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Bouis FX, Le Roy B, Agousty M. Chemical burns in a French submariner. BMJ Mil Health 2022; 170:e002167. [PMID: 35868714 DOI: 10.1136/military-2022-002167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/17/2022] [Indexed: 11/04/2022]
Affiliation(s)
| | - B Le Roy
- LASEM, French Military Health Service, Toulon, France
| | - M Agousty
- Submarine forces medical service, French Military Health Service, Brest, France
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Rabbani N, Calvet L, Espinel Y, Le Roy B, Ribeiro M, Buc E, Bartoli A. A methodology and clinical dataset with ground-truth to evaluate registration accuracy quantitatively in computer-assisted Laparoscopic Liver Resection. Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization 2021. [DOI: 10.1080/21681163.2021.1997642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- N. Rabbani
- EnCoV, Institut Pascal, Clermont-Ferrand, France
| | - L. Calvet
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
- IRIT, University of Toulouse
| | - Y. Espinel
- EnCoV, Institut Pascal, Clermont-Ferrand, France
| | - B. Le Roy
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Saint-Etienne, France
| | - M. Ribeiro
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
| | - E. Buc
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
| | - A. Bartoli
- EnCoV, Institut Pascal, Clermont-Ferrand, France
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Hobeika C, Cauchy F, Weiss E, Chopinet S, Sepulveda A, Dondero F, Khoy-Ear L, Grigoresco B, Dokmak S, Durand F, Le Roy B, Paugam-Burtz C, Soubrane O. Practical model to identify liver transplant recipients at low risk of postoperative haemorrhage, bile leakage and ascites. BJS Open 2021; 5:6073666. [PMID: 33609380 PMCID: PMC7893463 DOI: 10.1093/bjsopen/zraa031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
Background This study aimed to identify a subgroup of recipients at low risk of haemorrhage, bile leakage and ascites following liver transplantation (LT). Methods Factors associated with significant postoperative ascites (more than 10 ml/kg on postoperative day 5), bile leakage and haemorrhage after LT were identified using three separate multivariable analyses in patients who had LT in 2010–2019. A model predicting the absence of all three outcomes was created and validated internally using bootstrap procedure. Results Overall, 944 recipients underwent LT. Rates of ascites, bile leakage and haemorrhage were 34.9, 7.7 and 6.0 per cent respectively. The 90-day mortality rate was 7.0 per cent. Partial liver graft (relative risk (RR) 1.31; P = 0.021), intraoperative ascites (more than 10 ml/kg suctioned after laparotomy) (RR 2.05; P = 0.001), malnutrition (RR 1.27; P = 0.006), portal vein thrombosis (RR 1.56; P = 0.024) and intraoperative blood loss greater than 1000 ml (RR 1.39; P = 0.003) were independently associated with postoperative ascites and/or bile leak and/or haemorrhage, and were introduced in the model. The model was well calibrated and predicted the absence of all three outcomes with an area under the curve of 0.76 (P = 0.001). Of the 944 patients, 218 (23.1 per cent) fulfilled the five criteria of the model, and 9.6 per cent experienced postoperative ascites (RR 0.22; P = 0.001), 1.8 per cent haemorrhage (RR 0.21; P = 0.033), 4.1 per cent bile leak (RR 0.54; P = 0.048), 40.4 per cent severe complications (RR 0.70; P = 0.001) and 1.4 per cent 90-day mortality (RR 0.13; P = 0.004). Conclusion A practical model has been provided to identify patients at low risk of ascites, bile leakage and haemorrhage after LT; these patients could potentially qualify for inclusion in non-abdominal drainage protocols.
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Affiliation(s)
- C Hobeika
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - F Cauchy
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - E Weiss
- Department of Anaesthesiology and Critical Care, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - S Chopinet
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - A Sepulveda
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - F Dondero
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - L Khoy-Ear
- Department of Anaesthesiology and Critical Care, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - B Grigoresco
- Department of Anaesthesiology and Critical Care, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - S Dokmak
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - F Durand
- Department of Hepatology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - B Le Roy
- Department of Digestive and Oncological Surgery, Centre Hospitalier Universitaire Nord Saint-Etienne, Saint-Priest en Jarez, France
| | - C Paugam-Burtz
- Department of Anaesthesiology and Critical Care, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
| | - O Soubrane
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Clichy, France
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Mathilde B, Maoui K, Fovet M, Le Roy B, Roblin X, Phelip J, Williet N. 1553P Incidence of and risk factors for venous thromboembolism in patients with pancreatic ductal adenocarcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bou Saleh N, Voron T, De'Angelis N, Franco I, Canoui-Poitrine F, Mutter D, Brunetti F, Gagnière J, Memeo R, Pezet D, Monange B, Pereira B, Le Roy B. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: results from the CLIMHET study group. Tech Coloproctol 2020; 24:585-592. [PMID: 32291567 DOI: 10.1007/s10151-020-02202-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 03/30/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Laparoscopic right hemicolectomy (LRHC) is increasingly performed for the treatment of right colon disease. Nevertheless, standardization of the surgical technique regarding the performance of intracorporeal (IC) or extracorporeal (EC) anastomosis is lacking. The purpose of this study was to compare short-term postoperative outcomes in patients who had laparoscopic right colectomy either with IC or EC. METHODS This was a retrospective, non-randomized and multicenter study conducted from January 2005 to December 2015 on the CLIMHET study group cohort from five tertiary centers in France. Data were collected for all patients with LRHC to compare patient characteristics, intraoperative data and postoperative outcomes in terms of medical and surgical complications, duration of hospitalization and mortality. A multivariate analysis was performed to compare the results in the two groups. RESULTS Of the 597 patients undergoing LRHC, 150 had IC and 447 had EC. The incidence of medical complications (cardiac, vascular, and pulmonary complications) was lower in the IC group than in the EC group (13 vs 20%, p = 0.049). This difference remained significant in multivariate analysis after adjusting to field characteristics and patient histories (p = 0.009). Additionally, a shorter hospital stay (7 vs 8 days, p = 0.003) was observed in the IC group as compared to the EC group. This difference remained significant in favor of the IC group in multivariate analysis (p = 0.029). There was no difference between the groups as regards: surgical complications (p = 0.76), time of mobilization (p = 0.93), reintervention rate (p = 1) and 90-day mortality (p = 0.47). CONCLUSIONS Our results show that IC anastomosis in LRHC is associated with fewer medical complications and shorter hospital stays compared to EC anastomosis.
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Affiliation(s)
- N Bou Saleh
- Department of Digestive Surgery, Service de Chirurgie Digestive Et Hépato-Biliaire, CHU Estaing, 2, Place Lucie Aubrac, 63000, Clermont-Ferrand, France
| | - T Voron
- Department of Digestive Surgery, Georges Pompidou European Hospital, Paris, France
| | - N De'Angelis
- Department of Digestive Surgery, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor Hospital, AP-HP, Créteil, France
| | - I Franco
- Department of Emergency and Organ Transplantation, Azienda Ospedaliero-Universitaria, Bari, Italy.,Hepato-Biliary and Pancreatic Surgical Unit, IRCAD-IHU, University of Strasbourg, Strasbourg, France
| | - F Canoui-Poitrine
- Biostatistics Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France.,CEpiA EA7376, DHU Ageing-Thorax-Vessel-Blood, Université Paris Est (UPEC), Créteil, France
| | - D Mutter
- Hepato-Biliary and Pancreatic Surgical Unit, IRCAD-IHU, University of Strasbourg, Strasbourg, France
| | - F Brunetti
- Department of Digestive Surgery, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor Hospital, AP-HP, Créteil, France
| | - J Gagnière
- Department of Digestive Surgery, Service de Chirurgie Digestive Et Hépato-Biliaire, CHU Estaing, 2, Place Lucie Aubrac, 63000, Clermont-Ferrand, France
| | - R Memeo
- Department of Emergency and Organ Transplantation, Azienda Ospedaliero-Universitaria, Bari, Italy.,Hepato-Biliary and Pancreatic Surgical Unit, IRCAD-IHU, University of Strasbourg, Strasbourg, France
| | - D Pezet
- Department of Digestive Surgery, Service de Chirurgie Digestive Et Hépato-Biliaire, CHU Estaing, 2, Place Lucie Aubrac, 63000, Clermont-Ferrand, France
| | - B Monange
- Medical Department, Emile Roux Hospital, Puy-en-Velay, France
| | - B Pereira
- Clinical Research and Innovation Delegation (DRCI), CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - B Le Roy
- Department of Digestive Surgery, Service de Chirurgie Digestive Et Hépato-Biliaire, CHU Estaing, 2, Place Lucie Aubrac, 63000, Clermont-Ferrand, France.
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Voron T, Romain B, Bergeat D, Véziant J, Gagnière J, Le Roy B, Pasquer A, Eveno C, Gaujoux S, Pezet D, Gronnier C. Surgical management of gastric adenocarcinoma. Official expert recommendations delivered under the aegis of the French Association of Surgery (AFC). J Visc Surg 2020; 157:117-126. [PMID: 32151595 DOI: 10.1016/j.jviscsurg.2020.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Gastric adenocarcinoma (GA) is the 5th most common cancer in the world; in France, however, its incidence has been steadily decreasing. Twenty-five experts brought together under the aegis of the French Association of Surgery collaborated in the drafting of a series of recommendations for surgical management of GA. As concerns preoperative evaluation and work-up, echo-endoscopy aimed at clarifying lymph node status should be performed in all candidates for surgical resection and exploratory laparoscopy in cases of GA cT3/T4 and/or N+ for peritoneal carcinomatosis. On the other hand, PET-scan should not be performed systematically, but only when the other modalities for diagnosis prove insufficient. Laparotomy remains the route of choice to achieve total or partial gastrectomy with D2 lymph node lymphadenectomy for advanced lesions (>T2N0). To limit the risk of dumping syndrome and esophageal reflux and as a way of reestablishing continuity, construction of a jejunal pouch on Roux-en-Y following total gastrectomy is recommended. In cases of peritoneal carcinosis in GA with a low peritoneal cancer index (PCI) (<7) in a patient in good general condition whose disease is controlled by chemotherapy, macroscopically complete cytoreduction with intraperitoneal hyperthermal chemotherapy will probably be required, and it will have to take place in an expert center. Only in the event of Child A cirrhosis may gastrectomy with D2 lymphadenectomy be considered. Palliative gastrectomy or surgical bypass for distal stomach obstruction in a patient in good general condition may also be envisioned.
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Affiliation(s)
- T Voron
- General and Digestive Surgery Department, Saint-Antoine Hospital, AP-HP, Sorbonne University, Paris, France.
| | - B Romain
- General and Digestive Surgery Department, Hautepierre Hospital, Strasbourg, France.
| | - D Bergeat
- Hepato-biliary and digestive surgery Department, Pontchaillou Hospital, 2 rue Henri Le Guilloux, 35033 Rennes, France.
| | - J Véziant
- Hepato-biliary and digestive surgery Department-Hepatic Transplantation U1071 Inserm/University Clermont-Auvergne CHU Estaing, 1, place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand cedex 1, France.
| | - J Gagnière
- Hepato-biliary and digestive surgery Department-Hepatic Transplantation U1071 Inserm/University Clermont-Auvergne CHU Estaing, 1, place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand cedex 1, France.
| | - B Le Roy
- Digestive surgery and oncology Department, CHU Nord Saint-Etienne, Avenue Albert Raymond, 42270 Saint-Priest-en-Jarez, France.
| | - A Pasquer
- Digestive surgery Department, Édouard Herriot Hospital, Hospices Civils de Lyon, Place d'Arsonval, 69437 Lyon cedex, France.
| | - C Eveno
- Digestive surgery and oncology Department, Claude Huriez Hospital, 59000 Lille, France.
| | - S Gaujoux
- Department of Digestive, Hepato-biliary and Endocrine Surgery, Paris-Descartes University Hôpital Cochin-Pavillon Pasteur, 27 rue du Faubourg Saint Jacques, 75014 Paris, France.
| | - D Pezet
- Hepato-biliary and digestive surgery Department-Hepatic Transplantation U1071 Inserm/University Clermont-Auvergne CHU Estaing, 1, place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand cedex 1, France.
| | - C Gronnier
- Digestive surgery Department, Medico-chirurgical Center Magellan, avenue de Magellan, 33604 Pessac, France.
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Bachet JB, Moreno-Lopez N, Vigano L, Marchese U, Gelli M, Raoux L, Truant S, Laurent C, Herrero A, Le Roy B, Deguelte Lardiere S, Passot G, Hautefeuille V, De La Fouchardiere C, Artru P, Ameto T, Mabrut JY, Schwarz L, Rousseau B, Lepère C, Coriat R, Brouquet A, Sa Cunha A, Benoist S. BRAF mutation is not associated with an increased risk of recurrence in patients undergoing resection of colorectal liver metastases. Br J Surg 2019; 106:1237-1247. [PMID: 31183866 DOI: 10.1002/bjs.11180] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND BRAF mutation is associated with a poor prognosis in patients with metastatic colorectal cancer. For patients with resectable colorectal liver metastases (CRLMs), the prognostic impact of BRAF mutation is unknown and the benefit of surgery debated. This nationwide intergroup (ACHBT, FRENCH, AGEO) study aimed to evaluate the oncological outcome of patients undergoing liver resection for BRAF-mutated CRLMs. METHODS The study included patients who underwent resection for BRAF-mutated CRLMs in 24 centres between 2012 and 2016. A case-matched comparison was made with 183 patients who underwent resection of CRLMs with wild-type BRAF during the same interval. RESULTS Sixty-six patients who underwent resection for BRAF-mutated CRLMs in 24 centres were compared with 183 patients with wild-type BRAF. The 1- and 3-year disease-free survival (DFS) rates were 46 and 19 per cent for the BRAF-mutated group, and 55·4 and 27·8 per cent for the group with wild-type BRAF (P = 0·430). In multivariable analysis, BRAF mutation was not associated with worse DFS (hazard ratio 1·16, 95 per cent c.i. 0·72 to 1·85; P = 0·547). The 1- and 3-year overall survival rates after surgery were 94 and 54 per cent respectively among patients with BRAF mutation, and 95·8 and 82·9 per cent in those with wild-type BRAF (P = 0·004). Median survival after disease progression was 23·0 (95 per cent c.i. 11·0 to 35·0) months among patients with mutated BRAF and 44·3 (35·9 to 52·6) months in those with wild-type BRAF (P = 0·050). Multisite disease progression was more common in the BRAF-mutated group (48 versus 29·8 per cent; P = 0·034). CONCLUSION These results support surgical treatment for resectable BRAF-mutated CRLM, as BRAF mutation by itself does not increase the risk of relapse after resection. BRAF mutation is associated with worse survival in patients whose disease relapses after resection of CRLM, as for non-metastatic colorectal cancer.
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Affiliation(s)
- J-B Bachet
- Sorbonne Université, University Pierre and Marie Curie, Paris, France.,Department of Hepato-Gastroenterology, Hôpital Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - N Moreno-Lopez
- Department of Digestive Surgery, Dijon University Hospital, Dijon, France
| | - L Vigano
- Division of Hepatobiliary and General Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - U Marchese
- Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - M Gelli
- Department of General Surgical Oncology, Gustave Roussy Institute, Villejuif, France
| | - L Raoux
- Department of Digestive Surgery, University Hospital of Toulouse, University Paul Sabatier, Toulouse, France
| | - S Truant
- Department of Digestive Surgery and Transplantation, Lille University Hospital, Lille, France
| | - C Laurent
- Department of Hepatobiliopancreatic Surgery and Liver Transplantation, Saint André Hospital, Bordeaux, France
| | - A Herrero
- Department of General Surgery, Division of Transplantation, University of Montpellier - College of Medicine, Saint Eloi Hospital, Montpellier, France
| | - B Le Roy
- Department of Digestive Surgery, Estaing University Hospital, Clermont-Ferrand, France
| | - S Deguelte Lardiere
- Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré University Hospital, Reims, France
| | - G Passot
- Department of Surgical Oncology, Centre Hospitalier Lyon Sud, Pierre Benite, France
| | - V Hautefeuille
- Department of Gastroenterology, Amiens-Picardie University Hospital, Amiens, France
| | | | - P Artru
- Department of Oncology, Hôpital Privé Jean Mermoz, Lyon, France
| | - T Ameto
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
| | - J Y Mabrut
- Department of Hepatobiliopancreatic Surgery and Liver Transplantation, Hôpital Croix Rousse, Lyon, France
| | - L Schwarz
- Department of Digestive Surgery, Hôpital Charles Nicolle, Rouen, France
| | - B Rousseau
- Department of Oncology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - C Lepère
- Department of Gastroenterology and Digestive Oncology, European Georges Pompidou Hospital, AP-HP, Paris, France
| | - R Coriat
- Department of Gastroenterology and Digestive Oncology, Cochin Hospital, AP-HP, Paris, France
| | - A Brouquet
- Department of Digestive Surgery and Surgical Oncology, Bicêtre Hospital, AP-HP, Paris-Sud University, Le Kremlin Bicêtre, France.,Paris-Sud University, Le Kremlin Bicêtre, France
| | - A Sa Cunha
- Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Paul Brousse Hospital, Villejuif, France.,Paris-Sud University, Le Kremlin Bicêtre, France
| | - S Benoist
- Department of Digestive Surgery and Surgical Oncology, Bicêtre Hospital, AP-HP, Paris-Sud University, Le Kremlin Bicêtre, France.,Paris-Sud University, Le Kremlin Bicêtre, France
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Le Roy B, Dupré A, Gallon A, Chabrot P, Gagnière J, Buc E. Liver hypertrophy: Underlying mechanisms and promoting procedures before major hepatectomy. J Visc Surg 2018; 155:393-401. [PMID: 30126801 DOI: 10.1016/j.jviscsurg.2018.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Various procedures can promote hypertrophy of the future liver remnant (FLR) before major hepatectomy to prevent postoperative liver failure. The pathophysiological situation following portal vein embolization (PVE), hepatic artery ligation/embolization or hepatectomy remains unclear. On one hand, the main mechanisms of hepatic regeneration appear to be driven by hepatic hypoxia (involving the hepatic arterial buffer response), an increased portal blood flow inducing shear stress and the involvement of several mediators (inflammatory cytokines, vasoregulators, growth factors, eicosanoids and several hormones). On the other hand, several factors are associated with impaired liver regeneration, such as biliary obstruction, malnutrition, diabetes mellitus, male gender, age, ethanol and viral infection. All these mechanisms may explain the varying degrees of hypertrophy observed following a surgical or radiological procedure promoting hypertrophy the FLR. Radiological procedures include left and right portal vein embolization (extended or not to segment 4), sequential PVE and hepatic vein embolization (HVE), and more recently combined PVE and HVE. Surgical procedures include associated liver partition and portal vein ligation for staged hepatectomy, and more recently the combined portal embolization and arterial ligation procedure. This review aimed to clarify the pathophysiology of liver regeneration; it also describes radiological or surgical procedures employed to improve liver regeneration in terms of volumetric changes, the feasibility of the second step and the benefits and drawbacks of each procedure.
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Affiliation(s)
- B Le Roy
- Department of Digestive and Hepatobiliary Surgery, Hôpital Estaing, CHU Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France; UMR Auvergne UMR 6602 UCA/CNRS/SIGMA, Clermont-Ferrand Faculty of Medicine, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France.
| | - A Dupré
- Inserm, LabTAU UMR1032, Centre Léon-Bérard, Université Claude-Bernard Lyon 1, 69003 Lyon, France
| | - A Gallon
- Department of Vascular Radiology, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, place Henri-Dunant, 63000 Clermont-Ferrand, France; UMR Auvergne UMR 6602 UCA/CNRS/SIGMA, Clermont-Ferrand Faculty of Medicine, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France
| | - P Chabrot
- Department of Vascular Radiology, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, place Henri-Dunant, 63000 Clermont-Ferrand, France; UMR Auvergne UMR 6602 UCA/CNRS/SIGMA, Clermont-Ferrand Faculty of Medicine, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France
| | - J Gagnière
- Department of Digestive and Hepatobiliary Surgery, Hôpital Estaing, CHU Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
| | - E Buc
- Department of Digestive and Hepatobiliary Surgery, Hôpital Estaing, CHU Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France; UMR Auvergne UMR 6602 UCA/CNRS/SIGMA, Clermont-Ferrand Faculty of Medicine, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France
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Abstract
INTRODUCTION Surgical site infections (SSI) are a public health issue. The purpose of this review is to review the literature on methods of pre-operative skin preparation for the prevention of SSI in abdominal surgery. METHODS In order to obtain the best level of evidence, only meta-analyses and randomized controlled clinical trials were selected from the Cochrane Library and PubMed databases. High-powered non-randomized studies were included when results were not available for the questions asked. The primary endpoint was the rate of SSI within 30 days. RESULTS Analysis of the 20 selected studies suggested that hair removal in the operative field is not recommended except when it interferes with surgery; in this case, hair clipping or chemical depilation is recommended and shaving should be banned. For the pre-operative shower, the choice of a detergent product with or without antiseptic does not seem to matter, and there were no published data on the required number of showers or the interval before surgery. Application of an alcohol-based solution to the operative field for cutaneous disinfection is recommended; the products used seem to be equivalent, and there is no need for pre-operative detergent scrubbing. There is no strong evidence to recommend adhesive plastic drapes for clean or contaminated surgery. CONCLUSION Some recommendations on skin preparation before abdominal surgery to reduce the rate of SSI are based on a high level of evidence. Other recommendations such as the number and duration of pre-operative showers or use of adhesive plastic skin drapes are less well supported.
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Affiliation(s)
- K Poirot
- Service de chirurgie digestive, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - B Le Roy
- Service de chirurgie digestive, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - L Badrikian
- Service d'hygiène hospitalière, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - K Slim
- Service de chirurgie digestive, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France.
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Pietrasz D, Turrini O, Vendrely V, Laurent C, Terrebonne E, Hentic Dhome O, Sauvanet A, Simon JM, Coriat R, Portales F, Le Roy B, Pointet AL, Marthey L, Regenet N, Goere D, Artru P, Vaillant JC, Delpero JR, Bachet JB, Sa Cunha A. Preoperative chemoradiotherapy after induction FOLFIRINOX improve R0 resection margins rate and histological response in patients secondary resected in borderline or locally advanced pancreatic adenocarcinoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Le Roy B, Gelli M, Pittau G, Allard MA, Pereira B, Serji B, Vibert E, Castaing D, Adam R, Cherqui D, Sa Cunha A. Neoadjuvant chemotherapy for initially unresectable intrahepatic cholangiocarcinoma. Br J Surg 2017; 105:839-847. [PMID: 28858392 DOI: 10.1002/bjs.10641] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/05/2017] [Accepted: 06/10/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Locoregional extension of intrahepatic cholangiocarcinoma (ICC) at the time of diagnosis results in a low resectability rate and poor prognosis. The aim of this retrospective study was to assess the efficacy of neoadjuvant chemotherapy for locally advanced ICC. METHODS All consecutive patients with ICC between 2000 and 2013 were included prospectively in a single-centre database and analysed retrospectively. Patients with locally advanced ICC considered as initially unresectable received primary chemotherapy, followed by surgery in those with secondary resectability. Results of patients who underwent surgery for locally advanced ICC were compared with those of patients with initially resectable ICC treated by surgery alone. RESULTS A total of 186 patients were included in the study. Of 74 patients with locally advanced ICC, 39 (53 per cent) underwent secondary resection after a median of six chemotherapy cycles. Patients in this group were younger (P = 0·030) and had more advanced disease than those who had surgery alone, and presented more frequently with lymphadenopathy (P = 0·010) and vascular invasion (P = 0·010). Postoperative morbidity and mortality were no different between the groups. The median survival of patients who had surgery after chemotherapy was 24·1 months, and that of patients who had surgery alone was 25·7 months (P = 0·391). CONCLUSION Patients with locally advanced ICC treated by surgery following neoadjuvant chemotherapy had similar short- and long-term results to patients with initially resectable ICC who had surgery alone. Neoadjuvant chemotherapy as a first-line treatment for locally advanced ICC may be an effective downstaging option, facilitating secondary resectability in patients with initially unresectable disease.
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Affiliation(s)
- B Le Roy
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France.,Service de Chirurgie Digestive, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - M Gelli
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | - G Pittau
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | - M-A Allard
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | - B Pereira
- Biostatistics Unit (Direction de la Recherche Clinique et de l'Innovation), Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - B Serji
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | - E Vibert
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | - D Castaing
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | - R Adam
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | - D Cherqui
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
| | - A Sa Cunha
- Centre Hépato-Biliaire, Assistance Publique - Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France
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Affiliation(s)
- B Le Roy
- Service de chirurgie digestive, CHU Estaing, CHU de Clermont-Ferrand, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - K Slim
- Service de chirurgie digestive, CHU Estaing, CHU de Clermont-Ferrand, place Lucie-Aubrac, 63003 Clermont-Ferrand, France.
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Veziant J, Antomarchi O, Pezet D, Daniel G, Le Roy B. Laparoscopic distal gastrectomy with type D2 lymphadenectomy for adenocarcinoma (hybrid procedure) (with video). J Visc Surg 2017; 154:135-136. [PMID: 28395957 DOI: 10.1016/j.jviscsurg.2017.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- J Veziant
- Department of Digestive Surgery, Estaing hospital, CHU Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
| | - O Antomarchi
- Department of Digestive Surgery, Estaing hospital, CHU Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
| | - D Pezet
- Department of Digestive Surgery, Estaing hospital, CHU Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
| | - G Daniel
- Department of Digestive Surgery, Estaing hospital, CHU Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
| | - B Le Roy
- Department of Digestive Surgery, Estaing hospital, CHU Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France.
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Slim K, Le Roy B. Laparoscopic peritoneal lavage for perforated sigmoid diverticulitis - an example of surgical research failure. Colorectal Dis 2017; 19:208. [PMID: 28067988 DOI: 10.1111/codi.13598] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 10/26/2016] [Indexed: 12/27/2022]
Affiliation(s)
- K Slim
- Department of Digestive Surgery, CHU Estaing, Clermont-Ferrand, France
| | - B Le Roy
- Department of Digestive Surgery, CHU Estaing, Clermont-Ferrand, France
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Le Roy B, Fetche N, Buc E, Pereira B, Genty F, Antomarchi O, Gagnière J, Pezet D, Slim K. Feasibility prospective study of laparoscopic cholecystectomy with suprapubic approach. J Visc Surg 2016; 153:327-331. [PMID: 27118171 DOI: 10.1016/j.jviscsurg.2016.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Since the publication of laparoscopic cholecystectomy (LC) using three ports instead of four, no significant evolution has impacted on our clinical practice in order to improve length of stay, postoperative pain, time of recovery and cosmetic results. Recently, a renewed interest has been observed with the suprapubic approach, called occult scar laparoscopic cholecystectomy (OSLC). The aim of this prospective multicentric study was to evaluate the feasibility of OSLC in 2 French centers. METHODS From March to September 2014, 60 patients were prospectively included in this study. The operation incisions consisted of an umbilical incision for camera; an incision in the right groin for maneuvers of exposition and a suprapubic incision for instrumental dissection and clipping. Outcome was by operative time, operative complications, hospital length of stay, analgesia required after surgery, and cosmetic outcomes. The Patient Satisfaction Scale and Visual Analog Score (VAS) also were used to evaluate the level of cosmetic result and postoperative pain. RESULTS No laparoscopy was converted to an open procedure, the mean operative time was 53±20min. No patient had intraoperative bile duct injury or significant bleeding. The mean length of stay was 1.70±0.76 days. Two patients (3%) experienced postoperative complication (1 intra-abdominal abscess treated by antibiotics and 1 subcutaneous seroma of the 11-mm port wound treated successfully by needle aspiration). CONCLUSION The technique proved to be safe and feasible with no specific complication and without specific instrument. It offers satisfactory postoperative pain level and good cosmetic results.
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Affiliation(s)
- B Le Roy
- Digestive Department, Estaing Hospital, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France.
| | - N Fetche
- Digestive Surgery Department, Jacques-Lacarin Hospital, 1, boulevard Deniere, 03200 Vichy, France
| | - E Buc
- Digestive Department, Estaing Hospital, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - B Pereira
- Biostatistics Unit (DRCI), Clermont-Ferrand University Hospital, 63003 Clermont-Ferrand, France
| | - F Genty
- Digestive Department, Estaing Hospital, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - O Antomarchi
- Digestive Department, Estaing Hospital, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - J Gagnière
- Digestive Department, Estaing Hospital, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - D Pezet
- Digestive Department, Estaing Hospital, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - K Slim
- Digestive Department, Estaing Hospital, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
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Abstract
Portal biliopathy (PB) refers to the biliary abnormalities of the biliary ducts observed in patients with extrahepatic portal hypertension. Although majority of patients are asymptomatic, approximately 20% of these patients present with biliary symptoms (pain, pruritus, jaundice, cholangitis). The pathogenesis of PB is uncertain but compression by dilated veins into or around common bile duct may play the main role. CT-scan, MR cholangiopancreatography with MR portography should be the initial investigations in the evaluation of PB. Treatment is limited to symptomatic cases and is dictated by clinical manifestations and complications of the disease. Treatment of PB could be done by endoscopy (sphincterotomy, stone extraction or biliary stenting of the common bile duct) or surgery (definitive decompression by porto-systemic shunt followed by bilioenteric anastomosis, if necessary). This review describes pathogenesis, clinical features, investigation and management of portal biliopathy.
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Affiliation(s)
- B Le Roy
- Service de chirurgie et oncologie digestive, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France; Service de chirurgie hépatobiliaire, centre hépato-bilaire Paul-Brousse, 94800 Villejuif, France
| | - M Gelli
- Service de chirurgie hépatobiliaire, centre hépato-bilaire Paul-Brousse, 94800 Villejuif, France
| | - B Serji
- Service de chirurgie hépatobiliaire, centre hépato-bilaire Paul-Brousse, 94800 Villejuif, France; Faculté de médecine, université Mohammed Premier Oujda, Morocco
| | - R Memeo
- Service de chirurgie hépatobiliaire, centre hépato-bilaire Paul-Brousse, 94800 Villejuif, France
| | - E Vibert
- Service de chirurgie hépatobiliaire, centre hépato-bilaire Paul-Brousse, 94800 Villejuif, France.
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Affiliation(s)
- B Le Roy
- Service de chirurgie digestive, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - F Prunel
- Service de chirurgie digestive, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - K Slim
- Service de chirurgie digestive, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France.
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Delplanque B, Combe N, Boue-Vaysse C, Thaminy A, Agnani G, Le Roy B, Ruelland A. We-P14:466 Pure or blended rapeseed oil intake to reach human alphalinolenic recommendation increase plasma availability and conversion to eicosapentaenoic (EPA). ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81818-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Syeda F, Senault C, Delplanque B, Le Roy B, Thaminy A, Gripois D, Blouquit MF, Ruelland A, Mendy F, Lutton C. Postprandial variations in the cholesteryl ester transfer protein activity, phospholipid transfer protein activity and plasma cholesterol efflux capacity in normolipidemic men. Nutr Metab Cardiovasc Dis 2003; 13:28-36. [PMID: 12772435 DOI: 10.1016/s0939-4753(03)80165-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIM Plasma cholesterol efflux capacity is stimulated during postprandial (PP) hypertriglycerdemia. Plasma cholesteryl ester transfer protein (CETP) and phospholipid transfer protein (PLTP) are the key proteins in lipoprotein metabolism and remodelling, but their role during the PP cholesterol efflux process remains indeterminate. The aim of this study was to determine the effect of a fatty meal intake on plasma CETP and PLTP activities, and the capacity of plasma to promote cholesterol efflux, as well as to evaluate the relationship between these three key mechanisms of the reverse cholesterol transport process. METHODS AND RESULTS CETP and PLTP activities and the cholesterol efflux capacity of plasma were measured over eight hours following a fatty meal (1000 kcal, 62% fat) in 13 normolipidemic men. CETP activity and the cholesterol efflux capacity of plasma from Fu5AH cells increased after the meal, reaching a maximum after eight hours (respectively 32%, p = 0.06, and 6.5%, p = 0.045), whereas PLTP activity remained unchanged. CETP and PLTP activities did not correlate with plasma cholesterol efflux capacity in the fasting or PP state. Plasma CETP activity in the fasting state positively correlated with the plasma non-esterified fatty acid (NEFA) levels, but no correlation was found with any lipid or apolipoprotein postprandially. The cholesterol efflux capacity of plasma correlated positively with high-density lipoprotein (HDL) components, the best correlation being with the HDL phospholipid fraction in both the fasting and PP states. CONCLUSIONS These findings suggest that plasma CETP and PLTP activities in healthy normolipidemic subjects are differently regulated in the PP state, and are not correlated with the increased cholesterol efflux capacity of PP plasma. HDL-phospholipid remains the key factor in the regulation of the capacity of plasma to promote Fu5AH cell cholesterol efflux.
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Affiliation(s)
- F Syeda
- Laboratoire de Physiologie de la Nutrition, Bât: 447, Université Paris Sud, 91405 Orsay, France
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Senault C, Le Roy B, Sayed D, Thaminy A, Mendy F, Delplanque B. Increased postprandial plasma capacity of cellular cholesterol efflux in normolipidemic subjects. Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)80154-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Le Roy B, Ruelland A, Sayed F, Thaminy A, Bordeau V, Mendy F, Delplanque B. Plasma Apo-CIII and Apo-E levels, postprandial response and apolipoprotein E phenotype of normolipidemic subjects. Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)80500-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Delplanque B, Le Roy B, Jusselin I, Ruelland A, Motta C. 30% To 40% fat in the diet of normolipidemic men by supplementation with mono and/or polyunsaturated oils: Where are the limits for beneficial effects on lipemia? Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)80654-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Delplanque B, Le Roy B, Gripois D, Blouquit M, Mendy F. Leptin levels, delayed postprandial triglyceride response, and Apo-CIII distribution (TGRL and HDL) in normolipidemic subjects. Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)80577-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Borel P, Grolier P, Mekki N, Boirie Y, Rochette Y, Le Roy B, Alexandre-Gouabau MC, Lairon D, Azais-Braesco V. Low and high responders to pharmacological doses of beta-carotene: proportion in the population, mechanisms involved and consequences on beta-carotene metabolism. J Lipid Res 1998; 39:2250-60. [PMID: 9799811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
The aim of this study was to assess the interindividual variability of chylomicron beta-carotene response to a pharmacological load of beta-carotene in the population, to identify the mechanisms responsible for this variability, and to evaluate its consequences on beta-carotene status and metabolism. The variability, as estimated by the 3-h chylomicron beta-carotene response to 120 mg beta-carotene in 79 healthy male volunteers, was high (CV = 61%), but it was unimodal and all the subjects had detectable chylomicron beta-carotene. In 16 subjects randomly selected among the 79, the interindividual variability of the triglyceride-adjusted chylomicron (beta-carotene + retinyl palmitate) response (0-12.5 h area under the curve) was high (CV = 54%), suggesting that there is a high interindividual variability in the efficiency of intestinal absorption of beta-carotene. The chylomicron beta-carotene response was correlated (r = 0.50, P < 0.05) with the chylomicron triglyceride response. The beta-carotene status, as assessed by beta-carotene concentration in buccal mucosal cells, was correlated (r = 0.73, P < 0.05) with the triglyceride-adjusted chylomicron beta-carotene response, i.e., with the ability to respond to beta-carotene. The triglyceride-adjusted chylomicron retinyl-palmitate response was correlated (r = 0.55, P < 0.05) with the triglyceride-adjusted chylomicron beta-carotene response. Plasma all-trans retinoic acid slightly, but significantly, increased (+40%) 3 h after the beta-carotene load, but this increase was not related to the triglyceride-adjusted beta-carotene response. In conclusion, the ability to respond to beta-carotene is highly variable, but there is probably a very small proportion of true non-responders to pharmacological doses of beta-carotene in the healthy population. This variability is apparently mainly due to interindividual differences in the efficiency of intestinal absorption of beta-carotene and in chylomicron metabolism. The ability to respond to beta-carotene can affect the beta-carotene status and the provitamin A activity of beta-carotene, but it has apparently no effect on the amount of retinoic acid appearing in the plasma after the ingestion of a pharmacological dose of beta-carotene.
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Affiliation(s)
- P Borel
- Unité des Maladies Métaboliques et des Micronutriments, INRA Clermont-Ferrand 63000, France
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Abstract
The effect of the metabotropic glutamate receptor agonist trans-1-amino-1,3,cyclopentanedicarboxylic acid (trans-ACPD) on epileptiform activity induced in rat neocortical slices by exposure to Mg(2+)-free medium was examined. Trans-ACPD dose dependently (10-200 microM) decreased the frequency of spontaneous epileptiform events whilst increasing both the duration of afterpotentials and the number of afterbursts associated with single events. This effect on afterpotentials and afterbursting was particularly pronounced in 14-17 day-old rats and was blocked by the sigma ligand ditolyguanidine (DTG) 10 microM. The putative metabotropic glutamate receptor antagonist L-AP3 did not antagonise the actions of trans-ACPD. The results suggest a role for metabotropic glutamate receptors in epilepsy, possibly in the transition from interictal to ictal activity.
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Acharya GS, Nayak SK, Das BK, Das K, Roy BL. Cytodiagnosis of primary malignant melanoma at unusual sites. Indian J Cancer 1982; 19:35-9. [PMID: 7106830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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