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Biomedical subjects

X Martin

Publications and source records attributed to X Martin.

At least 145 records · Page 8Linked to original sources
PubMed1993

Extracorporeal repair of primary renal artery dissection.

Four cases of isolated dissection of the renal artery were diagnosed and treated in our institution. In 2 cases, angiography showed dissection of the left renal artery with involvement of peripheral branches; in 1 case, the dissection involved the right renal artery with complete occlusion of an upper-pole branch and upper-pole infarction, and 1 patient presented a bilateral dissection, limited to the main trunk on the right side and involving prepelvic and retropelvic branches on the left side. Surgical treatment consisted in renal autotransplantation in the iliac fossa after extracorporeal reconstruction of the arterial pedicle. The results were encouraging with normalization of blood pressure and improvement of renal function in all cases.

Aortic Dissection↗
PubMed1993

Benign prostatic hypertrophy treatment by transurethral radiofrequency hyperthermia with Thermex II.

We selected 50 patients with benign prostatic hyperplasia to be treated with hyperthermia at 44.5 degrees C. The treatment was performed with Thermex II. We excluded from this study all patients with a suspicion of prostatic adenocarcinoma or other previous surgical intervention on the prostate and we also excluded patients with pacemakers or coagulation problems. The follow-up time for these patients was 6 months. They were all evaluated by flow rate, measurement of postmicturation residue. Madsen score and transrectal sonography at 1, 3 and 6 months. We did not notice any modification of the prostatic volume, no modification of the urine residue but a moderate improvement of the flow rate. A significant improvement was observed on the symptom score since subjective symptoms were seen in 68% of the patients. Our results show that this method of treatment seems to compete with other classic medical treatments especially in the case of patients with a prostatic adenoma equal or smaller than 40 g and that hyperthermia is particularly active on irritative symptoms but does not compete with classic surgical procedures.

Aged↗
PubMed1993

[Pulsed Doppler ultrasonography in the month following renal transplantation].

Thirty-five children who underwent kidney transplantation were prospectively investigated with doppler ultrasound on day 3, 10 and 30 post-transplant, and at the time of acute dysfunction episodes. Resistive index was obtained from graft artery and was significantly elevated in patients with acute rejection episode or acute tubular necrosis (P < 0.05) without any significant difference between these two conditions. Children with episodes of cyclosporine nephrotoxicity displayed the same signal as children with normal graft function. Even if a daily follow-up should improve the specificity and the sensibility of doppler ultrasound examination, its ability to differentiate acute tubular necrosis from acute allograft rejection is not available enough. Further studies are required to evaluate duplex colour doppler ultrasonography in such conditions.

Acute Disease↗
PubMed1993

[A quiet revolution: the Wallstent urethral prosthesis (Urolume AMS)].

14 patients (mean age: 57 years) with posterior urethral stricture were treated by internal urethrotomy and implantation of one or several Wallsten prostheses. The stent had to be removed in 2 patients (15%), while 12 patients (85%) obtained satisfactory urethral patency (mean follow-up: 17.5 months). Complications were observed in 50% of cases. They were able to be treated endoscopically with a satisfactory result in 5 out of 6 cases (intraprosthetic calculi or stenosis of the ends of the stent; 2 patients who became incontinent after insertion of the stent regained normal continence after insertion of an artificial sphincter above the stent. The Wallsten endoprosthesis therefore appears to be a very satisfactory treatment for recurrent complex strictures of the posterior urethra.

Adult↗
PubMed1993

[Fragmentation of urinary calculi using the Lithoclast EMS. Technique and results].

The Lithoclast is an endoscopic lithotriptor which uses the ballistic energy produced by a small hand-held apparatus, by the movement of a small metal part (the projectile) driven by a jet of compressed air. The energy is transmitted to a metal rod whose diameter is selected according to the application: 0.8 or 1 mm in the ureter; 2 mm in the bladder and kidney. We have used this apparatus to treat 40 stones in 39 patients (25 ureteric stones, 11 renal stones, 4 bladder stones). Satisfactory fragmentation was obtained for 39 of the 40 stones (97.5%). The apparatus is very easy to use in the kidney and bladder (the risk of urinary tract perforation is very low at this level). The risk of perforation of the ureteric wall by 0.8 mm or 1 mm rods is considerable (12% of cases), but these punctate lesions heal rapidly over a double J stent. Special techniques should be used in the ureter to limit the risk of pushing the stone towards the renal pelvis.

Adult↗
PubMed1993

[Treatment of intradiverticular lithiasis by percutaneous methods (19 caliceal diverticuli)].

The main technical procedures in percutaneous nephrolithotomy are the direct puncture of the diverticulum (precise puncture may be required to place the tract directly on to the stone), and treatment duration the diverticulum could be coagulated and a large nephrostomy catheter could be left in place two days. No complication was encountered. One patient refused the treatment after unsuccessful puncture. The nephrostomy tube was left open for two days of drainage. Mean hospital stay was 5 days. Three patients required E.S.W.L because of persistent symptoms. One month after treatment 13 of 18 patients intravenous urography showed obliteration of the diverticulum (72%); Three months after 84% (15/18) of our patients were stone free and 94% (17/18) symptom free. Percutaneous nephrolithotomy should be performed for symptomatic patients, it has low complication rate and should be reserved for patients with persistent symptoms after E.S.W.L.

Adult↗
PubMed1992

[Lymphoproliferative syndromes associated with Epstein-Barr virus in transplantation].

We report 23 cases of lymphoproliferative diseases which occurred among 2,100 patients with kidney or combined kidney+pancreas transplant. Eleven patients developed a severe diffuse disease within the first 3 months post-transplantation; immunoblastic B cells of recipient origin infiltrated the bone-marrow, transplanted organs, liver, spleen, lymph nodes, lungs, and brain; immunoglobulin abnormalities with fever, leuko-thrombocytopenia and liver dysfunction constituted the symptoms; all patients received anti-lymphocyte globulins; 9 patients were also treated with cyclosporin. Three out of 6 tumors analysed were monoclonal. Epstein-Barr virus was present in 3 lesions analysed. Treatment consisted of cessation of immunosuppressive therapy. Nine patients died with lactic acidosis. Five patients had a less severe form. Seven patients had solid tumors involving the tonsils, lungs (2), lymph nodes (2), and bladder, 8 months after transplantation. All patients received cyclosporin; 4 also received anti-lymphocyte globulins and 3 OKT3. Tumor cells were immunoblasts expressing B cells markers at a late stage of B cell differentiation; 4 tumors were monoclonal. C myc was negative. Treatment consisted of cessation of immunosuppressive therapy, antiviral agents, and monoclonal antibodies (mAb): anti-CD21 and anti-CD24 mAb therapy was followed by cure of the lymphoma in 1 patient, by transient remission in a second one and by failure in the third patient. Two patients had a recurrence of the lymphoma and received chemotherapy; 2 patients died of the lymphoma, 1 died of unrelated cause; 4 are alive, 3 of them having a good graft function.

Antigens, CD↗
PubMed1992

Cardiac expressions of alpha- and beta-myosin heavy chains and sarcomeric alpha-actins are regulated through transcriptional mechanisms. Results from nuclear run-on assays in isolated rat cardiac nuclei.

In the heart, mRNA accumulations for sarcomeric actins and myosin heavy chains (MHC) are subject to diverse regulatorial processes. To study cardiac contractile protein transcriptional regulations, an in vitro transcription system using nonenzymatically isolated rat cardiac nuclei was characterized. Transcription was shown to be rapid and continuous during the first 20 min of incubation and 5.4-fold less than that seen from comparably isolated hepatocyte nuclei. Neither RNase nor DNase activities were detectable. Direct transcriptional analyses of the alpha- and beta-MHC and cardiac and skeletal alpha-actin genes from cardiac nuclei were performed. In 23-24-day-old rats, significant levels of transcription were seen for alpha-MHC and for the sarcomeric alpha-actins. beta-MHC was just detectable, and no positive signals were ever seen for fibronectin. We then compared the perecentages of MHC and sarcomeric alpha-actin expressions determined from 1) the transcriptional assays and 2) total isolated RNA (alpha-MHC: 90.1 +/- 4.8% (transcription), 93.0 +/- 4.7% (accumulation); beta-MHC: 9.9 +/- 4.8%, 7.0 +/- 4.7%; cardiac alpha-actin: 84.0 +/- 2.5%, 84.9 +/- 2.5%; skeletal alpha-actin: 16.1 +/- 2.5%, 15.0 +/- 2.5%). The results support the conclusion that the primary mechanisms controlling the accumulations of these gene products are transcriptional. Additionally, we show that an anti-sense mRNA showing strong homology or identity with the 5' end of the beta-MHC gene is transcribed in cardiac nuclei but not in hepatocyte nuclei.

Actins↗
PubMed1992

[Islets of Langerhans grafts and pancreas transplantation].

In theory, transplantation of the islets of Langerhans is the method of choice for the treatment of insulin-dependent diabetes. In actual fact, medical teams who have been working on this subject for about two decades have met with the problem of islet isolation, and for the time being this treatment cannot be considered effective. Pancreas transplantation gives satisfactory results in diabetics with renal impairment when it is coupled with kidney transplantation. However, it cannot yet be applied to all diabetics as its results are mediocre when performed alone, and it requires chronic immunosuppression. Pancreas transplantation not only increases the quality of life but also has the advantage of acting on degenerative complications: it may improve diabetic nephropathy, retinopathy and neuropathy. The results obtained are getting better year after year, and they are now close to those observed with other organ transplantations.

Diabetes Mellitus, Type 1↗
PubMed1992

Endoscopic treatment of vesicoureteral reflux prior to renal transplantation.

Endoscopic subureteral injection of Teflon was done in 34 potential renal transplant recipients to correct vesicoureteral reflux. Follow-up ranged from 6 to 24 months. After one injection reflux was corrected in 53.7% of the patients; this increased to 64.8% after a second injection. The procedure is simple, effective, without major morbidity, and avoids the risk of nephroureterectomy. However, efforts must be made to find an ideal substance with a higher biocompatibility and without risk of migration.

Adult↗
PubMed1992

Horseshoe kidney: the impact of percutaneous surgery.

Six patients with a stone disease and/or ureteropelvic junction obstruction in a horseshoe kidney underwent percutaneous surgery. No major complications were observed and only 1 patient presented residual fragments in the lower calyx 3 months after treatment. The special features of the use of percutaneous nephrolithotomy and endopyelotomy for this anomaly are described.

Adult↗