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Biomedical subjects

J Lansac

Publications and source records attributed to J Lansac.

At least 199 records · Page 11Linked to original sources
PubMed1986

[Use of the mixed antiglobulin reaction (MAR) latex test in routine detection of antisperm agglutinating antibodies in subjects with spontaneous autoagglutination].

A mixed antiglobulin reaction: M.A.R. latex test has been used to detect the presence of either IgG or IgA on the surface of spermatozoa in a selected population with spontaneous agglutination. Positive M.A.R. tests showed a highly significant correlation with the presence of antisperm antibodies in seminal plasma or serum and with sperm penetration in cervical mucus. Autoantibodies against spermatozoa were found in 4.25% of seminal fluid samples.

Autoantibodies↗
PubMed1986

[Postoperative vaginal pseudosarcoma. Apropos of a case].

We report a case of a pseudosarcoma in the scar of an anterior repair operation. The possibility that the lesion could be sarcomatous was raised by the histologists and by the appearance on the hysterogram of a filling defect in the fundus of the uterus which resembled a sarcomatous lesion. The patient was treated by external irradiation and total hysterectomy and colpectomy. The tumour belonged to that entity that is known under the name of "post-operative pseudosarcomatous nodule". The characteristics, clinical and histological, should be better known so that this mistake is not repeated. The treatment is just simple excision.

Aged↗
PubMed1986

[Effect of the etiology of sterility on the results of tubal microsurgery].

The authors have carried out a prospective study from the 1 January 1977 to the 31 December 1981 on 168 women, 89.3% of whom (150/168) had pure distal tubal microsurgery and 10.7% (18/168) had mixed surgery. The results were studied in relationship to the aetiological reason for tubal sterility, which was: salpingitis in 60 cases = 35.7%; appendicitis in 23 cases = 13.7%, endometriosis in 29 cases = 17.3%, termination of pregnancy in 22 cases = 13.1% and unknown causes in 34 cases = 20.2%. The figures for intra-uterine pregnancies were 32.74% after 24 months using a classical method of determining it and 31% using an actuarial method. There was a significant difference between endometriosis and the four other aetiologies. These latter could not be differentiated between one another. The level of ectopic pregnancies was 5.3% at 24 months, or 6.3% using an actuarial method. It was higher after endometriosis. It would therefore appear from the results of this study that endometriosis seems to be poor from a prognostic point of view when compared with the other aetiological causes and the results shown in the literature. Finally the authors discuss in cases of endometriosis whether it is correct to carry out a second operation after the first or to resort to the other possibility, namely in vitro fertilisation.

Adult↗
PubMed1985

Female genital tract and Peutz-Jeghers syndrome: an immunohistochemical study.

Systematic detection of endocrine cells was performed in two genital tracts from patients with Peutz-Jeghers syndrome (PJS). These tissues proved to be particularly rich in endocrine cells. The specialized cells were distributed in the cervix and fallopian tubes. In the cervix, they were confined to remarkable mucinous tumors related to "adenoma malignum." Serotonin, somatostatin, gastrin, and pancreatic polypeptide immunoreactive cells were characterized. In fallopian tubes, serotonin-storing cells and somatostatin cells were detected respectively among normal-appearing and mucinous areas of tubal epithelium; in addition, serotonin-storing cells were found in many mesonephric rests. This strongly contrasts with the usual paucity of endocrine cells in the female genital tract. However, none of the findings mentioned was really specific of PJS. In particular, endocrine cells seem to be an integral constituent of adenoma malignum, with or without PJS. These findings suggest a disturbance of tissular differentiation.

Adenocarcinoma↗
PubMed1985

Endocrine cells in the female genital tract.

Endocrine cells are normal inhabitants of the para-urethral, Bartholin's and endocervical glands and of mesonephric rests. All these cells were characterized as serotonin-storing cells. In the para-urethral and Bartholin's glands, serotonin-containing cells were most often found in the transitional epithelium of excretory ducts. Endocrine cells participated in some pathological conditions. Abundant argentaffin cells were observed among the terminal ductules in chronic bartholinitis and serotonin-storing cells were identified in a peculiar ectocervical epithelium. Numerous serotonin-storing cells were detected in a well-differentiated adenocarcinoma of cervix occurring in a patient with the Peutz-Jeghers syndrome. Argyrophilic cells were present in cases of endometrial carcinomas; a striking feature was the demonstration of gut peptide hormones in an unusual type of endometrial adenocarcinoma. Finally, serotonin-storing cells were a constituent of Brenner tumours. It is suggested that a similar endocrine pattern may be shared by tissues originating from both Müllerian ducts and the urogenital sinus.

Bartholin's Glands↗
PubMed1985

[Acute gonococcal salpingitis].

The authors describe their experience in handling cases of acute salpingitis in a retrospective study that lasted six years. The protocol of investigation in particular consisted in routine laparoscopy and a complete bacteriological investigation. 266 patients had laparoscopy on suspicion of salpingitis and the diagnosis was confirmed in 199 cases (64.8%). Out of the 134 patients who were fully explored bacteriologically and kept in the study the principal group consisted of cases of gonococcal salpingitis (41.8%), whereas 29.8% of the cases had infection with opportunistic pathogens and 28.3% were of doubtful aetiology or where no bacteria were discovered. The figures for recovery of gonococcal bacteria were constant throughout the six years of the study. Gonococcal salpingitis occurred more often in younger women (the mean age was 24.4 years). The signs that were statistically most frequent were: discharge, metrorrhagia and a raised sedimentation rate. The differences that concerned the epidemiology of the cases as well as the clinical and bacteriological data as given in our series and in the literature are presented and discussed.

Adolescent↗
PubMed1985

[Tubal choriocarcinoma: a case].

The authors report a case history of a tubal choriocarcinoma occurring in a woman of 38 years of age. This was 6 years after her second and last pregnancy and was diagnosed before operation. A summary of the complementary examinations is presented: An ultrasound showing a non-specific mass whose value therefore was somewhat limited; A hysterosalpingogram which showed an irregular tubal image suggestive of a cancer of the tube; Pelvic arteriography that made the signs of choriocarcinoma fairly clear. Discussion then developed in looking at the literature of those diagnostic features that are usually made. Most often this is by laparatomy when a ruptured extra-uterine pregnancy is suspected or when suspicion rests on a twisted ovarian cyst, a uterine fibroid, a tubo-ovarian abscess or blood in the peritoneal cavity in the third trimester of pregnancy, treatment, which is best given as a combination of surgery and chemotherapy, and pathogenic aetiology. It does seem that there are two principal mechanisms, the first being a malignant transformation of a tubal pregnancy, or a choriocarcinoma arising de novo without an ectopic pregnancy.

Adult↗
PubMed1985

[Clinically isolated discharges from the nipples. Apropos of 74 cases].

74 cases with discharge from the breasts were treated surgically by pyramidectomy and histology. The histology was studied. The causes were: 1) ectasia (55%), 2) papilloma (30%) and 3), much more rare, cancer (8%). A blood-stained discharge (31 cases, 42%) could be due to these three causes, but the 4 cancers and the 2 borderline lesions belonged to the group of blood-stained discharges. A serious discharge (17 cases, 23%) could be due to ectasia or a papilloma. A thick discharge (16 cases, 21.5%) is always due to ectasia. The lactiferous duct is treated clinically and using X-rays to outline it. X-ray diagnostic methods and cytology are used in making the diagnosis. Clusters of papillae show that there is intra-canular proliferation. The literature is reviewed and a scheme of treatment is outlined.

Adult↗
PubMed1985

[Bladder exstrophy and pregnancy. Apropos of 2 cases].

The authors report two cases of pregnant women suffering from exstrophy of the bladder. One of the patients had been operated on in childhood for reconstruction of the bladder, and the other had undergone Coffey's operation, so that both were able to lead practically normal lives in adulthood. Three children were born by prophylactic cesarean. Exstrophy of the bladder is often associated with other urological, genital or, on occasion, orthopedic, malformations. This article analyzes the consequences of these malformations on the course of pregnancy and delivery, and the consequences of pregnancy on the urinary tract or on the different types of surgical reconstruction. The indications for the type of delivery (natural passages or cesarean section) are discussed in the light of the author's personal experience and a review of the literature.

Abortion, Spontaneous↗
PubMed1985

[Complications and results of Wertheim's operation performed for the treatment of uterine cancer].

Enlarged colpohysterectomy with lymphadenectomy was performed in 199 patients for cancer of cervix (132 cases), of endometrium (67 cases), of vagina (2 cases) or of tubes (1 case) during combined radiosurgical therapy of these tumors. There was no mortality, the incidence of thrombo-embolic accidents was 3% and urinary fistula was not seen. A lumphocele developed in 7.5% of cases, this level being related to the degree of lymphatic curettage, which should involve not less than 13 glands to avoid lack of efficacy and not more than 20 glands to prevent complications, in cervical cancer. For endometrial cancer, curettage is limited to external iliac obturator glands and retrocrural nodes in young women, and is even omitted in elderly women.

Adolescent↗
PubMed1984

[Importance of arteriography in complicated trophoblastic disease].

Sixty two patients with gestational trophoblastic disease were investigated and treated between January 1977-December 1983. The value of pelvic arteriography was examined. The cases included: 45 moles with a simple outcome. 14 cases of invasive trophoblastic neoplasia after evacuation of the mole. 3 choriocarcinomas after full term pregnancy. Pelvic arteriography was performed in 14 patients. 9 of the 14 patients presented with persistent HCG secretion 6 to 8 weeks after evacuation of the mole. Before chemotherapy was begun, we looked for unfavourable prognostic features such as extra-pelvic metastases, multiple pulmonary metastases, high HCG secretion, delay between the initial event and starting chemotherapy of more than six months. The Ishizuka score was calculated. Six arteriography type I readings suggested choriocarcinoma with an Ishizuka score above five. Double chemotherapy (oncovin-methotrexate) was started successfully (with a one year follow up). Only two patients had unfavourable factors. Two arteriography type III suggested persistent moles, with an Ishizuka score below five. Chemotherapy (only methotrexate) was successful). It was not possible to classify the last arteriography, so the patient was treated successfully with double chemotherapy. Three patients failed to recover with chemotherapy. Arteriography was indicated to determine the site of HCG secretion. Three hysterectomies were performed. Tissue choriocarcinoma was found. Two diagnoses of choriocarcinoma were confirmed by arteriography: In one case an unexplained pleurisy appeared six months after full term. HCG was then positive. In the other case, extrauterine pregnancy was first suspected, but the woman had not had intercourse for six months. Arteriography demonstrated tubal choriocarcinoma. So pelvic arteriography is useful for managing complicated gestational trophoblastic disease.

Adolescent↗
PubMed1984

[Gonadal function in anorexia nervosa patients in the postcritical phase].

Resuming of menstruation is generally held as a hall mark of recovery in Anorexia Nervosa. Nevertheless, fifteen young women (17 to 28 years old) consulted us about secondary amenorrhea while the acute phase of illness was over. Basal gonadotropins and Estradiol (E2) were measured and a GnRH- TRH stimulation test was performed. Two groups of patients were considered: A - 7 patients with a normal Body Weight Index; B - 8 patients with a Body Weight Index still low. (- 20% - 30%). In group A, 6 out of 7 patients had a early onset of anorexia nervosa (within two years after menarche). In group B, 6 out of 8 patients had a late onset of their disease (more than five years after puberty). As for Body Weight, it seems that the prognosis is better when Anorexia Nervosa occurs within few years after menarche. By comparison with normal women of same age explored in early follicular phase, our population of Anorexia Nervosa showed no significant difference in basal levels of F.S.H., L.H., E2. Cumulative Response F.S. H./L.H. was slightly increased (= 1) compared with normal control (= 0,34). Basal and stimulated Prl were normal. When Body Weight Index was still low, LH and E2 were decreased whereas cumulative response F.S. H./L.H. was dramatically increased. A correlation between E2 and Body Weight Index was shown, low E2 usually fitting well with Low Body Weight Index. Prognosis is poorer for recovery of normal gonadal function in late onset Anorexia Nervosa. Nevertheless, in each group, some patients escaped this rule. Induction of ovulation with Clomifene let us disappointed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Exstrophy of the bladder and pregnancy].

Two patients with bladder extrophy who had been operated on during infancy (the one by reconstruction of the bladder and the other by Coffey's operation) had delivered by Caesarean section, in the one patient of one child and in the other of two normal children. They formed the basis of this study. Vesical extrophy or ectopia vesicae is a rare malformation (in 1/40 000 to 1/50 000 births). It occurs most often in male children. It can be associated with genital, urological and orthopaedic malformations. The principal complications that can occur in pregnancy are urinary tract infections, prematurity, malpresentations and genital prolapse. As far as the urological side is concerned the complications are of ureteric stones, metabolic troubles, stenosis or obstruction of the uretero-sigmoid anastomosis following Coffey's operation, and ileal prolapse if Bricker's operation had been undertaken. The ways in which the babies should be delivered are discussed, as are the risks of this malformation recurring in children who are born to mothers with vesical extrophy.

Adult↗
PubMed1984

[Spontaneous rupture of an aneurysm of the splenic artery in pregnancy. Apropos of a new case].

The authors report a case of a two para who was admitted as an emergency after collapsing at the end of her pregnancy. Various clinical examinations carried out on admission showed that she was in a state of hypovolemic shock with a marked drop in her blood pressure and a fast pulse as well as pain in the left hypochondrium radiating up to her shoulder. From the obstetrical point of view, there had been no bleeding and no uterine contractions and the fetal heart tracing showed a rate of 135. After intensive efforts at resuscitation an urgent laparotomy was carried out with as a first step Caesarian section which confirmed that there was no pathology in the placenta or uterus, followed by exploration of the abdominal cavity which revealed a large retro-peritoneal haematoma together with a ruptured aneurysm in the hilum of the spleen. Splenectomy was carried out after haemostasis of the splenic pedicle had been performed and this allowed her to recover without complications. Following this case the authors looked up the world literature and confirmed that the pathology was classic but very rare indeed, there being only 66 published cases. As far as its aetiology was concerned this aneurysm is not the same as a classical splenic aneurysm. The development of the aneurysm seems to take place during the pregnancy and the reason for this arterial aneurysm and its rupture in unknown. A theory has been advanced that circulatory and haemodynamic factors acquired in pregnancy reveal the congenital factor that is already present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Argyrophilic cells in mammary carcinoma.

Breast tumor tissues were treated by the Grimelius procedure and examined for the presence of argyrophilic cells. Carcinomas found to contain argyrophilic cells did not include classic carcinoid tumors; the group was, in fact, heterogeneous, comprising poorly differentiated ductal carcinomas, lobular carcinomas, carcinomas of uncertain origin, and colloid carcinomas. Colloid tumors were the most frequently encountered. The prominence of argyrophilic cells in colloid carcinomas raises the possibility that development into mucin-producing cells is propitious for endocrine differentiation.

Adenofibroma↗
PubMed1983

[The management of varicocele and fertility of the couple].

The authors studied 65 men who had a varicocele by semen analysis, estimating the levels of FSH, LH, testosterone and prolactin and in some cases the rise in FSH using GnRH. 59 cases were treated by operation and in each of these testicular biopsy was carried out on both sides. Indications are given as to the duration in years of the infertility, the localisation of the varicoceles and the preoperative semen analysis. It would appear that the FSH reading is most important. When it is more than 3.5 ng/ml no pregnancy occurred but when the level was within the mean range of 2.8 ng/ml the chances of pregnancy were higher. It came out at 43% of spouses becoming pregnant within 32 months. The authors make a plea for infertility in both partners to be treated by the same specialist.

Biopsy↗
PubMed1983

[Pregnancy and labor after insemination with frozen sperm from a donor].

A total of 168 out of 196 pregnancies that were obtained after A.I.D. have been followed up. Six cases were lost for follow-up (3%). The mean age was 30 years and 65% of the women had their ovulation induced. 130 nullipara were delivered. They were compared with a series of nullipara of the same age group and selected from 300 primiparous pregnancies who delivered in the department in the same year. The abortion rate was 12.5%. 79% of the pregnancies were normal in the 2nd and 3rd trimesters as compared with 83% in the control series. 94% delivered at term as compared with 97% in the control series. 21% of the women had Caesarean section as compared with 19.2% in the control series. The sex ratio was 1.08 as compared with 1.06 in the control series. There was no significant difference between the two series. It does seem, however, that the age factor is the most important factor of all in determining how frequent pathological conditions will be and the number of Caesareans that will have to be carried out. 14% were under 30 years of age as compared with 28.5% who were over 30 years of age, which is a significant difference. These results should be followed up in a larger series.

Abortion, Spontaneous↗