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Biomedical subjects

L Carbillon

Publications and source records attributed to L Carbillon.

32 records · Page 2Linked to original sources
PubMed1998

Virological and biological characteristics of cervical intraepithelial neoplasia grade I with marked koilocytotic atypia.

The aim of this study was to evaluate virologic and biological significance of marked koilocytotic atypia observed in some cases of grade I cervical intraepithelial neoplasia (CIN I). Thirty-one CIN I cervical biopsy specimens with marked koilocytotic atypia, defined by the presence of meganuclei in the superficial epithelial layers, were compared to 37 CIN I biopsy specimens with usual koilocytes for (1) the human papillomavirus (HPV) type and signal pattern as detected by nonisotopic in situ hybridization (ISH); (2) the proliferation index assessed by Ki 67 immunostaining and (3) the p53 labeling pattern. Interobserver agreement for meganuclei was excellent (k = 0.9). Twenty-five out of 68 biopsies (37%) were positive by ISH for the 6 of 11 HPV probe, 30 (44%) for the 16-18 probe, and 7 (10%) for the 31/33 HPV probe, 6 (9%) were negative for ISH. The presence of meganuclei was strongly related to high and intermediate risk HPV type (P = 0.0001). The sensitivity and specificity of meganuclei for the detection of high or intermediate risk HPV in CINI were 73 and 87%, respectively. Loss of p53 immunostaining in the lower third of the epithelium was also related to the presence of meganuclei (P < .05), but the MIB-1 index and ISH labeling pattern were not. In conclusion, marked koilocytotic atypia in CIN I is a reliable and sensitive marker for infection by high or intermediate-risk HPV, and might be a guide to therapy.

Antigens, Nuclear↗
PubMed1998

[Immunohistochemical characterization of the inflammatory infiltrate in the human endometrium prior to in vitro fertilization and embryo transfer].

UNLABELLED: Infiltrating leukocyte population appears at the time of implantation in the endometrium of human and other mammals with hemochorial placentation. This leukocyte population is mainly composed of macrophages and typical granular lymphocytes CD56+ CD16-. 63 endometrial samples were studied using immunocytochemistry, before IVF and embryo transfer. We evaluated the sensibility for the assessment of immunological relevant infiltrating cells, of classical histopathologic examination compared with quantitation of leukocyte-common-antigen antibody immunostaining. 21 samples were thoroughly studied during proliferative phase. RESULTS: The sensibility of classical histologic analysis for the semi-quantitative assessment of leukocyte population, even when performed by an experienced histopathologist, is only 62%. When leukocyte population during proliferative phase is dense, it is mainly composed of macrophages and CD56+ CD16- lymphocytes. CONCLUSION: Immunological reaction already reported around the time of implantation may occur at other period of the menstrual cycle. Close mechanisms of the control and functions of this characteristic reaction remain to clarify.

Adult↗
PubMed1997

Clinical biological features of Ballantyne syndrome and the role of placental hydrops.

Ballantyne syndrome was first described in association with severe hydrops fetalis caused by rhesus isoimmunization, and lately, in association with diverse etiologies of nonimmunological severe fetal hydrops. This report is a case of typical Ballantyne syndrome in association with lethal hydrops fetalis caused by Ebstein's anomaly. It is likely that any severe fetal hydrops with massive placental hydrops may produce Ballantyne syndrome. Hemodilution could be the main biological feature, differentiating Ballantyne syndrome from usual preeclamptic syndromes. Pathophysiological hypotheses are discussed.

Adult↗
PubMed1997

Different proximal and distal rearrangements of chromosome 7q associated with holoprosencephaly.

Four new cases of holoprosencephaly are described in fetuses exhibiting abnormal karyotypes with different distal and proximal rearrangements of the long arm of chromosome 7. Three of them showed terminal deletions of chromosome 7q, confirming the importance of the 7q36 region in holoprosencephaly. The karyotype of the fourth fetus showed an apparently balanced de novo translocation, t(7;13) (q21.2;q33), without any visible loss of the distal part of chromosome 7q. The involvement of new genes, different from the human Sonic Hedgehog gene (hShh) responsible for holoprosencephaly, or a positional effect are discussed.

Amniocentesis↗
PubMed1994

[Has the use of indomethacin during pregnancy consequences in newborn infants? Prospective study of 83 pregnant women and 115 newborn infants].

BACKGROUND: Prolonged exposure of pregnant women to indomethacin for tocolysis may have significant effects on the fetus or neonate, but their incidence is still debated. POPULATION AND METHODS: From January 1990 to July 1991, 83 pregnant women were prospectively given indomethacin for treatment of premature labor, after ineffective course of salbutamol. The initial dose of indomethacin was 100 mg, then the daily dose was 50 mg while salbutamol was continued. Indomethacin was discontinued beyond the 33rd week of gestational age. Efficacy of indomethacin was judged upon the disappearance of uterine contractions and the increased duration of pregnancy from the onset of treatment until delivery. Adverse effects of treatment were evaluated in the neonates. RESULTS: The mean duration of indomethacin administration was 16 days (range: 1-62 days); the mean total dose was 900 mg (range: 100-4500 mg). The reason for discontinuation of the treatment was its efficacy (41 patients), a gestational age of 33 weeks (12 patients), oligoamnios (21 patients), demonstration of fetal abnormalities (two patients). The mean interval between discontinuation of treatment and delivery was 5 weeks. Fourty three of the 58 patients who were given indomethacin before the 30rd week were delivered after the 33rd week. There was no adverse effect in the women and babies; all oligoamnios were spontaneously reversible. One hundred and fifteen babies were born including 12 who died during the first post-natal days. The rate of admission in an intensive care unit was similar to that of untreated pregnancies. CONCLUSIONS: Indomethacin can be safely used for treatment of premature labor provided that its administration is carefully monitored.

Female↗
PubMedDate not supplied

Fatal sepsis due to Escherichia coli after second-trimester amniocentesis.

The case of a pregnant woman (16th week) needing an amniocentesis is reported. She rapidly developed a septic shock. Despite vaginal delivery, curettage and antibiotherapy, the patient deteriorated with the onset of an acute respiratory distress syndrome and a typical disseminated intravascular coagulation. Bacteriological data showed positive blood cultures to Escherichia coli. Amniotic liquid was positive to the same E. coli. Cultures obtained from instruments, disinfectant solutions and gel used during the procedure were negative. On the contrary, amniotic and fetal cultures were positive to E. coli and Clostridium perfringens. She died 2 days later. The incidence of septic shock following amniocentesis is very low but we report the first case of fatal sepsis and multiorgan failure, due to E. coli and C. perfringens. The mechanisms of infection are discussed: contamination from the instruments, systemic dissemination of bacteria coming from an asymptomatic intra-amniotic infection, and inoculation of the placenta with a needle passing through the bowel.

Adult↗
PubMedDate not supplied

Fetal-placental and decidual-placental units: role of endocrine and paracrine regulations in parturition.

In primates, fetal adrenal and placental steroidogenic enzymatic systems are complementary in a fetal-placental unit, synchronizing fetal maturation and myometrial activation in late gestation. Moreover, as hemochorial placentation characterizes rodents and primates, paracrine regulations between decidua and placenta are essential to the immunotolerance of the conceptus and its development. Thus, the decidual-placental unit remains in a striking state of decidual quiescence throughout gestation, and the reversal of this quiescence is thought to play a key role in myometrial stimulation and the onset of parturition. A comprehensive view of the control of myometrial contractility, through the interaction of paracrine and endocrine modifications in late gestation, is proposed. The failure of these mechanisms underlie prematurity and the use of fetal therapy in threatened preterm labor.

Animals↗
PubMedDate not supplied

Intervillous and spiral artery flows in normal pregnancies between 5 and 10 weeks of amenorrhea using color Doppler ultrasonography.

OBJECTIVE: The aim of our study was to investigate early placental circulation development and spiral and uterine artery flows in normal 1st-trimester pregnancies. METHODS: A prospective study of intervillous and spiral artery flows in 49 normal pregnancies (5-10 weeks of amenorrhea) was performed. Transvaginal color and pulsed-wave Doppler techniques (6-MHz probe) were used as routine ultrasound scanning modalities before pregnancy termination for psychosocial reasons. RESULTS: In all pregnancies, between 5 and 10 weeks, continuous nonpulsatile intervillous flow (mean V(max) 3.55 cm/s) and spiral artery flow (mean peak systolic velocity 16.2 cm/s, mean diastolic index D/S 0.49 +/- 0.089) were detected. In the 47 women in whom the uterine artery flow was measured, the mean peak systolic velocity was 67.5 cm/s, the mean diastolic index was 0.12, and bilateral notching was observed. CONCLUSIONS: In all cases, between 5 and 10 weeks, slow and continuous nonpulsatile intrachorionic flow could be detected, whereas pulsatile flow was detected in spiral arteries. The true nature of this early intervillous circulation remains to be determined.

Adolescent↗
PubMedDate not supplied

First-trimester diagnosis of sirenomelia. A case report.

We report a case of sirenomelia diagnosed at 13 gestational weeks. This rare malformation sequence is characterized by fusion and rotation of the lower limbs to various degrees and anorectal atresia, usually associated with absence of bladder and agenesis or dysgenesis of the kidneys. Diagnosis is commonly made later in the second trimester of pregnancy with oligohydramnios as the alerting sign. Survival is extremely rare, and only possible in the absence of bilateral renal agenesis. In view of the dismal prognosis, early diagnosis allows for earlier and less traumatic therapeutic abortion.

Adult↗
PubMedDate not supplied

Doppler ultrasonography and implantation: a critical review.

Active perifollicular angiogenesis in ovaries and endometrium is linked with the quality of oocytes and endometrial receptivity, and consequently with the outcome of implantation. Studies evaluating ovarian velocimetry in relation to implantation and pregnancy rates bring essentially into play velocity values or non-quantitative parameters, whose reproducibility is low and which are hardly usable in daily practice. Conversely, the assessment of uterine artery flow by Doppler examination is easy and reproducible, and high impedance at the end of the follicular phase is a good predictive indicator of poor endometrial receptivity. In early pregnancy, Doppler investigation must not be used routinely because its safety is still under discussion; however, the available data show that impedance in the uterine and spiral arteries does not show any significant difference between normal and abnormal pregnancies (missed abortions or anembryonic pregnancies), and the significance of easily detectable intervillous flow is hotly debated, raising fundamental points.

Arteries↗
PubMedDate not supplied

The role of integrins in human embryo implantation.

Integrins are adhesion molecules present in endometrial, decidual, and extravillous cytotrophoblast (EVCT) cells. They participate in cell-cell adhesion as well as in adhesion between cells and components of the extracellular matrix, and they play an important role in the endometrial phenotype change that occurs during the secretory phase, the first stage of implantation. At the beginning of pregnancy, the change in integrin expression is synchronized with the trophoblast attachment (embryo-endometrium interactions with integrins alpha(v)beta3, alpha4beta1, alpha6beta1, and alpha7beta1) and the embryo's invasion of the decidua (integrins alpha6beta4-->alpha5beta1-->alpha1beta1-->alpha4beta1 switch from proliferative to endovascular EVCT). Several diseases, including preeclampsia, intrauterine growth retardation caused by vascular problems and defective luteal phases, may be explained by anomalies in integrin patterns.

Cell Adhesion Molecules↗
PubMedDate not supplied

Prospective evaluation of uterine artery flow velocity waveforms at 12-14 and 22-24 weeks of gestation in relation to pregnancy outcome and birth weight.

OBJECTIVE: Uterine artery flow velocity was prospectively assessed using Doppler ultrasound at 12-14 and 22-24 weeks of gestation in the prediction of subsequent complications related to uteroplacental insufficiency: preeclampsia, pregnancy-induced hypertension, fetal growth restriction, fetal death and placental abruption, and to elucidate its relationship with birth weight. METHODS: Uterine artery Doppler assessment was obtained during routine ultrasound screening in 263 unselected women. Flow velocity waveforms were coded according to the number of notches present at each scanning, respectively: none (0, 0), uni-/bilateral notches that disappeared (1, 0) or (2, 0), uni-/bilateral notches that persisted unilaterally (1, 1) or (2, 1), and persistent bilateral notches (2, 2). RESULTS: Complete outcome data was obtained for 243 (92.4%) women. Of these women, 55 (22.6%) and 84 (34.6%) women had uni- and bilateral notches, respectively, at 12-14 weeks' gestation; 14 (5.8%) and 21 (8.6%) patients had uni- and bilateral notches, respectively, at 22-24 weeks' gestation. Analysis of complication rates for the four groups showed that they increased with notch persistence (5.7, 13.5, 57.1 and 76.2%), while the corresponding mean birth weight declined (3,273, 3,180, 2,698 and 2,418 g). CONCLUSION: The absence or early disappearance of uterine artery notches is associated with fewer complications related to uteroplacental insufficiency and normal birth weight, whereas their late and partial disappearance or bilateral persistence tends to compromise the prognosis.

Adult↗
PubMedDate not supplied

Sickle cell and thiamine deficiency: case report of a fetal death.

The heterozygous state of the sickle cell trait is not known to be a cause of fetal death. This is a report of disseminated placental infarcts associated with thiamine deficiency in a patient with the sickle cell trait. This pathological association suggests an original physiopathological process.

Adult↗