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Biomedical subjects

G Lefort

Publications and source records attributed to G Lefort.

At least 73 records · Page 4Linked to original sources
PubMed1990

Pure fetal blood samples obtained by cordocentesis: technical aspects of 322 cases.

Three hundred and twenty-two percutaneous umbilical blood samplings were performed over 4 years in our prenatal diagnostic centre. A 3.5 MHz sector ultrasound transducer was used to guide a 22.5-gauge needle under local anaesthesia. Sampling was performed for rapid fetal karyotyping (within 72 h) in 120 cases, for diagnosis of fetal toxoplasmosis in 133 cases, for determination of the severity of Rh immunization in 15 cases, and for diagnosis of congenital rubella in 4 cases. Pure fetal blood was obtained in 98.7 per cent of the cases after two attempts. The approach to the cord was either transamniotic or transplacental. Puncturing was preferentially done at the placental insertion of the cord (72.2 per cent of the cases) and the mean blood sample volume was 3.5 ml. The rate of fetal death in utero was 1.9 per cent, including two cases of amnionitis, one trisomy 18, and one severe bradycardia. The failures were due to sampling at an early stage of pregnancy (before gestation week 18), to maternal obesity, oligohydramnios, and the inexperience of the operator.

Anemia, Sickle Cell↗
PubMed1990

Low levels of serum thyroglobulin after withdrawal of thyroid suppression therapy in the follow up of differentiated thyroid carcinoma.

We evaluated the reliability of very low serum thyroglobulin (Tg) levels (less than 3 ng/ml) obtained after withdrawal of thyroid suppression therapy in 224 patients without anti-Tg antibodies, who had undergone total thyroidectomy (125 patients) or thyroidectomy followed by 1 or more courses of 131I therapy (99 patients), by performing whole body scans after a therapeutic course of 131I given at the same time of Tg measurement. In 79 patients (35%) a positive scan, associated with a very low level of Tg, was noted. The 131I uptake was limited to the thyroid bed in 60 patients, but metastases were demonstrated in 19 patients (8.5%). These results are mainly explained by the much improved performance of scintigraphy after administration of therapeutic doses of 131I. In the majority of patients, especially those whose 131I uptake was limited to the thyroid bed, further scans were negative. Therefore, in these cases, negative Tg values can generally be considered an early indication of satisfactory evolution. However, in 8.5% of all cases, very low Tg levels were associated with metastases. Thus the follow up of thyroid cancer should not rely only upon Tg determination, even after suppression therapy withdrawal.

Adenocarcinoma↗
PubMed1990

[Open reduction by the Dunn technique in upper femoral epiphysiolysis. Report of 14 cases].

Fourteen of Dunn's operations for slipped upper femoral epiphysis were analysed in their indications and their results in comparison with others series. The open operation of the femoral head is a good method for the chronic highest displacements. The notion of an acute displacement leads us to ask for a previous bone scintigraphy in order to make sure of the integrity of the vascularisation. Thus, there was no complication of necrosis in this surgery, but unfortunately, there were two chondrolysis and one mechanical accident.

Adolescent↗
PubMed1990

[Congenital vesicovaginal fistula. Commentary and review of the literature apropos of a case].

A case of urinary incontinence through vesico vaginal fistula is related in a five year old girl. Its congenital origin is probable. The right ureteral orifice joins up with the fistula, in full duct. The corresponding kidney is hypotrophic and subjected to the vesico renal flow of the third degree. The incontinence disappears immediately. The literary studies have been analysed. Few are really vesico vaginal fistulas and few have a congenital origin.

Child, Preschool↗
PubMed1989

Metabolic fate of human choriogonadotropin.

Review of the literature reveals a number of recent insights concerning the metabolic fate of human choriogonadotropin (hCG). In man, only a fraction (21.7%) of the circulating hCG molecules is excreted in urine. Results from animal studies indicate that the retained hCG is taken up by various tissues, principally kidney, liver, and ovary, where degradation occurs. Ovarian uptake is receptor mediated and saturable. Hepatic uptake of hCG is not preceded by desialylation, and blockade of hepatic receptors for galactose-terminated glycoproteins does not impair hepatic accumulation of hCG. Kidney uptake is quantitatively the most important; parenchymal metabolism, as well as excretion in urine constitute major renal components of hCG disposal. The intracellular products of hCG catabolism in kidney include certain fragments of the hCG molecule that exhibit relative resistance to processing by degradative enzymes. These products are fragments of the hCG beta subunit that lack the hCG beta carboxyterminal antigenic determinant, but retain an hCG beta core antigenic determinant, and, thus, they are designated beta-core molecules. Both kidney from hCG-infused rat and urine from pregnant women contain beta-core molecules in great abundance, in fact, in greater abundance than hCG, itself. Structural characterizations of the beta-core purified from pregnancy urine indicate a mol. wt of about 10,000 and an absence of sialic acid, galactose, and carboxyterminal peptide region, including O-linked oligosaccharides. Human volunteers given purified hCG or hCG beta by infusion excrete beta-core in their urines, which establishes the existence of catabolic pathways in humans for the production of beta-core. Thus, urinary excretion of beta-core may reflect an important fate for the metabolic products of hCG degradation.

Chorionic Gonadotropin↗
PubMed1989

Interest of simultaneous ultrastructural characterization of morphology, cytochemistry and immune phenotype in a case of putative hybrid acute leukaemia.

A case of acute leukaemia is reported in which blast cells expressed some B-related antigens (namely the CALLA antigen) and no peroxidase activity at the optical level; however, some mature granular cells contained Auer rods. Simultaneous characterization of ultrastructural morphology, cytochemistry and immune phenotype was performed. There was an apparent mutual exclusion in the expression of myeloperoxidase activity and the CALLA antigen, and a heterogeneity in the CALLA expression among the blastic population. These results disagree with the hypothesis of a true biphenotypic leukaemia and demonstrate a complete heterogeneity between the lymphoblastoid cells and the myeloid ones. The interest of such a simple combined method in a case of putative hybrid acute leukaemia is emphasized.

Acute Disease↗
PubMed1989

[Adjusted cupula in the treatment of massive osteonecrosis of the upper part of the femur in adolescent children].

Six important necrosis of the apophysis of the femur were treated by arthroplasty with adjusted cup. This operation always made these hips painless, 5 times, the mobility was greatly improved. This a normal social life was quickly recovered. However, the distant future remains uncertain. With the exception of one immediate failure, one hip had to be reoperated, 8 years after the total arthroplasty.

Activities of Daily Living↗
PubMed1989

[F.G. syndrome: a rare and/or extremely polymorphic syndrome?].

We report a case of mental retardation associated with multiple congenital anomalies suggesting an F.G. syndrome. We discuss problems concerning genetic counselling and the management of future pregnancies. Unfortunately, no concrete strategy, concerning prenatal diagnosis, can be proposed.

Abnormalities, Multiple↗
PubMed1989

[Liposarcoma in children. Apropos of 3 cases and a review of the literature].

Liposarcoma is an uncommon tumour in childhood. Three cases are reported. Two patients remain alive and well without local recurrence or metastasis following the initial treatment, however one patient died as a result of direct tumour extension despite chemotherapy. A review of the literature revealed the following features: the extremity are the most common location, the predominance of myxoid histology and its best prognosis. The treatment is the complete surgical excision, the efficiency of radiotherapy or chemotherapy has not been formally proved.

Buttocks↗
PubMed1989

[Fetal blood sampling for karyotype using echoguided puncture of the cord. Study of 103 pregnancies].

Subcutaneous ultrasound guided puncture of the umbilical cord was carried out in order to obtain samples of blood in 103 fetuses. This was done to get the result of the karyotype quickly, i.e. in 72 hours. The indications were for diagnosis, particularly of malformations (63 cases) or intra-uterine growth retardation (24 cases). A small proportion of the indications were those for failures to carry out amniocentesis early or for checking on mosaics that were obtained after the culture of amniotic fluid cells. In 88% of the cases it was possible to obtain a karyotype and the results were checked with the sex of the fetus and the karyotype that had been obtained from amniocentesis. There were 11 abnormalities diagnosed. The chief indication of chromosome abnormality is fetal malformation. Because the result are obtained so quickly cordocentesis should replace late amniocentesis, at present when looking for fetal abnormalities.

Adolescent↗
PubMed1989

[Surgical treatment of gastroesophageal reflux in the child using Dor's anterior partial fundoplication procedure. Report of 37 cases].

A retrospective study of 37 children with gastroesophageal reflux, treated by Dor's anterior partial fundoplication procedure, objects a good clinical result in a rate of 95%. The late radiologic examinations confirm a good result in 84%, without gastroesophageal reflux or fundoplication alteration, with a mean follow-up of 6 years. The late efficiency of the partial fundoplication is assured by a safe fixation of the abdominal oesophagus and the partial fundoplication to the diaphragnatic crus.

Child↗
PubMed1988

[Hypoglycemia caused by overdose of a new anti-arrhythmia agent: cibenzoline. 3 cases].

Severe fasting hypoglycaemia were observed in three patients treated with cibenzoline, a new class I antiarrhythmic drug. Retrospective analysis of electrocardiographic changes and serum level determinations showed that these reactions were contemporaneous with intoxication by overdosage of the drug. None of the patients was taking any other drug known to produce this adverse reaction, and in the absence of any other cause of hypoglycaemia, we concluded that it was related to the administration of cibenzoline. Thus, cibenzoline is yet another class I antiarrhythmic agent producing hypoglycaemia as an adverse reaction. Serum insulin levels measured in two of the three patients during hypoglycaemia were inappropriately high, suggesting that cibenzoline might stimulate insulin secretion.

Aged↗
PubMed1988

[Unilateral hematocolpos in utero-vaginal duplication associated with homolateral renal agenesis. Apropos of 2 clinical case reports].

This is a report of two Cases of unilateral hematocolpos with ipsilateral renal agenesis in a bicornuate uterus with unilateral imperforate vaginal. The Symptoms, operative findings and surgical procedure are described. It is exceptional in the neonatal period to find an Hydro-Hematocolpos associated with complex genitourinary malformations. Easy diagnosis of Hydro-Hematocolpos and its effect on upper urinary tract are made by ultrasonography and intravenous urography.

Adolescent↗
PubMed1988

Thallium-201 imaging in the follow-up of differentiated thyroid carcinoma.

Since thallium-201 imaging has been reported as a potential means of follow-up of patients with differentiated thyroid carcinoma (DTC) during ongoing thyroid suppression therapy, the authors evaluated the diagnostic sensitivity of this procedure in 31 patients known to have metastases or local recurrence. Among 51 tumor sites 201TI imaging had a detection rate of 45% whereas 84% was noted for imaging with 131I administered in therapeutic doses. Thus, even though the effectiveness of the two radionuclides is not strictly comparable due to the difference in the administered doses, Thallium imaging cannot be recommended as the only modality for the follow-up of patients with DTC. Six of the eight tumor sites negative with 131I were positive with 201TI (especially metastatic cervico-mediastinal lymph nodes). So 201TI imaging may particularly be helpful in localizing metastases or recurrences in patients with a negative 131I scan and abnormal levels of serum thyroglobulin.

Bone Neoplasms↗
PubMed1988

[Disseminated osseous lymphangiomatosis. Apropos of 6 case reports].

Following six cases of disseminated bone lymphangiomatosis, the problem of potential haemorrhagic complications in the patients evolution has been focused. Consumption coagulopathy associated there, must be taken into account in view of therapeutic choices and vital prognosis evaluation.

Adolescent↗
PubMed1988

[Subperiosteal chondroma. Diagnostic contribution of x-ray computed tomography. Apropos of 2 cases].

Results of CT scan exploration are reported in two cases of subperiosteal chondroma, one in a 4 year old child affecting the anterior tibial tuberosity the other in a 9 year old child involving the upper end of humerus. Data from CT scan imaging were undoubtedly superior to those of conventional radiography and appear to be characteristic of this benign cartilaginous tumor, greatly facilitating correlation between clinical, radiological and pathologic findings. The scanner should allow certain situations to be dedramatized and the surgical attitude adapted when the functional prognosis is involved.

Bone Neoplasms↗
PubMed1987

[Amniotic disease. Apropos of a series of 20 cases].

Twenty patients with congenital constriction band syndrome are reviewed. Clinical manifestations and associated anomalies were analyzed with attention directed to distribution of the involvement and course of treatment. Constriction bands, amputation, and acrosyndactyly are the main clinical manifestations of the syndrome. Involvement of the distal portions of the extremity is most common, and the central digits are more frequently affected. Clubfoot deformity is the most frequently associated anomalies, those, associated, with deep constriction band at the below knee level are more severe and were due to compression neuropathy.

Amniotic Band Syndrome↗