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Biomedical subjects

C Nos

Publications and source records attributed to C Nos.

48 records · Page 3Linked to original sources
PubMed1995

Sterilization reversal: fertility results.

Fertility outcome following sterilization reversal by laparotomy was evaluated. We studied all sterilization reversals performed between January 1978 and December 1991; a total of 226 women were treated. Tubal anastomosis was performed according to the rules for microsurgery. The microsurgical technique comprised two main phases: preparation of the healthy tube segments and the anastomosis carried out on two layers. It was possible to study the subsequent fertility of 206 patients in all, as 20 patients were lost to follow-up (8.8%). Cumulative pregnancy rates were evaluated by life-table analysis. The overall intrauterine pregnancy rate, including births and miscarriages, was 69.9% (144 patients) after 2 years. The cumulative intrauterine pregnancy rate was 62% at 18 months. Analysis of the fertility results demonstrated that age was the most significant predictive factor. The cumulative intrauterine pregnancy rate at 2 years was 83.5% (61 cases) for patients < or = 33 years, 70% (35 cases) for patients aged 34-36 years, 62.5% (30 cases) for patients aged 37-39 years, and 51.4% (18 cases) for patients aged > or = 40 years. Even for patients aged approximately 40 years, microsurgical repermeabilization can be retained as the first choice rather than in-vitro fertilization.

Adult↗
PubMed1995

Conservative treatment of breast cancers by mammaplasty and irradiation: a new approach to lower quadrant tumors.

Conservative treatment of breast cancers confined to the lower quadrants often leaves a residual deformity. In order to prevent these poor cosmetic results, 20 patients with lower quadrant cancers have been treated since 1986 at the Institut Curie by wide lumpectomy combined with immediate remodeling of the gland by nipple-bearing superior pedicle mammaplasty and preoperative (9 cases) or postoperative (11 cases) irradiation. The contralateral breast was always rendered symmetrical at the same time. The mean weight of resection was 248 gm, and the resection margins were always free of tumor. The treatment protocols were not modified by the addition of mammaplasty to lumpectomy, and this combination did not induce any significant complications. The mean follow-up was 4.5 years (range 1 to 7.5 years). There was one case of local recurrence; there were four cases of metastases. In this series, the oncologic results were identical to those of conventional treatment by lumpectomy and irradiation. The cosmetic result was good or very good in 75 percent of patients and 91 percent of patients in the group in which mammaplasty was performed prior to irradiation. Treatment of breast cancers by superior pedicle reduction mammaplasty and irradiation is indicated in tumors located in the lower quadrants, whose size in relation to the breast volume is such that conventional conservative treatment by lumpectomy and irradiation would achieve a poor cosmetic result.

Adult↗
PubMed1993

[Acute aortic dissection during pregnancy. Surgical treatment with maternal and fetal rescue].

Acute aortic dissection (AD) seldom affects young women, but when it occurs it is, in almost one out of two cases, during pregnancy. We report a case of severe AD during pregnancy in which emergency surgery immediately saved the life of the mother and the foetus. The mother died of cardiac complications 13 days after the operation; the condition of the newborn is satisfactory.

Acute Disease↗
PubMed1993

[Inguinal hernia and endometriosis].

Endometriosis is an ubiquitary disease. It can be intra or extragenital. We report the case of a patient with an endometriosic nodule at the end of an inguinal hernia, there was no other sign. The diagnosis was done through pathology. The treatment, exclusively surgical was the cure of the hernia and the excision of the nodule.

Adult↗
PubMedDate not supplied

[Axillary lymph node surgery in 1998].

The need for a systematic axillary clearance in breast cancer is presently under question. Alternative methods include the omission of node biopsy in very small tumours and lymphadenectomy limited to the sentinel node. This article discusses the current procedures in axillary surgery in 1998, with information concerning the relationships between the tumour characteristics and the probability of nodal involvement, the new surgical techniques aiming at reducing morbidity, with special emphasis on sentinel node biopsy, and the therapeutic protocols presently being used at the Institut Curie.

Axilla↗
PubMedDate not supplied

Prognostic value of cytokeratin 19 fragment (CYFRA 21-1) and cytokeratin-positive cells in bone marrow samples of breast cancer patients.

The aim of this study was to investigate the relationship between the detection of micrometastatic cells by immunocytochemistry (ICC) with an anticytokeratin antibody and cytokeratin fragment (CYFRA 21-1) expression detected by an immunofluorescent assay in bone marrow of breast cancer patients. Micrometastatic CK+ cells were screened with a pancytokeratin antibody A45 B/B3 from bone marrow aspiration samples of 102 breast cancer patients (65 primary tumors, 10 local recurrences and 27 distant metastases). CYFRA 21-1 levels were assessed in bone marrow supernatant of these patients before collection of the mononucleated interface cells on a Ficoll-Hypaque density gradient and in 20 control patients. CYFRA 21-1 and CK+ cell detection by ICC were both correlated with clinical stage. CYFRA 21-1 was significantly elevated in patients with micrometastatic disease detected by ICC: 4.77 ng/mL (+/- 10.87 SD) versus 1.00 ng/mL (+/-1.36 SD) in patients with negative ICC (p=0.01). In univariate analysis, a CYFRA 21-1 value > or =1 ng/mL and the presence of CK+ cells were associated with a poorer survival for patients with stage I to III breast cancer (n=65). On multivariate analysis, only pathological nodal status and presence of CK+ cells in bone marrow were independent prognostic factors for overall survival. In conclusion, in this series CYFRA 21-1 was correlated with detection of CK+ cells by ICC in bone marrow, but cannot replace ICC. The presence of CK+ cells in bone marrow remains a strong independent prognostic factor in primary breast cancer.

Antigens, Neoplasm↗
PubMedDate not supplied

Evolution of multiple sclerosis lesions on serial contrast-enhanced T1-weighted and magnetization-transfer MR images.

BACKGROUND AND PURPOSE: Magnetization-transfer imaging is a technique that could provide indirect evidence of the characteristics of multiple sclerosis (MS) lesions. The purpose of this work was to study the evolution of MS lesions on T1-weighted MR images over time and to investigate changes in magnetization-transfer ratio (MTR) values of MS lesions with different initial appearances on contrast-enhanced T1-weighted images. METHODS: Eleven patients with relapsing-remitting MS were studied with MR imaging. The MTRs were calculated for 47 lesions that had been classified according to their appearance on contrast-enhanced T1-weighted images. Each patient was examined at four time points over a 1-year period. The MTR changes observed in the selected lesions were compared with their initial T1-weighted appearance. RESULTS: The lowest MTR values were initially found in hypointense nonenhancing lesions and in ring-enhancing lesions, with both types showing a hypointense center. Changes in MTR values were more dynamic and reversible in ring-enhancing than in hypointense nonenhancing plaques. Nodular-enhancing lesions had slightly lower initial MTRs than did isointense non-enhancing lesions. CONCLUSION: The absence or presence of contrast uptake may indicate a different pathologic basis for hypointense MS lesions on T1-weighted MR images. These differences should be kept in mind when considering T1 lesion load as a surrogate marker of disability in MS.

Adult↗
PubMedDate not supplied

[Syphilitic meningoradiculitis in a patient with HIV].

Meningoradiculitis is a rare presentation of neurosyphilis. In patients infected by human immunodeficiency virus (HIV), the first diagnosis to consider is cytomegaloviral (CMV) infection, as this is the most common cause of meningoradiculitis in these patients. The course of the disease and its response to treatment is highly influenced by immunodepression. We present an HIV+ patient with clinical meningoradiculitis due to syphilis.

Aged↗