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  • 1
    ISSN: 1432-2277
    Keywords: Renal artery stenosis ; Stenosis, renal artery ; Angioplasty for renal artery stenosis ; Hypertension, renal artery stenosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract One hundred thirty-eight patients with transplant renal artery stenosis (TRAS) were identified among 1200 patients undergoing renal transplantation in our university hospital. Severe systemic hypertension was the main symptom leading to a diagnosis of TRAS. Only 88 TRAS patients were given interventional treatment consisting of percutaneous angioplasty (PTA; n=49) or surgical repair (SR; n=39). The immediate success rate was 92.1% for SR and 69% for PTA. The long-term success rate was 81.5% for SR and 40.8% for PTA, with a follow-up period of 56.7±22.4 months (SR group) and 32±28.1 months (PTA group). PTA morbidity reached 28%, compared to 7.6% in the SR group. In spite of these results, we still favor PTA as a first line interventional treatment when TRAS is recent, linear, and distal and primary SR in cases of kinking and proximal TRAS.
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  • 2
    ISSN: 1432-2277
    Keywords: Ureteral obstruction in renal transplantation ; Antegrade ureteral dilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report on eight kidney-allografted patients treated for delayed ureteral obstruction between January 1986 and January 1987. In all cases, standard endourological dilation was performed using a balloon catheter, and this was followed by insertion of a pigtail stent. All eight cases showed improvement 1 month after dilation (decrease in creatinine and caliceal dilation). At 6 months, renal function had deteriorated in six patients but remained good in two. One of the six patients was redilated with apparently good results. The remaining five were operated on using their own ureter. We conclude that while internal drainage helps in distinguishing between obstruction and other causes of creatinine increase, antegrade dilation is the treatment of choice for delayed ureteral obstruction.
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  • 3
    ISSN: 1432-2277
    Keywords: Kidney transplantation ; gastrointestinal complications ; Gastrointestinal complications ; kidney tranplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract One wonders whether the use of cyclosporin, histamine receptor antagonists, low doses of steroids, and early diagnosis and treatment actually modify the incidence, morbidity, and mortality of gastrointestinal (GI) and pancreatic complications in renal transplantation. To find out, we reviewed 614 kidney transplant recipients between January 1984 and December 1988. One hundred patients (16.2%) were found to have GI and/or pancreatic complications in the following distribution: 9.6% gastroduodenal, 1.3% pancreatic, 4% colonic, and 0.4% small bowel. None of the patients presenting a gastroduodenal ulcer had perforation or bleeding. Fifty-five percent of the patients with this complication had a past history of esogastroduodenal disease, compared to 19.6% in recipients without gastroduodenal complications. Some 4.4% of the patients had a small bowel or a colonic complication and four died of peritonitis due to bowel perforation. Mortality was 35% in those having intestinal resection and/or perforation with peritonitis. Sixteen percent of patients with colonic complications had a known history of diverticula, compared to 3% for those without colonic complications. The incidence of GI and/or pancreatic complications in renal transplant recipients remains high and has caused 1.1% of the deaths in our series. Mortality is essentially due to upper GI bleeding, peritonitis following perforation, and infectious colitis. Better detection of gastroduodenal and colonic disease before transplantation seems to be mandatory. Prevention with histamine H2 receptor antagonists and early surgical treatment of complicated colonic diverticula help to reduce the morbidity and mortality in kidney graft recipients.
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  • 4
    ISSN: 1279-8517
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion Le développement actuel des transplantations hépatiques, le retard que prend la France en transplantation pancréatique nécessitent de mettre au point des techniques qui autorisent les prélèvements simultanés des 2 organes dans tous les cas. La réalisation de ces prélèvements se heurte aux variations des a. hépatiques, qu'il faut done rechercher par la dissection ou par une artériographie pré-opératoire. De telles techniques nécessitent une grande souplesse des techniques de prélèvements et de réparation.
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  • 5
    ISSN: 1434-0879
    Keywords: Aortic kidney perfusion ; Aortic liver perfusion ; Organ transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To find whether the liver can be procured after exclusive aortic perfusion, three organ perfusion models were used in three groups of donor rats. Group 1 underwent liver wash-out via the portal vein; in group 2, the kidneys alone were perfused via the aorta; and group 3 underwent simultancous aortic perfusion of liver and kidneys. All perfusion flow rates in the three groups were adjusted to physiological values. Harvested organs were transplanted and recipient animals were killed 4h after transplantation to study liver and kidney viability by using intracellular ATP measurement. Liver ATP was lower (P〈 0.005) in the portal perfusion group (group 1: 1.396±0.412) than in the aortic perfusion group (group 3: 2.181±0.061). Kidney ATP was comparable in groups 2 and 3: 1.066±0.09 vs 1.059±0.273 (μmol/g) tissue. Liver cooling was quicker with portal perfusion than with the aortic flush (20°C in 20 s vs 15°C in 60 s). Aortic perfusion at a physiologic flow rate has no detrimental effect on renal viability studied by intracellular ATP measurement. We conclude that liver cooding via the aortic route only is a good alternative to portal perfusion and seems to give good preservation. Application of this observation to emergency procurement in humans is still the subject of controversy.
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  • 6
    ISSN: 1279-8517
    Keywords: A. of the liver/pancreas ; Hepatic a. ; Pancreatic a. ; Transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les prélèvements couplés du foie et du pancréas total sont anatomiquement possibles, à condition de rechercher les variations des a. hépatiques. En cas d'a. hépatique médiane unique le pancréas peut être prélevé avec le tronc cœliaque, l'a. mésentérique supérieure. Le foie peut être prélevé avec toute son a. hépatique. En cas d'a. hépatique gauche, le foie doit être prélevé avec le tronc cœliaque, l'a. hépatique gauche et l'a. hépatique médiane. Le pancréas doit être prélevé avec l'a. mésentérique supérieure et l'a. splénique doit être réimplantée dans l'a. mésentérique supérieure à condition que l'a. pancréatique dorsale naisse bien de l'a. splénique. En cas d'a. hépatique droite, le foie doit être prélevé avec l'a. hépatique médiane, l'a. hépatique droite et l'a. mésentérique supérieure. Le pancréas doit être prélevé avec l'a. mésentérique supérieure, l'a. hépatique commune, l'a. gastro-duodénale et l'a. splénique.
    Notes: Summary Combined liver and whole pancreas procurement is feasible provided that anatomical variations of the hepatic a. are kept in mind and recognised. In case of a single middle hepatic a., the pancreas can be procured with the celiac axis and the superior mesenteric a. The liver is harvested with all its artery. In case of a left hepatic a., the liver should have the celiac axis, the left and the middle hepatic a. The pancreas is harvested with the superior mesenteric a. on which the splenic a. will be implanted, provided that the dorsal pancreatic a. is really coming from the splenic a. In case of a right hepatic a., the liver is procured with the middle hepatic a., the right hepatic a. and the superior mesenteric a. The pancreas will have the celiac axis, the common hepatic a. with the gastroduodenal branch and the splenic a.
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  • 7
    ISSN: 1279-8517
    Keywords: Anatomy ; Prostate ; Computer model
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les auterurs rapportent une technique de reconstruction tridimensionnelle assistée par ordinateur en utilisant les informations de coupes sériées. Cette reconstruction a été faite avec un micro-ordinateur courant. Cette technique a été appliquée à la reconstruction d'une prostate de lapin commun européen.
    Notes: Summary We report a computer assisted three dimensional reconstruction technique using serial sections. This reconstruction was achieved by means of a common microcomputer. The organ analyzed in this study was the common European rabbit prostate.
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  • 8
    ISSN: 1279-8517
    Keywords: Anatomy ; Prostatic innervation ; Computer reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé La prostate d'un enfant de 10 ans, a été sectionnée au microtome en 4 300 coupes. Les nerfs ont été colorés avec un anticorps monoclonal anti PS 100 et toutes les informations ont été recueillies sur un programme informatisé. L'innervation de la prostate est très abondante, les fibres nerveuses de la prostate craniale (zone centrale) suivent une voie parallèle à la face antérieure des vésicules séminales, vers la prostate caudale. La zone péri-urétrale est richement innervée par des nerfs venant de la périphérie, la prostate caudale contient aussi de nombreuses fibres nerveuses de taille variable. Nous avons identifié un grand nombre de nerfs le long de la face antérieure des vésicules séminales et entourant les faces latérales de la capsule prostatique, elles pénètrent la capsule prostatique et toute la circonférence de la prostate caudale. La capsule prostatique est couverte par de nombreuses fibres nerveuses et des ganglions qui forment un véritable réseau nerveux péri prostatique. L'urètre est innervé par de nombreuses fibres de plus de 30 µm de diamètre.
    Notes: Summary The entire prostate of a 10 year old boy was cut with a microtome into 4300 serial slices. The nerves were stained using a monoclonal antibody called anti PS 100. All information was recorded using a computer reconstruction programme. The prostatic nerve supply is very abundant. The nerve fibers of the cranial prostate (central zone) follow a pathway parallel to the anterior surface of the seminal vesicles going towards the caudal prostate. The periurethral zone is widely innervated by nerves arising from the periphery. The caudal prostate also contains many nerve fibers of variable size. We identified many nerve fibers along the anterior surface of the seminal vesicles and surrounding the lateral aspect of the prostatic capsule. They penetrate the capsule and the whole circumference of the caudal prostate. The prostatic capsule is covered by numerous nerve fibers and ganglia, which form a true periprostatic nerve network. The urethra is supplied by numerous thick fibers of more than 30 µm in diameter.
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