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Biomedical subjects

P Morice

Publications and source records attributed to P Morice.

At least 91 records · Page 5Linked to original sources
PubMed1997

EndothelinA receptors in human uterine leiomyomas.

OBJECTIVE: To determine if there are endothelin receptors on human uterine leiomyomas. METHODS: Samples of leiomyomas from eight patients were analyzed for [iodine (I)-125]endothelin-1 binding. Several subtype-selective ligands were used to determine the endothelin receptor population. RESULTS: Binding of [125I]endothelin-1 to uterine leiomyoma membranes was specific and saturable, with a mean +/- dissociation constant 85.5 +/- 8.4 pM. Competition binding studies showed that the order of potency was endothelin-1 > endothelin-3, which was consistent with the presence of the endothelinA receptor subtype. Binding of [125I]endothelin-1 was displaced by an endothelinA-selective antagonist, but not by sarafotoxin 6c, an endothelinB-selective agonist. An endothelins-selective ligand was not specifically bound to leiomyoma. CONCLUSION: These results indicate that only endothelinA receptors are present in human uterine leiomyomas. We speculate that endothelin-1 may act through these endothelinA receptors to influence the development or regulation of hypertrophy and proliferation of the human myometrium during pregnancy and in uterine disorders like leiomyomas.

Adult↗
PubMed1997

The role of laparoscopy in the diagnosis and management of heterotopic pregnancies.

The object of this report is to discuss diagnosis and treatment of heterotopic pregnancies. Thirteen consecutive cases referred to our institution are reviewed. In 54% of cases the heterotopic pregnancy was asymptomatic. The ectopic pregnancy was visualized prior to surgery in 69% of the cases. The treatment was surgical in every case and performed laparoscopically in 77% of cases. Ten patients underwent salpingectomy and three salpingostomy. In all, 60% of intrauterine pregnancies that were viable at the time of diagnosis of the heterotopic pregnancy had a favourable outcome. Diagnosis of heterotopic pregnancy is difficult. Laparoscopy allows both diagnosis and treatment, and the outcome of the intrauterine pregnancy is comparable to that obtained with laparotomy.

Adult↗
PubMed1997

[Current treatment of malignant epithelial tumors of the ovary].

Surgery is the essential element of staging and treatment of malignant ovarian tumours. Regardless of the stage, it must include peritoneal cytology, hysterectomy with bilateral adnexectomy, omentectomy, pelvic and lumbo-aortic lymphadenectomy, appendicectomy and multiple peritoneal biopsies. In stage I tumours, in young women desiring a subsequent pregnancy, preservation of the uterus and contralateral ovary can be proposed. In stages II, III and IV, the therapeutic strategy consists of primary surgery and systematic chemotherapy (6 cycles). Radical surgery is essential in these cases, as the size of the residual tumour at the end of operation constitutes the major prognostic factor. To optimize the quality of tumour debulking, the maximum of visible carcinomatous nodules must be resected with, if necessary, gastrointestinal resections. The value of second-look surgery, after 6 cycles of chemotherapy, is currently controversial: it is only indicated in the context of randomized trials. Borderline malignant ovarian tumours have a good prognosis regardless of their stage. Surgery can very often be conservative, particularly in young women. Adjuvant chemotherapy has been shown to be effective in these tumours. Many studies are underway to define the value of new cytostatic molecules and "interval" surgery (intercalated between several courses of chemotherapy).

Adult↗
PubMed1997

Laparoscopy for adnexal torsion in pregnant women.

OBJECTIVE: To report on six cases of adnexal torsion in pregnant women treated by operative laparoscopy. STUDY DESIGN: A retrospective study. Between January 1989 and March 1996, 26 patients with adnexal torsion were treated by operative laparoscopy. Of these patients, six were pregnant (23%). The types of operative procedure and outcome were studied. RESULTS: Adnexal torsion occurred between 6 and 13 weeks of amenorrhea. Two cases involved hyperstimulation, 3 cases a functional cyst and 1 case a dermoid cyst. In 4 cases laparoscopic treatment consisted of untwisting followed by puncture of the ovarian cyst; in 1 case it involved intraperitoneal cystectomy and in another simple untwisting of the adnexa. The immediate postoperative history was uncomplicated. In one patient with ovarian hyperstimulation, torsion recurred three weeks after the initial operation. No miscarriages occurred. CONCLUSION: In the hands of skilled surgeons, laparoscopy is well suited to the diagnosis and treatment of adnexal torsion occurring during the first trimester of pregnancy. Beyond 16 weeks or when there is any suspicion of torsion on a suspected tumor, it is preferable to use laparotomy.

Adnexal Diseases↗
PubMed1997

[Surgical strategy for peritoneal carcinosis of ovarian origin].

Cancer of the ovary is usually discovered in an advanced stage after development of peritoneal carcinosis. Surgery is a fundamental element for diagnosis and treatment. Therapeutic strategy for cancer of the ovary discovered in an advanced stage includes first-line surgery and systematic postoperative chemotherapy. The essential prognostic factor is the quality of the initial surgical resection and the size of the residual tumoral tissue. Hysterectomy with adnexectomy, omentectomy, lumbo-ovarian and pelvic node dissection and extensive excision of visible carcinosis nodules, with if need digestive resection, are required for optimal tumor reduction. This aggressive surgery should be performed by well trained surgical teams.

Adnexa Uteri↗
PubMed1996

Salpingectomy - the laparoscopic surgical choice for ectopic pregnancy.

The aim of this study was to assess the fertility outcome after ectopic pregnancy (EP) treated by laparoscopic salpingectomy. Among the 375 patients who underwent this operation between January 1983 and December 1993, there were 145 patients who desired pregnancy and whose contralateral tube was not obstructed. The overall rate of intrauterine pregnancy (IUP) was 50.3%, with an EP rate of 15.2%. These results were analysed according to the patients' past history together with the condition of the contralateral tube at the time of the laparoscopy. We defined two groups. Group 1 included patients who had no previous history of tubal surgery and whose contralateral tube was normal. Group 2 comprised those patients who had a previous history of tubal surgery and/or those whose tube was pathological, but not obstructed. Postoperative fertility of the patients in group 1 was significantly higher than that of the patients in group 2, with IUP rates of 75 and 36.6% respectively (P < 0.001), and a risk of EP recurrence of 9.6 and 18.3% respectively. In group 1, the actuarial IUP rate at 24 months was significantly higher than that for the patients in group 2 (66.7 versus 36.9%; P < 0.001). The patient's past history and the condition of the contralateral tube were the two major factors related to fertility outcome after laparoscopic salpingectomy for EP. In patients with no past history of tubal surgery or infertility and whose contralateral tube was normal, the fertility results after laparoscopic salpingectomy appeared comparable to those observed after conservative laparoscopic treatment.

Adult↗
PubMed1996

[Radical laparoscopic surgery of ectopic pregnancy: results from a continuous series of 383 interventions].

From January 1983 to December 1993, 375 patients underwent laparoscopic salpingectomy. Six complications (1.5 %) were observed. Among 145 patients with a patent contralateral tube who desired pregnancy, 73 had an intrauterine pregnancy (50.3 %) and 22 had ectopic pregnancy (15.2 %). These results are discussed according to the contralateral tube status and gynecologic past history.

Adolescent↗
PubMed1995

History of infertility.

Infertility has always been a constant preoccupation. The problems it raises today on medical, social, ethical, political and religious levels bear witness to this emphasis, but also to how complicated infertility is to deal with and understand. This study not only examines the history of infertility and the treatments applied but also the repercussions for infertile women socially. As we look through history, we find that the attitudes of physicians have often reflected the role of the woman and her image in society.

Arab World↗
PubMed1995

Laparoscopic management of asymmetric Mayer-Rokitansky-Kuster-Hauser syndrome.

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a partial or complete absence (agenesis) of the uterus with an absent or hypoplastic vagina. Until now, the recommended treatment, when resection of a rudimentary horn was indicated, was laparotomy. We report a case of MRKH syndrome in which the patient benefited from laparoscopic surgery for bilateral resection of rudimentary horns. Laparoscopy is not only useful for diagnosis of uterine malformations but can also be valuable for any treatment required for this type of malformation, this being carried out during the same operative procedure, thus avoiding laparotomy for the patient. The creation of an artificial vagina is performed during a second operation.

Adolescent↗