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Biomedical subjects

D Querleu

Publications and source records attributed to D Querleu.

At least 145 records · Page 8Linked to original sources
PubMed1991

Laparoscopic pelvic lymphadenectomy in the staging of early carcinoma of the cervix.

Laparoscopic pelvic lymphadenectomy was performed in 39 patients. An incision of the peritoneum between the round and infundibulo-pelvic ligament on each side gave access to the retroperitoneal space. Subsequently, laparoscopic surgery allowed precise dissection of external and internal iliac vessels, umbilical artery, and obturator nerve. The peritoneum was left open, and the lymph was drained into the peritoneal cavity. No lymphocele was observed. Three to 22 (mean, 8.7) nodes were removed, and there was no significant morbidity. Sensitivity and specificity were 100% in this preliminary experience. It is thus possible to remove the first-line regional lymph nodes of the cervix for pathologic examination. Because "skip" metastases are quite rare in early cervical carcinoma, the risk of missing a positive node is low. Brachytherapy alone, vaginal surgery, or, in microinvasive carcinoma, conization alone can be applied safely without the need of a staging laparotomy in cases with negative nodes.

Biopsy↗
PubMed1990

Ultrasound-guided transcervical metroplasty.

A new technique of metroplasty is described. The septum is divided with 4-mm endoscopic scissors introduced into the uterine cavity through the cervix. The whole procedure is monitored by a real-time ultrasound scanner. Twenty-four patients were operated on with this technique. No complication was encountered. Fifteen patients had third trimester deliveries or ongoing pregnancies. Among 12 patients who had suffered repetitive pregnancy losses, 11 desired pregnancy: 10 have been successfully pregnant beyond the second trimester (91.7%), 8 are delivered, and the living birth rate is 72.7%. These results equal those obtained after hysteroscopic metroplasty. The procedure is short, safe, requires no special equipment, and does not necessitate concomitant laparoscopy.

Abortion, Spontaneous↗
PubMed1990

Alcohol use in pregnancy, craniofacial features, and fetal growth.

STUDY OBJECTIVE: The aim was to study the relationship between the level of alcohol consumption in pregnancy and craniofacial characteristics of the neonate. DESIGN: This was a prospective survey of a sample of pregnant women, stratified on prepregnancy level of alcohol consumption. SETTING: The study was carried out at the public antenatal clinic of Roubaix maternity hospital. PARTICIPANTS: During an eight month period, 684 women (89% of those eligible) were interviewed in a standardised way at their first antenatal clinic visit. Of these, all who were suspected of being alcoholic or heavy drinkers (at least 21 drinks per week) were selected for follow up, as was a subsample of light (0-6 drinks per week) and moderate (7-20 drinks per week) drinkers. Of 347 women selected in this way, 202 had their infants assessed by a standardised morphological examination. MEASUREMENTS AND AND MAIN RESULTS: Suggestive craniofacial characteristics of the infants, present either in isolation or in association with growth retardation ("fetal alcohol effects"), were compared in relation to maternal alcohol consumption (alcoholic 12%; heavy drinking 24%; moderate drinking 28%; light drinking 36%). No differences were found between light and moderate drinkers. Infants born to alcoholics had a greater number of craniofacial characteristics and the proportion with features compatible with fetal alcohol effects was higher. There was a similar trend for infants of heavy drinkers. Infants of heavy drinkers who had decreased their alcohol consumption during pregnancy had fewer craniofacial features. Infants of heavy smokers were also found to have increased numbers of craniofacial characteristics. CONCLUSIONS: Craniofacial morphology could be a sensitive indicator of alcohol exposure in utero. Altered morphology is usually considered specific for alcohol exposure, but the relation observed with smoking needs further exploration.

Adult↗
PubMed1989

[Adjuvant treatment of tubal surgery. Randomized prospective study of systemically administered corticoids and noxythiolin].

The effectiveness of systemic corticosteroids in the prevention of adhesion formation and reformation has been recently questioned, on the grounds of non randomized studies. Noxythiolin has been tried in animal experiments, but never in the human. In this paper, a randomized study of the effect of dexamethasone and/or noxythiolin versus no treatment has been conducted by the Group d'Etude des Adhérences Pelviennes. 126 patients have been operated upon by microsurgery (salpingectomy and/or salpingolysis). Adhesions have been assessed by a score derived from the American Fertility Society endometriosis classification, before operation and by laparoscopy 3 to 6 months later. The mean improvement on adhesion score was 23.2 in the corticosteroid treated group, 19.3 in the noxythiolin group, 15.7 in the noxythiolin and corticosteroid group, 10.2 in the control group. 40% of patients (13 out of 32) in the corticosteroid group, versus 26% (5 out of 29) in the noxythiolin and corticosteroid group and 19% (6 out of 31) in the control group (p less than 0.02) became pregnant. No adverse effect has been noted. These results support the use of corticosteroids in infertility surgery.

Dexamethasone↗
PubMed1989

[Hysterosalpingographic aspects of ovarian and peritoneal endometriosis. Case-control study].

A clustering of radiologic signs is associated with the presence of ovarian and/or peritoneal endometriosis: some indicate fibrosis of utero-sacral ligaments (isthmic dissection of the uterus, fixed retroversion); others are linked to pathology of the tube (ampullar retention of dye after evacuation, sometimes inducing false aspects of hydrosalpinx); the last ones suggesting peritoneal adhesions (incomplete peritoneal diffusion). All these signs have been systematically studied, independently of the diagnosis, on 154 hysterosalpingograms of infertile patients known to have patent tubes at laparoscopy: in 107 out of these cases endometriosis was diagnosed at laparoscopy; the 47 last cases constituted the control group. The results confirm that all the signs described are significantly more frequent in cases of endometriosis, although non-specific for this condition. On the contrary, neither adenomyosis, tubal diverticulosis, nor intramural polyps are significantly linked to external endometriosis. In conclusion, some radiologic signs suggest the presence of peritoneo-ovarian endometriosis. Their detection is possible only on high quality pictures, including a last one taken after 10 to 20 minutes walking, to feature the anomalies of tubal evacuation and peritoneal diffusion. The clustering of these signs allows the clinician to propose an early laparoscopy in the work-up of an infertility case. Furthermore, some of these salpingograms provide evidence of a functional disorder of tubal motility in endometriosis, possibly responsible for the low fertility associated with the disease.

Endometriosis↗
PubMed1989

[Transvaginal hysterectomy. Sub-serous technic].

Intramyometrial coring is a useful method to reduce the size and increase the accessibility to the fundus uteri during vaginal hysterectomy, avoiding unnecessary traction on the utero-ovarian pedicles. A circumferential incision of the isthmus, 5 millimeters deep, gives access to an avascular plane between the myometrial mass and the superficial muscular layer and serosa of the uterus. Coring is easy, safe, non-hemorrhagic and allows the extension of indications of the vaginal route for hysterectomy.

Female↗
PubMed1988

[Retrograde section of uterine septa under ultrasonic control].

A new technique for the treatment of uterine septa is described. The septum is divided by the transcervical route, using 4 mm endoscopic scissors. Simultaneously, real-time ultrasonography confirms the diagnosis of septate uterus and ensures the safety of this blind procedure. Ultrasonic guidance also enables the septum to be divided along the medial antero-posterior plane and the distance between the upper limit of the section and the fundus uteri to be measured. The operation is rapid, carries a limited risk, leaves no uterine or abdominal scar and requires no special equipment. The elective indication for section of uterine septa is habitual abortion. This convenient method can also be used in women who have never been pregnant during coelioscopy for sterility or section of a vaginal septum.

Endoscopy↗
PubMed1988

Fetal hearing.

The fetus can hear during the last trimester of pregnancy. Consistent responses to acoustic stimuli have been observed from 28 weeks onwards. Animal experiments as well as investigations in the human lead to the conclusion that sounds from outside the mother are attenuated, but rarely by more than 30 decibels; external conversations are audible. Only 30% of the phonetic information is available to the fetus, but intonation is almost perfectly transmitted to the amniotic sac. Evidence is accumulating that the mother's voice or different sound patterns from the same voice are learnt by the fetus. Thus there are indications that short-term auditory memory may be present by the end of pregnancy.

Auditory Perception↗
PubMed1988

[Organogenesis of hearing. Development of the ear].

From a review of the literature, the authors describe the development of the auditory organ, from embryogenesis to function, explaining the hearing abilities of the newborn as well as the possibilities of hearing in utero.

Animals↗
PubMed1988

[Organogenesis of hearing. Ontogenesis of the auditory pathways].

A general review of the bibliography concerning the embryonic development of the auditory receptor provides a better knowledge of this topic, and anatomical basis of prenatal hearing, the existence of which has recently been demonstrated. The auditory receptor appears to be functional from the second trimester of pregnancy, but hearing seems mainly possible after 35 weeks.

Animals↗
PubMed1988

[Dysgerminoma of the ovary. Current diagnosis and therapy].

From a review of the literature, the authors present some new facts on the diagnosis of ovarian dysgerminoma, as well as a therapeutic protocol for the treatment of extended forms, as well as the conservative treatment of localized forms in women wishing to become pregnant.

Dysgerminoma↗
PubMed1988

[Meconium fluid. Significance and management].

The authors have tried to determine the significance of meconial fluid by studying 3 groups: a first group (MF) representing the meconial fluid observed at he beginning, the second group where the meconial fluid was observed secondarily (SMF) and a third group which is the reference group (RG). The presence of meconial fluid is an ominous sign and an element of prognosis of fetal distress. Meconial fluid at the beginning may be present physiologically, but there are authentic pathological cases with a markedly decreased residual Apgar at 5 minutes. In addition, the perinatal mortality is 4 times higher. In the group with secondary meconial fluid, it is more of an obstetrical emergency. Distress occurs on a healthy fetus along with labor. The signs are occurring with abnormalities of the fetal heart rhythm which do not aggravate the prognosis. These data are confirmed with the study of the pH at the cord. The risk of meconial fluid is inhalation and its complications. The authors conclude by insisting of the need for nasopharyngeal aspirations soon as the fetal head is delivered.

Adult↗