75 results on '"M. Pouyet"'
Search Results
2. Age associated changes in peripheral airway smooth muscle mass of healthy horses
- Author
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M. Bullone, M. Pouyet, and Jean-Pierre Lavoie
- Subjects
Pathology ,medicine.medical_specialty ,Aging ,040301 veterinary sciences ,Peripheral airways ,Age related changes ,0403 veterinary science ,03 medical and health sciences ,0302 clinical medicine ,Smooth muscle ,Age related ,medicine ,Animals ,Horses ,Airway smooth muscle ,Equine ,Lung ,Muscle, Smooth ,Equine asthma ,General Veterinary ,business.industry ,04 agricultural and veterinary sciences ,Anatomy ,respiratory system ,musculoskeletal system ,respiratory tract diseases ,Peripheral ,medicine.anatomical_structure ,030228 respiratory system ,Muscle ,Animal Science and Zoology ,Smooth ,business ,Airway closure - Abstract
Peripheral airway smooth muscle (ASM) mass is increased in severe equine asthma, but no information is available on age related changes in ASM. In this study, peripheral ASM dimensions were determined in healthy horses of different ages. The thickness of the peripheral ASM layer was constant in horses of different ages, but ASM occupied a greater proportion of the inner wall area in young horses compared to older horses. This finding suggests that equine airways experience a decrease in the relative abundance of ASM with age.
- Published
- 2017
3. Pilot study of the combination of interferon alfa and ribavirin as therapy of recurrent hepatitis C after liver transplantation
- Author
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J. Baulieux, C Ducerf, Christian Trepo, M Elliott, M Pouyet, M. Chevallier, U Palazzo, and Thierry Bizollon
- Subjects
Adult ,Male ,medicine.medical_specialty ,Combination therapy ,Anemia ,medicine.medical_treatment ,Alpha interferon ,Pilot Projects ,Liver transplantation ,Antiviral Agents ,Gastroenterology ,chemistry.chemical_compound ,Maintenance therapy ,Recurrence ,Internal medicine ,Ribavirin ,medicine ,Humans ,Interferon alfa ,Hepatology ,biology ,business.industry ,Interferon-alpha ,virus diseases ,Alanine Transaminase ,Middle Aged ,medicine.disease ,Hepatitis C ,digestive system diseases ,Liver Transplantation ,Surgery ,Liver ,Alanine transaminase ,chemistry ,biology.protein ,RNA, Viral ,Drug Therapy, Combination ,Female ,business ,medicine.drug - Abstract
Recurrent hepatitis C virus (HCV) in liver transplant patients is a major cause of graft loss, liver failure, and need for retransplantation. The results available to date with the use of interferon alfa (IFN-alpha) in the treatment of recurrent HCV in liver transplant patients have been disappointing. The aim of this study was to evaluate the efficacy and clinical utility of post-transplant combination therapy with IFNalpha2b (3 million units 3 times weekly) and oral ribavirin (1,200 mg/d) for a duration of 6 months, followed by maintenance with ribavirin alone for an additional 6 months. Twenty-one liver transplant recipients with recurrent hepatitis C infection (HCV-RNA-positive; active hepatitis without rejection on biopsy) were enrolled in this study. Pretreatment serum alanine transaminase (ALT) levels were at least two times the upper limit of normal. Before treatment, all patients were HCV-RNA-positive and mean HCV-RNA titers were 125 million genome-equivalents/mL. Mean pretreatment histological score was 6.3 +/- 2. After 6 months of combination therapy, all 21 patients had normal ALTs. Ten patients (48%) cleared HCV-RNA from their serum, as assessed by polymerase chain reaction (PCR), and HCV-RNA levels decreased significantly in the others (P = .0001). Improvement in histological score was seen in all patients after combination therapy (P = .0013). During maintenance ribavirin monotherapy, ALT remained normal in all but 1 of the 18 patients who tolerated therapy. HCV-RNA reappeared in 5 patients, but HCV-RNA levels did not return to pretreatment levels (P = .0004). Comparison of pretreatment and postribavirin monotherapy liver biopsies revealed improvement in all but 1 of the 18 patients who tolerated ribavirin (P = .0002). Side effects were restricted to anemia, which necessitated cessation of ribavirin therapy in 3 patients. No patient experienced graft rejection during the study period. These results are significantly better than those reported with IFN-alpha monotherapy. Most importantly, there was a complete absence of graft rejection. These results suggest that the combination of IFN-alpha and ribavirin is effective in reducing HCV-RNA levels and ameliorating hepatocellular injury in recurrent HCV after liver transplantation, and that maintenance therapy with ribavirin monotherapy can maintain the biochemical and histological response.
- Published
- 1997
4. Bench test for measurement of differential RCS of UHF RFID tags
- Author
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Jacques Perdereau, Tan-Phu Vuong, M. Pouyet, Smail Tedjini, A. Pouzin, Laboratoire de Conception et d'Intégration des Systèmes (LCIS), Institut Polytechnique de Grenoble - Grenoble Institute of Technology-Université Pierre Mendès France - Grenoble 2 (UPMF), Institut de Microélectronique, Electromagnétisme et Photonique - Laboratoire d'Hyperfréquences et Caractérisation (IMEP-LAHC), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), Laboratoire commun de métrologie LNE-CNAM (LCM), Laboratoire National de Métrologie et d'Essais [Trappes] (LNE )-Conservatoire National des Arts et Métiers [CNAM] (CNAM), and Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Engineering ,Radar cross-section ,Spectrum analyzer ,business.industry ,020208 electrical & electronic engineering ,Electrical engineering ,020206 networking & telecommunications ,02 engineering and technology ,Signal ,Power (physics) ,law.invention ,Ultra high frequency ,Modulation ,law ,0202 electrical engineering, electronic engineering, information engineering ,Electronic engineering ,Radio-frequency identification ,Electrical and Electronic Engineering ,Radar ,[SPI.NANO]Engineering Sciences [physics]/Micro and nanotechnologies/Microelectronics ,business ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience; A bench test for differential radar cross-section (ΔRCS) measurement is described. The principle is to measure the power difference between the low and high modulation state of the tag and calculate the ratio with the received power. To do this, devices such as an arbitrary generator that replaces the reader, and a real-time spectrum analyser to receive and analyse the signal backscattered by the tag, are used; both devices can be configured in frequency and power. The first measurements are performed manually and the results demonstrate the validity of the proposed method. The automation of the system is carried out in order to make the measurement faster, less hardwork, more precise and more repeatable.
- Published
- 2010
5. Determination of measurement uncertainties applied to the RCS and the differential RCS of UHF passive RFID tags
- Author
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Audrey Pouzin, Tan-Phu Vuong, L. Dreux, M. Pouyet, Jacques Perdereau, Smail Tedjini, Domenget, Chahla, Laboratoire de Conception et d'Intégration des Systèmes (LCIS), Institut Polytechnique de Grenoble - Grenoble Institute of Technology-Université Pierre Mendès France - Grenoble 2 (UPMF), Institut de Microélectronique, Electromagnétisme et Photonique - Laboratoire d'Hyperfréquences et Caractérisation (IMEP-LAHC), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), and Lcis, Valence
- Subjects
Engineering ,Radar cross-section ,business.industry ,020208 electrical & electronic engineering ,020206 networking & telecommunications ,02 engineering and technology ,[SPI.TRON] Engineering Sciences [physics]/Electronics ,[SPI.TRON]Engineering Sciences [physics]/Electronics ,Ultra high frequency ,[PHYS.COND.CM-GEN] Physics [physics]/Condensed Matter [cond-mat]/Other [cond-mat.other] ,[PHYS.COND.CM-GEN]Physics [physics]/Condensed Matter [cond-mat]/Other [cond-mat.other] ,0202 electrical engineering, electronic engineering, information engineering ,Electronic engineering ,Measurement uncertainty ,Differential (infinitesimal) ,business ,ComputingMilieux_MISCELLANEOUS - Abstract
Measurement methodology and theoretical equations to RCS and ΔRCS determination are recalled and the measurement uncertainties are evaluated in this paper. Even if measurement uncertainties are generally not required for RFID, it is important to understand and to be able to determine the measurement uncertainty. Currently, manufacturers and testing laboratories present some results of RFID measurements but never show the associated uncertainty. Yet, seeing the values of the uncertainties, it is clear that they are not negligible.
- Published
- 2009
6. [Hemodynamic tolerance and rapid hypertrophy of a hepatic graft corresponding to less than 30% of the ideal mass in pigs]
- Author
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M, Pouyet, C, Paquet, I, Mechet, Y, Le Derf, P, Bernard, P, Figueiredo, F, Berger, and O, Boillot
- Subjects
Transplantation, Heterotopic ,Portal Vein ,Swine ,Anastomosis, Surgical ,Hemodynamics ,Bilirubin ,Hypertrophy ,Organ Size ,Constriction ,Liver Transplantation ,Mesenteric Veins ,Liver ,Models, Animal ,Animals ,Bile Ducts ,Splanchnic Circulation ,Ligation - Abstract
Evaluation of a new pig liver transplantation technique for survival and hypertrophy of a small-sized graft by providing adapted and controlled venous portal flow.[corrected] Twenty Large-White pigs underwent heterotopic liver transplantation after a mesocaval shunt and ligation of the superior mesenteric vein downstream from the shunt. The donor-to-recipient weight ratio was below 30%. Furthermore, recipient's biliary duct and portal vein into the hilum were tied. In a control group, no mesocaval shunt was performed and the graft received the entire splanchnic venous flow.The mesocaval shunt provided diversion of 60% of the splanchnic blood flow. The median survival of study pigs was 39 days (range: 8-98). Median serum bilirubin levels at 1 week were 12 micromol/L (range: 4-59). At autopsy, graft weight was increased to 2.7 times the initial weight and histological findings were normal. In the control group, all pigs died quickly from acute splanchnic congestion.In a model of heterotopic liver transplantation using small-sized grafts, complete diversion of mesenteric blood flow through a mesocaval shunt resulted in hemodynamic tolerance and hypertrophy of a graft corresponding to less than 30% of the ideal mass.
- Published
- 2002
7. Correction of acute liver cell failure disorders through liver xenoperfusion: experimental study
- Author
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M. Adham, J.M. Sab, C. Ducerf, D. Tassaux, C. Vianey-Saban, M. Chevallier, E. de la Roche, Q.V. Le, T. Bizollon, C. Barakat, G. Debize, M. Vernet, M. Pouyet, and J. Baulieux
- Subjects
Adult ,Pathology ,medicine.medical_specialty ,Swine ,Transplantation, Heterologous ,Antibodies, Heterophile ,Vitamin k ,Biological effect ,medicine ,Animals ,Humans ,Amino Acids ,Transplantation ,medicine.diagnostic_test ,Plasma Exchange ,business.industry ,Liver cell ,Bilirubin ,Complement C4 ,Blood Proteins ,Complement C3 ,Liver Failure, Acute ,Blood Coagulation Factors ,Perfusion ,Artificial organ ,Mechanism of action ,Immunoglobulin M ,Immunoglobulin G ,Surgery ,medicine.symptom ,Liver function tests ,Complication ,business - Published
- 1997
8. Plasma amino acid study during discordant liver xenoperfusion
- Author
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M. Adham, C. Vianey-Saban, C. Ducerf, S. Boyer, E. de la Roche, A. Taibi, M. Pouyet, and J. Baulieux
- Subjects
chemistry.chemical_classification ,Transplantation ,medicine.medical_specialty ,Swine ,Transplantation, Heterologous ,Liver failure ,Insuficiencia hepatica ,Amino Acids, Cyclic ,Biology ,Amino acid ,Perfusion ,Endocrinology ,chemistry ,Internal medicine ,Blood plasma ,medicine ,Animals ,Humans ,Surgery ,Amino Acids ,Ex vivo ,Amino Acids, Branched-Chain - Published
- 1997
9. Changes in serum proteins during isolated pig liver xenoperfusion
- Author
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M. Adham, C. Ducerf, M. Vernet, D. Rigal, E. De La Roche, T. Bizollon, A. Taibi, M. Pouyet, and J. Baulieux
- Subjects
Transplantation ,Pathology ,medicine.medical_specialty ,Time Factors ,Globulin ,Swine ,Transplantation, Heterologous ,Albumin ,Blood Proteins ,Biology ,Blood proteins ,Perfusion ,Liver ,Immunology ,medicine ,biology.protein ,Animals ,Humans ,Surgery ,Serum Globulins ,Pig liver ,Serum Albumin ,Liver Circulation - Published
- 1997
10. Orthotopic liver transplantation in presence of hepatocellular carcinoma
- Author
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M, Adham, C, Ducerf, T, Bizollon, B, Bancel, N, Irani, E, De La Roche, J, Baulieux, and M, Pouyet
- Subjects
Adult ,Male ,Survival Rate ,Carcinoma, Hepatocellular ,Actuarial Analysis ,Biopsy, Needle ,Liver Neoplasms ,Humans ,Female ,Middle Aged ,Liver Transplantation ,Retrospective Studies - Published
- 1996
11. [Heterotopic experimental liver transplantation with portal revascularization of the graft on the distal splenic vein of the recipient]
- Author
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C, Ducerf, J, Malaise, P, Caillon, J, Margotton, E, Gonnet, and M, Pouyet
- Subjects
Necrosis ,Postoperative Complications ,Transplantation, Heterotopic ,Liver ,Portal Vein ,Splenic Vein ,Swine ,Anastomosis, Surgical ,Animals ,Thrombosis ,Liver Transplantation - Abstract
A model of heterotopic liver transplantation had been studied. The graft was laid under the recipient liver and the portal blood flow was supplied by anastomosis with the distal part of the splenic vein. Both liver can then receive portal blood through two parallel portal circulation. Liver function of transplant was satisfactory at three months after transplantation. Their had been no alteration of the recipient liver during the same period.
- Published
- 1994
12. Repeated hepatic resections for colorectal metastases
- Author
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C, Gouillat, C, Ducerf, C, Partensky, J, Baulieux, P, Berard, and M, Pouyet
- Subjects
Adult ,Male ,Reoperation ,Treatment Outcome ,Liver Neoplasms ,Hepatectomy ,Humans ,Female ,Middle Aged ,Neoplasm Recurrence, Local ,Colorectal Neoplasms ,Survival Analysis ,Aged - Abstract
Repeated hepatic resection (RHR) for recurrent colorectal metastases remains uncommon and controversial. We report our experience in order to assess the feasibility and the potential oncologic benefit of such an aggressive management. From 1981 to 1991, 13 patients underwent a RHR. The first hepatic resection had been an anatomic hepatectomy removing between two and six segments in 10 patients and a wedge resection in three. The RHR was performed after a mean delay of 16 +/- 10 months (5-35) from the first liver procedure. The RHR was an anatomic hepatectomy in eight patients (including a right hepatectomy in three) and a minor resection (tumorectomy or segmentectomy) in five. Three patients underwent a third liver resection for recurrence. There was no post-operative mortality. Eleven patients died from recurrence after a mean survival of 17 +/- 13 months from the second hepatic procedure (range: 6-47). One patient died from unrelated disease after 12 months and one was alive free of recurrence 22, 53 and 84 months after third, second and first hepatectomy respectively. The median survivals from the second and first hepatic resections were 17 and 31 months, respectively. It is concluded that in the well-trained team, RHR is feasible and safe even after major primary hepatectomy. However the oncologic benefit remains questionable.
- Published
- 1993
13. [Hepatic epithelioid hemangioendothelioma. A case with liver transplantation. Review of the literature]
- Author
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B, Bancel, L M, Patricot, P, Caillon, C, Ducerf, and M, Pouyet
- Subjects
Adult ,Male ,Hemangioendothelioma ,Liver Neoplasms ,Humans ,Liver Transplantation - Abstract
Epithelioid hemangioendothelioma (HEE) is an unusual malignant neoplasm of vasculo-endothelial origin, arising in soft tissues, lung and liver. One case of hepatic HEE is reported in a 32 year-old man wit an isolated multinodular hepatomegaly. The diagnosis was made by the histologic examination of biopsy specimens. At the time of diagnosis, there was evidence of pulmonary metastasis. However, an orthotopic liver transplantation was performed. The tumor cells were immunoreactive with factor VIII-related antigen, BNH9 and vimentin. There was no expression of cytokeratin and epithelial membrane antigen. The patient is alive and well 24 months after. The thoracic X-ray are unchanged. This case is compared with the 84 others cases of the literature. Fourteen experienced a favorable outcome after transplantation. Extra-hepatic dissemination doesn't contra-indicate the graft. But hilar vascular involvement may be correlated with worse prognosis.
- Published
- 1993
14. Orthotopic liver transplantation for type 1 Gaucher's disease
- Author
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C, DuCerf, B, Bancel, P, Caillon, M, Adham, P, Guibaud, G, Spay, and M, Pouyet
- Subjects
Liver Cirrhosis ,Male ,Gaucher Disease ,Liver ,Biopsy ,Humans ,Child ,Liver Transplantation - Published
- 1992
15. [Orthotopic liver transplantation for severe amanita phalloides poisoning]
- Author
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M, Pouyet, P, Caillon, C, Ducerf, S, Berthaud, Y, Bouffard, B, Delafosse, A, Thomasson, C, Pignal, and C, Pulce
- Subjects
Amanitins ,Phalloidine ,Amanita ,Humans ,Female ,Mushroom Poisoning ,Chemical and Drug Induced Liver Injury ,Middle Aged ,Liver Transplantation - Abstract
Forty-eight hours after a women was poisoned by ingesting Amanita phalloides mushrooms, she developed fulminant hepatic failure with collapse, pH 7.24, lactic acidosis 7.6 mmol/l, hypoglycaemia 3.5 mmol/l, anuria and stage IV coma requiring tracheal intubation and mechanical ventilation. Transaminase level was up to 8,000 UI/l. Prothrombin and factor V levels were below 10 percent, with an APT time of 86 s versus a 29 s control time. Twenty-four hours after her admission, the patient underwent orthotopic liver transplantation. The postoperative period was uneventful, with return to consciousness and rapid normalization of hepatic biochemistry values, without signs of acute rejection. This 10th published case of orthotopic liver transplantation for Amanita phalloides poisoning with acute hepatic necrosis confirms that this type of treatment must be systematically envisaged in all such cases.
- Published
- 1991
16. Continuous arteriovenous haemodialysis during emergency hepatic retransplantation: two case reports
- Author
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Dominique Robert, S. Workineh, M. Pouyet, M. P. Bailly, P. Gaussorgues, and F. Salord
- Subjects
Adult ,Graft Rejection ,Male ,Reoperation ,medicine.medical_specialty ,Resuscitation ,medicine.medical_treatment ,Hemodynamics ,Liver transplantation ,Critical Care and Intensive Care Medicine ,Necrosis ,Postoperative Complications ,Anesthesiology ,medicine ,Humans ,Dialysis ,business.industry ,Liver Diseases ,Graft Occlusion, Vascular ,Vascular surgery ,Acute Kidney Injury ,Middle Aged ,Surgery ,Liver Transplantation ,Transplantation ,Hemodialysis ,Hemofiltration ,business - Abstract
Two patients with severe hepatic and renal failure underwent emergency hepatic retransplantation (2nd and 6th day after transplantation). Continuous arteriovenous haemodialysis was begun before surgery and successfully performed, without any incident, during the retransplantation with a biospal (SCU/CAVH AN 69 S) device, without pump. Vascular access was obtained with femoral catheters. Such a continuous dialysis and ultrafiltration allowed us to infuse massive amounts of blood products before and during surgery and to maintain pH, potassium and lactate at levels compatible with survival in anuric patients. Standard haemodialysis replaced CAVHD when haemodynamic stability was restored.
- Published
- 1990
17. [Surgical treatment of peptic stenosis of the esophagus]
- Author
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C, Ducerf, J, Baulieux, P, Caillon, and M, Pouyet
- Subjects
Adult ,Aged, 80 and over ,Male ,Reoperation ,Colon ,Duodenum ,Anastomosis, Surgical ,Anastomosis, Roux-en-Y ,Enema ,Middle Aged ,Esophageal Stenosis ,Humans ,Female ,Esophagoscopy ,Barium Sulfate ,Esophagitis, Peptic ,Aged ,Follow-Up Studies - Abstract
36 patients with peptic strictures were operated between 1981 and 1987. 40 operations performed because 4 recurrences after a first intervention obliged to a re-operation. The conservative procedure was used in 29 cases (72.5%). A resection had to be done in 11 cases (27.5%), with 3 re-operations after a first conservative treatment. 1 patient died in hospital. The follow up concerns all patient after a minimum of 2 years. 31 patients (88%) remained symptom free, but 4 patients required further surgery. No mortality and a low morbidity with conservative surgical method were observed. The rate of success was 76% with 24% of recurrence. For us, the best conservative method is total fundoplicatio if possible (sometimes on a gastric cone in case of reflux stricture with shortening of the esophagus). The duodenal diversion is recommended if approach of hiatus is too difficult (re-operation) and in case of alkaline reflux.
- Published
- 1990
18. Positive pressure inspiratory aid v assisted mechanical ventilation after esophageal surgery
- Author
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J. Baulieux, C. Kopp, F. Boyer, J.J. Fargier, M. Pouyet, D. Robert, J. Chagny, and J.F. Moskovtchenko
- Subjects
Mechanical ventilation ,Respiratory rate ,business.industry ,Sedation ,medicine.medical_treatment ,Positive pressure ,Hemodynamics ,Context (language use) ,Esophageal cancer ,Critical Care and Intensive Care Medicine ,medicine.disease ,Anesthesia ,medicine ,medicine.symptom ,business ,Respiratory minute volume - Abstract
Ten patients undergoing resection for esophageal cancer were randomized postoperatively into two groups. In group 1, five patients were supported with positive pressure inspiratory aid (PPIA); whereas, in group 2, five patients were managed with conventional assisted mechanical ventilation (AMV). Both groups had ventilatory support for 18 hours and then were extubated subject to defined criteria. Compared to AMV, PPIA patients felt comfortable, used less sedation, and the PaO 2 , was higher, with PaC0 2 and pHa close to normal values. These favorable results were obtained despite a decrease in respiratory rate and expired minute volume. No adverse effects in terms of hemodynamic alterations, weaning difficulties, or pulmonary complications were seen. PPIA differs from other pressure support modes by providing a virtually unlimited inspiratory flow and an expiratory trigger that ends the inspiretory phase. These features provide a zero end inspiratory flow phase, thereby allowing patients to control inspiratory time and vary or modulate their own inspiratory effort. In the context of routine postoperative ventilatory support for esophageal resection patients, PPIA offers advantages over AMV.
- Published
- 1987
19. Adaptation of a microcomputer system to a modified split Hopkinson bar
- Author
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J L Lataillade, J M Pouyet, and C Signoret
- Subjects
High rate ,Materials science ,business.industry ,Microcomputer system ,General Engineering ,General Physics and Astronomy ,General Materials Science ,Structural engineering ,Split-Hopkinson pressure bar ,business ,Instrumentation - Abstract
A modification of a split Hopkinson pressure bar is presented. The experimental data, obtained with this testing apparatus, are treated by means of a graphic microcomputer. The behaviour relationship sigma =f( epsilon ) for high rates of strain is rapidly achieved and then can be used for modelisation.
- Published
- 1980
20. [Peroperative radiotherapy. Initial experience at the Red Cross Hospital]
- Author
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G, De Laroche, M, Pouyet, D, Lyonnet, J P, Gérard, I, Sentenac, X, Montbarbon, J L, Gaudin, P, Janody, J, Chagny, and J, Fargier
- Subjects
Adult ,Male ,Radiotherapy, High-Energy ,Intraoperative Care ,Humans ,Female ,Radiotherapy Dosage ,Middle Aged ,Particle Accelerators ,Combined Modality Therapy ,Aged ,Gastrointestinal Neoplasms - Abstract
Intra operative radiation therapy is a new look at an old idea (Rich). In relation with the first experience at the Croix-Rousse Hospital with orthovoltage, a review of technical choices, surgical problems, and biological questions is presented. The analysis of literature about accumulated clinical results suggest that local control in recurrence, residual, or inoperable tumor can be obtained by combined surgery IOR, and external beam irradiation. This short experience demonstrate the feasibility of the treatment as a routine and emphasizes the need for continued study.
- Published
- 1986
21. Electromyogramme (EMG) digestif postopératoire précoce chez l'homme et le chien
- Author
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Françoise Achard, Monique Denavit, Roche M, M. Pouyet, and Revues Inra, Import
- Subjects
Embryology ,[SDV.AEN] Life Sciences [q-bio]/Food and Nutrition ,Reproductive Medicine ,[SDV.BDD] Life Sciences [q-bio]/Development Biology ,Medicine (miscellaneous) ,Animal Science and Zoology ,Biology ,[SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology ,Developmental Biology ,Food Science - Published
- 1984
22. [Crohn's disease. Apropos of 72 surgical cases]
- Author
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D, Bigay, P H, Berard, J, Cuilleret, M, Guillaud, M, Pouyet, E, Saubier, and G, Guillemin
- Subjects
Adult ,Male ,Adolescent ,Age Factors ,Middle Aged ,Intestines ,Sex Factors ,Crohn Disease ,Recurrence ,Methods ,Humans ,Female ,Child ,Aged - Abstract
The authors report a series of 72 cases of Crohn's disease, and discuss the clinical and pathological aspects, the surgical treatment and results. A critical study of the operations in view of the requirements of the disease showed that incomplete resection was mainly responsible for the recurrences. In most cases, the word relapse was more suitable to describe the poor results noted. Immediate radical removal gives such good results that these outweigh the functional disadvantages.
- Published
- 1976
23. [Proposal for the repair of traumatic cavo-suprahepatic lesions]
- Author
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M, Pouyet
- Subjects
Extracorporeal Circulation ,Liver ,Humans ,Venae Cavae - Published
- 1988
24. [Hepatic intra-arterial chemotherapy using an implantable pump]
- Author
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M, Pouyet, L, Chollat, and B, Salles
- Subjects
Liver Neoplasms ,Humans ,Infusions, Intra-Arterial - Published
- 1984
25. [Fulminant and subfulminant hepatitis treated by orthotopic transplantation of the liver. Apropos of 10 cases]
- Author
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M, Pouyet, C, Ducerf, P, Gaussorgues, F, Salord, M, Sirodot, P, Caillon, J M, Dubois, M, Rivoire, J, Baulieux, and P, Bouletreau
- Subjects
Adult ,Graft Rejection ,Male ,Adolescent ,Middle Aged ,Hepatitis B ,Severity of Illness Index ,Liver Transplantation ,Hepatic Encephalopathy ,Acute Disease ,Humans ,Female ,Emergencies ,Aged ,Follow-Up Studies - Abstract
In the period between 15/12/1987 and 15/08/1989, ten patients with either fulminating or subfulminating hepatitis have been treated by orthotopic liver transplantation (O.L.T.). Six patients are doing well in the post-operative period with a mean follow-up of 12 months (7-23 months). No evidence of neurological sequelae has been observed and recurrence of HB virus infection was absent from the three cases who survived hepatitis B transplantation. Four out these ten patients died after initial successful O.L.T... One patient succumbed 7 days after O.L.T. from sepsis or early super-acute rejection, the second 21 days after O.L.T. from neuromeningeal listeria, the third 43 days post O.L.T. from acute rejection, while the fourth developed cytomegalovirus pneumonia and died 61 days after O.L.T. Orthotopic liver transplantation has become the treatment of fulminating hepatitis. It is an emergency which is usually accompanied by successive difficulties in decision making: indication criteria, then acceptance or refusal of ABO incompatible grafts (5/10) and of suboptimal donors. Orthotopic liver transplantation for fulminating hepatitis is technically easy to perform, but usually requires the use of extra-corporal veno-venous circulation. Accompanying intensive medical care is essential and usually includes one or multiple plasmaphereses to correct existing coagulopathy without any fluid or sodium overload to the circulation.
- Published
- 1989
26. [Results of hepatic intra-arterial chemotherapy using an implanted pump in hepatic metastases of colorectal adenocarcinoma]
- Author
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A M, Pouyet, J, Baulieux, P, Caillon, P, Janody, and C, Ducerf
- Subjects
Male ,Evaluation Studies as Topic ,Rectal Neoplasms ,Colonic Neoplasms ,Liver Neoplasms ,Humans ,Infusions, Intra-Arterial ,Antineoplastic Agents ,Female ,Adenocarcinoma ,Middle Aged ,Infusion Pumps - Published
- 1987
27. [Excisional surgery of hepatic metastases of colorectal adenocarcinoma]
- Author
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M, Pouyet, J, Baulieux, C, Ducerf, and P, Caillon
- Subjects
Adult ,Male ,Liver Neoplasms ,Adenocarcinoma ,Middle Aged ,Combined Modality Therapy ,Actuarial Analysis ,Hepatectomy ,Humans ,Female ,Neoplasm Recurrence, Local ,Colorectal Neoplasms ,Aged ,Follow-Up Studies - Abstract
Between 1981 and 1985, 39 patients had hepatic resection for colorectal cancer liver metastases 44 operations (5 iteratives resections) were performed with 33 major hepatectomy. There was no mortality. Long term results showed: a one year 53% survival, a two years 23% survival, a three years 11% survival. 28 patients had recurrences; 15 of these 28 had hepatic recurrences. According to recent literature the high level of hepatic recurrence suggest that surgical resection should be accompanied with regional chemotherapy.
- Published
- 1988
28. [Total pharyngo-laryngo-esophagectomy with reestablishment of continuity by intestinal pull-up; apropos of 15 cases]
- Author
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J P, Haguenauer, M, Pouyet, J, Baulieux, J C, Pignat, J, Leval, and J, Gaillard
- Subjects
Male ,Esophageal Neoplasms ,Pharyngectomy ,Colon ,Esophagoplasty ,Stomach ,Humans ,Female ,Laryngectomy ,Pharyngeal Neoplasms ,Middle Aged ,Aged - Published
- 1984
29. [The treatment of traumatic lesions of the superior hepaticocaval veins. A report on 53 cases (author's transl)]
- Author
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M, Pouyet and J P, Perrin
- Subjects
Vena Cava, Superior ,Liver ,Humans ,Hepatic Veins ,Hemostasis, Surgical - Published
- 1980
30. Diagnostic needle arthroscopy of the scapulohumeral joint in standing sedated horses.
- Author
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Pouyet M and Bonilla AG
- Subjects
- Animals, Arthroscopy instrumentation, Arthroscopy methods, Cadaver, Female, Horses, Male, Arthroscopy veterinary, Needles veterinary, Shoulder Joint surgery
- Abstract
Objective: To describe the technique to perform diagnostic standing scapulohumeral joint needle arthroscopy with a 1.2-mm-diameter arthroscope in horses., Study Design: Experimental study., Animals: Eight thoracic limbs in phase 1 and six horses in phase 2., Methods: In phase 1, the feasibility of the technique was evaluated by using a craniolateral arthroscopic approach. An evaluation of the visible structures of the scapulohumeral joint was performed with both a needle arthroscope and a 4-mm-diameter arthroscope. In phase 2, the technique was performed in six healthy sedated horses to validate the technique in live animals and to report any complications or limitations., Results: In phase 1, joint evaluation was similar between arthroscopes and allowed complete evaluation of approximately the lateral half of the humeral head and the lateral glenoid rim. In phase 2, all joints were successfully accessed, and fluid extravasation was mild. Arthroscopic visualization was complete for the centrolateral aspect of the joint in all horses and either complete (3/6) or partial (3/6) for the craniolateral and caudolateral structures, respectively. The procedure was rapidly performed and well tolerated, and no postoperative complications occurred., Conclusion: The described technique was simple and allowed direct inspection of the scapulohumeral joint. Nonetheless, the standing nature of the technique prevents evaluation of the medial aspect of the humeral head and most of the glenoid cavity., Clinical Significance: Needle arthroscopy of the scapulohumeral joint is feasible in horses and offers a diagnostic technique that may improve the surgeon's diagnostic ability for certain shoulder pathologies., (© 2020 American College of Veterinary Surgeons.)
- Published
- 2021
- Full Text
- View/download PDF
31. Validation of a 2-mm videoendoscope for the evaluation of the paranasal sinuses with a minimally invasive technique.
- Author
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Pouyet M and G Bonilla A
- Subjects
- Animals, Cadaver, Minimally Invasive Surgical Procedures methods, Reproducibility of Results, Video-Assisted Surgery instrumentation, Video-Assisted Surgery methods, Endoscopes veterinary, Horses surgery, Minimally Invasive Surgical Procedures veterinary, Paranasal Sinuses surgery, Video-Assisted Surgery veterinary
- Abstract
Objective: To describe the technique, experience, and limitations of using a 2-mm flexible endoscope to perform standing minimally invasive sinoscopy., Study Design: In phases 1 and 2, we used cadaveric heads (ex vivo). In phase 3, we used unaffected horses (in vivo)., Animals: Five cadaveric equine skulls in phase 1 and 10 cadaveric equine skulls in phase 2. Six horses older than 5 years in phase 3., Methods: In phase 1, the specimens were used to determine the suitability of the endoscope for sinoscopy and the ideal landmarks to approach the paranasal sinuses through minisinusotomies performed with a 14 gauge needle. In phase 2, a nonblinded evaluation of the visualization of the different sinus compartments was performed, and a score was attributed to each structure. Procedures were video recorded and compared with direct visualization of the sinuses after performing frontal and maxillary flaps. In phase 3, the technique was validated in healthy horses under sedation., Results: The landmarks determined in phase 1 allowed a thorough exploration of the sinuses in phases 2 and 3. Sinoscopy findings were confirmed after direct visualization of the sinuses via frontal and maxillary bone flaps in phase 2. The procedure was well tolerated by all horses., Conclusion: Minimally invasive sinoscopy was readily performed without relevant complications in standing horses. A thorough evaluation of most sinus structures was obtained only using the frontal and the rostral maxillary portals., Clinical Significance: Minimally invasive sinoscopy offers an alternative diagnostic tool to veterinarians. A specialized endoscope and appropriate training are required to perform this minimally invasive procedure., (© 2019 The American College of Veterinary Surgeons.)
- Published
- 2020
- Full Text
- View/download PDF
32. Age associated changes in peripheral airway smooth muscle mass of healthy horses.
- Author
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Bullone M, Pouyet M, and Lavoie JP
- Subjects
- Animals, Horses physiology, Aging physiology, Horses anatomy & histology, Lung anatomy & histology, Muscle, Smooth anatomy & histology
- Abstract
Peripheral airway smooth muscle (ASM) mass is increased in severe equine asthma, but no information is available on age related changes in ASM. In this study, peripheral ASM dimensions were determined in healthy horses of different ages. The thickness of the peripheral ASM layer was constant in horses of different ages, but ASM occupied a greater proportion of the inner wall area in young horses compared to older horses. This finding suggests that equine airways experience a decrease in the relative abundance of ASM with age., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
33. Adult left liver transplantation from split livers and living donors: a 14-year single-center experience.
- Author
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Boillot O, Sagnard P, Guillaud O, Ber CE, Pouyet M, and Dumortier J
- Subjects
- Adolescent, Adult, Female, Follow-Up Studies, Graft Survival, Humans, Liver Failure mortality, Liver Transplantation methods, Male, Middle Aged, Prognosis, Survival Rate, Young Adult, Graft Rejection mortality, Liver Failure surgery, Liver Transplantation mortality, Living Donors, Postoperative Complications mortality
- Abstract
Background: In an era of organ scarcity, the use of left liver grafts for adult recipients could increase the access to liver transplantation (LT). The aim of this study was to evaluate the results in a single-center series of adult left LT over a 14-yr period., Patients and Methods: Between March 1996 and March 2010, 30 adult patients underwent LT with a left liver obtained from 16 split cadaveric livers and 14 living donors (LD). Portal vein inflow modulation was performed in selected cases., Results: A total of 19 (63.3%) grafts had early dysfunction leading to graft failure in six cases (20%). One third of the grafts developed small-for-size syndrome (SFSS). One-yr patient and graft survival was 80% and 76.7%, respectively. Regarding two successive periods, one-yr patient and graft survival dramatically increased from 62.5% to 100% (p = 0.01) and 56.2% to 100% (p = 0.002), respectively. Multivariate analysis disclosed that completion of a portosystemic shunt and the occurrence of post-operative ascites were significantly associated with graft failure., Conclusions: Our results support that improved surgical techniques and careful patient selection can lead to a safe use of left livers for transplantation in adult recipients. Inflow modulation could be performed in very selected cases., (© 2013 John Wiley & Sons A/S.)
- Published
- 2013
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34. Liver regeneration and hemodynamics in pigs with mesocaval shunt.
- Author
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Pouyet M, Méchet I, Paquet C, and Scoazec JY
- Subjects
- Anastomosis, Surgical methods, Animals, Glycogen metabolism, Ligation, Liver blood supply, Liver cytology, Liver surgery, Liver Circulation, Liver Transplantation, Living Donors, Splanchnic Circulation, Sus scrofa, Hepatectomy methods, Liver Regeneration, Mesenteric Veins surgery, Vascular Surgical Procedures methods, Vena Cava, Inferior surgery
- Abstract
Background: A surgical technique using a mesocaval shunt and downstream ligation of the superior mesenteric vein has been recently proposed to overcome the size limitations that restrict the use of partial liver grafts. We designed an experimental study in pigs to evaluate the capacities of liver regeneration and hemodynamic changes after completion of this procedure., Material and Methods: Liver regeneration after left hepatectomy was compared between two groups of five pigs, with or without mesocaval shunt, sacrificed 11 to 14 days after surgery. A third group of five animals was used for hemodynamic studies., Results: Liver regeneration in study animals was 45.3% of controls. This was obtained despite a reduction of the venous inflow to 15.6% of the control, resulting in a net decrease of the total blood inflow to 56% of the control, despite a compensatory increase in the arterial inflow. There was no significant difference in mitotic index, hepatocellular size, and glycogen content between study and control animals., Conclusion: Our experimental study confirms that the regenerative capacities of the pig liver are largely preserved despite the dramatic reduction of the venous blood inflow, reduced to its gastroduodenosplenopancreatic component. This lends further support to the hypothesis that the gastroduodenosplenopancreatic blood is enriched in hepatotrophic factors, likely to originate from the pancreas and duodenum.
- Published
- 2007
- Full Text
- View/download PDF
35. Uncoupling the systemic circulation and the Ex Vivo circuit during experimental isolated liver perfusion.
- Author
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Lhuillier F, Pouyet M, Méchet I, Liotard D, Merle E, Delafosse B, Goudable J, Vianey-Saban C, and Viale JP
- Subjects
- Animals, Blood Flow Velocity physiology, Female, Perfusion, Swine, Blood Circulation, Extracorporeal Circulation methods, Liver blood supply, Liver Circulation
- Abstract
Performing an ex vivo liver perfusion as a transient liver support requires perfusing the liver with a flow of 1 ml/min per kg of liver, which could reach 25% of the cardiac output when a human liver is used. This high flow could be detrimental in patients with acute liver failure. Therefore, in an ischemic-induced liver failure pig model, we developed a circuit allowing low flows going out of and into the systemic circulation, whereas the flow going through the ex vivo liver is maintained at a high value. This was obtained by uncoupling the ex vivo circuit from the systemic circulation. Ex vivo liver perfusion was performed in a closed circuit with a flow averaging 1 ml/min per kg of ex vivo liver (700 to 800 ml/min, according to the weight of the livers we used). It was linked to the systemic circulation with input and output flows equal to that used during hemodialysis (200 ml/min). Compared with previously reported direct circuits, this perfusion system was well tolerated from a circulatory point of view. After the induction of ischemic liver failure, the ex vivo liver perfusion led to an increase in urea, branched amino acids to aromatic amino acid ratio, and fractional clearance of indocyanine green and galactose and to a decrease in ammonia and lactic acid. This system allowed the ex vivo liver to keep its clearing properties despite a low extracorporeal flow. It represents an extracorporeal circuit that could be used in place of the direct extracorporeal high-flow liver perfusion.
- Published
- 2006
- Full Text
- View/download PDF
36. Liver function during extracorporeal whole liver perfusion in a pig model of acute ischemic liver failure.
- Author
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Méchet I, Lhuillier F, Blanchet MC, Pouyet M, Viale JP, Goudable J, Annat G, Scoazec JY, Boillot O, Liotard D, Merle E, and Delafosse B
- Subjects
- Animals, Disease Models, Animal, Female, Ischemia complications, Liver blood supply, Liver physiology, Liver Failure etiology, Liver Failure physiopathology, Liver Function Tests, Swine, Liver Failure therapy, Renal Dialysis methods
- Abstract
The shortage of livers for transplant has renewed interest in the potential of temporary liver support such as extra corporeal whole liver perfusion. In an ischemic induced liver failure model we perfused an extra corporeal liver through only a portal vein and assessed the function of this ex vivo liver by using hepatic tests to estimate elimination as well as synthesis capacities. Acute liver failure was performed in five control pigs by a hepatic devascularization associated to an end to side portocaval shunt. In a treated group, 5 to 6 h after this hepatic devascularization, animals were connected to an extra corporeal liver perfused via the portal vein with blood withdrawn from the ischemic liver animal from its portal vein. Devascularization of the liver induced an increase in liver enzymes and ammonia, a drop in the ratio of branched chain amino acids to aromatic amino acids, and a decrease in blood urea and indocyanine green and galactose clearances. In treated animals, urea, amino acid ratio, and clearances increased after the ex vivo liver perfusion. In this group, mean bile production and mean liver oxygen consumption were 13.7 +/- 3.6 ml/h and 16.1 +/- 7.7 ml/min, respectively. In an acute ischemic liver failure pig model, an extra corporeal whole liver perfusion demonstrated detoxification properties as well as synthesis capacities.
- Published
- 2004
- Full Text
- View/download PDF
37. Effect of mesocaval shunt on survival of small-for-size liver grafts.
- Author
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Pouyet M and Paquet C
- Subjects
- Animals, Hypertrophy, Swine, Graft Survival, Liver Transplantation adverse effects, Liver Transplantation pathology, Portasystemic Shunt, Surgical
- Published
- 2004
- Full Text
- View/download PDF
38. Portomesenteric disconnection for small-for-size grafts in liver transplantation: Preclinical studies in pigs.
- Author
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Boillot O, Mechet I, Le Derf Y, Bernard P, Figueiredo P, Berger F, Paquet C, and Pouyet M
- Subjects
- Animals, Liver pathology, Liver surgery, Liver Circulation, Liver Transplantation mortality, Splanchnic Circulation, Sus scrofa, Body Constitution, Liver Transplantation methods, Mesenteric Veins surgery, Portal Vein surgery, Portasystemic Shunt, Surgical
- Abstract
This study reviews the evaluation and results of a new liver transplantation technique for small-for-size grafts with portomesenteric disconnection. Twenty Large-White pigs underwent heterotopic liver transplantation after a mesocaval shunt, ligation of the superior mesenteric vein downstream from the shunt, and ligation of the recipient portal vein near the native liver. The donor-to-recipient weight ratio was 24%, and the graft-to-recipient weight ratio was 0.6%. In five control pigs, no mesocaval shunt was performed. The mesocaval shunt provided diversion of 60% of the splanchnic blood flow. The median survival of study pigs was 39 days (range, 8 to 98). Median serum bilirubin levels at 1 week were 12 micromol/L (range, 4 to 59). At autopsy, graft weight was increased to 2.7 times the initial weight and histologic findings were normal. In the control group, all pigs died quickly of acute splanchnic congestion. Portomesenteric disconnection was effective to achieve survival of small-for-size grafts in pig liver transplantation.
- Published
- 2003
- Full Text
- View/download PDF
39. Small-for-size partial liver graft in an adult recipient; a new transplant technique.
- Author
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Boillot O, Delafosse B, Méchet I, Boucaud C, and Pouyet M
- Subjects
- Animals, Female, Humans, Middle Aged, Organ Size, Portacaval Shunt, Surgical, Postoperative Period, Swine, Graft Survival, Liver Transplantation methods
- Abstract
We report a new technique of adult liver transplantation using a small-for-size graft. In order to avoid graft congestion and failure by overperfusion, we completely diverted the superior mesenteric venous flow by a mesocaval shunt with downstream ligation of the superior mesenteric vein. The recipient recovered well, and the graft had normal histology and function at 5 months follow-up. Given the current scarcity of cadaveric donors, this technique may increase the numbers of adult recipients by using left lobes from cadaveric split liver grafts.
- Published
- 2002
- Full Text
- View/download PDF
40. [Hemodynamic tolerance and rapid hypertrophy of a hepatic graft corresponding to less than 30% of the ideal mass in pigs].
- Author
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Pouyet M, Paquet C, Mechet I, Le Derf Y, Bernard P, Figueiredo P, Berger F, and Boillot O
- Subjects
- Anastomosis, Surgical, Animals, Bile Ducts, Bilirubin blood, Constriction, Hypertrophy, Ligation, Mesenteric Veins surgery, Models, Animal, Organ Size, Portal Vein surgery, Splanchnic Circulation, Swine, Transplantation, Heterotopic, Hemodynamics, Liver pathology, Liver Transplantation methods
- Abstract
Background and Objective: Evaluation of a new pig liver transplantation technique for survival and hypertrophy of a small-sized graft by providing adapted and controlled venous portal flow., Material and Methods: [corrected] Twenty Large-White pigs underwent heterotopic liver transplantation after a mesocaval shunt and ligation of the superior mesenteric vein downstream from the shunt. The donor-to-recipient weight ratio was below 30%. Furthermore, recipient's biliary duct and portal vein into the hilum were tied. In a control group, no mesocaval shunt was performed and the graft received the entire splanchnic venous flow., Results: The mesocaval shunt provided diversion of 60% of the splanchnic blood flow. The median survival of study pigs was 39 days (range: 8-98). Median serum bilirubin levels at 1 week were 12 micromol/L (range: 4-59). At autopsy, graft weight was increased to 2.7 times the initial weight and histological findings were normal. In the control group, all pigs died quickly from acute splanchnic congestion., Conclusion: In a model of heterotopic liver transplantation using small-sized grafts, complete diversion of mesenteric blood flow through a mesocaval shunt resulted in hemodynamic tolerance and hypertrophy of a graft corresponding to less than 30% of the ideal mass.
- Published
- 2001
41. Plasma amino acid study during discordant liver xenoperfusion.
- Author
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Adham M, Vianey-Saban C, Ducerf C, Boyer S, de la Roche E, Taibi A, Pouyet M, and Baulieux J
- Subjects
- Amino Acids, Branched-Chain blood, Amino Acids, Cyclic blood, Animals, Humans, Swine, Transplantation, Heterologous, Amino Acids blood, Perfusion methods
- Published
- 1997
- Full Text
- View/download PDF
42. Correction of acute liver cell failure disorders through liver xenoperfusion: experimental study.
- Author
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Adham M, Sab JM, Ducerf C, Tassaux D, Vianey-Saban C, Chevallier M, de la Roche E, Le QV, Bizollon T, Barakat C, Debize G, Vernet M, Pouyet M, and Baulieux J
- Subjects
- Adult, Amino Acids blood, Animals, Antibodies, Heterophile blood, Bilirubin blood, Blood Coagulation Factors analysis, Complement C3 analysis, Complement C4 analysis, Humans, Immunoglobulin G blood, Immunoglobulin M blood, Swine, Transplantation, Heterologous, Blood Proteins analysis, Liver Failure, Acute blood, Liver Failure, Acute therapy, Perfusion methods, Plasma Exchange
- Published
- 1997
- Full Text
- View/download PDF
43. Changes in serum proteins during isolated pig liver xenoperfusion.
- Author
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Adham M, Ducerf C, Vernet M, Rigal D, de la Roche E, Bizollon T, Taibi A, Pouyet M, and Baulieux J
- Subjects
- Animals, Humans, Liver blood supply, Liver Circulation, Perfusion, Serum Albumin metabolism, Serum Globulins metabolism, Swine, Time Factors, Transplantation, Heterologous, Blood Proteins metabolism, Liver physiology
- Published
- 1997
- Full Text
- View/download PDF
44. Pilot study of the combination of interferon alfa and ribavirin as therapy of recurrent hepatitis C after liver transplantation.
- Author
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Bizollon T, Palazzo U, Ducerf C, Chevallier M, Elliott M, Baulieux J, Pouyet M, and Trepo C
- Subjects
- Adult, Alanine Transaminase blood, Drug Therapy, Combination, Female, Humans, Interferon-alpha adverse effects, Liver pathology, Male, Middle Aged, Pilot Projects, RNA, Viral blood, Recurrence, Ribavirin adverse effects, Antiviral Agents administration & dosage, Hepatitis C drug therapy, Interferon-alpha administration & dosage, Liver Transplantation adverse effects, Ribavirin administration & dosage
- Abstract
Recurrent hepatitis C virus (HCV) in liver transplant patients is a major cause of graft loss, liver failure, and need for retransplantation. The results available to date with the use of interferon alfa (IFN-alpha) in the treatment of recurrent HCV in liver transplant patients have been disappointing. The aim of this study was to evaluate the efficacy and clinical utility of post-transplant combination therapy with IFNalpha2b (3 million units 3 times weekly) and oral ribavirin (1,200 mg/d) for a duration of 6 months, followed by maintenance with ribavirin alone for an additional 6 months. Twenty-one liver transplant recipients with recurrent hepatitis C infection (HCV-RNA-positive; active hepatitis without rejection on biopsy) were enrolled in this study. Pretreatment serum alanine transaminase (ALT) levels were at least two times the upper limit of normal. Before treatment, all patients were HCV-RNA-positive and mean HCV-RNA titers were 125 million genome-equivalents/mL. Mean pretreatment histological score was 6.3 +/- 2. After 6 months of combination therapy, all 21 patients had normal ALTs. Ten patients (48%) cleared HCV-RNA from their serum, as assessed by polymerase chain reaction (PCR), and HCV-RNA levels decreased significantly in the others (P = .0001). Improvement in histological score was seen in all patients after combination therapy (P = .0013). During maintenance ribavirin monotherapy, ALT remained normal in all but 1 of the 18 patients who tolerated therapy. HCV-RNA reappeared in 5 patients, but HCV-RNA levels did not return to pretreatment levels (P = .0004). Comparison of pretreatment and postribavirin monotherapy liver biopsies revealed improvement in all but 1 of the 18 patients who tolerated ribavirin (P = .0002). Side effects were restricted to anemia, which necessitated cessation of ribavirin therapy in 3 patients. No patient experienced graft rejection during the study period. These results are significantly better than those reported with IFN-alpha monotherapy. Most importantly, there was a complete absence of graft rejection. These results suggest that the combination of IFN-alpha and ribavirin is effective in reducing HCV-RNA levels and ameliorating hepatocellular injury in recurrent HCV after liver transplantation, and that maintenance therapy with ribavirin monotherapy can maintain the biochemical and histological response.
- Published
- 1997
- Full Text
- View/download PDF
45. [Delayed restoration of intestinal continuity after Hartmann's operation. 1957].
- Author
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Bertrand P, Guillemin G, Saubier E, and Pouyet M
- Subjects
- Anastomosis, Surgical methods, Colostomy methods, History, 20th Century, Humans, Anastomosis, Surgical history, Colon surgery, Colostomy history, Rectum surgery
- Published
- 1997
46. The isolated perfused porcine liver: assessment of viability during and after six hours of perfusion.
- Author
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Adham M, Peyrol S, Chevallier M, Ducerf C, Vernet M, Barakat C, De La Roche E, Taibi A, Bizollon T, Rigal D, Pouyet M, and Baulieux J
- Subjects
- Animals, Electrolytes metabolism, Hemodynamics, Lactic Acid metabolism, Organ Preservation, Perfusion, Swine, Time Factors, Liver physiology
- Abstract
Isolated liver perfusion was developed for the study of liver physiology and preservation. The recent development of new perfusion devices and appropriate liver preservation solutions prompted us to reconsider liver perfusion for the specific purpose of evaluating viability in terms of biochemical changes, paying special attention to modifications in the histological ultrastructure. Twenty-two isolated pig livers were perfused with autologous blood. Arterio-portal perfusions were carried out using an extracorporeal perfusion circuit with a hollow fibre membrane oxygenator. Four groups of pig livers were studied using three different liver flushing solutions [Ringer's lactate, ELOHES, and University of Wisconsin (UW)] and two different oxygenation modalities. Liver function tests and histological studies were done. Our results revealed that a high partial oxygen pressure (PO2) level was deleterious to the ultrastructural elements of hepatocytes, in particular to the mitochondria. It was also associated with deficient metabolic performance, i.e., poor bile production and lack of aerobic metabolism. Normal blood gas values could be obtained with the use of air for liver oxygenation. Flushing of the liver with Ringer's lactate or a macromolecular solution such as ELOHES was associated with severe liver cell injuries, as reflected by a marked rise in liver enzymes and histological lesions. Satisfactory results were obtained when UW solution was used for liver harvesting. We conclude that an appropriate liver preservation solution, normal blood gas values, and normal physiological arterio-portal pressure and blood flow are essential for appropriate liver function with preservation of liver architecture and of hepatocyte ultrastructures. Total bilirubin in bile and Factor V are sensitive indicators of good liver function.
- Published
- 1997
- Full Text
- View/download PDF
47. Requirements for physiological perfusion of isolated liver with autologous blood.
- Author
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Adham M, Peyrol S, Barakat C, Vernet M, Chevallier M, Finzi M, Berger I, Raccurt M, Bonnefont C, Rigal D, Ducerf C, Baulieux J, and Pouyet M
- Subjects
- Animals, Bilirubin blood, Blood, Blood Glucose analysis, Factor V analysis, Hemodynamics, Lactates blood, Liver blood supply, Liver pathology, Mitochondria, Liver pathology, Perfusion, Prothrombin Time, Swine, Time Factors, Urea blood, Liver physiology, Organ Preservation
- Published
- 1996
48. Orthotopic liver transplantation in presence of hepatocellular carcinoma.
- Author
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Adham M, Ducerf C, Bizollon T, Bancel B, Irani N, De La Roche E, Baulieux J, and Pouyet M
- Subjects
- Actuarial Analysis, Adult, Biopsy, Needle, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Female, Humans, Liver Neoplasms mortality, Liver Neoplasms pathology, Male, Middle Aged, Retrospective Studies, Survival Rate, Carcinoma, Hepatocellular surgery, Liver Neoplasms surgery, Liver Transplantation mortality, Liver Transplantation pathology
- Published
- 1996
49. Functional and immunological study of isolated liver xenoperfusion.
- Author
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Adham M, Peyrol S, Vernet M, Bonnefont C, Barakat C, Rigal D, Chevallier M, Berger I, Raccurt M, Ducerf C, Baulieux J, and Pouyet M
- Subjects
- Animals, Bile metabolism, Bilirubin analysis, Complement System Proteins analysis, Erythrocytes, Factor V analysis, Humans, Liver immunology, Liver pathology, Oxygen Consumption, Perfusion, Prothrombin Time, Serum Albumin, Swine, Liver physiology, Transplantation, Heterologous
- Published
- 1996
50. Hepatic outflow study after piggyback liver transplantation.
- Author
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Ducerf C, Rode A, Adham M, De la Roche E, Bizollon T, Baulieux J, and Pouyet M
- Subjects
- Adult, Female, Hemodynamics, Humans, Male, Middle Aged, Venous Pressure, Hepatic Veins physiopathology, Liver Transplantation
- Abstract
Background: Hepatic vein outflow is discussed in liver transplantation after preservation of recipient retrohepatic vena cava. The aim of this study was to compare two methods of suparahepatic caval anastomosis., Methods: From January 1993 to January 1995, 81 patients received 88 liver transplants because of liver cirrhosis (n = 70), acute liver failure (n = 7), elective retransplantation after hepatic artery thrombosis (n = 2), giant hemangioma (n = 1), and combined liver-small bowel transplantation (n = 1). Seven patients underwent urgent retransplantation, 12 had preoperative transjugular intrahepatic portocaval stent, and 11 had portal vein thrombosis. Five patients required extracorporeal venous shunt. A total of 82 liver transplantations had preservation of RHVC, and 70 patients received temporary end-to-side portacaval shunt. Suprahepatic caval anastomosis was carried out in 52 patients (group 1) between the graft suprahepatic vena cava and the ostia of recipient left and median hepatic veins. Thirty patients (group 2) had associated 3 cm vertical cavotomy with partial clamping of RHVC. In the fourth postoperative month 20 patients from each group had pressure and gradient measurement made among the hepatic veins, right atria, and the RHVC., Results: Mean pressure gradient between hepatic veins and right atria was 0.75 +/- 0.49 mm Hg in group 1 and 2.06 +/- 0.85 mm Hg in group 2. Between the RHVC and the right atria it was 0.63 +/- 0.5 mm Hg in group 1 and 2.22 +/- 1.29 mm Hg in group 2. A pressure gradient higher than 3 mm Hg was considered hemodynamically significant. This pressure gradient was found between the hepatic veins and right atria in 10% of patients in group 1 and 40% of patients in group 2 (p = 0.03) and between the RHVC and right atria in 15% of patients in group 1 and 30% of patients in group 2 (p = 0.3)., Conclusions: Preservation of the recipient RHVC with recipient caval anastomosis at the ostia of the median and left hepatic veins is a reliable technique without any hepatic venous outflow alteration. Associated cavotomy is not necessary.
- Published
- 1996
- Full Text
- View/download PDF
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