challenged this attitude. Some risk factors for extraneural spread of CNS tumors have been determined, but the absence of risk factors does not exclude the possibility of metastases. To our knowledge, 13 cases of CNS tumor transferral with organ transplantation (one heart, three livers, eight kidneys, one kidney/pancreas) have been reported in the literature. Even if no prospective evaluation of the CNS tumor transmission risk with transplantation has been undergone, this risk may be estimated between a little more than 0% and 3% from retrospective series. The authors consider that patients with CNS tumor should be accepted as donors as long as the risk of dying on the waiting lists is significantly higher than the tumor transferral risk. Therefore the authors would have no restriction for transplanting organs from donors with benign or low-grade CNS tumor. For high-grade tumors, the authors would consider these donors as "marginal donors," and balance the risk of tumor transmission with the medical condition of the recipient.

Brain Neoplasms↗
PubMed2000

Effects of cold and warm ischemia on the mitochondrial oxidative phosphorylation of swine lung.

BACKGROUND: The aim of the study was to investigate the consequence of warm and cold ischemia on lung mitochondria in order to define bioenergetic limits within lung could be suitable for pulmonary transplantation. METHODS: Twenty-two pigs underwent lung harvesting after lung flush with Euro-Collins solution. Mitochondria were isolated from fresh lungs, from lungs submitted to 24 or 48 hr of cold ischemia, to 30 or 45 min of warm ischemia, and to 30 min of warm ischemia followed by 24 or 48 hr of cold ischemia. Mitochondrial oxidative phosphorylation parameters were determined in isolated mitochondria by in vitro measurement of oxygen consumption. RESULTS: Relative to controls, mitochondria submitted to cold ischemia showed an alteration in the oxidoreductase activities of the respiratory chain but no membrane permeability alteration. After 48 hr of cold ischemia, there was a decrease in the yield of the oxidative phosphorylation. Thirty minutes of warm ischemia did not alter the mitochondrial respiratory parameters. However, lung submitted to 45 min of warm ischemia showed mitochondrial damage as a decrease in the oxidative phosphorylation efficiency and ADP availability but no change in the oxidoreductase activities. Relative to cold ischemia alone, 30 min of warm ischemia preceding cold ischemia promoted no significant change in the respiratory parameters. CONCLUSIONS: On bioenergetic basis, lung submitted to warm ischemia could be suitable for transplantation if the warm ischemia duration does not exceed 30 min. This could be a major concern in lung procurement from non-heart beating donors.

Animals↗
PubMed2000

Iatrogenic thyrotoxicosis: causal circumstances, pathophysiology, and principles of treatment-review of the literature.

Thyrotoxicosis is the clinical syndrome that results when tissues are exposed to high levels of circulating thyroid hormones. In most instances thyrotoxicosis is due to hyperthyroidism, a term reserved for disorders characterized by overproduction of thyroid hormones by the thyroid gland. Nevertheless, thyrotoxicosis may also result from a variety of conditions other than thyroid hyperfunction. The present report focuses on the etiologies, pathophysiology, and treatment of iatrogenic thyrotoxicosis. Iatrogenic thyrotoxicosis may be caused by (1) subacute thyroiditis (a result of lymphocytic infiltration, cellular injury, trauma, irradiation) with release of preformed hormones into circulation; (2) excessive ingestion of thyroid hormones ("thyrotoxicosis factitia"); (3) iodine-induced hyperthyroidism (radiologic contrast agents, topical antiseptics, other medications). Among these causes of iatrogenic thyrotoxicosis, that induced by the iodine overload and cytotoxicity associated with amiodarone represents a significant challenge. Successful management of amiodarone-induced thyrotoxicosis requires close cooperation between endocrinologists and endocrine surgeons. Surgical treatment may have a leading yet often underestimated role in view of the potential life-threatening severity of this disease, whereas others kinds of iatrogenic thyrotoxicosis are usually treated conservatively.

Amiodarone↗
PubMed2000

[Evaluation of the Ultracision ultrasonic dissector in thyroid surgery. Prospective randomized study].

STUDY OBJECTIVE: This prospective randomized study was designed to evaluate the efficacy, safety and cost of the ultrasonic hook in thyroid surgery, in comparison with conventional hemostasis. METHODS: Thirty-four consecutive euthyroid patients with multinodular goiter undergoing total thyroidectomy were randomly assigned to either group I, Ultracision or group II, conventional hemostasis. Preoperative, intraoperative and postoperative biochemical, clinical, surgical and economic variables were compared in each group. RESULTS: Use of the ultrasonic hook resulted in a significant reduction in operating time (70.7 +/- 18.3 versus 96.5 +/- 28.9 minutes), blood loss (74.5 +/- 50.9 g versus 134.6 +/- 108.42 g), and postoperative analgesic consumption (paracetamol (mg): 700 +/- 722 versus 1888 +/- 978), and may also reduce the incidence of transient hypoparathyroidism (5.8% versus 23.5%). The ultrasonic hook was no more expensive than conventional hemostasis, as long as a minimum of 15 patients shared the initial unit cost of the device. CONCLUSION: Although the use of the ultrasonic dissector does not allow a major cost-saving in total thyroidectomy, the essential advantages were a significant reduction of intraoperative blood loss, length of operating time and postoperative analgesic consumption.

Adult↗
PubMed2000

[[Hypnosedation, a new method of anesthesia for cervical endocrine surgery. Prospective randomized study].

UNLABELLED: Retrospective studies have confirmed the feasibility and safety of thyroid and parathyroid procedures performed under hypnoanesthesia (hypnosis, local anesthesia and minimal conscious sedation) as sole method of anesthesia. This very effective technique seems to provide physiological, psychological and economic benefits for the patient. STUDY AIM: To assess, by means of a prospective randomized study, the advantages of hypnosedation as an alternative to general anesthesia in terms of clinical and laboratory parameters. PATIENTS AND METHODS: Twenty patients operated under hypnoanesthesia were compared to 20 patients operated under conventional anesthesia. The two groups were compared in terms of inflammatory, neuroendocrine, hemodynamic and immunologic parameters and postoperative course (pain, fatigue, muscle strength and stress). RESULTS: No clinical or demographic differences were observed between the two groups. Operative times, bleeding, weight of specimens, and surgical comfort were similar. Significant differences in terms of inflammatory response and hemodynamic parameters were observed in favor of hypnoanesthesia. Neuroendocrine and immunological parameters were similar. Patients of the hypnoanesthesia group had significantly less postoperative pain. Postoperative fatigue syndrome and convalescence were significantly improved in these patients. CONCLUSION: This study confirms that, in our hands, hypnosedation presents real advantages over general anesthesia, in patients undergoing thyroid surgery.

Adult↗
PubMed1999

Mutation analysis of the MEN1 gene in Belgian patients with multiple endocrine neoplasia type 1 and related diseases.

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disorder characterized by tumors in parathyroids, enteropancreatic endocrine tissues, anterior pituitary, and other tissues. The gene for MEN1 has recently been cloned and shown to code for a 610-amino acid protein of enigmatic function which probably acts as a tumor suppressor. Several mutations causing the MEN1 phenotype have been recently identified. In order to determine the spectrum of MEN1 gene mutations in a sample of 25 Belgian patients, we have systematically screened the 10 exons and adjacent sequences of the MEN1 gene by means of an automatic sequencing protocol. Twelve different mutations were identified including nonsense, frameshift, splicing, and missense mutations. Two of these mutations (D172Y and 357del4) occurred more than once. A missense mutation was also found in a kindred with familial hyperparathyroidism. We observed no significant correlation between the nature or position of mutation and the clinical status. We have also detected 6 intragenic polymorphisms and DNA sequence variants and have analyzed their frequencies in our population.

Belgium↗
PubMed1999

Afferents to the rostral olfactory bulb in sheep with special emphasis on the cholinergic, noradrenergic and serotonergic connections.

The olfactory bulb (OB) is involved in the processing of olfactory information particularly through the activation of its afferents. To localize their cell origin in sheep, a specific retrograde fluorescent tracer, Fluoro-Gold, was injected into the olfactory bulb of seven ewes. By using immunocytochemical techniques, retrogradely labeled neurons were colocalized with choline acetyltransferase, tyrosine hydroxylase, dopamine-beta-hydroxylase and serotonin to characterize cholinergic, noradrenergic and serotonergic Fluoro-Gold-labeled neurons. Most afferents originated from the ipsilateral side of the injection site. The OB received major inputs from the anterior olfactory nucleus (AON), the piriform cortex (PC), the olfactory tubercle, the diagonal band of Broca (DBB) and the amygdala. Other retrogradely labeled neurons were observed in the taenia tecta, the septum, the nucleus of the lateral olfactory tract, the preoptic area, the lateral hypothalamic area, the mediobasal hypothalamus, the lateral part of the premammillary nucleus, the paraventricular nucleus of the hypothalamus, the paraventricular thalamic nucleus, the central grey, the substantia nigra (SN), the ventral tegmental area (VTA), the lateral nucleus to the interpeduncular nucleus (IIP), the raphe and the locus coeruleus (LC). Contralateral labeling was also found in the AON, the PC, the SN compacta, the VTA, the IIP and the LC. Cholinergic Fluoro-Gold-labeled neurons belonged to the horizontal and vertical branch of the DBB. Noradrenergic afferents came from the LC and serotoninergic afferents came from the medial raphe nuclei and the 1IP. These data are discussed in relation with olfactory learning in the context of maternal behavior in sheep.

Animals↗
PubMed1999

Asymptomatic adrenal tumours: criteria for endoscopic removal.

OBJECTIVE: Assessment of criteria for videoscopic removal of adrenal lesions discovered incidentally. DESIGN: Open prospective study. SUBJECTS: 63 patients operated on for 65 adrenal tumours. OUTCOME MEASURES: Relevance of proposed criteria: secreting adrenal lesion; diameter larger than 4 cm or increase in size at any re-evaluation; computed tomogram of intratumoral necrosis, haemorrhage, or irregular margins; high concentrations of dehydroepiandrosterone (DHEAS). RESULTS: Laparoscopic adrenalectomy was successful in 61 patients (97%). There were 4 minor complications. Criteria allowed us to identify correctly : phaeochromocytoma (n = 23), primary hyperaldosteronism (n = 18), Cushing's adenoma or disease (n = 7), single metastasis (n = 4), adenoma with DHEAS or cortisol hypersecretion (n = 3). 8 non-secreting incidental tumours (13%) were operated on. CONCLUSION: Simple criteria for videoscopic adrenalectomy for lesions discovered incidentally allowed us to reduce the number of doubtful indications (positive predictive value 87%).

Adolescent↗
PubMed1999

Hypnoanesthesia for endocrine cervical surgery: a statement of practice.

OBJECTIVES: To assess the feasibility of endocrine cervical surgery under hypnoanesthesia as a valuable, safe, efficient, and economic alternative to general anesthesia. METHODS: Between April 1994 and June 1997, 197 thyroidectomies and 21 cervical explorations for hyperparathyroidism were performed under hypnoanesthesia (HYP) using Erikson's method. Operative data and postoperative course of this initial series were compared to a contemporary population of patients (n = 119) clinically similar except that they declined HYP or were judged unsuitable for it, and who were therefore operated on under general anesthesia (GA). RESULTS: The surgeons all reported better operating conditions for cervicotomy using HYP. Conversion from hypnosis to GA was needed in two cases (1%). All patients having HYP reported a pleasant experience and, keeping in mind that the GA group is not a randomly assigned control group, both had significantly less postoperative pain and analgesic use. Hospital stay was also significantly shorter, providing a substantial reduction in the costs of medical care. The postoperative convalescence was significantly improved after HYP and a full return to social or professional activity was significantly quicker. CONCLUSION: From this study, we conclude that HYP is an effective technique for providing relief of intraoperative and postoperative pain in endocrine cervical surgery. The technique results in high patient satisfaction and better surgical convalescence. This technique can therefore be used in most well-chosen patients and reduces the socioeconomic impact of hospitalization.

Adult↗