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Biomedical subjects

G Body

Publications and source records attributed to G Body.

At least 37 records · Page 2Linked to original sources
PubMed1997

Etiology, prognosis and management of nuchal cystic hygroma: 25 new cases and literature review.

OBJECTIVE: To develop an algorithm for the prenatal management of patients when a cystic hygroma is diagnosed by ultrasonography. METHODS: We report a personal series of 25 cases diagnosed between 10 and 23 weeks gestation and a review of the literature comprising a total of 999 cases. We focused on the etiologies and the value of various prognostic factors in the management of cystic hygromas. These include karyotype, alpha-fetoprotein levels, sonographic findings in the fetus and within the hygroma itself, and natural history. RESULTS: According to the literature, fetal chromosomal abnormalities were associated with cystic hygromas in 62% of the cases. Turner's syndrome remains the most common (33%) but Down's syndrome, Trisomy 18 and Trisomy 13 are not rare (15, 7 and 2%). Others have Mendelian abnormalities. The prognosis remains gloomy. The literature reports that only 9% of cases result in healthy children with normal karyotypes. The remaining 91% are either terminated (89%) or liveborn (2%), but with chromosome abnormalities or various malformations. CONCLUSION: The prognostic factors associated with a poor outcome are an abnormal karyotype and associated structural malformations. Resolution of the hygroma by 20 weeks gestation suggests a good prognosis, but is not definitive. All other factors evaluated do not appear to be of prognostic value at this time. Careful analysis of these prognostic factors is very important to identify the small percentage of normal children and to advise parents effectively for a future pregnancy.

Adult↗
PubMed1997

[Retroperitoneal malignant fibrous histiocytoma].

Malignant fibrous histiocytoma is the commonest soft tissue sarcoma of adults. The soft tissue of the extremities is the commonest primary site of malignant fibrous histiocytoma. It is much less common in the female retroperitoneum, leading to diagnostic errors. The clinical, radiographic and CT signs are non-specific. This tumor can only be diagnosed by histology. An initial complete resection is essential for successful treatment of the primary tumor. Radiation therapy is limited and chemotherapy has only been successful in a limited number of cases. This tumor has a poor prognosis. These lesions are relatively rare and consequently difficult to study. The authors report three cases and review the literature.

Adult↗
PubMed1997

[Complications of laparoscopy caused by trocars. Preliminary study from the national registry of the French Society of Gynecologic Endoscopy].

OBJECTIVE: To describe laparoscopic complications due to trocar insertions and to define their prevention as well as their risk factors. STUDY DESIGN: The SFEG registry of laparoscopic complications was used for our study; 26 complications due to trocar insertions were recorded to this day by the register including 12 vascular injuries, 9 bowel injuries, 3 bladder perforations and 2 incisional herinas. In order to avoid accidents of this technique, patient profile, laparoscopy indications, trocar type, diagnosis and treatment of the complications as well as the outcome must be defined. RESULTS: Whatever the operator's experience, the indication of laparoscopy and the trocar type some patients seem to have complications at laparoscopy: 70% of studied group had prior surgical treatment and 50% were over weight. However, it appeared that safety rules were not been taken into account for one-third of the trocar injuries. Consequently, laparotomy was used by the same surgeons for these complications in 89% of cases, laparotomy was delayed in 27% of the cases. CONCLUSION: In order to prevent laparoscopic complications, the surgeon must (i) inform the patients about risks which may occur, (ii) be careful, and (iii) declare each complication to a national registry such as the SFEG registry.

Adult↗
PubMed1996

Evolution of blood coagulation activators and inhibitors in the healthy human fetus.

Blood coagulation proteins were determined in 285 healthy fetuses from 19 to 38 weeks' gestation and compared with those of 60 normal full-term newborns and 40 adult controls. Prolongation of the coagulation screening tests, prothrombin time, activated partial prothrombin time, and thrombin clotting time, in fetuses throughout intrauterine life was explained by low levels of vitamin K-dependent factors (II, VII, IX, and X), contact factors (XI, XII, prekallikrein, and high-molecular-weight kininogen), factor V, factor VIII, and fibrinogen. Low levels of antithrombin III, heparin cofactor II, protein C and protein S, and tissue factor pathway inhibitor were also found, and these probably contributed to a satisfactory hemostatic balance. Some of these parameters were evaluated by both immunologic and functional assays to detect possible "fetal" proteins. An increase in factor levels was observed after the thirty-fourth week of intrauterine life for most of the coagulation activators and inhibitors, but only factors V and VIII reached adult values at birth. This study therefore showed that fetal hemostasis is a dynamic system that evolves gradually toward the neonatal state and then toward the adult state.

Adult↗
PubMed1996

Morphometric epididymal epithelium analysis in obstructive azoospermic men: predictive values in fertilization rates.

PURPOSE: Our purpose was to determine the obstructed epididymal epithelium morphometric state and to elucidate the influence of morphometric parameters on the fertilizing ability of aspirated spermatozoa. METHODS: During MESA with IVF, epididymal tissue samples were carefully dissected, fixed, and prepared for morphometric analysis. The epithelium of the three regions was studied: head, body, and tail (when present). The total area/luminal area ratio, epithelium thickness, and stereocilium length were measured. RESULTS: We have found significant differences in the total area/luminal area ratio, epithelium thickness, and stereocilium length in obstructed epithelium length > 4 versus 0.5-2 cm (P < or = 0.01). Epithelium thickness and stereocilium length were significantly lower when no fertilization was observed in IVF. CONCLUSIONS: These results suggest that morphometric data of obstructed epididymis epithelium can be used as a means of explaining the failure of IVF with epididymal spermatozoa.

Cell Separation↗
PubMed1996

Treatment of fibromas.

This study defines the current modes of treatment of patients with uterine fibromas with a review of the literature. Progesterone treatments appear to be principally used in cases of minor functional symptomatology and we discuss recent studies of mifepristone. GnRH agonists are particularly effective in preoperative treatment for conservative surgery. The indications and results of hysteroscopic resection and laparoscopic myomectomy are compared to those of classic myomectomy and hysterectomy. The indications for myolysis are discussed.

Female↗
PubMed1996

Ureteral endometriosis revealed by an acute renal failure.

The authors report a case of an acute renal failure secondary to an obstructive bilateral ureteral endometriosis. They show the limits of the clinical diagnosis as well as the limits of additional explorations and discuss the therapeutic management at the time and in the after effects of the initial acute period.

Acute Kidney Injury↗
PubMed1996

Congenital diaphragmatic hernia: can prenatal ultrasonography predict outcome?

OBJECTIVE: We wanted to establish whether prenatal ultrasonography predicts postnatal outcome in congenital diaphragmatic hernia. STUDY DESIGN: We designed a retrospective multicenter cohort study of 135 patients with congenital diaphragmatic hernia (122 left, 10 right, 2 bilateral, 1 anterior). In isolated left congenital diaphragmatic hernia five potential prenatal prognostic factors were studied: diagnosis at < or = 25 weeks' gestation, polyhydramnios, intrathoracic stomach, small abdomen, and major mediastinal shift. RESULTS: None of the 44 fetuses or infants who had multiple malformations survived. Of the 91 cases of isolated congenital diaphragmatic hernia, there were 82 live births; 76 of these infants had a left congenital diaphragmatic hernia. Of these, 51 (67%) died postnatally. A statistically significant relation was found between mortality and polyhydramnios, intrathoracic stomach, and major mediastinal shift. Mortality increased as a function of the number of these prognostic factors from 20% when none was present to 94% when all three were present. CONCLUSION: In the majority of cases of isolated left congenital diaphragmatic hernia the prognostic value of fetal ultrasonography is too low to alter perinatal management.

Cohort Studies↗
PubMed1996

[Color Doppler ultrasonography of local recurrent breast cancer].

Local lesions occurring after conservative surgery for breast neoplasms require diagnostic means capable of detecting and assessing the recurrence of such cancers. In the present color-coded Doppler was used in 20 women who had under gone conservative surgery (mean 4 years before) to screen all suspect lesions. Among the 14 malignant lesions assessed histologically, one or more arterial vessels were detected inside or beside the lesion in 13. Among the 6 benign lesions, only of one arterial vessel was detected, in all cases far from the lesion (12.5 to 3.3 mm). No significant difference was observed for systolic velocities and resistance index. These results indicate high accuracy of color coded Doppler examination associated with echotomography and mammography for positive diagnosis of recurrent lesions in post-conservative follow-up of breast cancer.

Adult↗
PubMed1996

[In utero measurement of the umbilical cord in full term pregnancy].

OBJECTIVE: The length of the umbilical cord varies widely from one pregnancy to another. Although its average length is 50 cm, this measurement could vary from as little as 20 cm to more than one metre. The purpose of our study was to evaluate, in utero, the length of the umbilical cord during the third trimester of pregnancy knowing the propagation velocity of the pressure wave along the cord. MATERIAL AND METHODS: The computation of the apparent length requires two ultrasound transducers, one situated at the aortic fetal arch, the other at the placental extremity of the umbilical artery. Knowing the velocity of the pressure wave (v), as well as the time interval between the systolic peak of two waves (delta t), we can deduce the length of the umbilical cord (delta t x v). RESULTS: The comparison between the calculated length and the actual length measured shows a significant correlation with a probability of 1%. CONCLUSION: The knowledge of the length of the umbilical cord is quite useful in the physio-pathological interpretation of the placental resistance index. It is also of interest, before the delivery, to know the length of the cord in order to foresee dystocy and how it relates cord which is either too short or too long.

Blood Flow Velocity↗
PubMed1996

[Indications for castration in women treated for breast cancer].

Historically, castration has been the first endocrine treatment in breast carcinoma. In premenopausal metastatic patients, castration improves quality of survival during a median period of 10 months, in one third of patients. As adjuvant treatment, prophylactic castration can be an alternative to chemotherapy in patients with positive receptors. Prospective randomized trials are being conducted to define indications of each adjuvant treatment.

Antineoplastic Agents, Hormonal↗
PubMed1995

Prenatal diagnosis of trisomy 8 mosaicism in CVS after abnormal ultrasound findings at 12 weeks.

We describe a case of trisomy 8 mosaicism in which fetal chromosome analysis was prompted by ultrasound abnormalities, i.e., hygroma colli and dilatation of the renal pelves. Chorionic villus sampling (CVS) was performed, with a false-negative result on direct karyotype analysis, although cultured trophoblasts revealed trisomy 8 mosaicism. Fetal autopsy confirmed the abnormalities found on ultrasound examinations and fetal tissue examination showed different levels of trisomy 8 mosaicism. To our knowledge, this is the first prenatal diagnosis of trisomy 8 made on ultrasound findings.

Abnormalities, Multiple↗
PubMed1995

Endometriosis of the sciatic nerve: case report demonstrating the value of MR imaging.

Among the many causes of sciatica, endometriosis, a rare aetiology, should be considered in menstruating women in view of the diagnostic strategy and ensuing therapeutic implications. We report a case of sciatic nerve involvement with endometriosis in contact with the nerve in the left sciatic notch. Exploration by MRI was invaluable for the diagnosis, revealing a signal on the stem of the nerve suggestive of a lesion with haemorrhagic content.

Adult↗
PubMed1995

Abdomino pelvic irradiation after second-look laparotomy for stage III ovarian carcinoma.

OBJECTIVE: The purpose of this retrospective analysis of 34 patients with stage III ovarian carcinoma was to review results and morbidity of whole abdominal irradiation after surgery and chemotherapy. METHODS AND MATERIALS: All of the 34 patients had reached a complete clinical remission after first cytoreductive surgery and chemotherapy. After second-look laparotomy each patient underwent whole abdominal irradiation. Except for two patients with chronic myelosuppression, the dose administered was of 22.5 Gy to the abdominal cavity with a boost of 22.5 Gy added to the pelvis. RESULTS: Three and 5-year overall survival rates were 62% and 43%, respectively. Three and 5-year disease-free survival rates were 53% and 38%. Twenty-three patients (68%) developed local relapse or local disease progression. Metastasis occurred in five cases and were always associated with an abdominal cavity recurrence. Residual disease after first cytoreductive surgery appeared as a prognostic factor in univariate analysis. Patients with unresected residuum had a 5-year survival probability of 35% versus 83% for patients without residual disease. We observed 12% grade-3 intestinal toxicities and one fatal case of radiation enteritis. CONCLUSION: Despite its curative potential, the long term benefit of whole abdominal irradiation in the multimodality treatment of advanced ovarian carcinoma must be evaluated in well designed controlled trials.

Antineoplastic Agents↗
PubMed1995

[Fetal cerebral accident due to massive fetomaternal hemorrhage. A case report].

Massive fetomaternal haemorrhage (FMH) occurs in 0.12 to 0.5% of pregnancies. It is most often spontaneous and involves uncomplicated near-term pregnancies. It causes fetal anaemia, with or without fetal distress and hydrops fetalis. To our knowledge only one paper has reported a neurological complication (hemiplegia). We describe one case of FMH (maximal Kleihauer test = 6.5%) at 28 weeks gestation, which was spontaneous, reversible, associated with sinusoidal fetal heart rare (FHR) and hydrops fetalis; and complicated by an intraventricular antenatal haemorrhage at 30 weeks gestation. Echographic abnormalities decreased. The infant was born at 40 weeks gestation. Clinical examination was normal during the first week of life. At the age of 4 1/2 months, examination showed axial hypotonia and moderated dilatation of intracerebral lateral ventricules without any other brain damage. At the age of 24 months, the child had retarded walking and hypotonia. The outcome was spontaneously favourable with disappearance in utero of the intraventricular haemorrhage (HIV), without hydrocephalia or ischaemic lesions. Three cases of similar FMH have been reported but none of them described cerebral complications. Intrauterine intravascular transfusion should be proposed early. No single pathophysiological mechanism of FMH has been universally accepted and there is no aetiological treatment. The risk of recurrence of FMH in later pregnancies requires careful follow-up.

Adult↗