Re: Insertion of double pigtail ureteral stent for the prevention of urological complications in renal transplantation: a prospective randomized study.
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Humans↗
Biomedical subjects
P Thibault
Publications and source records attributed to P Thibault.
[Feasibility of "Valsalva Leak Point Pressure". Prospective study].
OBJECTIVE: To prospectively evaluate the feasibility of determination of the Valsalva Leak Point Pressure (VLPP). PATIENTS AND METHODS: From 1st January to 31st July 1996, 155 consecutive patients investigated for urinary incontinence with no pelvis static disorder performed Valsalva manoeuvres during cystomanometry in order to determine the VLPP. The examination was performed in the standing position at a filling volume of 200 cc with then without a vesical pressure transducer. The mean age of the patients was 54 +/- 16 years (range: 16-84 years). RESULTS: The mean maximal intensity of abdominal straining pressure measured by the intravesical transducer was 72 +/- 28 cm of water. The VLPP could not be determined in 50.4% of cases, as the abdominal straining pressure during the Valsalva manoeuvre was less than 60 cm of water. No correlation was observed between abdominal straining pressure and patient age (r = 0.13; p > 0.1). CONCLUSION: Leak Point Pressure cannot always be determined by the Valsalva method. Other techniques of progressive increase of intravesical pressure must be investigated.
Adolescent↗
[Cowper's gland: anatomic, physiological and pathological aspects].
Cowper's glands are small appendages of the male genital tract, that are sometimes observed on intravenous urography voiding films. They are involved in the immune defence of the genitourinary tract, play a role in fertility, and secrete many glycoproteins, including PSA. They can be visualized in the form of a duct image parallel to the urethra, sometimes associated with opacification of the gland on IVU. This image can be differentiated from a fistula, extravasation of contrast agent, urethral duplication, or an artefactual image, by the course parallel to the urethra, the upper limit not exceeding the urogenital diaphragm, and the position of the orifice. These glands can be affected by neoplastic, infectious, stone and especially cystic disease: syringocele. The physician should think of these glands in patients with unusual genitourinary symptoms in order not to miss disease of these organs, and to prescribe appropriate treatment.
Bulbourethral Glands↗
Development of electrophoretic conditions for the characterization of protein glycoforms by capillary electrophoresis-electrospray mass spectrometry.
A capillary electrophoresis (CE) method using acidic buffers and capillaries coated with Polybrene, a cationic polymer has been developed for the separation of glycoproteins and glycopeptides. Electrophoretic conditions have been optimized to provide resolution of individual glycoforms observed for different glycoprotein preparations. These conditions were found to be entirely compatible with the operation of electrospray mass spectrometry (ESMS), which facilitated the assignments of possible carbohydrate compositions of glycopeptides arising from digests of glycoproteins. By using operating conditions enhanced the formation of oxonium fragment ions prior to mass spectral analysis, selective identification of glycopeptides was achieved for complex samples such as those from proteolytic digests or chemical cleavages. Examples of applications are presented for ribonuclease B, ovalbumin, horseradish peroxidase, and a lectin from Erithrina corallodendron using both CE-ESMS and CE with ultraviolet detection (CE-UV).
Carbohydrate Conformation↗
Separation and characterization of O-deacylated lipooligosaccharides and glycans derived from Moraxella catarrhalis using capillary electrophoresis-electrospray mass spectrometry and tandem mass spectrometry.
Electrophoretic methods have been developed for the analysis of complex carbohydrates derived from lipooligosaccharides (LOS) of Moraxella catarrhalis using capillary electrophoresis coupled to electrospray mass spectrometry (CE-ESMS). Separation of lipooligosaccharides (LOS) arising from mild hydrazinolysis of the intact lipopolysaccharides (LPS) was achieved using aqueous ammonium formate, and enabled identification of sites of heterogeneity (phosphates, phosphoethanolamine, and pendant acyl groups) on either the lipid A or the core oligosaccharide. More complex mixtures of carbohydrates obtained from the complete deacylation and dephosphorylation of LOS were amendable to electrophoretic conditions using both anionic and cationic separation. In particular, electrophoretic conditions were developed which permitted resolution of closely related oligosaccharides according to the number of carbohydrate residues appended to the core structure. Structural characterization of carbohydrates and LOS released from the hydrazinolysis and acid hydrolysis treatment of the intact LPS was achieved using tandem mass spectrometry (MS-MS) for samples introduced by direct flow injection. Taken together, the combination of CE-ESI-MS and MS-MS analyses provided valuable information on the heterogeneity of the LOS population in which a significant level of variability was found mostly in the lipid A portion.
Acylation↗
Simultaneous occurrence of diarrhetic and paralytic shellfish poisoning toxins in Spanish mussels in 1993.
Mussel aquaculture is an important industry for the Galician Rias, located in northwestern Atlantic coast of Spain. Since 1976 this region has been seriously affected by incidents of paralytic and diarrhetic shellfish poisoning (PSP and DSP). A particularly bad episode occurred in 1993, when the toxic event lasted for an unusually long period. Many people were stricken ill with unusual symptoms. In this paper we report on the chemical analysis of toxic 1993 mussel samples, using the techniques of liquid chromatography and capillary electrophoresis coupled with mass spectrometry. These analyses revealed a very complex toxin profile, with both PSP and DSP toxins present. Two DSP toxins, okadaic acid and DTX2, were observed, while the primary PSP toxins were B1 and the decarbamoylated derivatives of saxitoxin, GTX2 and GTX3. Small amounts of saxitoxin and other as yet unidentified PSP toxins were observed.
Animals↗
Probing the microheterogeneity of O-specific chains from Yersinia ruckeri using capillary zone electrophoresis/electrospray mass spectrometry.
The analysis of underivatized oligosaccharides arising from mild acid hydrolysis of endotoxins from Yersinia ruckeri serotype O2 was achieved using on-line capillary zone electrophoresis-electrospray mass spectrometry (CZE-ESMS). This technique provided unparalleled resolution of the different glycans obtained from purified fractions of the native endotoxins or from hydrolysis of lipopolysaccharides from Y. ruckeri. Electrophoretic conditions enabling the separation of anionic and cationic analytes were developed to determine possible sites of heterogeneity on either the core or the O-chain glycans. Structural characterization of underivatized oligosaccharides identified in the ion electropherograms was achieved using tandem mass spectrometry under low-collision energy conditions.
Acrylic Resins↗
Post-translational proteolytic processing and the isolectins of lentil and other Viciae seed lectins.
Electrospray mass spectrometry was used to identify precisely the proteolytic cleavage points within, and at the C-termini of, the proprotein forms of four Viciae lectins that give rise to their two-chain forms. The lectins examined were the pea and lentil lectins, favin and the Lathyrus odoratus lectin, which represent each of the four genera in this tribe. The molecular mass data showed single beta-chain forms for each lectin, with masses consistent with the available sequence and glycopeptide data, indicating that each came from a single proprotein. In contrast, the pea, lentil and L. odoratus alpha-chains occurred in as many as five forms, due to multiple C-terminal cleavage points. Only favin showed a single alpha-chain form. The alpha-chain mass data were again consistent with the sequence information available, except for the lentil lectin alpha-chain which was re-determined by protein sequencing. The two isolectin forms of this protein were shown to arise from alpha-chain species with and without residue Lys53. The mass spectrum of concanavalin A was also examined and both the single-chain form and the two fragment forms showed no evidence of C-terminal heterogeneity.
Amino Acid Sequence↗
Prospective study of men with clinical benign prostatic hyperplasia treated with alfuzosin by general practitioners: 1-year results.
OBJECTIVES: To investigate in men with benign prostatic hyperplasia (BPH) treated in the general practitioner setting (1) the magnitude and durability of symptom score improvement with alfuzosin; (2) the effect on patients perceived health-related quality of life (HRQL) and sexuality, (3) adverse outcomes and treatment failure; and (4) progression to acute urinary retention and prostate surgery. METHODS: A large, open outcome study was undertaken in the general practitioner setting in France, and a cohort of men with symptomatic BPH who received alfuzosin for 12 months was established. A total of 5849 patients (mean age 66.7 years) were enrolled by 1508 general practitioners in France. Men were examined at baseline and at 3 months, 6 months, and 1 year. To produce standardized outcome measures of disease-specific health status, under the conditions of routine care in the community, patients in the study completed a self-administered symptom questionnaire (score range 0 to 40) and a new, validated BPH-specific HRQL questionnaire (score range 0 to 200). Questionnaires were completed at baseline and during follow-up at 3, 6, and 12 months. RESULTS: Alfuzosin was effective in reducing symptoms; 98% (420) of severely and 85% (2479) of moderately symptomatic patients experienced improvement. At 3 months, the global symptom score was reduced by 9.49 +/- 0.08 (-53%), and this reduction persisted for the remainder of the study (-9.76 +/- 0.11). In contrast to the global reduction of symptom scores, there was a time-dependent improvement (+18.41 +/- 0.32 [+30%], +18.45 +/- 0.54 [+37%], and +23.42 +/- 0.57 [+43%] at 3, 6, and 12 months, respectively), in patients' perception of HRQL status. The magnitude of the improvement in HROL status was significantly more pronounced for those patients who had moderate or severe nocturia and daytime frequency at baseline than for those who had mild levels of the same symptoms. Sexuality score at baseline was significantly related to age and was significantly (P < 0.0001) higher in patients less than 70 years old than in older patients. Improvement in patients' perceived sexuality was significant at 12 months (P < 0.0001) and was correlated with age. CONCLUSIONS: The results of this large cohort study demonstrate the effectiveness of alfuzosin in reducing symptom severity and improving HRQL status over a 12-month period in men with BPH. It also suggests that HQRL and symptom severity are different and complementary entities. The results of the present study highlight the improvement in HRQL and patients' perceived sexuality that can be achieved in symptomatic patients with BPH receiving a 12-month course of alfuzosin therapy.
Adrenergic alpha-Antagonists↗
Saphenofemoral incompetence treated by ultrasound-guided sclerotherapy.
BACKGROUND: Published long-term recurrence rates are higher after sclerotherapy than after surgery for the treatment of varicose veins involving greater saphenous tributaries associated with saphenofemoral incompetence (SFI). Duplex ultrasound has recently become the gold standard for the diagnosis of venous disorders, and over the past 5 years, has been utilized during sclerotherapy to guide injections more precisely. OBJECTIVE: To determine greater saphenous vein recanalization and recurrence rates of varicose veins associated with SFI after duplex ultrasound-guided outpatient sclerotherapy. METHODS: Ambulatory patients with varicose veins deriving from greater saphenous vein reflux associated with SFI documented by duplex ultrasound from two private practices were treated by duplex ultrasound-guided compression sclerotherapy using 3% sodium tetradecyl sulphate. Patients were followed by clinical and duplex examinations annually. RESULTS: Forty-eight of 202 (23.8%) limbs were found to have recanalized by duplex ultrasound at 1 year, and 0/28 (0%) at 2 years (48/202, 23.8% cumulative rate). Clinical recurrences (visible varicosity or symptoms occurred in 46/202 (22.8%) of limbs at 1 year, and 10/28 (35.7%) at 2 years (56/202, 27.2% cumulative rate). There were no intra-arterial injections or other complications. CONCLUSION: Duplex ultrasound enhances the precision and therefore, both the efficacy and safety of saphenous vein sclerotherapy when performed by experienced practitioners. While awaiting long-term follow-up to document the progressive recurrence rate over time, our results at 2 years are superior to those after conventional sclerotherapy, and compare favorably with those after surgical interruption.
Adult↗
Improvement of postischemic renal function by limitation of initial reperfusion pressure.
PURPOSE: This study was designed to determine whether lowering the initial reperfusion pressure can improve renal function after ischemia. MATERIALS AND DESIGN: Sixty minutes of warm renal ischemia was induced in 2 groups of 8 minipigs by clamping the left renal artery. Right kidneys were kept in situ as controls. In the standard reperfusion group, ischemic kidneys were immediately reperfused at systemic pressure. In the controlled reperfusion group, the renal artery reperfusion pressure was maintained at 60 mm. Hg for the initial 20 minutes of reperfusion by use of a regulating pump and then at systemic pressure for the next 100 minutes. RESULTS: On the basis of the postischemic anuria rate, glomerular filtration rate and renal histology, renal tolerance to ischemia was significantly improved in the controlled reperfusion group. CONCLUSION: These findings of improved renal function recovery after warm ischemia by controlled low reperfusion pressure may have clinical relevance to the reperfusion technique used after renal transplantation in humans.
Animals↗
Silica-aerogel thermal expansion induced by submonolayer helium adsorption.
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Journal Article↗
[Training of urologists].
Urologists in France are combining classical teaching programmes and innovative cooperative efforts to better train their future colleagues. Candidate urologists participate in a 2-year programme during the last year of the 5 year general surgery internship and an additional post-internship year. Courses in anatomy, infectiology, oncology, and tissue repair are given together with special courses in emergency surgery and urology. An innovative project developed by the French College of Urology invites trainees to participate in cooperative national seminars on a specific theme. Each seminar is proposed conjointly be at least two teams in different university hospitals. This provides fruitful exchange of techniques and opinions between teams and offers trainees a stronger trainer-trainee relationship with a larger number of established leaders. The programme is regularly assessed by the College. These theoretical training sessions are completed by clinics in general and digestive surgery, orthopaedic surgery and at least 2 years in an urology clinic. The post-internship year is essential for the future urologist. As "chef de clinique" in an urology unit, he has immediate responsibility for patient care under the guidance of a senior and is progressively give total control of the most sophisticated procedure. The French College of Urology is currently examining proposals for determining accreditation criteria for teaching centres and continuous evaluation of the objectives for practical training within the framework of the associations of national urologists working together in the European Board of Urology.
Foreign Medical Graduates↗
Complete amino acid sequence of the Aa6 subunit of the scorpion Androctonus australis hemocyanin determined by Edman degradation and mass spectrometry.
The primary structure of the hemocyanin Aa6 subunit from the scorpion Androctonus australis was resolved by using protein sequencing and mass spectrometry for analysis of the polypeptide chain and of fragments obtained by CNBr, trypsin, and chymotrypsin cleavage. Due to the high sensitivity of the methodologies used, only a small amount of material, less than 1 mg, was consumed. The complete sequence is composed of 626 amino acid residues and the protein is not glycosylated but probably phosphorylated at Ser374. Its molecular mass measured by mass spectrometry (71,890 +/- 7 Da) is about 30 Da higher than the mass calculated from the sequence data (71,860.1 Da). The origin of this difference is not clear but could result from minor molecular heterogeneities. Within the chelicerates, the Aa6 subunit of the arachnid A. australis shares 405 identical residues with chain e of another arachnid, Eurypelma californicum, and 399 with chain alpha of the merostom Tachypleus tridentatus. The degrees of identity between these three subunits, which are known to occupy the same location in the native hemocyanin oligomers, are significantly higher than those existing between the subunits a, d, and e of E. californicum. This favors the hypothesis that gene duplications, leading to separate chains in one species, have occurred before the divergence between arachnids and merostoms.
Amino Acid Sequence↗
Mass spectral analyses of microcystins from toxic cyanobacteria using on-line chromatographic and electrophoretic separations.
The application of capillary electrophoresis and of reversed-phase liquid chromatography coupled to electrospray mass spectrometry is presented for the analysis of microcystins isolated from toxic strains of Microcystis aeruginosa. The separation performance of these two techniques is compared in terms of both sensitivity and of resolution of closely related microcystins. Quantitation of microcystin-LR present at low micrograms/ml concentrations in cell extracts is demonstrated using both techniques. A marked advantage of capillary electrophoresis over liquid chromatography was its ability to resolve different desmethyl microcystin-LR analogues. Identification of these positional isomers was facilitated using capillary electrophoresis combined with tandem mass spectrometry (MS-MS). Rationalization of fragment ions observed in MS-MS spectra of microcystins was made possible through comparison with 15N labelled microcystins obtained from stable isotope feeding experiments. The potential of tandem mass spectrometry in providing selective detection of microcystins in cell extracts, and in structural characterization of novel microcystins, was also investigated.
Amino Acid Sequence↗
A new synthesis of 6-O-acylsucroses and of mixed 6,6'-di-O-acylsucroses.
Various 6-O-acylsucroses were synthesized in good yields from unprotected sucrose in N,N-dimethylformamide and the appropriate 3-acylthiazolidine-2-thiones 6 or 3-acyl-5-methyl-1,3,4-thiadiazole-2(3H)-thiones 7. A selective ionization of the free sugar by sodium hydride or triethylamine, followed by acylation with 6, gave 2-O-acylsucroses which were subjected in situ to intramolecular isomerizations using 1,8-diazabicyclo[5.4.0]undec-7-ene (DBU) or an aqueous solution of triethylamine to yield 6-O-acylsucroses. The later were otherwise obtained directly when sucrose was acylated with 6 or 7 in the presence of DBU. Moreover, mixed 6,6'-di-O-acylsucroses were readily obtained from 6'-monoacylates by using a Mitsunobu reaction without involving the concomitant formation of the 3',4'-epoxide.
Acylation↗
C-terminal post-translational proteolysis of plant lectins and their recombinant forms expressed in Escherichia coli. Characterization of "ragged ends" by mass spectrometry.
Electrospray mass spectrometry was used to accurately measure the molecular masses of single chain lectins from legume seeds and also of three recombinant lectins, expressed in Escherichia coli. The five single chain lectins, Erythrina corallodendron lectin, soybean and peanut agglutinins, Dolichos biflorus lectin, and Phaseolus vulgaris hemagglutinin E, all showed evidence of C-terminal proteolytic processing, in some cases to "ragged" ends, when their masses were compared to those expected from their cDNA sequences and their known carbohydrate chains. Recombinant forms of the lectins from E. corallodendron, soybean, and peanut also showed C-terminal trimming, but not to the same points as the natural forms. Discrepancies between the protein and cDNA sequences of the E. corallodendron lectin were resolved by combined liquid chromatography-mass spectrometry peptide mapping and protein sequencing experiments, and the presence of a second glycosylation site was demonstrated. Our data show that all of these lectins undergo C-terminal proteolytic processing of a readily attacked peptide segment. This trimming is frequently imprecise, and the resulting heterogeneity may be a major contributor to the appearance of isolectin forms of these proteins.
Amino Acid Sequence↗
Analysis of the N-linked oligosaccharides of human C1s using electrospray ionisation mass spectrometry.
Information on the structures of the oligosaccharides linked to Asn residues 159 and 391 of the human complement protease C1s was obtained using mass spectrometric and monosaccharide analyses. Asn159 is linked to a complex-type biantennary, bisialylated oligosaccharide NeuAc2 Gal2 GlcNAc4 Man3 (molecular mass = 2206 +/- 1). Asn391 is occupied by either a biantennary, bisialylated oligosaccharide, or a triantennary, trisialylated species NeuAc3 Gal3 GlcNAc5 Man3 (molecular mass = 2861 +/- 1), or a fucosylated triatennary, trisialylated species NeuAc3 Gal3 GlcNAc5 Man3 Fuc1 (molecular mass = 3007 +/- 1), in relative proportions of approximately 1:1:1. The carbohydrate heterogeneity at Asn391 gives rise to three major types of C1s molecules of molecular masses 79,318 +/- 8 (A), 79,971 +/- 8 (B), and 80,131 +/- 8 (C), with an average mass of 79,807 +/- 8. A minor modification, yielding an extra mass of 132 +/- 2, is also detected within positions 1-153.
Asparagine↗