Biomedical subjects
C Sureau
Publications and source records attributed to C Sureau.
[Development of therapeutic strategies in infertility of the couple].
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[Fetal diastolic index in the internal carotid arteries. Preliminary results in normal and pathologic pregnancies].
The authors studied a series of 87 blood flow measurements in the internal carotid arteries of fetuses. After a brief survey of cerebral blood flow a description is given of the technique for measuring this flow. They use the index D/S just as in measuring umbilical artery flow. In normal pregnancy the carotid diastolic index hardly rises and stays low, which confirms that there is a high resistance in the system. When abnormal flow rates are found in the umbilical artery the carotid diastolic index rises to protect the brain against hypoxia. The rise in the carotid diastolic index could be the last abnormality which precedes the appearance of fetal cardiac rhythm changes.
[Termination of pregnancy and evacuation of the uterine contents in the second trimester. Use of a prostaglandin E2 analog: sulprostone].
The authors used sulprostone on 165 women whose pregnancies had lasted more than 12 weeks. The principal indications were: intra-uterine fetal deaths in 65 cases and an antenatal diagnosis of fetal malformations in 75 cases. Three routes of administration of the drug were employed: extra-amniotic in 15 women; intravenous in 62 women; intramuscular in 88 women. The doses used (adding together the intramuscular and intravenous routes) were: ampoule of 500 micrograms of sulprostone in 25% of cases; ampoules in 50% of cases; ampoules in 25% of cases. It was found to be very effective: by the intravenous route 88.70% expelled the fetus in 24 hours with a mean induction delivery time of 11 hours; by the intramuscular route 89.77% expelled in 24 hours with a mean induction delivery time of 11 hours 45 minutes. The side effects were not common: nausea in 17.6%; vomiting in 16.4% and diarrhoea in 6%. Ther marked effectiveness of sulprostone on the one hand and the good tolerance on the other indicate the effects of this product, which are a strong action on the uterus and a feeble action on the smooth muscle of other organs.
Production of hepatitis B virus by a differentiated human hepatoma cell line after transfection with cloned circular HBV DNA.
Closed-circular HBV DNA was introduced into cells of the established human hepatoma culture HepG2. The culture medium of one of 40 single-cell clones contained HBV surface antigen (HBsAg), core-related antigens (HBc/eAg), and HBV DNA sequences. HBV DNA and DNA polymerase activity were detected in particles resembling both nucleocapsids and complete virions (Dane particles). Intracellular integrated and extrachromosomal HBV DNA sequences were detected. Relaxed-circular and single-stranded forms of viral DNA were identified as likely replicative intermediates of the HBV genome. In conclusion, in vitro production of Dane-like particles by transformed human hepatocytes has been achieved. This model should be valuable as a cell culture system for studying virus replication and virus-host cell interactions.
[Immunological disorders of coagulation in habitual abortion. Prospective study].
The physiopathological role of antithromboplastin-type circulating anticoagulants in habitual abortion may be envisaged since the presence of antithromboplastin has been reported in most studies on women at high risk of abortion. To avoid a possible statistical bias, we conducted a prospective study in a sufficiently large group of women with habitual abortion (n = 99) compared with a control group of women with normal fecundity (n = 50). In addition, all women were investigated for lupus symptoms. The circulating antibody was detected by the diluted thromboplastin time and activated cephalin time methods. The results were considered positive when the patient/control diluted thromboplastin time ratio was 1.2 and/or when the increase in activated cephalin time was not corrected by a control plasma. In the patients' group, 10 women (10%) had an anti-thromboplastin type circulating anticoagulant, whereas no circulating anticoagulant could be detected in the control group. Three women with circulating anticoagulant had signs of systemic lupus erythematosus. None of the patients presented with Soulier-Boffa syndrome. These data have established a significant correlation between habitual abortion and circulating anticoagulant whilst avoiding statistical bias. Our results suggest that women with idiopathic habitual abortion should be subjected to systematic immunological exploration and that a small number of them should be followed attentively.
Can the number of cesarean sections be reduced without risk? An analysis of rates and indications in a university clinic.
This study concerns women followed from the first trimester of pregnancy, in a university clinic in Paris in 1977, 1979 and 1981. The cesarean section rate was separately analysed for primiparas, and multiparas with and without previous cesarean section. The overall rate of cesarean section was 11.4% in 1977, 17.2% in 1979 and 21.1% in 1981. The 9.6% increase observed between 1977 and 1981 is mainly attributable to an increase in primary cesarean section, particularly among primiparas, between 1977 and 1979. This does not seem to have arisen from sample variations. There is a change in obstetrical attitude and more cesarean sections are performed in cases of hypertension, breech presentation or intrauterine growth retardation. The greater number of previously sectioned women explains the increase in the rate between 1979 and 1981. The main fact among primiparas is the 18.8% increase in diagnosis of dynamic dystocia between 1979 and 1981. Three key areas allow us to envisage a reduction in cesarean section rate: obstetrical attitude towards previous cesarean section, breech presentation, and management of labor, whose perturbations lead to diagnosis of dynamic dystocia.
Autoimmunity, fetal losses, lupus anticoagulant: beginning of systemic lupus erythematosus or new autoimmune entity with gynaeco-obstetrical expression?
Among the various autoantibodies commonly found in women with systemic lupus erythematosus, the so-called lupus anticoagulant has been described in association with fetal losses. Recently, women with repeated spontaneous abortions and lupus anticoagulant, but no apparent systemic lupus erythematosus have been described. We have studied prospectively the possible connections between fetal losses and autoimmunity in a large control study of 130 idiopathic habitual aborters. These non-pregnant patients without any antecedent autoimmune disease were explored for the presence for autoantibodies especially lupus anticoagulant. Ten percent of the patients exhibit an antithromboplastin antibody (lupus anticoagulant) and half of this group possesses a striking association of biological manifestations of autoimmunity. In conclusion, two points appear: firstly, statistical correlation is demonstrated between antithromboplastin antibody and habitual abortion; secondly, doubt remains about the significance of the association between autoimmunity, fetal losses and antithromboplastin: beginning of systemic lupus erythematosus or new autoimmune entity with gynaeco-obstetrical expression.
The renin-angiotensin system in pregnancy and parturition.
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[Eulogy on Maurice Lacomme (1897-1986)].
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[On a decree establishing the list of instruments that may be used by midwives].
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A comparison of uterine motility in the pregnant and non-pregnant cynomolgus monkey (Macaca fascicularis) and pregnant woman: a manometric and electromyographic study.
The use of a combination of manometric and electromyographic methods provided a reliable technique for evaluating variations in uterine activity in conscious macaque monkeys and women. The technique was particularly useful for obtaining data on the influence of steroid hormones. During the spontaneous menstrual cycle of the macaque, uterine motility, after being weak and poorly synchronized during the follicular phase, became still weaker with impaired synchronization during the luteal phase and then much stronger and well-synchronized at the time of menstruation. There was no evidence in vivo of any relationship between the existence of gap junctions in the myometrium of non-pregnant animals and the various patterns of uterine motility. During the last third of pregnancy in macaques, the initiation of electrical activity in various uterine areas was always synchronous with and related to mechanical contraction. The same results were obtained in preparturient women. Thus, improved uterine coordination does not appear to be the mechanism by which the uterine contractile strength increases to expulse the foetus at the end of pregnancy. Apart from the particular situation of non-pregnant animals under progestative influence, in which activity was constantly non-propagated, we could not find any evidence of a general pattern which would indicate only one site for the initiation of activity and its extension to the whole uterus.
A monoclonal antibody against an erythrocyte ontogenic antigen identifies fetal and adult erythroid progenitors.
A murine monoclonal antibody (MoAb) designated FA6-152 has been obtained by immunizing mice with fetal erythrocytes. This antibody agglutinates fetal but not adult erythrocytes. Among blood cells, this antibody bound to both adult and fetal monocytes, platelets, and reticulocytes, but did not react with lymphocytes and granulocytes. Fluorescent labeling of marrow cells and of in vitro BFU-E, CFU-GM, and CFU-MK-derived colonies has shown that the antigen defined by FA6-152 MoAb was absent from the granulocytic precursors and was detected on the megakaryocytic lineage at a later stage of differentiation than the platelet-specific markers. In contrast, the antigen appeared as a very early marker of the erythroid differentiation since all erythroblasts, including proerythroblasts, were labeled even before the expression of glycophorin A. Cells from adult marrow and fetal liver were sorted with the FA6-152 MoAb and studied by electron microscopy and cell culture. The negative fraction contained granulocytic, monocytic, and megakaryocytic precursors, whereas the positive fraction was devoid of these precursors and contained monocytes, erythroblasts at all stages of maturation, and a homogeneous population of blasts. Cultures have shown that the only hematopoietic progenitors present in this positive fraction were CFU-E and some BFU-E. The antigenic density was related to the differentiation stage of the erythroid progenitors. In conclusion, this antibody is similar to the previously described 5F1 MoAb (Bernstein and Andrews, J Immunol 128:876, 1982; and Andrews et al, Blood 62:124, 1983) and provides a useful probe for studies leading to improved understanding of normal and malignant erythroid differentiation.
Induction of labour with mifepristone after intrauterine fetal death.
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Exercise test as a physiological form of antepartum stress test.
Exercise test (ET) was repeated in 5-7 day intervals between 35 and 43 weeks of gestation in normal and high-risk pregnancies. The obtained FHR patterns were categorized according to their incidence in different clinical situations and correlated with appearance of amniotic fluid at amniocentesis and incidence of fetal distress in subsequent labor. Prospective meaning of ET is drawn for evaluation of utero-placental reserve and degree of umbilical cord pathology. Consistency and dynamics of FHR pattern is stressed out. Advantage of ET to OCT is discussed.
Pregnancy-related changes in the distribution of glycosaminoglycans in the cervix and corpus of the human uterus.
We investigated the variations in the distribution of glycosaminoglycans (GAG) in the cervical, isthmic and corporeal stroma of the pregnant and non-pregnant human uterus. The GAG were measured in non-pregnant (n = 9) and pregnant (n = 14) cervices, in non-pregnant (n = 8) and pregnant (n = 6) uterine isthmus, and in non-pregnant (n = 12) and pregnant (n = 5) uterine corpus. Heparan sulfate is abundant in the isthmic and corporeal stroma. This has to be related to a larger content in blood vessels and muscular cells at this level than in the cervix. The distribution of hyaluronic acid and dermatan sulfate is the same in the cervix as in the corpus, but the amount of these GAGs is lower in the former, which could be due to a lower connective tissue content. Two of the main features of cervical maturation, increased hydration, and decreased dermatan sulfate concentration, were found also in the pregnant corporeal stroma. These results suggest that connective tissue maturation is not only a cervical phenomenon and could play a role in active and/or passive mechanical properties of the myometrium during late pregnancy and labor.
[Hypotheses concerning variations in sperm motility in peritoneal fluid].
We have studied the effects on sperm motility in peritoneal fluid taken from fertile women at different times of the cycle as well as from sterile women in the pre-ovulatory phase. We have compared the effects on the movement of sperms in part in a solution of pure Tyrode and in part in a solution of Tyrode containing hydroxytoluene, which is an antioxydising agent, in order to try to find out the mechanism that immobilises sperms in these sterile women. In equal concentrations we have found that this substance can be protective against immobilisation, which itself was due to the liquids coming from abnormal pelvis, in the antioxydising agent that was used. Furthermore it was found, in liquid taken from the peritoneal cavities of fertile patients in the pre-ovulatory phase, that it behaves like a Tyrode medium to which one has added a complex antiperoxide comprised of bovine serum albumin and mercaptoethanol. This complex has been found to protect spermatozoa against loss of motility which leads to complete standstill when Tyrode solution alone is used after incubation for six hours under the conditions under which we conducted the experiment. From these observation it does seem to us that the female genital tract does undergo changes during the menstrual cycle which allow sperms to stay motile and that this is probably the same effect as the abumin mercaptoethanol complex. This equilibrium is broken when there are lesion in the pelvis such as endometriosis or inflammatory disease by secretion of peroxydising substances such as fatty acids and the oligopeptides that occur in inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)
Influence of the oral administration of micronized progesterone on plasma and tissue levels of steroids in human pregnancy.
A single dose of micronized progesterone, orally administered to women at different stages of pregnancy, induced an immediate increase in the plasma levels of progesterone. Progesterone was administered to another group of women just before elective cesarean section. Levels of progesterone, oestradiol-17 beta and oestrone were determined in plasma, placenta and at different sites of the myometrium obtained during the surgical procedure. Results were compared to those observed in a control group of women who did not receive progesterone. Progesterone levels demonstrated a marked increase in plasma and in the whole myometrium 150 min after administration; the levels then decreased rapidly to control values within one hour. The concentrations of progesterone in the placenta did not show any change. Evident modifications of the oestrogen levels appeared in the myometrium and in the placenta after the administration of progesterone whereas no change occurred in the plasma. No difference was observed in estradiol-17 beta in the myometrium whereas an increase was seen in the placenta. Estrone levels decreased in the myometrium and in the placenta. This study demonstrates a prompt delivery of an orally administered natural progesterone to the myometrial target tissue and subsequent modifications in the estrogen pattern. This provides a theoretical mechanism for the clinical use of progesterone in the prevention of premature labor.