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Biomedical subjects

D Querleu

Publications and source records attributed to D Querleu.

At least 163 records · Page 9Linked to original sources
PubMed1988

[Intra-amniotic transmission of the human voice].

New acoustic measurements in amniotic environment permit to specify the conditions of transmission of human voices: voices emerge, incompletely covered by a low background noise, but however higher pitched near the placenta. The recognition of phonemes in utero is rather weak, approximately 30 per cent and appreciably identical for all voices and different mode of emission. Therefore this type of recognition is likely to play a minor role: the voices are evenly toneless by lack of high-pitch, and there is no obvious superiority of the intelligibility of direct maternal voice. The recognition of vowels by their second forming, as well as the emergence (demonstrated with special microphones) of impulse noises with very high-pitch components and of synthetic speech, confirm the possibility of transmission of frequencies exceeding 1,500 Hz to the intra-amniotic environment. On the contrary, melody recognition is excellent: probably major role of this factor. The loudness of the maternal voice transmitted to the uterus exceeds markedly that of outside voices, and this voice is certainly accessible to the fetus, most of the time. The demonstration of the transmission to the amniotic fluid of noises and voices enables to consider the possibility of perception.

Amniotic Fluid↗
PubMed1987

[Tubal sterility. Attempt at cost-benefit comparison between in vitro fertilization and surgery].

The choice that exists when confronted with a case of tubal sterility that can be operated on between in vitro fertilisation straight off or surgery is an example where an analysis of the cost effectiveness may help to make the medical decision. This should, however, depend on several parameters that can not be calculated, such as the other factors in the infertility, the ability for other techniques to be applied, and what the couple want. When the expected success rate for surgery is less than 25 to 35% at present, given the results that are obtainable by in vitro fertilisation surgery is contra-indicated. On the other hand, when the tubal surgery results are expected to be good, and given the introduction of new surgical techniques above 50% success rate, for the next few years at least there are excellent indications to operate. In the distant future it is probable that reversal of sterilisation which gives good operative results will stay as an operation, while tubal blocks that are due to infection will have to resort to in vitro fertilisation, although if laparoscopic surgery can be carried out that might be preferable.

Cost-Benefit Analysis↗
PubMed1987

[Low transverse laparotomy with rectus abdominus section in gynecology and obstetrics. Apropos of 1,000 cases].

The authors report 1,000 cases (357 cesarean sections, 230 hysterectomies for benign lesions, 157 conservative utero-adnexal procedures, 128 tubal plasties, 58 prolapse or incontinence procedures, 70 cancers) ,of laparotomies performed according to the technique described by Mouchel in 1980, i.e. strictly supra-pubic and transverse, from skin to peritoneum, including section of the rectus abdominis. This incision enables to perform in ideal technical conditions, with a minimal complication rate (3 hematomas, 2 incisional hernias for 1,000), and satisfactory esthetic results, almost all of the gynecological and obstetrical surgical procedures (90% of two among the authors' practice). The only contra-indications are, except for cases of previous median laparotomy, ovarian tumors. Neither the high risk of infection, nor obesity, extended hysterectomy, nor fetal distress, represent contra-indications, which is a definite advantage over the Pfannenstiel incision. As compared with the median incision which at some time offered similar results, the esthetics and mainly the strength of the abdominal wall are markedly superior.

Abdominal Muscles↗
PubMed1987

[Communicating uteri. Study and review of the literature. Apropos of 11 cases].

The authors are reporting 11 communicating uteri's cases. This class of uterine malformation present 1 a 2% of the malformation. They report Musset's classification and Toaff too. The Musset's type 2 is more frequent. After a summary of diagnostic, the authors describe the treatment during and outside the pregnancy.

Adolescent↗
PubMed1987

[Epidemiology of extrauterine pregnancy].

An epidemiological study of ectopic pregnancy shows an increased frequency, a diminution of mortality by ectopic pregnancy. This review of the literature points out the influence of several factors implicated in the increased incidence of ectopic pregnancy: pelvis inflammatory disease (PID), intrauterine device and other contraceptive methods tubal ligation, induced abortions, tubal microsurgery, proximal tubal disease, ovulation induction and in vitro fertilization, diethylstilboestrol (DES) syndrome.

Female↗
PubMed1987

[Lasers in gynecological microsurgery. Comparative experimental study].

Forty Wistar female rats were the subject of a laser resection of the uterine horn with microsurgical anastomosis, comparing the effect of various available lasers with blade section. The animals were divided in four groups. The first group, with 10 animals, underwent a resection of each uterine horn, using the CO2 laser, with a one layer anastomosis using ethilon 10/10, under microscope. Five of them were examined one week later and the five others three weeks later, with evaluation of the adhesions, patency of the anastomosis and its histological examination. The three other groups underwent a resection using an Argon laser, Yag laser or scissors. With the Yag laser, the lumen disappeared completely and the mucosa as well as the musculosa were totally destroyed. In the other groups, adhesions were noted as well as a variable inflammatory reaction, in early and late evaluations. However, this reaction is minimal after a resection with scissors, moderate after CO2 laser, significant after Argon laser. It is concluded that only the CO2 laser is suitable for gynecological microsurgery; however, the only advantage over a scissor resection is a faster operating time and a better hemostasis; the other parameters are in favor of blade resection. Thus, it seems that laser resection is not an ideal procedure in humans, for tubal resection before anastomosis.

Animals↗
PubMed1986

[Pregnancy after treated breast cancer. Results of a case-control study].

Sixty-eight cases of pregnancy after carcinoma of the breast were collected during a survey conducted by the Société Française de Gynécologie: 27 patients had one or several pregnancies interrupted at an early stage; 41 patients had at least one uninterrupted pregnancy. The fate of these patients was compared to that of 136 controls similar in all respects, except for the absence of post-cancer pregnancy. There was no significant difference in survival curves: the 10-year survival rate in our 68 patients was 71% (90% in those with N- cancer; 71% in those with N+ cancer, with no significant difference between cases and controls in each group). The patients whose pregnancies were interrupted had the same prognosis as those who delivered at term. The survival of 14 patients who conceived within 6 months of the breast cancer treatment was not significantly different from that of the corresponding controls. Pregnancy after breast cancer does not seem to alter the prognosis of the disease. In women with good prognosis cancer, the survival rate is excellent whatever the delay between cancer and pregnancy, and women should not be discouraged from having children; in women with poor prognosis cancer (N+), the outcome is not modified by pregnancy, and it remains lethal in about 50% of cases.

Adult↗
PubMed1986

[Pregnancy following surgery for cancer of the breast].

Twenty-tree cases of pregnancy subsequent to mastectomy for carcinoma of the breast were observed. This association accounts for 8% of cases of breast carcinoma in potentially fertile women under 40. The overall prognosis is good, with a crude survival of 89% at 5 years and 70% at 10 and 15 years, superior to the figures observed in a control group matched for age, stage and date of treatment. Nevertheless, after elimination of the "selection effect" (pregnancy is more likely to occur in patients with a prolonged survival and no evidence of disease), no evidence of a biological effect of pregnancy was found: the prognosis in cases in which the delay from cancer to pregnancy is short is not different from the prognosis of the matched group. However, the disease free interval was longer in the pregnancy group.

Adenocarcinoma↗
PubMed1985

[Prevention of peritoneal adhesions by local treatments. Experimental study in the rat].

Those local treatments that are most used clinically for the prevention of adhesions in the pelvis have been evaluated experimentally using peritoneal abrasion in the rat. In a first experiment these products, namely dexamethasone, high molecular weight dextran, and noxytioline, were compared with a saline solution on the one hand which confirmed the effect of these substances in preventing adhesions, and on the other hand showed that noxytioline was about as effective as dextran 70 and better than corticosteroids. The score for adhesions that were found were; in the control series an average of 9.25, in the dexamethasone series 6, in the dextran 70 series 4.1 and in the noxytioline series 4.00. This last substance, which has been for less broadly studied than dextran, was then made the subject of a second experiment carried out in the same way as the first, and showing that the anti-adhesion effect was not something that was added on to its anti-bacterial effect because noxytioline alone was more effective than a broad spectrum antibiotic by itself, and adding the two together gave a still better result. It would seem to us that using noxytioline and dextran 70 together does not improve the results achieved by using each substance by itself.

Animals↗
PubMed1984

[Diagnostic evaluation of fetal distress during pregnancy by a sound stimulation test].

A vibro-acoustic stimulus induces in the human fetus over 28 weeks of gestational age some modifications of the fetal heart rate. Absence of response, as a single test, has been used to suggest the diagnosis of fetal jeopardy (Read and Miller, Trudinger and Boylan). In this series, the pronostic value of the sound stimulation test (SST) was evaluated in association with the results of the widely used non stress test (NST). In 78 patients, 93 pathological NST, quantified by means of the Fischer's score, were assessed by SST. The results showed a good correlation between NST and SST : SST appears to be negative (no fetal response) in respectively 10%, 48% and 100% of NST tracings with Fischer score of 7, 6 or less than or equal to 5. Thus, when the basal Fischer score indicates fetal distress, no complementary test is needed (all 11 infants showed low Apgar score or acidosis). On the other hand, when the NST is less severely abnormal (score 6 or 7), the SST allows a good discrimination of the risk of neonatal distress. Among 62 cases explored less than one week before birth, a 27% (17/62) overall probability of neonatal depression (low Apgar score at 5 minutes and/or acidosis in the umbilical artery at birth) was noticed. The SST was interpreted as reactive in 44 cases of this group, with only 8 depressed neonates (18.2%). In the other 18 cases, a negative SST was followed by birth of 9 depressed infants (50%). The difference is statistically significant (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗
PubMed1984

[Reaction of the newborn infant less than 2 hours after birth to the maternal voice].

Our group provided in 1981 evidence of a transmission of external voices, particularly the mother's voice, into the pregnant uterus in the human. The present study was carried out in order to investigate the actual perception and memorisation of this particular feature of the fetal environment. 25 infant newborns, 20 within the first hour of life and 5 during the second hour, with no post-natal experience of the mother's voice, were submitted to five females voices. The mother's voice rank was determined by randomization. The stimulus consisted in the first name of the newborn, repeated three times, with no associated visual or tactile perception. The behavior of the newborn was studied on videotapes by three of the investigators, without knowledge of the rank of the mother. Three levels of response were determined: no reaction, weak response (segmental movement) and complete response (orienting movement). The behavioral responses to the mother's voice were significantly different (p less than 0.01). The mother induced 36% of complete responses, when the unknown voices induced only 12% (p less than 0.001). Because the intonation of the mother was found, as expected, significantly warmer, this factor had to be controlled. After exclusion of cold voices, a significant difference persisted (45% of complete responses to the mother versus 16% to the other women, p less than 0.02). A fetal perception of external sounds in demonstrated. Moreover, evidence of a prenatal experience of the mother's voice, possibly involved in the process of attachment, is provided.

Auditory Perception↗