Search PubMed⌕ Search

Biomedical subjects

B Salle

Publications and source records attributed to B Salle.

At least 37 records · Page 2Linked to original sources
PubMed1996

Micro-albuminuria analysis and pregnancy. An approach to detect placentary insufficiency?

OBJECTIVE: To assess the value of micro-albuminuria analysis (MA) in predicting clinical complications of placentary insufficiency in women with no known risk factor. STUDY DESIGN: A blind prospective investigation 20-24 weeks into pregnancy in a nulliparous population with no known risk factor. A reactive strip with a positive threshold value of 10 mg/l is used to detect MA. Judgment criteria concerning the progress of pregnancy are based on blood pressure during the 8th and 9th month of pregnancy and on the 2nd day after delivery, on albuminuria analysis in the 8th and 9th month of pregnancy and by the existence of fetal hypotrophia at birth. RESULTS: Some 218 patients participated in the investigation. MA was positive in 62 cases (28.4%). Of the 197 births which occurred 54 (27.4%) cases of positive MA, 34 (17.2%) cases presented positive judgment criteria indicating placentary insufficiency. The 21 others pregnancies are in course. MA sensitivity was thus 79.4% and specificity 83.4%. Negative predictive value (NPV) was 95.1% and positive predictive value (PPV) 50%. CONCLUSION: Our test is a reliable, simple and easily reproducible indicator of micro-albuminuria. In comparison with other tests it gives a good detection rate of a risk group for complication of placentary insufficiency. NPV is excellent, virtually excluding the occurrence of excessive blood pressure or intra-uterine growth retardation. PPV is less good.

Albuminuria↗
PubMed1996

Transvaginal ultrasound studies of vascular and morphological changes in uteri exposed to diethylstilbestrol in utero.

The aim of this prospective study was to establish complementary data of uteri exposed to diethylstilbestrol (DES) in utero for transvaginal analysis and vascularity changes during the menstrual cycle. A total of 28 women with DES-exposed uteri were compared with 60 non-exposed women. Transvaginal ultrasound and colour Doppler imaging were performed on days 5 and 22 of the menstrual cycle. Uteri were measured on sagittal and transverse scans. Uterine length, width, thickness and uterine cavity length and width were measured. Uterine volume and uterine cavity area were calculated. DES-exposed uterine volume was equal to 31.84 +/- 3.37 cm3. The cavity area of DES-exposed uterus was equal to 35.85 +/- 3.93 cm2. Cervix length of DES-exposed uterus was significantly smaller than that of non-exposed uterus. The uterine artery pulsatility index (PI) of DES-exposed uterus was significantly higher than that of normal uterus. Blood flow remained stable throughout the menstrual cycle. The PI of DES-exposed uterus remained stable during the menstrual cycle, as in non-exposed uterus, and it decreased during the luteal phase. This lack of modification in vascularity of DES-exposed uterus may explain miscarriages and obstetric complications such as intrauterine growth retardation or pre-eclampsia. The data may have implications for the assessment of reproductive status and the design of future studies on disorders of implantation in DES-exposed uterus.

Adult↗
PubMed1996

Transvaginal hysterosonographic evaluation of septate uteri: a preliminary report.

The objective of this study was to evaluate the diagnostic value of hysterosonography in septate uterine congenital abnormalities and more particularly in septate uteri. A total of 14 patients with a history of repeated spontaneous abortion or infertility who had previously undergone hysterosalpingography were included in this study. Patients were first examined by standard transvaginal ultrasound. Hysterosonography was then carried out by the intrauterine injection of an isotonic saline solution. The septate uteri were diagnosed by hysterosonography in all 14 patients (100%). Hysterosonography permitted the measurement of the thickness and height of the septum. Hysterosonography and transvaginal ultrasound enabled the correct diagnosis of malformation type in eight cases (57%). The accuracy of hysterosonography in postoperative control was greater than that of hysteroscopy. Transvaginal hysterosonography with saline solution is a low-cost, easy and helpful examination method for septate uteri. We propose that hysterosonography should be performed for the primary investigation of infertility and repeated miscarriages.

Female↗
PubMed1996

[Activation of T-lymphocytes in Crohn disease and in ulcerative hemorrhagic rectocolitis. Therapeutic implications].

Inflammatory bowel disease (IBD) encompasses two forms of intestinal inflammation: ulcerative colitis and Crohn's disease. Besides abnormalities of immunoglobulins production and complement activation, T lymphocytes play an important role in pathogeny of these diseases. Although T-cells number is increased in intestinal mucosa of such patients, CD4/CD8 ratio of T lymphocytes subsets is normal in mucosa. Activated T-cells expressing interleukin-2 receptors (CD25) are increased in lamina propria from patients with IBD. Cytokines induce abnormal expression of class II antigens of major histocompatibility complex by epithelial cells which may act as antigen presenting cells to CD4 T-cells. Better understanding of pathogenic mechanisms in IBD might justify new immunosuppressive therapeutics to treat these patients.

Antibodies, Monoclonal↗
PubMed1995

Spontaneous and evoked otoacoustic emissions in pre-term and full-term neonates: is there a clinical application?

In neonates and infants, hearing impairment leads to impaired language and cognitive development. For that reason, early detection of this sensory deficit is of outstanding importance, particularly in pre-term neonates, who constitute a high risk population in regard to very early acquired hearing loss. Evoked (EOAE) and spontaneous otoacoustic emission (SOAE) recording in 93 pre-term and full-term neonates revealed that this technique is potentially useful for auditory screening in neonatology units. EOAEs and SOAEs can be recorded successfully from 30 weeks of conceptional age. SOAEs were found to be prevalent in females and presented higher peak numbers in right than in left ears. Furthermore, SOAE incidence in pre-term and full-term neonates was found to be high in EOAE positive ears, associated with strong and robust EOAEs.

Acoustic Stimulation↗
PubMed1995

Spontaneous otoacoustic emissions in preterm neonates: prevalence and gender effects.

A number of lines of evidence indicate that the human cochlea is fully functional as a mature sound transducer by 6 months of age. However, information about the development of the active cochlear mechanisms and notably the development of outer hair cell (OHC) activity is yet incomplete. Recording and analysis of otoacoustic emissions (OAEs), probably generated by the OHCs of the organ of Corti, have led to a better understanding, in humans, of how sounds are analysed in the cochlea by means of active mechanisms. Evoked OAEs (EOAEs) and spontaneous OAEs (SOAEs), when they can be recorded in full-term and preterm neonates, show different characteristics from those in adults, suggesting that maturation of the peripheral auditory system is incomplete at birth. To learn more about this maturation, using the best-established facts concerning SOAEs in adults, such as their greater prevalence in females and also in right ears, SOAEs were studied in more detail in 81 preterm neonates, from 30 to 40 weeks of conceptional age, all presenting bilateral EOAEs according to objective criteria. The first finding of this study was that SOAEs existed and could be recorded as of 30 weeks of conceptional age in humans. Some SOAE characteristics in preterm neonates, such as prevalence, peak number and acoustic frequencies, showed similarity with full-term neonates. Comparison of other criteria between the two populations, such as greater SOAE prevalence in right ears and higher SOAE peak number in females, suggested that these developmental factors emerge around term in humans. Comparison of SOAE characteristics between male and female preterms suggested that male preterms were less advanced in peripheral auditory development than were female preterms.

Acoustic Stimulation↗
PubMed1995

[Role of pulsed color Doppler in the presurgical evaluation of pelvic masses].

OBJECTIVES: To evaluate the prognostic value of colour pulsed Doppler in a prospective study of pelvic masses comparing resistance index, serum CA 125 and echographic findings with histology results. METHODS: A prospective study included 91 patients examined at the Gynaecology-Obstetrics unit at the Croix-Rousse Hospital. Pelvic masses were classified as benign or malignant tumours on the basis of echography findings. Serum CA 125 was assayed before surgery; malignancy was suspected for levels above 35 IU/ml. A colour pulsed Doppler examination was performed at the same time as the echography. Tumours were classed as vascular or non-vascular. A resistance index < or = 0.5 was considered pathological. The sensitivity and specificity of each examination were determined. The ROC method was used to determine best threshold level for the resistance index. Finally, the performance of the 3 tests was analyzed with the Metha algorithm. All patients underwent exeresis of the pelvic mass. The pathology report was taken as the definitive diagnosis. RESULTS: A total of 80 benign masses were analyzed. Thirty percent of them had a vascularization detectable with colour pulsed Doppler. One case of dermoid cyst has a resistance index below 0.5. Echography gave doubtful results in 6 cases and CA 125 was higher than 35 in 9. There were 10 cancers of the ovary and 1 borderline tumour. Four had a resistance index above 0.5, but the operator reported a hypervascular tumour in all cases. Three of these tumours had been classified as benign after echography and CA 125 was < 35 IU in 4. The mean resistance index for benign tumours was 0.71 compared with 0.41 for malignant tumours. The sensitivity of colour pulsed Doppler was 0.66 with a specificity of 0.99 when the resistance index was below 0.5. For an index considered to be pathological; below 0.76, the sensitivity was 100% and the specificity 85%. CONCLUSIONS: Colour pulsed Doppler gives valuable pre-operative information on ovarian masses. Its performance is as least as good as CA 125 assay or echography.

Adult↗
PubMed1995

[Hysterosonographic study of the uterine cavity].

OBJECTIVE: Evaluate the reliability, safety and performance of hysterosonographic assessment of the uterine cavity. MATERIALS AND METHODS: Hysterosonography was performed in 220 patients with injection of sterile saline into the uterine with a novel catheter. Among these patients, 132 patients then underwent a hysteroscopy or hysterectomy with a histology examination. RESULTS: There were 8 failures: 2 synechiae, 3 atresias of the cervix, and massive reflux in 3 cases. No other complication occurring. Hysterosonography appeared to give more information on the uterine cavity than standard vaginal sonography. In cases with metrorrhage before menopause, the diagnosis was correct in 75.4% of the cases. Errors were related to confusion between polyp and hyperplasia. In post-menopausal metrorrhagia, there was 92% agreement between sonography and histological results. Agreement was 86.3% in cases of infertility. CONCLUSION: Hysterosonography using saline solution injected with a novel catheter can be an excellent means of evaluating the uterine cavity and can completely replace classical hysterography, thus avoiding many exploratory hysterocopies.

Bias↗
PubMed1994

[Transvaginal pulsed color Doppler ultrasound in the study of the menstrual cycle].

Pulsed colour-Doppler imaging in the latest development in transvaginal sonography. Our objective is to study the uterine and ovarian perfusion during the menstrual cycle in normal fertile conditions. We studied 11 healthy volunteer women free of hormonal treatment. All studies were performed by the same operator, with the same sonograph. Measurements are made in the uterine arteries and their branches (arcuate, radial, spiral arteries) and in the ovarian vessels. The resistance index of Pourcelot (RI = [sequence: see text]) is used as reference. The statistic test is the non-parametric test of Kruskall-Wallis. The uterine and ovarian vascularization varied greatly during the menstrual cycle. Blood flow increased significantly in the luteal phase in the uterine arteries and their branches even in the active ovarian arteries. So, in the uterine artery, the RI was 0.43 in the follicular phase, 0.50 during the ovulatory peak, and 0.41 in the luteal phase. These variations were significant (p = 0.04). These results were the same all along the uterine artery. In the acurate arteries, the RI was respectively 0.75, 0.93, 0.72 at the same time of the menstrual cycle (p = 0.04). In an anovulatory cycle, blood flow remained unchanged and the arterial compliance remained stable. Quick and reproductible blood flow measurements are possible with transvaginal colour-Doppler. Millimetric vessels such as arcuate, radial and spiral arteries can be studied. This non-invasive technology can be used as a part of routine work in the management of infertility.

Adult↗
PubMed1994

Regional chemotherapy (with mitomycin C) and intra-operative hyperthermia for digestive cancers with peritoneal carcinomatosis.

Intraperitoneal chemo-hyperthermia with mitomycin C was used to treat 28 patients with far advanced digestive adenocarcinoma and histologically confirmed peritoneal carcinomatosis. Surgical resection of the primary tumor was possible in 17 cases. After closure of the abdominal wall, intraperitoneal chemo-hyperthermia was performed for 90 to 120 minutes under general anesthesia and 32 degrees C hypothermia, through 3 intraperitoneal drains forming a closed circuit, using 10 mg/l of mitomycin C in 6 liters of peritoneal dialysate heated to an inflow temperature of 46-49 degrees C. No mortality occurred, and there were 2 post-operative complications, with transitory biological side effects. In 9 out of 10 patients with preoperative malignant ascites, the ascites cleared after treatment. One-year survival rate was 54.2%. These encouraging preliminary results show that intraperitoneal chemohyperthermia with mitomycin C is a safe and reliable treatment for peritoneal carcinomatosis in far advanced digestive cancers.

Adenocarcinoma↗
PubMed1994

[Effect of fibrin glue on lymphostasis during lymph node excisions. Prospective randomized study in 40 patients].

To evaluate the efficacy of fibrin glue for lymphostasis during axillary and inguinal lymph node removal, we conducted a prospective randomized study including 40 patients. Post-operative mortality and morbidity rates were not different throughout the 2 groups. However they were significant decreasement in drainage duration, in drainage quantity and in hospital duration in the group "with" fibrin when compared with the group "without".

Adenocarcinoma↗
PubMed1993

Functional maturation of cochlear active mechanisms and of the medial olivocochlear system in humans.

The aim of this study was to investigate the functional development of cochlear active mechanisms and of the medial efferent olivocochlear system. Otoacoustic emissions (evoked and spontaneous) were recorded in 42 preterm neonates (conceptional age ranging form 33 to 39 weeks) and a control group of 20 young normal-hearing adults. Medial olivocochlear system activity was examined by coupling evoked otoacoustic emission recording to a contralateral stimulation. Otoacoustic emission recordings were carried out using the Otodynamic ILO88 software and hardware. The stimuli were unfiltered clicks and the contralateral stimulation was broad band noise of 50 and 70 dBSPL delivered by an Adam generator. The results revealed the presence of EOAEs and SOAEs from at least 33 weeks in humans, suggesting that the functional maturation of the outer hair cells is nearly complete at that age. The study further revealed that the contralateral stimulation had no effect on evoked otoacoustic emissions in preterm neonates. The lack of activity observed in medial olivocochlear system indicated functional immaturity here, at least before full-term birth.

Adult↗
PubMed1993

[Cancers of the stomach and peritoneal carcinoses: will hyperthermia be a new therapeutic approach?].

Overall survival rate of gastric adenocarcinoma is poor whatever the therapeutic is. Main reasons for this poor prognosis are regional failure and local recurrences. Using hyperthermia could be of interest in peritoneal carcinomatosis during gastric carcinoma: in vitro cytotoxic effect of hyperthermia is well known. Using hyperthermia in combination with intra peritoneal chemotherapy could improve local control. Preliminary results of pilot studies treating peritoneal carcinomatosis with intra peritoneal chemohyperthermia are reported.

Antineoplastic Agents↗
PubMed1993

[Intraperitoneal chemo-hyperthermia in the treatment of peritoneal carcinomatosis of ovarian origin. Initial cases, physiopathologic data].

The authors report the first results using intraperitoneal hyperthermic chemotherapy with mitomycin C or cisplatinum with protective hypothermia up to 32 degrees C in four cases of peritoneal carcinomatosis secondary to cancer of the ovary which was resistant to conventional treatment. They were stage III and IV in the FIGO classification. There were no post-operative complications. Two patients are still alive 4 and 6 months after intraperitoneal hyper-chemotherapy. Hypothermia has its own action of destroying tumour cells and potentiates the effects of chemotherapy. We have, following the work of the japanese, devised a therapeutic regime combining chemotherapy and intraperitoneal hyperthermia.

Aged↗
PubMed1993

[Prenatal diagnosis of adenomatoid malformation of the lung. 5 cases and review of the literature].

The authors report five cases of adenomatoid malformation of the lung (AML) diagnosed in the antenatal period. Since 1977, when Stocker et al. published their classification of these malformations into three anatomical types, the ultrasonographic features have been well systematized, thereby enabling treatment to be modified according to the AML type. Type I and II have a good prognosis (about 20% of neonatal deaths) and only require close supervision. Thoracocentesis may be necessary in case of significant anasarca or hydramnios. The progression and prognosis of type III AML are very bad, since a favorable course is observed in only 10% of the foetuses. Intrauterine surgery has already been successfully attempted in on case and might modify the situation. Most authors are in favour of therapeutic abortion when signs of bad prognosis are present.

Adult↗