Biomedical subjects
Publications and source records attributed to L Moreau.
Percutaneous testicular sperm aspiration and ICSI were performed in 5 cases of excretory azoospermia. Usable sperm have always been obtained, two pregnancies were initiated.
Hibernomas are benign tumors derived from brown fat that most often present as painless, slowly enlarging masses in the interscapular region, the neck, the inguinal region and the mediastinum. We report one case of hibernoma of the axillary region and we review the clinical presentation, diagnostic and therapeutic of this kind of soft tissue neoplasm.
We have recently demonstrated that bone sialoprotein (BSP), a bone-matrix protein involved in hydroxyapatite crystal formation, is ectopically expressed in human breast cancers. We explored a possible association between expression of BSP in primary breast cancer and patients' survival. We analyzed BSP expression in 454 breast-cancer patients by immunohistochemistry on archival paraffin-embedded material using an anti-BSP polyclonal antibody. BSP expression was correlated to survival, tumor size, axillary lymph-node status and first site of distant metastasis. Of the breast cancers analyzed, 89% expressed detectable amounts of BSP. We found a statistical association between expression of BSP and poor prognosis as indicated by survival curves analyzed using the log rank and the Gehan methods. BSP expression was significantly higher in breast-cancer patients with axillary lymph-node involvement. Interestingly, survival of patients with positive lymph nodes but BSP-negative tumors was significantly higher than that of patients with no lymph-node involvement but BSP-positive cancers. The frequency of bone metastases was higher in the group of patients with BSP-positive tumors (22%) than in the group with BSP-negative cancers (7%). There was a significant increase in the incidence of lung metastases in patients whose tumors were negative for BSP. Our data show that bone sialoprotein expression in breast cancer is associated with poor prognosis. BSP detection also appears to be a valuable marker with which to identify, among the lymph-node-negative patients, those who have high risk of disease progression.
PURPOSE: This study evaluated the efficiency of in vitro fertilization with a modified sperm preparation technique for male infertility, to avoid systematic recourse to ICSI. METHODS: The sperm function stimulants pentoxifylline, 2-deoxyadenosine, and follicular fluid were used during the sperm preparation of IVF trials for two groups of patients: couples with long-standing infertility and previous IVF failures and couples with male-factor infertility scheduled for their first treatment. RESULTS: Forty-nine attempts were performed in the first group. The overall fertilization rate (percentage of zygotes with two pronuclei 18 hr after sperm insemination) was 30% and the clinical pregnancy rate per transfer was 33%. For the second group, 30 attempts were performed. The fertilization rate was 29.6% and the clinical pregnancy rate was 62.5% per transfer. The total number of recovered motile sperm appears to be a significant parameter: a cutoff value of 0.25 million motile sperm recovered after capacitation treatment has a good prognostic value for choosing between IVF with sperm enhancers and ICSI. CONCLUSIONS: The described modified IVF could constitute an alternative to the systematic use of ICSI.
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Coordinated expression of genes involved in development, differentiation and malignant transformation is regulated by transcription factors including homeodomain-containing proteins. However, most of their cDNA sequences are still unknown. We report here the molecular characterization of three newly cloned HOXA1 transcripts from human breast cancer cells. In addition, we provide evidence that these alternatively spliced transcripts encode one homeodomain-containing protein and two products lacking the conserved DNA-binding domain. Moreover, we demonstrate that all three HOXA1 transcripts are induced by retinoic acid in MCF7 cells. Taken together, our results suggest that HOXA1 gene may be a key element in the establishment of the breast cancer cell phenotype.
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This survey reports on 10 case-studies of drug-induced pneumonitis. The drugs under consideration are amiodarone, methotrexate, chlorambucil, sulindac, nilutamide-leuproreline, cyclothiazide, with the possible addition of bleomycin. In each case, one or more bronchoalveolar lavage were carried out and in most cases it was also possible to perform a transbronchoscopic lung biopsy. The results of these tests are analysed in order to ascertain their contribution to diagnosis and prognosis. Regarding diagnosis, bronchoalveolar lavage does not evidence a typical cellular configuration characterizing drug-induced alveolitis. Moreover, transbronchoscopic lung biopsy plays no part in diagnosing this pathology. Both these tests, however, help to eliminate other hypotheses. Regarding prognosis, transbronchoscopic lung biopsy provides no information, unlike bronchoalveolar lavage in which a high rate of neutrophils in the lavage fluid is sometimes associated with the development of pulmonary fibrosis.
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This study evaluates the prognostic value of uterine Doppler performed on the day of embryo transfer in an in vitro fertilization program. Patients were divided into two groups according to the type of ovarian stimulation. The Doppler investigation was carried out using vaginal sonography. The pulsatility index was used to evaluate the uterine blood flow pattern. The hormonal profile (estradiol, luteinizing hormone (LH) and progesterone) was correlated to Doppler results and to the pregnancy rate. The comparison between patients treated with analogs and those who were not shows a significant difference in their hormonal profile. In the first group, we found a higher estradiol and progesterone serum concentration. The LH level and the pulsatility index were statistically lower. The endometrium was thicker in patients treated with gonadotropin releasing hormone agonists. In the group of patients treated with analogs, the statistical analysis showed no significant difference in the mean pulsatility index value in women who achieved a pregnancy and in those who failed. In the group of patients who received no agonists, only one variable was significantly different: the mean age was lower in women who became pregnant. We observed no ongoing pregnancy in women who had a pulsatility index value higher than two standard deviations (pulsatility index = 3.55). We therefore suggest the use of this value as a threshold. Thus, if a patient has a high uterine artery impedance, cryopreservation should be used and embryo transfer should be postponed to a subsequent cycle, or embryo transfer delayed for a few days using co-culture. This study clearly shows the impact of hormonal response on the Doppler value and on the pregnancy rate. However, the use of a threshold value for uterine artery pulsatility index might have a clinical impact in the future management of patients attending an in vitro fertilization program.
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Microinjection of capacitated sperm into the perivitelline space of oocytes has been performed in a case of male infertility attributed to excretory azoospermia. In this particular case, a spermatocele detected five years ago was observed, which provide motile spermatozoa. These sperm collected by direct puncture into the cyst, were capacitated using discontinuous Percoll gradient. After ovarian stimulation, seventeen oocytes were collected. Nine of them were used for classical IVF whereas the other eight were submitted to microinjection. Only one oocyte of the second group fertilized and cleaved 48 hours later. A clinical pregnancy was achieved after embryo transfer and a normal, healthy boy delivered at term.
From a retrospective study of 80 cases of heart transplantation, the contribution of chest X-rays to the diagnosis of viral pneumonia was studied. Among 66 episodes of pneumonia, a viral cause was proved in 16 cases (CMV: 9, Herpes: 7), with 13 cases during the first 4 months. CMV pneumonia was revealed in 3 cases by a diffuse pulmonary infiltrate with a rapidity fatal outcome and in 6 cases by focal infiltrates that disappeared within 1 and 7 weeks. Herpes pneumonia was immediately revealed, in 5 cases, by a diffuse infiltrate. In 11 out of 16 cases, the viral pneumonia improved but its course was complicated by the development of another pneumonia.
The authors report ten cases of drug induced lung diseases, complicated by respiratory failure of whom five were attributed to cytotoxic drugs and five to non cytotoxic drugs. The drug induced lung disease presented as acute respiratory distress syndrome in two cases, alveolar interstitial lung disease in three cases, purely interstitial in five cases. There was acute respiratory failure (ARF) in eight cases and chronic respiratory failure (CRF) in two cases. Among the five patients admitted for cytotoxic drug induced lung disease and ARF, four recovered and one died of diffuse destructive pulmonary fibrosis. Among the five patients having non cytotoxic drug induced lung disease, three were in ARF and recovered. The other two had CRF and died of diffuse pulmonary fibrosis. The diagnostic of drug induced lung disease was established in each case with the chronology of the clinical events, the exclusion of other possible causes of the lung disease and the evolution after removal of the incriminated drug. Broncho-alveolar lavage (BAL) had a major diagnostic value. It was contraindicated by respiratory failure in five cases. The predominant alveolar cell type was lymphocyte (four cases), eosinophil (three cases) and neutrophil (one case), BAL was realized with a provocation test and demonstrated the pathogenic role of cyclothiazide in one case. No specific information was given by histology. The prognosis did not seem to be linked to the severity of the initial clinical picture, or to the nature of the underlying neoplastic disorder, but to the degree and evolution of the pulmonary fibrosis.
The results of brainstem evoked response audiometry (BERA) in a series of 113 patients with neurosensory hearing loss from both tumoral and non tumoral origin are reported. In 37 cases of non tumoral pathology, confirmed by CT-scan or NMR (14 cases) a retrocochlear type of evoked response was observed. The tumoral cases were mainly neurinomas (70 cases). There was a kophosis in 14 cases, typical retrocochlear responses in 52 cases, doubtful responses in 2 cases and in another 2 cases no electrophysiological disturbances could be observed. The systematic stimulation at 4 KHz seems to sensitize the BERA method. According to the authors it remains the first choice investigation technique of unilateral hearing loss. The results of this study are compared with those of the literature.
Microinjection of capacitated sperm into the perivitelline space of oocyte was offered to one couple with persistent infertility of mixed origin. The husband's semen was subnormal, whereas his wife had definitive tubal occlusion and polycystic ovaries. Four previous in vitro fertilization (IVF) attempts were performed but no fertilization was obtained. After superovulation, 13 oocytes were collected. Ten were submitted to microinjection and two were damaged during the procedure. One of the remaining eight had two pronuclei 18 hr after microinjection and progressed to a four-cell embryo after 48 hr. After reimplantation, a normal pregnancy was initiated, caryotype (46XX) was checked at 17 weeks. A normal and healthy girl has been delivered at term.
The relationships between essential fatty acid (EFA) composition of colostrum and white adipose tissue (WAT) were examined on day 5 after delivery in 69 healthy women. Fatty acid composition was assessed by capillary gas chromatography, and 33 fatty acids were detected in colostrum and in WAT. Total polyunsaturated fatty acid (PUFA) content was similar in colostrum and in WAT (15.7 +/- 3.1% and 16.1 +/- 3.8%, respectively), but long-chain PUFA content was higher in colostrum than in WAT (2.9 +/- 0.6% and 1 +/- 0.2%, respectively; P less than 0.001). The concentrations of linoleic acid were significantly correlated between colostrum and WAT (r = 0.77, P less than 0.0001). No correlation was found for alpha-linolenic acid. The relationships between long-chain PUFA composition of colostrum and WAT suggested that individual factors along with tissue specificity of the mammary gland are involved in either the capacity of desaturating and chain-elongating pathways and/or incorporation of long-chain PUFAs into colostrum.