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Biomedical subjects

P Michaud

Publications and source records attributed to P Michaud.

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

[Surgical treatment of genital prolapse by vesicovaginal interposition of the myometrium].

The authors propose a new technique for the surgical treatment of uterine prolapse. The technique consists of placing the myometrium between the bladder and the vagina after amputation of the cervix uteri and total excision of the endometrium. The bladder is then supported by a strong and well vascularized muscular tissue. Anterior transposition of the cervical pedicles and fixation of the myometrium to the anterior vagina ensure that the fitting is solid and in the correct direction. These modifications of the old technique of vesico-vaginal uterine interposition suppress the drawbacks which have gradually led to the rejection of the Wertheim-Schauta operation.

Endometrium↗
PubMed1990

[Cushing's syndrome: the diagnostic and treatment problems in 27 cases].

Problems of diagnosis and treatment were analyzed in 27 patients with Cushing syndrome (25 confirmed by anatomic findings) followed for a mean of 50 months. The etiology was Cushing disease in 14 (52%), suprarenal tumor in 9 (33%) and ectopic secretion of ACTH in 4 (15%). Determination of plasma cortisol levels at 4 PM or 11 PM was a highly sensitive test for the presence of this syndrome (100%). High resolution computed tomography was considerably more effective than conventional X ray studies of the sella in patients with Cushing disease (42 vs 20%). Treatment has been totally effective in all patients with benign suprarenal lesions. Cure was obtained in 64% of patients with pituitary lesions and 0% of patients with Cushing syndrome associated to malignancy.

Adenoma↗
PubMed1990

[Retroplacental hematoma and factor XI deficiency].

The authors report a case of premature separation of a normally located placenta at 28 weeks, associated with factor XI deficiency. The deficiency became known 6 weeks before the acute episode. In this particular case the deficiency did not occur in the context of congenital abnormalities, hepatocellular insufficiency nor any autoimmune disease. This rare case raises the problem of the role of a coagulation disorder in the etiopathogenesis of retroplacental hematoma.

Adult↗
PubMed1989

Lack of effect of methimazole on thyrocyte cell-surface antigen expression.

The nature of the immunosuppressive effect of antithyroid drugs has been a subject of controversy. It has been claimed that these agents exert a direct effect on the immune system, although we and others have suggested that the drugs affect the thyroid cells primarily with consequent reduced thyrocyte-immunocyte signalling. This may occur from reduced thyroid hormone production and/or reduced antigen presentation by the thyrocytes to local T lymphocytes. Using a cytotoxicity assay system, with chromium-51 labelling, monoclonal antibodies against thyroperoxidase (TPO) and HLA-DR, and complement, we have measured the expression of TPO and HLA-DR on cultured normal human thyroid cells; we have also measured thyroglobulin (Tg) release by radioimmunoassay into the medium of the cultured cells. The thyroid cells were stimulated with TSH or thyrotropin binding inhibitory immunoglobulin (TBII) for 48 hours before measuring for TPO induction, and with interferon gamma (IFN-gamma) (with or without TSH or TBII) for thyrocyte HLA-DR expression. A dosage of 1.6 milliunits per ml of TSH resulted in a significant increase in TPO expression on thyrocytes when compared with control unstimulated thyroid cells (p less than 0.001). The concentrations of Tg released into the medium with TSH or TBII were also significantly higher than those of the control thyrocytes. IFN-gamma at 200 units per ml induced HLA-DR expression, but did not induce thyrocyte TPO expression, or Tg release. Addition of the antithyroid drug, methimazole (MMI), at different concentrations, in addition to the other stimulators, IFN-gamma, TSH, or TBII, did not result in any inhibition of TPO, Tg release, or HLA-DR expression on the thyroid cells. It would thus appear that the pathways for stimulation for the expression of TPO and HLA-DR appear to be different. Finally, MMI does not cause its immunosuppressive effect by any reduction of thyroid antigen expression or release.

Antigens, Surface↗
PubMed1989

[Phyllodes breast tumors].

Phyllodes tumors represent a particular class in breast pathology. They are defined as bi-tissue, fibro-epithelial tumors, similar to fibro-adenomas, but their connective tissue component is greatly predominant. They are infrequent as they represent only 3% of breast tumors. They mainly occur during the premenopausal period, since alteration of the hormonal balance may play a role. The authors feel that they represent only a type of the evolution of the fibroadenomas with a relationship, in time, following the sequence: fibroadenomaphyllodes tumor-sarcoma. The diagnosis is exclusively made by histology and there is no pathognomonic sign, whether it is clinical or mammographic. The course is essentially characterized by the possibility of local recurrences, sometimes numerous, and by the occurrence of metastases in case of malignant phyllodes tumor. These two possibilities are correlated with the histological stage of the tumor. The treatment is definitely surgical, possibly mastectomy in case of large or aggressively active tumor.

Breast Neoplasms↗
PubMed1989

[Spontaneous abortion with an IUD and Candida chorioamnionitis].

Interruption and expulsion of a stillborn fetus in patients with an IUD Candida albicans chorioamniotic infection is a very rare obstetrical event. Generally, the diagnosis is established in retrospect by the routine histological examination of the products of expulsion and the demonstration of a specific chorioamniotic infection. This infection occurs by upward dissemination in a pregnancy where the amniotic membrane is unbroken, with the IUD being the facilitating factor of infection. Prevention appears to be the withdrawal of an IUD at the beginning of pregnancy.

Abortion, Spontaneous↗
PubMed1988

[Comparative study of two methods of determining plasma and salivary theophylline].

A new method for theophylline assay (Aris method), uses an immuno enzyme assay on a solid-phase (strips). We compared it to a HPLC method for 33 plasma samples and 85 saliva samples in children and adults. The correlation-coefficient between the two methods is highly significant (r = 0.976 for plasma samples and r = 0.99 for saliva samples) although we found a significant difference: the average difference is 0.789 microgram/ml for plasmatic levels and 0.55 microgram/ml for saliva levels. The values are rather low and remain widely satisfactory for posology adaptations. The reproducibility of the Aris method is similar to the HPLC method. Its sensitivity is quite satisfactory and can be improved. Yet the good correlations we obtained for plasma as well as for saliva, the rapidity, simplicity, specificity and low cost of this new technique should make the theophylline estimation easier in hospitals and laboratories.

Chromatography, Liquid↗
PubMed1988

[Spontaneous rupture of the spleen in relation to a splenic pregnancy. Apropos of a case].

Spontaneous rupture of the spleen related to an ectopic pregnancy is exceptional but must be kept in mind. The clinical picture is dominated by signs of haemoperitoneum and shock. Except in an emergency, the plasma BhCG titration, abdominal ultrasonography and CT-Scan, offer a major contribution. If the exploration through a Pfannenstiel incision is normal, the surgeon should not hesitate to extend it through the mid-line. The diagnosis is almost always made on pathological examination.

Adult↗
PubMed1986

Response of the maternal, fetal, and neonatal pituitary-thyroid axis to thyrotropin-releasing hormone.

Thyrotropin releasing hormone (TRH) readily crosses the placenta and stimulates the fetal pituitary. We studied the response of the maternal and fetal pituitary-thyroid axes to TRH and the influence of prenatal exposure to TRH on the physiological postnatal increase in thyrotropin (TSH) and triiodothyronine (T3) in the neonate. Twenty-six pregnant women received TRH (400 or 600 micrograms) intravenous or saline (controls) either 2 or 12 h before elective cesarean section at term. Administration of 400 micrograms of TRH resulted in significant elevations of maternal TSH (15.7 +/- 2.9 versus 3.2 +/- 0.4 microU/ml, p less than 0.01) and prolactin (416 +/- 94 versus 223 +/- 41 ng/ml, p less than 0.05) 2 h later. Maternal T3 remained unchanged. A higher dose of TRH (600 micrograms) produced comparable results. Maternal administration of TRH (400 micrograms) 2 h before delivery resulted in significant increases in fetal TSH and T3 over controls (21.1 +/- 3.7 versus 4.8 +/- 1.0 microU/ml, and 132 +/- 12 versus 64 +/- 9 ng/dl, p less than 0.01, respectively). Cord blood hormone levels 12 hours after TRH administration were similar to controls. Higher doses of TRH did not produce further increases in fetal TSH or T3. Control and treated neonates demonstrated similar physiological postnatal increases in TSH and T3, suggesting that prior exposure to TRH did not blunt this response. These data suggest that maternal administration of TRH is an effective way of increasing fetal T3 levels, and that this treatment does not inhibit the postnatal surge in TSH and T3.

Female↗