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O Bouchot

Publications and source records attributed to O Bouchot.

At least 19 recordsLinked to original sources
PubMed2006

Release of secondary free radicals during post-ischaemic reperfusion is not influenced by extracellular calcium levels in isolated rat hearts.

In this study, we evaluated the impact of the calcium concentration present in the perfusion medium (1.2-3 mM) on contractile performance, lactate dehydrogenase (LDH) release and secondary free radical production during post-ischaemic reperfusion of isolated rat hearts. The impact of calcium concentration on post-ischaemic free radical release was investigated using the Electron Paramagnetic Resonance (EPR) technique and spin trapping with the lipophilic spin trap alpha-phenyl N-tert-butylnitrone (PBN). The evolution of left ventricular end diastolic pressure (LVEDP) in both groups followed the same pattern, but we observed that ischaemic and post-ischaemic contracture was more severe in the group of hearts perfused with 3 mM of calcium as compared with those perfused with 1.2 mM of calcium. A large release of alkyl/alkoxyl species occurred in all hearts from the onset of reperfusion and remained at a high level during the 30 min of reperfusion with no return to basal values. The kinetics and intensity of these releases were the same in both groups. In conclusion, in a range of extracellular calcium levels (1.2-3 mM), the release of alkyl/alkoxyls radicals does not seem to be calcium-dependent. Due to the protective actions of PBN itself, the results of simultaneous investigations of the effects of radical scavengers on isolated heart function may be limited. However, since many pharmacological properties (antioxidant, cellular protector, NO precursor ...) are attributed to PBN, studies investigating oxidative stress with such a multi-faceted tool make interpretation difficult.

Animals↗
PubMed2005

[Upper urinary tract: physiology, pathophysiology of obstructions and function assessment].

The urine is transported from the renal papilla to the bladder through the upper urinary tract which allows this transport to be safe and comfortable, i.e., without any risk or pain for the kidney. This active transport depends on the smooth muscle contractile properties. The upper urinary tract is totally autonomous; this feature allows the preservation of its function after renal transplantation. However, despite its accessory role, the autonomous nervous system can modulate its activity. Upper urinary tract obstruction involves adaptative mechanisms which are different depending on the type (acute, chronic, acquired or congenital) of obstruction. Functional evaluations of the upper urinary tract are aimed at identify the urine transport conditions and the relationship between obstruction and clinical conditions such as hydronephrosis, pain or impaired renal function.

Humans↗
PubMed2004

[Penis tumours: techniques and indications].

Although penis epidermoid carcinoma is a relatively rare tumour, early identification and treatment are necessary to avoid mutilating and sometimes morbid surgery. Awareness of disease epidemiology is mandatory for preventing the evolution of an underlying tumour (absent or insufficient hygiene, congenital or acquired phimosis, preepitheliomathous lesions such as Bowen's disease). Conservative surgical or radio-therapeutic techniques may be considered, provided the lesion is superficial and with a diameter < 30 mm. In all other cases, penis amputation is necessary. Penis epidermoid carcinoma spreads by vascular and lymphatic diffusion. Dynamic scintigraphy for the identification of a sentinel node and screening of subclinical metastasis is currently under evaluation. In case of palpable inguinal adenopathy, inguinal lymphadenectomy should be proposed if technically performable. Although superficial lymphadenectomy is associated with a low morbidity rate (about 3% of mild complications) deep inguinal Lymphadenectomy is far more morbid and disabling. Compliance with pre- and post-operative measures, and total patient compliance are necessary to minimize as far as possible such morbidity.

Amputation, Surgical↗
PubMed2002

Endovascular treatment as first choice in chronic intestinal ischemia.

The purpose of this study was to define the place of endovascular treatment in chronic intestinal ischemia (CII). We report here a series of 19 consecutive patients treated with percutaneous angioplasty of the intestinal arteries. We excluded patients with acute ischemia, from the study. From January 1, 1989 to December 31, 2001, 19 patients with symptomatic CII were treated by endovascular techniques. This study group included 11 men and 8 women with a mean age of 59 years (range 30 to 90 years). The clinical presentation included postprandial pain in 16 patients, weight loss in 14 patients, with a mean weight loss of 7.4 kg (range 0 to 30 kg); and gastroparesis in 2 patients. Stenoses were significant in the single superior mesenteric artery (SMA) in 2 patients and in two arteries in 17 patients, including the celiac artery (CA) and SMA (n = 13), CA and inferior mesenteric artery (IMA) (n = 1), and SMA and IMA (n = 3). Balloon angioplasty was performed in only one of the arteries in each patient, 15 times in the SMA and 4 times in the CA. In 7 patients, angioplasty required stenting because of recoil (n = 5) or dissection (n = 1). In one patient the lesion was stented primarily, because of adjacent thrombus on the stenosis. Our results showed that initial treatment of CII can be endovascular. Focus on one artery only, seems to be reasonable and efficient in the short and long term.

Adult↗
PubMed2002

[Discitis after spinal anesthesia for transurethral resection of the prostate].

We described a case of discitis and meningitis following spinal anaesthesia for transurethral resection of the prostate. The patient received antibiotics for a month before surgery, because of Klebsiella prostatitis. Spinal anaesthesia was performed in L3-L4 interspace by using 22G Quincke needle. Bacteriaemia occurred during the first postoperative hours. Ten days after spinal anaesthesia, patient suffered from lumbar pain, exacerbated by vertebral percussion, and motor weakness within lower limb, which was marked on right side. MRI examination showed L3-L4 discitis with psoas abcess in regard, and epiduritis marked around L3 right spinal root. CSF examination confirmed meningitis but no bacteria was found. Antibiotics were administered over a 6 weeks period, and then patient discharged from hospital without neurological sequellae. Infectious discitis related to disk puncture during spinal anaesthesia and postoperative bacteriaemia was likely in our patient.

Aged↗
PubMed2001

Risk analysis and long-term survival in patients undergoing resection of T4 lung cancer.

OBJECTIVE: The aim of this study is to identify the risk group of patients with T4 lung cancer who could more likely benefit from surgical resection. METHODS: Between January 1, 1990, and December 31, 1998, 77 patients underwent pulmonary resection for T4 lung cancer: lobectomy (n = 20), bilobectomy (n = 4) and pneumonectomy (n = 53). The T4 sites of mediastinal involvement were: Intrapericardiac portions of the pulmonary artery (n = 30), left atrium (n = 19), aorta (n = 8), superior vena cava (n = 8), carina (n = 7), the esophagus (n = 8) and the vertebral body (n = 6). Ten patients had multiple neoplastic nodules in the same lobe of the lung. RESULTS: Overall survival rates at 1, 2 and 3 years were 46, 31 and 21%, respectively. Factors adversely affecting survival with univariate analysis included the localization of tumours in the lower lobe (P = 0.04) and both the involvement of superior and inferior mediastinal lymph nodes (P = 0.03). Multivariate analysis included two factors adversely affecting survival: the location of the primary tumour and the nodal stations involved. Regression tree analysis classified the patients into low-risk group (primary tumour in upper lobe or in main stem bronchus and pN0 or pN1 or superior or inferior mediastinal nodes involved), intermediate-risk group (primary tumour in upper lobe or in main stem bronchus and both superior and inferior mediastinal nodes involved, primary tumour in inferior lobe and pN0 or pN1 or inferior mediastinal nodes involved) and high-risk group (primary tumour in inferior lobe and both superior and inferior nodes involved). The 3-year survival rates were 36% for the low-risk group, 4% for the intermediate-risk group and 0% for the high-risk group (P = 0.006). CONCLUSIONS: In patients with T4 lung cancer, the surgery can justify itself for tumours in the upper lobe or in the main stem bronchus and with pN0 or pN1.

Adult↗
PubMed2001

Management of major blunt renal lacerations: is a nonoperative approach indicated?

OBJECTIVES: The aim of the study was to determine whether a nonoperative approach is able to reduce renal parenchymal loss after renal trauma. METHODS: Sixty-four consecutive patients with major blunt renal lacerations were treated from 1988 to 1999. Initial management was conservative. In group 1 (35 patients) delayed hemorrhage, persistent urinoma or hemodynamic instability were dealt with by open surgery. In group 2 (29 patients), most complications were dealt with using endoscopic procedures; open surgery was reserved exclusively for major complications. RESULTS: In group 1, 7 patients were not operated and 28 patients were managed surgically. Twenty (57%) patients underwent total (8) or partial (12) nephrectomy. In 8 patients the surgical intervention was open drainage of perinephric collection (6) and/or renorrhaphies (2). Four patients in this group developed urinary fistulae treated successfully with ureteral stents. Length of hospital stay was 9.6 days (3-25 days). In group 2, persistent hemodynamic instability led to nephrectomy in 1 case. The remaining 28 patients were managed conservatively, with endoscopic ureteric stenting in 5 cases. A persistent urinary extravasation with hyperthermia led to open drainage of perinephric urinoma (5) and renorrhaphy (2). No delayed nephrectomy was necessary. Average hospital stay was 12 days (5-21 days). Only 1 patient in this group developed hypertension. CONCLUSION: For most patients and with close follow-up available, conservative treatment represents a real alternative to open surgery in major blunt renal lacerations. In our experience, open surgery usually results in loss of renal parenchyma.

Adolescent↗
PubMed2001

Fracture embolization of a Tekna mitral prosthesis: case report.

The modified Duromedics-Tekna bileaflet pyrolitic carbon mechanical prosthesis was reintroduced by Baxter in 1990. This report details the first case of sudden leaflet fracture of a Tekna mitral valve five years after implantation, which was managed successfully by replacement with a St. Jude Medical mechanical prosthesis. The fracture had occurred transversely, with the fragments embolizing to the terminal aortic bifurcation and the left common femoral artery. These were localized by computed tomography and removed two days after valve replacement.

Aorta↗
PubMed2001

[Lumbar pain and hydrocalyx].

The authors report the case of a patient presenting with disabling left lumbar pain. Complementary investigations confirmed the diagnosis of isolated hydrocalyx with no organic cause. Surgical treatment was conservative with caliceal plasty. The authors discuss the diagnostic and therapeutic management by analogy between this type of hydrocalyx and Fraley's syndrome.

Child↗
PubMed2001

[Substitutive non-modeled uretero-ileoplasty].

OBJECTIVES: To evaluate the indications and results of replacement uretero-ileoplasties performed over the last six years. MATERIAL AND METHODS: Over a period of 6 years, 8 patients underwent subtotal or total replacement uretero-ileoplasty involving a total of 9 renal units. Preoperative temporary urinary diversion was performed in each patient. The mean preoperative serum creatinine was 88 mumol/l (range: 53 to 150). Uretero-ileoplasty was performed for ureteric stricture in 7 cases (bilateral in one case and in a solitary kidney in one case), ureteric necrosis following renal transplantation without a donor ureter in one case and urothelial tumour on a solitary kidney in one case. RESULTS: The mean follow-up was 54 months. The mean operating time was 218 minutes for uretero-unilateral ileoplasties, with a mean length of hospital stay of 12 days (range: 10 to 18 days). The following complications were observed: acute urinary retention, stenosis of the ileo-vesical implantation treated by endoscopic dilatation, 2 incisional hernias after midline laparotomy, one case of stones of the ileo-vesical anastomosis, non-febrile urinary tract infections treated on an outpatient basis. The functional result was considered to be satisfactory in every case. No electrolyte disorders were observed. Mean postoperative serum creatinine was 86 mumol/l (range: 59 to 140). CONCLUSION: In this recent series with a mean follow-up of 4.5 years, replacement uretero-ileoplasty successfully treated partial or total complex ureteric lesions with a low morbidity.

Adolescent↗
PubMed2000

Preoperative intraarterial thrombolysis before surgical revascularization for popliteal artery aneurysm with acute ischemia.

Because a popliteal artery aneurysm (PAA) generates emboli that progressively deteriorate the distal arterial network, they can constitute limb-threatening lesions. In 20 to 40% of cases, discovery of PAA coincides with sudden occlusion and resulting acute ischemia. In 40 to 60% of these patients, surgical revascularization fails and amputation is required. The objective of this prospective study was to assess the value of intraarterial thrombolysis to restore distal runoff before surgical revascularization. Between January 1, 1992 and December 31, 1996, we treated 15 PAA causing acute ischemia in 15 male patients with a mean age of 66.7 years (range, 44 to 87 years). Diagnosis was documented by clinical examination and ultrasound imaging. Intraarterial thrombolysis was performed under arteriographic control through a multiperforated catheter inserted by the anterograde femoral route to the thrombus. After an initial bolus of 100,000 U of urokinase, 600,000 to 1,600,000 U was continuously infused over a period of 6 to 18 hr. Heparin sodium was administered throughout thrombolysis. Surgical revascularization was performed within 1 to 4 days (mean, 2 days) after thrombolysis by exclusion and bypass in 14 cases and percutaneous transluminal angioplasty with stenting in 1 case. The ensuing results showed that, if performed carefully, intraarterial thrombolysis can safely prepare patients presenting with occluded PAA with acute ischemia for surgical revascularization to restore distal runoff. We use this combined technique routinely in our department. Morbidity is low in comparison with the risks of amputation.

Acute Disease↗
PubMed2000

Intrathecal anesthesia: ropivacaine versus bupivacaine.

We compared intrathecal ropivacaine to bupivacaine in patients scheduled for transurethral resection of bladder or prostate. Doses of ropivacaine and bupivacaine were chosen according to a 3:2 ratio found to be equipotent in orthopedic surgery. One hundred patients were randomly assigned to blindly receive either 10 mg of isobaric bupivacaine (0.2%, n = 50) or 15 mg of isobaric ropivacaine (0.3%, n = 50) over 30 s through a 27-gauge Quincke needle at the L2-3 level in the sitting position. Onset and offset times for sensory and motor blockades and mean arterial blood pressure were recorded. Pain at surgical site requiring supplemental analgesics was recorded. Cephalad spread of sensory blocks was higher with bupivacaine (median level, cold T(4) and pinprick T(7)) than with ropivacaine (cold T(6) and pinprick T(9)) (P<0.001). Eight patients in Group Ropivacaine received IV alfentanil (P<0.01). Onset time (mean +/- SD) to T(10) anesthesia and offset time at L2 were not different (bupivacaine = 13 +/-8 min, 127+/-41 min; ropivacaine = 11+/-7 min, 105+/-29 min). Complete motor blockade occurred in 43 patients with bupivacaine and in 41 patients with ropivacaine (not significant). Total duration of motor blockade was not different. No difference in hemodynamic effects was detected between groups. No patient reported back pain. We conclude that 15 mg of intrathecal ropivacaine provided similar motor and hemodynamic effects but less potent anesthesia than 10 mg of bupivacaine for endoscopic urological surgery.

Aged↗
PubMed2000

Intermittent androgen suppression in the treatment of metastatic prostate cancer.

BACKGROUND: To assess the feasibility of intermittent androgen suppression in patients with metastatic prostate cancer and to quantify the improvement in the quality of life. METHODS: Forty-three patients with M1 b prostate cancer were treated by intermittent hormonal deprivation using luteinizing hormone-releasing hormone (LHRH) analogue alone (n = 11), or associated with an antiandrogen (n = 32). The prospective nonrandomized study required an initial therapy period of 12 months with a stable biological response during 6 months (PSA, testosterone). Treatment was resumed when the serum PSA value recovered to 20 ng/ml, or when local failure or new bone metastasis occurred. The assessment of quality of life was carried out using the EORTC QLQ-C30. RESULTS: The mean follow-up time was 43.7 months. After the initial 12 months of androgen suppression, one patient with a minimal disease was off-therapy with a follow-up of 18 months. For the 42 other patients, the mean off-therapy period was 6.7 months. In the second therapy period (9-12 months), 7 patients were hormono-independent and died with a mean survival time of 27 months; 35 patients were responders. The mean off-therapy length in the second cycle was short (3.8 months). After this time, androgen suppression therapy was reintroduced permanently, but 10 patients were hormono-independent. No difference was observed in the EORTC QLQ-C30 between therapy and off-therapy periods, only a rapid decrease in adverse events due to the hormonal deprivation was reported in all cases during the off-therapy period. CONCLUSIONS: Intermittent androgen suppression in patients with M1 b prostate cancer could be associated with a significant period off-therapy in the first cycle (55.8%), and with a chance of second hormone response. But in the second cycle, the off-therapy period length was short and required a careful follow-up.

Aged↗
PubMed1999

Intrathecal bupivacaine in humans: influence of volume and baricity of solutions.

BACKGROUND: The effects of volume and baricity of spinal bupivacaine on block onset, height, duration, and hemodynamics were studied. METHODS: Ninety patients undergoing endoscopic urologic procedures were randomized to receive 10 mg of intrathecal bupivacaine at L2-L3 level in sitting position. In the operating room, commercial products were diluted as needed with NaCl 0.9% to obtain isobaric solutions (density, 1.005-1.008) or with NaC 10.9% and glucose 30% to obtain hyperbaric solutions (density, 1.031-1.037) of 2, 5, or 10 ml (six groups of 15 patients each). Three minutes after spinal injection the patients were placed in lithotomy position. Sensory blockade was assessed using pinprick and cold sensation tests, and motor blockade was assessed using a four-point scale. RESULTS: Onset times to maximal cephalad spread of spinal blockade were similar with isobaric and hyperbaric solutions. A greater maximal cephalad spread of anesthesia was obtained with diluted isobaric bupivacaine but was not associated with more hypotension. Volume had no effect on cephalad extent of anesthesia with hyperbaric bupivacaine. Times for regression of anesthesia to L2 and offset of motor block were longer with isobaric than with hyperbaric solutions of bupivacaine. The intensity of motor blockade was decreased with diluted hyperbaric bupivacaine. No patient reported back pain. CONCLUSION: In this study, volume had no significant influence on either cephalad spread or duration of sensory blockade for either isobaric or hyperbaric bupivacaine. Time for offset of anesthesia was shorter with hyperbaric bupivacaine compared with isobaric solutions.

Aged↗
PubMed1999

[Skin graft urethroplasty].

OBJECTIVES: To evaluate the results of skin graft urethroplasty (SGU) in the management of urethral stricture. MATERIAL AND METHODS: Twenty eight patients, with a mean age of 54 years, treated by SGU were reviewed with a mean follow-up of 24.5 months (range: 1-66). The first-line material skin graft material was the foreskin or, in its absence, the penile skin or skin of the arm was used. RESULTS: This study demonstrated a satisfactory result (no clinical signs, maximum flow rate > or = 15 ml/s, no need for salvage surgery) in 67.9% of cases. Although the early complication rate was low, 8 stenoses were observed during subsequent follow-up; 3 of which required open surgical revision. The other relapses were treated by internal urethrotomy or hetero- or autodilatations. This study showed that urine sterility at the time of surgery was a decisive factor. CONCLUSION: The preferential indication for this type of urethroplasty remains a bulbar urethral stricture with sterile urine. However, the aetiology and length of the stricture are not discriminant factors.

Adolescent↗
PubMed1999

[Surgery of varicocele: results concerning sperm motility and morphology].

STUDY OBJECTIVE: This study evaluated the changes induced by surgical treatment of varicocele on the classical parameter of the sperm count as well as the parameters of Kruger's classification. MATERIAL AND METHODS: Comparative analysis of sperm concentration, mobility and head morphology was performed on the sperm counts obtained before and 6 months after surgery in 159 infertile patients with clinical left varicocele, suspected of being the only aetiological factor for infertility. RESULTS: Sperm mobility and the percentage of spermatozoa with normal head morphology were significantly increased after treatment. The percentage of spermatozoa with normal morphology was only slightly improved, due to the absence of improvement of flagellar and intermediate segment abnormalities. Fifty-nine term pregnancies were obtained after treatment, corresponding to 41.1% of treated patients. CONCLUSION: Treatment of varicocele in infertile patients can improve sperm count and morphology parameters, particularly abnormalities of the head according to Kruger's strict criteria. The number of pregnancies observed argues in favour of the treatment of varicocele, when it constitutes the only aetiological factor for infertility.

Adult↗
PubMed1998

Comparative analysis of MiB1 and p53 expression in human bladder tumors and their correlation with cancer progression.

Expression of p53 and MiB1, markers of tumor proliferation, was evaluated in human bladder tumors, and correlated with ploidy and cancer progression in 83 consecutive patients. Transurethral resection of a newly diagnosed bladder tumor was performed in 73 cases, and systematic bladder biopsies were performed in 10 cases after bacillus Calmette-Guerin (BCG) treatment. p53 and MiB1 expression were performed by an immunohistochemical technique and the ploidy was determined on a frozen fragment of the tumor. p53 expression was correlated in relation to grade, stage and combination of grade and stage. MiB1 expression was correlated with cytological grade, and a significant difference was demonstrated between pT0 and pTa, pTa, and pT1, pTa and pT2 tumors but not between pT1 and > or = pT2 tumors. A discordance was observed for the comparison of p53 and MiB1 values, stage by stage, suggesting that these two techniques are independent of each other. A larger proportion of aneuploid tumors were positive for p53 and MiB1 (64.8 vs. 86.5%, respectively), but p53 and MiB1 immunostaining were not better indicators than ploidy alone to predict cancer progression.

Antibodies, Monoclonal↗