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Pascal Eschwege

Publications and source records attributed to Pascal Eschwege.

16 recordsLinked to original sources
PubMed2006

Expression of epidermal growth factor receptor and proliferative activity of cyst epithelium in human renal cystic diseases.

Pathogenesis of malignancies in patients with polycystic kidney disease (PKD) is not clearly understood. Epidermal growth factor receptor (EGF-r) production by mature kidney plays a role in promotion of epithelial hyperplasia and cyst formation, its involvement in further progression is however not proven. Ki-67 is a marker for cellular proliferation. We assessed immunohistochemical expression of EGF-r and Ki-67 in epithelium of normal kidney, single cysts without PKD, epithelial tubular cells lining simple cysts and cysts with papillary proliferation in PKD patients, and analyzed the relationship with the occurrence of malignant tumors in these cases. 72% of PKD displayed EGF-r staining in epithelium lining cysts versus 33% in normal epithelium and 70% in epithelium of normal kidney. Ki-67 was increased in papillary cystic epithelium (24%) and in cysts lined by flat epithelium (66%). Renal cancers in PKD showed EGF-r staining in 33%, but no Ki-67 expression. EGF-r function and proliferative activity in cyst formation in PKD remains to be explored. EGF-r and Ki-67 expressions are not predictive of development of carcinoma in PKD.

Adult↗
PubMed2004

Environmental, genetic, and molecular features of prostate cancer.

Prostate cancer is the sixth most common cancer in the world and the third leading cause of cancer in men. The increase in the understanding of prostate carcinogenesis over the past 15 years has helped to define crucial steps in the natural history of the disease, namely initiation and progression to androgen independence. This heterogeneous disease encompasses a range of environmental and familial factors, which provides strong support for the use of chemopreventive strategies. Most patients with advanced prostate cancer are treated with androgen-deprivation therapy, which leads to a striking regression of androgen-responsive cancer cells. A transition from an androgen-responsive to an androgen-unresponsive stage is seen during the clinical course in almost all patients with prostate cancer. This transition also signals a substantial worsening of prognosis. Here, we review the most important findings in prostate carcinogenesis and the molecular anomalies associated with the androgen-refractory stage.

Environmental Exposure↗
PubMed2004

[Cyclooxygenase 2 inhibitors and urologic and gynaecologic cancers].

PGE2 is one of the most important prostaglandin involved in the oncogenesis. PGE2 is found at high concentration level in the most of epithelial cancer. Urologic and gynaecologic cancer express the enzyme which are at the origin of PGE2: cyclooxygenase 2. Cox2 inhibitors present anticancer properties demonstrated in wide varieties of cellular and animal models. Human applications are currently tested in many clinical trials for bladder, prostate and uterine carcinomas.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2004

[Scrotal angiofibroblastoma].

Angiomyofibroblastoma of the scrotum is a rare and benign tumour which affect old patient. It's treatment is surgical. A case of angiomyofibroblastoma of the scrotum is reported in a 34 years old man. The literature is reviewed with special reference to the ethiopathogenesis, clinical features and treatment of this tumour entity.

Adult↗
PubMed2004

[Prostatic cancer].

Explore the source record for details and available documents.

Antineoplastic Agents↗
PubMed2004

[Cyclooxygenase 2 inhibitors and urologic and gynaecologic cancers].

PGE2 is one of the most important prostaglandin involved in the oncogenesis. PGE2 is found at high concentration level in the most of epithelial cancer. Urologic and gynaecologic cancer express the enzyme which are at the origin of PGE2: cyclooxygenase 2. Cox2 inhibitors present anticancer properties demonstrated in wide varieties of cellular and animal models. Human applications are currently tested in many clinical trials for bladder, prostate and uterine carcinomas.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2003

Urodynamic testing predicts long-term urological complications following simultaneous pancreas-kidney transplantation.

INTRODUCTION: Combined pancreas-kidney transplantation is the treatment of choice for patients with type I diabetes mellitus associated with chronic renal failure. The introduction of the bladder drainage technique constituted a marked improvement of the surgical technique with a reduction of life-threatening complications. However, drainage of pancreatic secretions via the urinary bladder causes urological complications leading, in some cases, to cystoenteric conversion. We retrospectively analysed whether pre-operative urodynamic findings may predict the subsequent development of urological complications and influence the choice of exocrine secretion drainage. PATIENTS AND METHODS: From 1987 to 1997, 39 bladder-drained simultaneous pancreas-kidney transplantations were performed in 16 men and 23 women with a mean age of 38.5 yr. All patients underwent a complete urological assessment prior to surgery, including medical history, physical examination, urethrocystography and urodynamic assessment. RESULTS: Twenty-eight patients are alive with a mean follow-up of 62 +/- 8 months. In 60% of cases, both kidney and pancreas remain functional. Seven patients experienced recurrent lower urinary tract infections. Six patients suffered from chemical urethritis (four men and two women) and six suffered from recurrent haematuria (blood transfusions were required in two patients). One patient had incrusted stones at the site of duodenal staples. Urological complications were mostly observed in the 22 patients (79%) with abnormal urodynamic characteristics (Relative risk: 5.1). Intravenous Somatostatin failed to definitively cure these complications in most cases. Seven patients (17%) (five with urethritis, two with haematuria) required cystoenteric conversion. Two patients developed post-operative ileal fistula, one cutaneous and one into the bladder. All urinary symptoms resolved in these seven patients. CONCLUSION: The frequency of specific urinary complications is high (28%) in bladder-drained simultaneous pancreas-kidney transplantation patients. These complications are statistically more frequent in the case of an abnormal pre-transplant urodynamic assessment.

Adult↗
PubMed2003

Incidence of renal and liver rejection and patient survival rate following combined liver and kidney transplantation.

Multiple organ transplantations are used to treat chronic multiple organ failure. However, long-term mortality and graft tolerance remain to be evaluated. We carried out a retrospective and comparative analysis of 45 patients who underwent a combined liver and kidney (LK) transplantation (LKT) from the same donor. They were compared to 86 matched patients who underwent kidney (K) transplantation (KT). All patients had an organic renal failure associated with cirrhosis (n = 35) or with inherited disease (n = 10). Nineteen (42.9%) had been transplanted previously. The patients' survival rate was 85% at 1 year and 82% at 3 years. Seven patients died within the first 3 months, due to severe polymicrobial infection. Two patients in the LK population (4.2%) developed acute rejection of the kidney graft compared to 24 of the 86 matched renal transplanted patients (32.6%). In parallel, acute liver rejection was observed in 14 cases (31.1%) in the LK population. The occurrence of acute rejection was not associated with panel-reactive lymphocytotoxic antibodies (n = 16), nor with positive cross-matches (n = 3). Four of the 45 patients (8.8%) subsequently developed chronic renal allograft rejection, and 16 cases of chronic hepatic dysfunction were noted (42.2%). In conclusion, the overall survival rate following combined liver kidney transplantation is acceptable, and LKT can be proposed to patients with kidney failure associated with liver dysfunction, primary oxaluria or amyloid neuropathy. The main cause of mortality in this population was severe infectious complications. The frequency of acute kidney rejection was lower than in single transplantation.

Adolescent↗
PubMed2003

Cyclooxygenase-2 inhibitor NS398 enhances antitumor effect of irradiation on hormone refractory human prostate carcinoma cells.

PURPOSE: We examined the potential therapeutic effect of NS398, a selective cyclooxygenase-2 (COX-2) inhibitor, combined with irradiation on human prostate adenocarcinoma DU145 cells. MATERIALS AND METHODS: The effect on tumor growth, proliferation testing and clonogenic survival was determined to evaluate its antitumor effect when exposed to NS398 or combined with irradiation. Immunoblotting analyses were done to detect the expression of COX-2, nuclear factor-kappaB p50 and Rel A p65 because evidence suggested a biological association of COX-2 with alterations in these markers. Reverse transcriptase-polymerase chain reaction was also performed to show its effect on the transcription level of COX-2. RESULTS: Exposure of DU145 cells to NS398 alone suppressed proliferation in a dose and time dependent manner. Examination of the NS398 effect on the radiation response showed marked enhancement of radiosensitivity. Western blot indicated that NS398 down-regulated the expression of COX-2, nuclear factor-kappaB, p50 and Rel A p65, whereas the effect was more pronounced when combined with irradiation. Reverse transcriptase-polymerase chain reaction showed that the NS398 antitumor effect was associated with COX-2 transcription inhibition. Importantly COX-2 expression was enhanced by irradiation but this phenomenon was abolished when cells were exposed to NS398. Inhibition of tumor growth in animal model was observed when mice were treated with NS398 alone and irradiation alone, and this effect was maximal when treated with NS398 and irradiation. CONCLUSIONS: These results suggest that NS398 could be used as a potential therapeutic agent combined with irradiation for prostate adenocarcinoma.

Adenocarcinoma↗
PubMed2003

Imaging of burned-out testis tumor: five new cases and review of the literature.

OBJECTIVE: Burned-out tumors of the testis are extremely rare. From 5 new cases, the clinical and radiologic findings are discussed in light of a review of the literature. METHODS: Over a 13-year period, 5 patients 17 to 50 years old were admitted with metastatic germ cell neoplasms. All were explored by thoracic and abdominal computed tomography and scrotal sonographic examination. RESULTS: The disease was revealed by the presence of lymphadenopathies in 4 of these patients: retroperitoneal in 3 and supraclavicular in the other. Scrotal sonography revealed abnormalities in all cases. CONCLUSIONS: Burned-out tumors may cause some confusion in the diagnosis, because secondary tumors can often be mistaken for primary tumors. Careful evaluation of the testis is crucial for identifying the primary lesion site; all abnormalities shown on clinical or sonographic scrotal examination call for orchidectomy.

Adolescent↗
PubMed2003

[Prospective study of harvest-to-transplant time: proposed organization].

INTRODUCTION: The cold ischaemia time of a kidney before transplantation has a negative impact on the risk of acute tubular necrosis and graft survival. This cold ischaemia time can be reduced by a different organization of harvesting, organ distribution and transplantation. MATERIAL AND METHODS: Seventy nine organ donor case files from the same hospital were reviewed from reception of the donor until transplantation. 135 renal transplantations, including 60 kidneys and 14 kidney-pancreas transplants were performed on site with organs harvested from these donors. The various phases of harvesting were studied: reception and resuscitation of the patient took 30 hours, and the diagnosis of brain death, information of the families and transfer of the donor to the operating room for harvesting took 11 hours. RESULTS: The mean cold ischaemia time was 6 hours when kidney-pancreas transplantation was performed and 22 hours 30 minutes for isolated local renal transplantation. The decisive factor is the time required to obtain HLA typing, which is only performed during organ harvesting for isolated renal transplantation. HLA typing and lymph node sampling in the intensive care unit would save 7 hours. CONCLUSION: The authors recommend that HLA typing and lymph node sampling for cross matches be performed in the intensive care unit in order to reduce the cold ischaemia time.

Adult↗
PubMed2002

Impact of different combined preservation modalities on warm ischemic kidneys: effect on oxidative stress, hydrostatic perfusion characteristics and tissue damage.

Hemodynamic disorders in brain dead organ donors induce hypoxia, warm ischemia and finally tissue damage. A cold preservation period also induces tissue and cellular lesions. The two major modes of preservation are cold storage (CS) and hypothermic pulsatile perfusion (HPP). We aimed to compare the influence of each mode of preservation and their combination on oxidative stress, perfusion characteristics and tissue damage, after a period of warm ischemia. Rat kidneys which had undergone ischemia (0, 30, 60 min) were preserved either by CS (12, 24 h), or by HPP (12 h), or by a combination of both (HPP+CS, CS+HPP), in University of Wisconsin cold storage solution (UWCSS) at + 4 degrees C. During HPP, renal vascular pressure decreased then increased to reach 90 mmHg after perfusion for 7 h. If HPP followed CS, the mean pressure reached 200 mmHg, showing successive high amplitude peaks. HPP had a deleterious effects on tissue structure with tubular necrosis, and induced an increase in catalase (Cat) and a decrease in manganese superoxide dismutase (Mn SOD) and gluthatione peroxidase (GPx) activity. Copper zinc superoxide dismutase (Cu/Zn SOD) activity was not reduced except with CS+HPP. During CS, we observed an increase in GPx, Cu/Zn SOD and Cat activity, a decrease in Mn SOD activity and no histological alterations in the kidney. CS induces a slight oxidative stress which is not important enough to induce major tissue damage. HPP with UWCSS induces a stronger stress, which overpowers the antioxidant defences, inducing tissue damage. The reperfusion of HPP with UWCSS emphasises the stress initiated by CS. In addition an increase in damage occurred in the CS + HPP group.

Adenosine↗
PubMed2002

[What are the arguments in favour of local allocation of kidneys harvested for transplantation?].

UNLABELLED: The rules of organ allocation allow one of the two kidneys harvested to be transplanted locally while the other is exchanged. This rule of local priority does not exist in all countries. The purpose of this article is to determine whether this rule provides a benefit for the patient. 804 locally harvested kidneys were compared to 1196 exchanged kidneys transplanted between 1970 and 2000 by the same renal transplantation team. RESULTS: The cold ischaemia time was shorter (-6 h), the number of cases of HLA identity was lower (-0.8), the rate of acute tubular necrosis was lower (-9), and the median graft survival of was 7 months longer for local kidneys. DISCUSSION: An article analysing the North American register reached similar conclusions: the local attribution rule reduces the cold ischaemia and the graft loss at one year. CONCLUSION: The local attribution rule has the advantage of increasing the organ harvesting rate from borderline donors, reducing the cold ischaemia, and improving the results: this rule should therefore be maintained.

Adult↗
PubMedDate not supplied

Bilateral lower limb hypoesthesia after radical prostatectomy in the hyperlordotic position under general anesthesia.

PURPOSE: To report a case of postoperative bilateral lower limb hypoesthesia occurring after surgery under general anesthesia in the hyperlordotic position for radical prostatectomy. The possible pathophysiologic mechanisms are discussed. CLINICAL FEATURES: This 52-yr-old patient was slightly overweight and was on fenofibrate for hypercholesterolemia. He had no history of cardiovascular disease. Arterial blood pressure was overall well maintained except for a very transient hypotension at surgical incision. Blood loss was moderate and did not require transfusion. Soon after recovery, the patient complained of paresthesia in both legs and neurological examination revealed bilateral lower limb hypoesthesia, compatible with an incomplete medullar syndrome at the level of T12-L1. On postoperative day one, a plain magnetic resonance imaging scan demonstrated a hyperintense signal in the spinal cord from T8 to T9 on T2-weighted images consistent with ischemia of the spinal cord whereas the heterogeneous aspect of the spinal cord was due to an unusually high fat content of the epidural space. Neurological signs improved progressively and one week later the patient had recovered normal sensory functions of both lower limbs. CONCLUSION: Although arterial ischemia is the most common cause of postoperative spinal cord injury, other mechanisms may be invoked. We raise the possibility that a combination of intraoperative risk factors (hypotension, excessive postural changes) with anatomic predispositions (increased epidural venous pressure or fat content, previous bone disease) can produce arterial and/or venous ischemia of the spinal cord.

Humans↗