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L Marpeau

Publications and source records attributed to L Marpeau.

At least 109 records · Page 6Linked to original sources
PubMed1999

[Microdeletion of 22q11 and conotruncal cardiopathies: contribution of prenatal diagnosis].

OBJECTIVE: We report our experience on prenatal diagnosis of 22q11 deletion by fluorescent in situ hybridation (FISH). PATIENTS AND METHODS: From February 1997 to April 1998, prenatal diagnosis of 22q11 deletion was performed in 13 cases of congenital conotruncal heart defects. FISH was carried out using D22S75 DiGeorge's chromosome region probe. RESULTS: Microdeletions of 22q11 were detected in 4 fetuses with tetralogy of Fallot (3 cases) and pulmonary atresia with ventricular septal defect (1 case). Termination of pregnancy was performed in two cases for severe congenital heart defect. A third malformed fetus died immediately after a blood sampling procedure. The last fetus, with a tetralogy of Fallot malformation, was born and underwent corrective cardiac surgery. The dysmorphic features of this fetus was suggestive of DiGeorge's syndrome, and the development status was normal. CONCLUSION: Prenatal detection of 22q11 only played a minor role in the decision to terminate the pregnancy in our study.

Chromosomes, Human, Pair 22↗
PubMed1998

Full-term delivery following intracytoplasmic sperm injection with frozen-thawed immotile testicular spermatozoa.

We present one of the very few deliveries occurring following intracytoplasmic sperm injection of thawed immotile testicular spermatozoa from a testicular biopsy of a man with bilateral congenital absence of the vas deferens. A first attempt in the 33 year old woman with fresh testicular biopsy extracted spermatozoa was unsuccessful. The supernumerary spermatozoa were cryopreserved for later use. After thawing, testicular spermatozoa were immotile. From 11 intact oocytes injected with frozen-thawed immotile testicular spermatozoa, a two pronuclear fertilization rate of 27% and a cleavage rate of 100% were obtained. A total of three embryos was transferred resulting in a singleton pregnancy and the birth of a normal female baby.

Adult↗
PubMed1998

[Quality of data acceptable for perinatal epidemiology surveillance: assessment of the health certificate at birth and the national obstetrics medical file. Study in three Seine-Maritime maternal wards].

Data from several sources could be used for perinatal epidemiology surveillance aimed at an assessment of regional programs such as those proposed by the Superior Committee for Public Health. A retrospective study of 561 births was conducted in three maternity wards in the French Seine Maritime department in order to evaluate the reliability of two data sources: the national obstetrics medical file and the health certificate at birth. The delivery room records were used as the gold standard. The sensitivity of the obstetrics file was better than that of the health certificate. With the obstetrics file, it was possible to identify almost all the vaginal route interventions, almost all the premature births and all the cesareans. With the health certificate, 39-58% of the vaginal route interventions, 61% of the premature births and 61-72% of the cesareans performed in the three wards studied were identified. The quality of data in the obstetrics file appears to be better than that in the health certificate but only concerns 40% of births in the geographical area studied. Inversely, the health certificate is theoretically delivered for all births (actually delivered for 93%). Integrating these two information systems could be an optimum solution.

Bias↗
PubMed1997

Long-term follow-up after adjuvant chemotherapy in completely resected early stage ovarian carcinoma.

OBJECTIVE: To evaluate the impact of standardized staging, surgery and adjuvant chemotherapy on survival of patients with completely resected early ovarian carcinoma. STUDY DESIGN: We performed a multicentric retrospective analysis of 283 patients with early stage ovarian carcinoma consecutively treated between 1977 and 1993. Borderline tumours were excluded. A comprehensive staging was performed during initial laparotomy. Patients were treated by standardized surgical resection and all excepted stage IA received a 6-course adjuvant chemotherapy. RESULTS: Eighty patients were excluded because of incorrect substaging, inadequate surgery and adjuvant therapy. The analysis was performed on 203 patients with completely resected early stage ovarian cancer (139, stage I; 64, stage II). Relapse-free survival and overall survival rates for stage I were 66 and 69%, respectively. Relapse-free survival and overall survival rates for stage II were 57 and 61% respectively. Median time of relapse was 18 months (range, 1-107 months). Sites of relapse were peritoneum (45%), retroperitoneal lymph nodes (37%) and distant metastases (18%). Relapses occurring within 18 months had a median survival after relapse of 9 months while later relapses had a median survival of 22 months (P = 0.005). There was no significant difference in relapse-free and overall survival according to the age, performance status and pathology. Cisplatin-based chemotherapy improved the 10-year overall survival of patients with stage IIB and IIC as compared to chemotherapy without cisplatin (oral melphalan. CMF regimen); 91 vs. 33% (P = 0.012) and 75 vs. 42% (P = 0.05), respectively. Cisplatin-based regimens did not improve survival in stage IA, IB and IIA. CONCLUSIONS: Early ovarian cancers have a good prognosis after comprehensive staging, complete surgery and adjuvant chemotherapy. Cisplatin-based regimens compared to melphalan and CMF showed a significant increase of survival in stage IIB and IIC. Prognosis of relapse depends on the relapse-free interval duration.

Adult↗
PubMed1997

Nicardipine versus salbutamol in the treatment of premature labor. A prospective randomized study.

OBJECTIVE: To compare the tocolytic action and the side effects of nicardipine to those of salbutamol in patients presenting premature labor in order to propose nicardipine as a promising alternative to salbutamol in the treatment of premature labor. STUDY DESIGN: Ninety patients admitted to the Saint-Antoine Hospital (Paris, France) for premature labor were included in this prospective randomized open study comparing nicardipine and salbutamol. Each study group included 45 patients. RESULTS: The mean term of delivery in the nicardipine group was 38.4 +/- 1.7 and 37.6 +/- 2.1 weeks in the salbutamol group (P < 0.05). The percentage of deliveries after 37 gestational weeks was higher with nicardipine (P < 0.05). The birthweight of infants was 3131 +/- 488 g with patients treated with nicardipine and 3019 +/- 494 g with the salbutamol group (NS). The Apgar scores were identical in the two groups at 1 and 5 min. There was no statistically significant difference in the number of neonates admitted into intensive care nor the premature infant center between the two groups. Nicardipine reduced the systolic and diastolic blood pressure whereas there was no change in the salbutamol group. Maternal pulse rate was significantly increased in the salbutamol group (P < 0.01) and was unchanged in the nicardipine group. The most common side-effects with nicardipine were headaches, and with salbutamol, tremors and palpitations. CONCLUSIONS: Nicardipine is a tocolytic agent as effective as salbutamol in the treatment of premature labor. The use of nicardipine is an interesting alternative to salbutamol, especially in cases of hypertension, diabetes or maternal cardiopathy.

Adult↗
PubMed1997

[Early debulking surgery after chemotherapy in advanced cancer of the ovary].

The main prognostic factor in advanced ovarian cancer is the volume of residual disease after the initial laparotomy. Early debulking surgery after several cycles of chemotherapy, before the emergence of resistant cell lines, could improve the prognosis of patients with bulky residual disease. This study concerns patients with advanced ovarian cancer entered into three prospective trials including IV cisplatin and anthracycline-based chemotherapy, early debulking surgery after three cycles of chemotherapy in case of initial residual disease superior 2 cm and intraperitoneal consolidation chemotherapy. Among 160 patients with stage III or IV, 80 (50%) had at least a residual tumor of more than 2 cm in diameter. Early debulking surgery was effectively performed in 54 patients (67.5%), leaving 39 patients with no residue over 2 cm. Twenty-one patients had no macroscopic residual disease. The median survival of all patients with initial residual disease over 2 cm was 23 months. Patients with no macroscopic residual disease at early debulking surgery had a median survival of 44 months. Early debulking surgery appears useful in advanced ovarian cancer with bulky residual disease. The objective of this operation is to achieve no macroscopic residual lesion.

Antineoplastic Agents↗
PubMed1997

[Agenesia of the canal of Arantius. A case report].

Looking for the etiology of hydramnios which became symptomatic at 21 weeks' gestation ultrasonography revealed a hepatic vascular abnormality without other symptoms. The suspected diagnosis was agenesis of the ductus venosus with creation of a high grade arteriovenous shunt between the umbilical vein and the inferior vena cava. Agenesis of the ductus venosus may be one expression of the different possible systemic-portal-umbilical abnormalities. Physiological consequences vary according to the type of substitutive anastomoses.

Adult↗
PubMed1997

[Peritoneal tuberculosis].

Peritoneal tuberculosis remains a common problem in impoverished areas of the world. Immigrants and AIDS patients are two population groups at particular risk for abdominal tuberculosis in our country. The most common presenting symptoms of tuberculous peritonitis are abdominal pain, ascites and weight loss in more than 80% of cases. Results of sonographics studies are non specific and high serum CA 125 levels can be found. Pulmonary tuberculosis is concomitantly discovered in 50% of cases. Tuberculous peritonitis is of the exsudative type in 95% of cases and requires multiple studies of peritoneal fluid. Tuberculous peritonitis is suspected when exsudate and lymphocytes are present with no malignant cells, and high interferon gamma and adenosine desaminase activity. AFB is detected in the peritoneal fluid cultured conventionally in 80% of cases. Laparoscopy combined with peritoneal biopsy is effective for the diagnosis of tuberculous peritonitis in 75 to 85% of cases. Peritoneal tuberculosis is treated with antituberculous drugs for a period of nine months.

Antitubercular Agents↗
PubMed1997

[Late post-partum hemorrhage after cesarean section due to rupture of a false aneurysm of the uterine pedicle].

We report a recent case of late post-partum hemorrhage attributed to a consecutive aneurysm breaking in the uterine cavity. Childbirth by cesarean section was the main cause of the consecutive aneurysm which was maintained by a wound from the uterine vessels. The diagnosis was confirmed by the angiography. This procedure permits treatment by fistula embolization with decreased morbidity, while preserving future prospects of pregnancy. Consecutive aneurysm is of an unknown etiology and not as rare as commonly thought. Wounds of the uterine vessels caused by cesarean section may occur spontaneously.

Adult↗
PubMed1996

Termination of 2nd and 3rd trimester pregnancies with mifepristone and misoprostol.

OBJECTIVE: The purpose of this study was to evaluate our use of the association of mifepristone and misoprostol for terminating second and third trimester pregnancies. STUDY DESIGN: One hundred and six patients undergoing termination of pregnancy between January 1993 and June 1995 in our center were studied. Each patient received 600 mg of mifepristone followed 24 h later by 400 microgrammes of misoprostol every 6 h. RESULTS: The average interval from the first administration of misoprostol to expulsion was 12.5 +/- 7.5 h (interval markedly decreased to 9.6 +/- 6.3 h in cases of intrauterine fetal death). CONCLUSION: The efficacy of the association of mifepristone and misoprostol is comparable with that of current regimens with grealer ease of utilization and at a much lower cost.

Abortifacient Agents, Nonsteroidal↗
PubMed1996

[Mifepristone and misoprostol in therapeutic abortions].

OBJECTIVES: To report our experience with the mifepristone and misoprostol combination in second and third trimester medically induced abortion. TYPE OF STUDY: Prospective study without control group between January 1993 and december 1994. STUDY SITE: Saint-Antoine Hospital, Paris. PATIENTS: Fifty-three patients admitted for a medically induced abortion. RESULTS: Induction-to-abortion mean time was 12.9 +/- 7.5 hours (time distinctly decreased in fetal death: 8.3 +/- 4.4 hours). CONCLUSION: The combination of misoprostol with mifepristone has equivalent with the other protocol used for therapeutic pregnancy termination, is less expensive (25 to 100 times) and finally is simple and non-invasive.

Abortifacient Agents, Nonsteroidal↗
PubMed1995

[Locoregional recurrences of breast cancer].

AIM OF THE STUDY: To determine the characteristics of 51 cases of isolated local regional breast cancer recurrence. METHODS: Retrospective study from 1980 to 1992, survival calculated according to Kaplan-Meier and log-rank test. RESULTS: Twenty-five patients had had a conservative treatment of her primary tumour, 26 had been treated by modified radical mastectomy. Local regional recurrence rate was 9%: 44% of recurrences after lumpectomy and 43% of recurrences after mastectomy occurred within 2 years after the initial treatment. Site of local regional recurrence was chest wall only (16 cases), breast only (15 cases) or axillary or supraclavicular node with or without chest wall or breast involvement (20 cases). The actuarial 5-year survival rate after recurrence is 54%. It depends on the time to recurrence (40% if time to recurrence was less than 2 years, 68% if more than 2 years, p < 0.10), on initial node involvement (36% for N+, 71% for N-, p < 0.15) and on the site of recurrence (chest wall: 43%; breast: 48%; regional node: 12%, p < 0.10). CONCLUSION: Like in the literature, severe recurrences are early recurrences, lymph node recurrences and recurrences following a primary tumour with involved axillary nodes.

Actuarial Analysis↗