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Biomedical subjects

C Bourgain

Publications and source records attributed to C Bourgain.

At least 37 records · Page 2Linked to original sources

Light and electron microscopic analysis of human testicular spermatozoa and spermatids from frozen and thawed testicular biopsies.

The morphological changes caused by freezing and thawing human testicular spermatozoa have been assessed here. Retrieval of testicular biopsies was carried out on six patients with obstructive azoospermia preparatory to intracytoplasmic sperm injection (ICSI). Light microscope analysis was carried out on testicular cells and ultrastructural analysis was carried out on spermatozoa and different spermatid stages before and after the freezing procedure. Upon examination under light microscopy, all germ cells presented increased vacuolization in their cytoplasm and shrinkage or swelling of the nuclei and cytoplasmic membranes. These altered structures were accentuated in the spermatocyte I cell which often presented disrupted membranes. The ultrastructural findings under transmission electron microscopy demonstrated that after freezing and thawing the major types of cryoinjury were the swelling and rupture of inner and outer acrosomal and plasma membranes. The acrosome material often appeared as dispersed material or as condensed spots or was even lost. Such damage was observed mainly at the spermatozoa and late spermatid stages. We conclude that the freezing and thawing of testicular biopsies causes similar morphological damage to testicular spermatozoa and frozen-thawed ejaculated spermatozoa. It is still unclear whether these changes in testicular spermatozoa after freezing and thawing may compromise its use in the ICSI procedure.

Adult↗

[Massive poisoning by African bee stings].

BACKGROUND: Bee stings can cause severe toxic effects when envenomation is massive. CASE REPORT: While touring in Casamance (Southern Senegal) a white male was severely stung by a swarm of African bees. The massive envenomation caused rhabdomyolysis, hemolysis and acute renal failure. Pathology examination of kidney and bladder specimens showed vasculitis affecting both arteries and veins. The patient was treated with several hemodialysis sessions and renal function returned to normal three months after the incident. DISCUSSION: Bees in Africa, known as "killer bees", are particularly aggressive. They have recently been imported from tropical zones in America where a large number of deaths have been reported. Most cases of massive envenomation have shown acute tubular necrosis or renal involvement with myoglobinuria or hemoglobinuria. The renal pathology observed in our case is not usually described.

Acute Kidney Injury↗

Deep benign fibrous histiocytoma of the knee: CT and MR features with pathologic correlation.

Magnetic resonance imaging and pathologic findings in a 28-year-old patient with a giant deep benign fibrous histiocytoma in the popliteal fossa of the right knee are described. The MR imaging findings include a well-delineated oval mass with low signal intensity on T1-, and high signal intensity on T2-weighted, images, and marked peripheral contrast enhancement. To the best of our knowledge, this is the first report on the MR findings in this entity.

Adult↗

Ultrastructure of gametes after intracytoplasmic sperm injection.

The ultrastructure of 18 metaphase-II oocytes after intracytoplasmic sperm injection (ICSI) was analysed from 30 min to 8 h following the microinjection. Three control metaphase-II oocytes were not injected. The 21 oocytes were embedded individually and examined in serial pole-to-pole sections. Seventeen oocytes had been matured in vitro from the germinal vesicle stage and showed ultrastructural alterations due to long-term culture. In microinjected oocytes, membrane-bound vacuoles and oolemma inclusions were found at the injection site. The ICSI oocytes showed evidence of plasma-membrane damage and increased oocyte exchange processes with residual and multivesiculated bodies. Gamete membrane fusion was not observed. Acrosome reaction was observed within the ooplasm 15 min after ICSI. Sperm elements were not incorporated into any oocyte vacuole. Onset of oocyte activation was associated with sperm chromatin decondensation. Cortical granules were released at 60 min and two pronuclei were formed at 6 h after ICSI. The male and female pronucleus formation was asynchronous. The findings suggest specific ICSI-related morphological features of early fertilization.

Cytoplasm↗

Nasal mucosal sarcoidosis: a case report.

The authors present a case of nasal mucosal sarcoidosis. Its low incidence may be due to unawareness of this sometimes forgotten entity. Crusting and nasal obstruction may be the first symptoms of this multisystemic disease. With the nasal endoscope, today's most helpful tool for examining the nose and its adjacent structures, the otolaryngologist can diagnose this disease at an early stage.

Humans↗

Endometrial evaluation by aspiration biopsy on the day of oocyte retrieval in the embryo transfer cycles in patients with serum progesterone rise during the follicular phase.

OBJECTIVE: To investigate the effect of subtle serum P rise before hCG administration on endometrial maturation in stimulated cycles. DESIGN: Case-control study. SETTING: Tertiary referral center. PATIENT(S): Twenty patients with serum P < or = 0.9 ng/mL (group I) (conversion to SI unit, 3.180), 20 patients with premature P rise (> or = 1.1 ng/mL, group II), and 20 patients with normal serum P (group III). INTERVENTION(S): Patients in groups I and II underwent endometrial aspiration biopsies on the day of oocyte retrieval in the ET cycles themselves. Patients in group III, without endometrial biopsies, were chosen as controls. MAIN OUTCOME MEASURE(S): Comparison of endometrial maturation, correlation between endometrial dating and cumulative P exposure, and/or number of days of P > or = 1.1 ng/mL and comparison of clinical outcome. RESULT(S): Groups I and II showed a secretory activity of the endometrium. In group II, the endometrial dating correlated neither with P exposure nor with the number of days of subtle P rise. Clinical pregnancies were observed in both groups but none in cases with endometrium advanced > 3 days. Similar pregnancy and implantation rates were observed between groups I and III. CONCLUSION(S): These data suggest that an endometrial aspiration biopsy performed on the day of oocyte retrieval may be used to assess endometrial receptivity in patients with serum P rise.

Abortion, Spontaneous↗

Expression of the jun family of genes in human ovarian cancer and normal ovarian surface epithelium.

The jun genes (c-jun, jun-B and jun-D) play a role in critical cell functions such as proliferation, differentiation and apoptosis. We documented jun expression at the mRNA and protein level in human ovarian cancer tissues (n=28), surface epithelial cells of normal ovaries (n=14) and ovarian cancer cell lines (n=6). Almost all of ovarian tumors as well as normal ovaries concomitantly express c-jun, jun-B, and jun-D mRNA. Immunohistochemistry was less sensitive and revealed nuclear c-Jun and Jun-B proteins in the malignant epithelial cells of respectively 38% and 11% of ovarian tumors and in the surface epithelium of a normal premenopausal ovary. In cultured ovarian cancer cells, c-jun and jun-B expression is inducible by serum and TPA and is therefore not constitutive. The c-jun and jun-B proteins therefore play a role both in differentiation of the normal ovarian surface epithelium, as well as in the proliferation of epithelial ovarian cancer cells. High jun-B expression relates to a more malignant phenotype both in vitro and in vivo. The jun-D gene is suppressed in ovarian cancer cells as compared to normal ovarian surface epithelial cells in situ and in vitro. Downregulation of jun-D might therefore be part of the malignant ovarian epithelial cell phenotype.

3T3 Cells↗

Jejunal stromal tumor.

A case of jejunal stromal tumor is reported. Clinical findings included melena, syncope, and palpable abdominal mass. CT scans showed an abdominal mass with characteristics simulating an intra-abdominal abscess.

Aged↗

Frequent deletion of chromosome 19 and a rare rearrangement of 19p13.3 involving the insulin receptor gene in human ovarian cancer.

Human ovarian cancer cells usually have multiple specific chromosomal deletions which can be detected by cytogenetic analysis or molecular techniques. Tumour suppressor genes might be located in these deleted chromosomal segments. The importance of these different loci is usually estimated from the frequency with which they are deleted. Here we report a 59% loss of heterozygosity for chromosome 19 in the DNA of human invasive epithelial ovarian cancer from a series of 37 patients. In all cases informative on both chromosomal arms a subchromosomal loss is observed. Analysis of the same tumours for chromosome 17p and 11p loss suggests that loss of chromosome 19p/q is less important than 17p loss, but more important than 11p loss. The deletion of chromosome 19q seems to be associated with distant, hematogeneous metastasis (stage IV). In two patients with high grade tumours, the deletion involves a rearrangement of the insulin receptor locus (19p13.3). This suggests that some of the previously described frequent cytogenetic 19p+ markers and 19p13.3 breaks observed in high grade ovarian cancers, might actually occur in the insulin receptor gene.

Adolescent↗

Improved detection of DNA aneuploidy in primary breast cancer using quantitative DNA image analysis in combination with fluorescent in situ hybridization technique.

To obtain more information about the relationship between numerical aberrations of chromosome 1 and the overall DNA content of breast cancer cells, fluorescent in situ hybridization with a pericentromeric probe for this chromosome and image analysis based densitometry were carried out on imprints of benign (15 cases, mainly fibroadenomas) and malignant breast disease (31 invasive ductal carcinomas out of 45 cases). The most pronounced aneuploidy was observed in invasive ductal and lobular carcinoma cases both by in situ hybridization and DNA content (76.7 and 75.0% were aneuploid). The frequency of cells with two spots for chromosome 1 was 48.3 and 51.5%, respectively, as compared to 80.3% in control lymphocytes. There was a weak overall correlation (r2 = 0.83) between DNA content and copy number of chromosome 1 in the malignant samples, although some of the DNA diploid/near diploid carcinomas showed a marked aneusomy for this chromosome. Also, some aberrations were present in the benign breast disease samples. Classification of cases by a linear discriminant analysis was most accurate when both techniques were combined (77% of cases correctly classified, according to anatomo-pathological diagnosis). The variables which received the highest weight in the linear discriminant function are the percentage DNA-diploid cells and the fraction of cells with two spots for chromosome 1. The sensitivity and sources of error of both techniques is considered.

Aneuploidy↗

Proton-pump inhibition and gastric giardiasis: a causal or casual association?

Two patients who developed gastric giardiasis after 2 weeks of treatment with omeprazole 20 mg b.i.d. followed by omeprazole 20 mg per day for 2-6 weeks are described. In one patient, gastric giardiasis occurred in the presence of only mild intestinal metaplasia. In the other patient, Giardia lamblia infection had resolved 4 weeks after the cessation of omeprazole treatment, which, to our knowledge, is the first case reported in the literature. It is tempting to speculate that gastric giardiasis can develop in the absence of mucosal abnormalities during hypochlorhydria induced by treatment with a high dose of a proton-pump inhibitor. Specific treatment may not be required if the drug can be stopped and no other gastric disease causing hypochlorhydria is present.

Aged↗

Pregnancy and birth after high serum progesterone concentrations during the follicular phase in an in-vitro fertilization cycle with gonadotrophin-releasing hormone agonist suppression.

This case illustrates the possibility of achieving a pregnancy and birth when elevated progesterone concentrations (> 4 ng/ml) are present during the follicular phase (from 6 days before human chorionic gonadotrophin injection) of a gonadotrophin-releasing hormone agonist/menotrophin cycle for in-vitro fertilization (IVF). The present patient underwent three IVF/embryo transfer cycles in which progesterone concentrations were repeatedly increased from the midfollicular phase onwards. A pregnancy was achieved after the first IVF attempt but ended in a miscarriage in the 19th week of gestation. During the second IVF attempt an endometrial biopsy taken on the day of oocyte retrieval revealed an endometrial advancement of 2 days. A successful pregnancy and birth was again achieved after the third IVF attempt although progesterone concentrations were considerably increased from 6 days before the ovulatory stimulus.

Adult↗

Aneuploidy for chromosome 1 and overall DNA content in benign and malignant breast disease.

Fluorescence in situ hybridization (FISH) with a probe for the pericentromeric region of chromosome 1 and DNA content measurements by image-analysis-based densitometry have been carried out on imprints of benign and malignant breast tissue. In general, an increase in the number of spots per nucleus was observed in the invasive carcinomas, with a large intercellular variation. In comparison with lymphocytes from controls, some cases of benign breast disease already had an increased frequency of aneusomy of chromosome 1, although they were all (near)diploid by DNA-content. However, an overall concordance between the DNA content measurements and the results of FISH was observed, although some exceptions were seen. A statistically significant correlation between the DNA index and the mean number of spots for chromosome 1 per nucleus was found. A linear discriminant analysis was applied on the data; the resulting classification of patients was most accurate when parameters describing DNA content and FISH results were combined.

Aneuploidy↗

Human endometrial maturation is markedly improved after luteal supplementation of gonadotrophin-releasing hormone analogue/human menopausal gonadotrophin stimulated cycles.

In human cycles stimulated for ovulation with gonadotrophin-releasing hormone (GnRH) agonists and human menopausal gonadotrophin (HMG), a luteal phase defect has been described. To evaluate the influence on the endometrium, endometrial development in GnRH agonist/HMG stimulated cycles was assessed in cycles with and without luteal phase supplementation. Endometrial histological maturation, ultrastructure and oestrogen receptor (ER) and progesterone receptor (PR) status were analysed in the mid-luteal phase. Serum concentrations of oestradiol and progesterone were measured daily from days 1-5 of the luteal phase. Supplementation of the luteal phase was achieved with either human chorionic gonadotrophin or natural progesterone, administered intramuscularly or intravaginally. In non-supplemented cycles all endometrial features were consistent with an impaired progesterone bioavailability. After supplementation of the luteal phase, fewer signs of luteal phase deficiency were visible, especially with the intravaginal route of progesterone administration. We concluded that the endometrial parameters confirm the need for luteal support in GnRH agonist/HMG stimulated cycles.

Adult↗

Disseminated peritoneal leiomyomatosis. An unusual case.

Disseminated peritoneal leiomyomatosis (DPL) is a very rare disorder, characterized by the presence of multiple intraabdominal smooth muscle nodules and frequently associated with a high estrogen production. We report on a 43-year-old woman with DPL and simultaneous bilateral ovarian cystic teratomas. There were no overt endocrine abnormalities. Due to distinct cellular pleomorphism on a frozen section, complete removal of smooth muscle nodules was suggested, but could not be achieved because of severe bleeding. Two years after resection of the ovarian tumors but with residual DPL, the patient is doing well, with no evidence of malignant disease.

Adult↗

A prospective randomized study on oestradiol valerate supplementation in addition to intravaginal micronized progesterone in buserelin and HMG induced superovulation.

A prospective randomized study was conducted to evaluate the use of adding oestradiol valerate 6 mg per os daily to intravaginal micronized progesterone (600 mg daily) as luteal supplements. The study comprised 378 infertile women superovulated with a gonadotrophin releasing-hormone agonist (GnRHa) and human menopausal gonadotrophins (HMG) for in-vitro fertilization (IVF) or zygote intra-Fallopian transfer (ZIFT). The clinical pregnancy rate was similar (29%) whether or not oestradiol valerate was added to intravaginal progesterone. Eighteen out of twenty-two endometrial biopsies were in phase, and morphological evaluations of the two luteal supplementation groups were not different. Serum hormone profiles in singleton pregnancies showed a similar day of appearance of human chorionic gonadotrophin (HCG) in both protocols but significantly lower oestradiol concentrations arose in the group without oestradiol valerate. In 32% of the singleton pregnancies, the first appearance of HCG occurred later than day 12 after HCG injection; in those ongoing pregnancies, corpus luteum rescue--as measured by significantly lower serum oestradiol and progesterone concentrations--was compromised. This study provided no evidence of any benefit of routinely supplementing GnRHa/HMG cycles with oestradiol valerate in addition to intravaginal micronized progesterone.

Administration, Intravaginal↗