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Biomedical subjects

M Robert

Publications and source records attributed to M Robert.

370 records · Page 21Linked to original sources
PubMedDate not supplied

[Gastroesophageal reflux after the surgical treatment of esophageal atresia].

The experience of the authors concerns 100 neonates treated for esophageal atresia between 1968 and 1980. A retrospective study of the sequelae observed in 73 survivors (age 3 to 15 years) found 26 cases of gastroesophageal reflux. This study demonstrates a high incidence of reflux in children who initially presented with a fistula and long gap esophageal atresia. It also shows that chronic respiratory disorders are more frequent in these patients and that esophagitis is the principal factor leading to stricture of the anastomosis stubborn to dilatation. In 14 patients, the severity of the clinical and endoscopic symptoms justified a surgical antireflux procedure, the only guarantee of clinical and radiologic recovery, with long term confirmation in 9 patients.

Adolescent↗
PubMedDate not supplied

[Xanthic lithiasis in the child. A study of one case. Review of the literature (author's transl)].

Seeking medical help because of an acute urinary retention, a 3-year-old child showed at intravenous urography (IVU) multiple radiotransparent lithiases. Hypouricemia suggested a diagnosis of xanthuria. The problems of this condition due to a congenital deficiency in xanthine oxydase are studied in a review of the literature. 56 xanthic lithiases have been published and since the work of Dent and Philpot, 28 xanthinurias have been reported.

Child, Preschool↗
PubMedDate not supplied

[Comparative study of continuous epidural analgesia versus intermittent, patient-controlled, epidural analgesia during labor].

OBJECTIVE: To assess the analgesic efficacy and the incidence of side effects of three procedures of epidural analgesia during labor. PATIENTS AND METHODS: One hundred and one nulliparous pregnant women at term with cephalic presentation were randomly allocated to 3 groups (A: 31, B: 35, C: 35). Group A was given an initial dose of 8 ml bupivacaine 0.25% (20 mg) with epinephrine 1/200,000 and 50 micrograms fentanyl followed by a continuous infusion of 8 ml/h bupivacaine 0.125% (10 mg/h) with epinephrine 1/400,000. The initial dose in group B was 10 ml bupivacaine 0.125% (12.5 mg) with epinephrine 1/400,000 and 50 micrograms fentanyl followed by a continuous infusion of 12 ml/h bupivacaine 0.0625% (7.5 mg/h) with epinephrine 1/800,000 and 12 micrograms/h fentanyl. In group C the initial dose was the same as for group A, but maintenance was provided through a patient-controlled (PCA) system with 5 ml bupivacaine 0.25% (12.5 mg) and epinephrine 1/200,000 set for a minimum interval of 1 h. If analgesia was inadequate all patients could receive top-ups of 5 ml bupivacaine 0.25% (12.5 mg) with epinephrine 1/200,000. RESULTS: Quality of analgesia was similar in all three groups. We found no significant differences in level of sensory/motor blockade, hemodynamic changes, side effects or type of delivery. The total dose of bupivacaine was highest in group A, whereas group B received the higher total dose of fentanyl. The number of Apgar scores under 8 was highest in group A, although the scores rose within 5 min of delivery in all cases. CONCLUSIONS: We believe that the protocol of choice is the one used with group B (initial dose of 10 ml bupivacaine 0.125% + epinephrine 1/400,000 + 50 micrograms fentanyl followed by 12 ml/h bupivacaine 0.0625% + epinephrine 1/800,000 + 12 mu cg/h fentanyl in continuous infusion). The use of PCA systems with our unscreened patients yielded no advantages over the procedure used with group B.

Adult↗
PubMedDate not supplied

Fate of antibodies bound to lymphocyte surface. I.--Study with complement-dependent cytotoxicity, indirect immunofluorescence and radiolabelled antibodies.

Anti-HL-A alloantiserum, heterologous antilymphocyte globulins and anti-beta2m antisera were allowed to react to human lymphocytes in vitro. The fate of the antigen-antibody complexes formed at the cell surface has been studied by means of the lymphocytoxicity test in the presence of rabbit complement, radiolabelled antibodies and the indirect immunofluorescence technique. Those techniques demonstrated that initially bound antibodies disappear from the cell surface. This disappearance requires optimal conditions; it does not result from a mere dissociation of antibodies but likely represents partial degradation, internalization and release of antigen-antibody complexes into the extracellular medium. This phenomenon can be regarded as a reflection of the dynamic state of the cell membrane, although it differs from the redistribution of antigen-antibody complexes on the lymphocyte surface (patching and capping). Possible implications of such events are discussed in relation to triggering or blocking of lymphocyte proliferation.

Antibodies↗
PubMedDate not supplied

[Long-term results of Burch's cervico-cystopexy. Apropos of 40 cases].

Forty patients with stress urinary incontinence, treated between April 1982 and June 1988 according to Burch's technique, were reviewed. 24 (60%) successes, 8 (20%) major improvements and 8 (20%) failures were recorded with a mean follow-up of 85 months. Compared to the early postoperative findings, a marked deterioration in urinary continence was observed in 4 cases (10%). These results are in contrast with earlier papers reporting remarkable stability of the therapeutic performance of this type of cervicocystopexy. Although too brief to allow reliable statistical analysis, this series simply draws attention to the hypothetical long-term efficacy of Burch's operation.

Adult↗
PubMedDate not supplied

[Urologic manifestation of Waldenström's disease. Apropos of a case with pyelo-ureteral location].

The authors report a case of Waldenström's disease in which the initial staging assessment reveals an isolated tumour of the left upper urinary tract. Combination chemotherapy (6 courses of protocol M2) induced a marked reduction in the monoclonal IgM peak and in the tumour mass. In the light of this atypical case, which emphasises the diversity of the potential sites of Waldenström's macroglobulinaemia, the authors review its potential for progression and the various therapeutic modalities available.

Humans↗
PubMedDate not supplied

[Piezoelectric extracorporeal lithotripsy of calculi of the median ureter (EDAP LT 02)].

OBJECTIVE: To evaluate the performance of in situ piezolectric extracorporeal shock-wave lithotripsy (ESWL) in the middle part of the ureter. MATERIAL AND METHODS: 36 consecutive patients presenting with stones of the middle part of the ureter were treated by in situ piezoelectric ESWL (EDAP LT 02). The maximal dimensions of the stones ranged from 5 to 14 mm (m = 7.8). Moderate or severe ureterohydronephrosis was present in 19 cases (53%) and a double J stent had been previously implanted in 6 cases (17%). The ESWL sessions were performed in the ventral supine position without any anaesthesia or systematic premedication, but an IM injection of 100 mg of pethidine was administered during poorly tolerated treatments. RESULTS: The stone was located easily in 23 cases (64%) and with greater difficulty in 13 cases (36%), as an intraoperative intravenous injection of contrast agent was performed in 6 cases (17%). The number of sessions per patient ranged from 1 to 2 (m = 1.16). The complete sucess rate was 75%, with a 64% success rate after a single ESWL session. The performances were statistically independent of stone dimensions and the degree of obstruction of the urinary tract. The complication rate was 5.5%, but no ancillary endoscopic or percutaneous treatment was required. CONCLUSION: In situ piezoelectric ESWL allows effective management of most stones of the middle part of the ureter. However, the treatment of stones with a maximal diameter < 5 mm, especially poorly radiopaque stones, can raise problems of localization. Very large or impacted stones, especially when complicated by urinary tract infection, should be preferably treated by first-line ureteroscopy.

Adult↗
PubMedDate not supplied

[Urethral recurrence after cysto-prostatectomy for bladder tumor].

OBJECTIVE: To evaluate the frequency, predictive parameters and prognosis of urethral recurrence after cystoprostatectomy for urothelial bladder cancer. MATERIAL AND METHODS: From 1989 to 1994, 8 of a series of 185 patients (4.3%) treated by cystoprostatectomy for bladder carcinoma between 1988 and 1993 developed urethral recurrence revealed by urethral bleeding, with a follow-up of 6 to 36 months (m = 16). RESULTS: The initial bladder tumour was localized in 3 cases and multifocal in 5 cases. The posterior urethra was not involved in 5 cases, but presented lesions of CIS in 1 case and neoplastic infiltration also involving the prostate in 2 cases. These recurrences were treated by urethrectomy, as first-line treatment in 7 cases and after failure of endoscopic treatment in 1 case. A balanic recurrence required distal penectomy following insufficient urethral resection. The course was very rapidly unfavourable for 3 patients with generalized cancer and an intercurrent disease was fatal in 1 other case. With a follow-up of 12 to 44 months (m = 26), 4 patients are alive with no obvious signs of disease progression. CONCLUSION: The indications for prophylactic urethrectomy can be reserved to patients with positive urethral resection margins, provided all other cases are submitted to strict surveillance. In the context of a replacement bladder, it is essential to exclude neoplastic involvement of the posterior urethra or prostate, especially in patients previously treated by intravesical instillations.

Carcinoma↗
PubMedDate not supplied

Fate of antibodies bound to lymphocyte surface. II.--Degradation and release of immune complexes.

The fate of horse anti-human lymphocyte globulins, rabbit anti-human beta2 microglobulin antibodies and anti-HL-A alloantibodies radiolabelled with 125I and complexed to their corresponding lymphocyte surface antigens, was investigated. During prolonged incubation at 37 degrees C, part of these antibodies were actively released into the surrounding medium after enzymatic degradation occuring either intracellularly or at the cell surface. Metabolism of the antibodies was temperature-dependent and involved only antibodies able to react with antigens on the cell surface. Sephadex G200 filtration of the small percentage of non dialysable radioactive products in the supernatant revealed that all the 125I-anti-human lymphocyte globulin was recovered as a macromolecular structure in the void volume. Similar experiments were performed with 51Cr labelled lymphocytes coated with anti-lymphocyte globulins: treatment with anti-horse immunoglobulin precipitated part of 51Cr activity in the void volume which was therefore associated with anti-human lymphocyte globulin as an immune complex. The same protocol applied to the other two antibodies studied showed that anti-beta2 microglobulin antibodies were recovered both as macromolecular and 7 S immune complexes, whereas anti-HL-A antibodies were recovered as macromolecular, 7 S and still smaller immune complexes.

Antibodies↗