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P Poitout

Publications and source records attributed to P Poitout.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Penile endoscopy: technique, results].

The authors report their experience based on 200 consecutive examinations. Peniscopy is an outpatient examination of the penis using a magnification system: commercial magnifying glass or colposcope. It consists of examining the whole penis in detail with the naked eue and then with a magnitification system after application of 5% acetic acid to the glans and prepuce in order to identify subclinical lesions. Biopsies can be performed when necessary. Three basic types of lesions may be observed: concylomas, macules, papules. However, the signs of mucocutaneous lesions are difficult to interpret, especially when they are subclinical. There are 2 types of false lesions: physiological papules of the corona of the glans and a diffuse acidophilic reaction. Topical treatment or laser destruction of the lesions can be performed at the same time as the examination, when necessary. The current indications for this technique are discussed. When learning this technique, the authors recommend the extensive use of biopsies and training with an experienced examiner.

Humans↗
PubMed1991

Anti Xa activity and prothrombinase inhibition in patients treated with two different doses of enoxaparin in gynecologic surgery.

A prospective open study was performed in a series of 547 patients undergoing gynecologic surgery. A dose of 20 mg of enoxaparin was administered to all patients 2 hours before surgery. Then patients at high risk of thrombosis (mostly oncologic surgery) received 40 mg of enoxaparin daily whereas those at moderate risk received 20 mg of enoxaparin daily. The principal aim of this prospective open study was to monitor amidolytic anti Xa activity and to study the inhibition of intrinsic prothrombinase using prothrombin consumption measurement as a simple and global test. A second aim was to investigate efficacy and tolerance of these regimens. Treatment tolerance was satisfactory with both regimens since the total incidence of bleeding was 1.8%. A single patient developed a clinically significant thrombosis during hospital stay. The results confirm and extend previous reports regarding a dose effect relationship between the dose of Enoxaparin and plasma Anti Xa activity 3 hours after s.c. injection. A significant relationship was found between Anti Xa activity and patients body weight. Interestingly a dose dependent inhibition of intrinsic prothrombinase was observed when using a one stage prothrombin consumption assay in whole blood. This test in whole blood can be considered as closer to physiological conditions than assays performed in citrated platelet rich or platelet poor plasma samples. The mechanism of intrinsic prothrombinase inhibition during prophylactic treatment with enoxaparin requires further investigation.

Adult↗
PubMed1991

Catalase-associated abnormalities and H2O2 increase in pre-neoplastic and neoplastic lesions of the human lower female genital tract and their near adjacent epithelia.

We report that an internal and non-UV-dependent type of neoplasia, the human cervical intraepithelial neoplasia (SIL), is also deficient in catalase activity, like the UV-induced tumors in the autosomal recessive human epithelial disease, xeroderma pigmentosum (XP). Whether or not the lesions are papillomavirus (HPV) positive in the different categories of preneoplastic and neoplastic extracts, the following parameters are affected: i), catalase activity level; ii), kinetic profile of catalase activity; iii), H2O2 increase. Mathematical treatment of these parameters (CONSTEL-Program), unambiguously distinguishes between normal and pathological cases. Such analyses make it possible to grade the pathological samples into 4 classes, depending on their deviance from normality. These classes may be correlated with the gradual steps in the process of malignant transformation defined by histological and clinical diagnosis. We found conformity between catalase activity and histological analyses in 66 biopsies, out of a total of 100 biopsies (35 patients). Moreover, 23 patients presenting decreased catalase activities in 31 biopsies showed disease progression after 3 to 6 months contrary to surgery histological data. We show that ATP synthesis in the presence of catalase and H2O2 (further aspect of catalase function), may occur in neoplastic extracts at much lower concentrations of H2O2 than in normal extracts. Thus, the catalase abnormality seems to be a good tool to study pre-neoplastic to neoplastic evolution of lesions and their adjacent tissues of the lower female genital tract; furthermore, i) it provides an earlier, more powerful means of detecting micro-SIL in progression to squamous cell carcinoma, than combined clinical and histological examinations; ii) model for investigating drugs such as in situ H2O2 scavengers or agents increasing glutathione peroxidase activity (GSH).

Adult↗
PubMed1991

Epithelial tumors of the ovary: CT findings and correlation with US.

One hundred thirty patients with 170 epithelial ovarian tumors were prospectively studied with computed tomography (CT) before surgery. Ultrasound (US) was performed in 108 patients with 138 tumors. At pathologic examination, 78 tumors (46%) were benign, 14 (8%) borderline, and 78 (46%) malignant. CT results were compared with surgical and pathologic findings in all patients. CT enabled detection of 148 of 170 tumors (87%), and US enabled detection of 118 of 138 tumors (86%). Benign serous cystadenomas (n = 42) were correctly characterized with a sensitivity of 69% at CT and 70% at US. Benign mucinous cystadenomas (n = 21) were correctly characterized with a sensitivity of 62% at CT and 50% at US. Malignancy was suggested in nine of 14 patients (64%) with borderline tumors at CT and in five of 14 (36%) at US. The overall accuracy of characterization of benign versus malignant tumors (including borderline tumors) was 94% with CT and 80% with US. In the 108 patients studied with both CT and US, the sensitivity of CT was significantly superior to that of US (P less than .03), whereas there was no significant difference in specificity (P = .125).

Carcinoma, Papillary↗
PubMed1991

Epithelial tumors of the ovary: comparison of MR and CT findings.

Forty patients with 50 ovarian epithelial tumors of the ovary were retrospectively studied. They underwent computed tomography and magnetic resonance (MR) imaging within 1 week of surgery. MR examinations were performed with a superconducting magnet (0.5 T) and predominantly T1- and T2-weighted MR imaging. T1-weighted MR images were obtained in eight patients after contrast material was administered. Signal intensity of tumors was compared with that of urine, muscle, and fat. Morphologic features that were evaluated included size, vegetations, septations, wall thickness, fluid or solid components, and vascularity. On the basis of signal intensity and morphologic characteristics, MR imaging helped in the correct diagnosis of benign serous cystadenoma in 10 of 13 tumors, benign mucinous cystadenoma in seven of 10 tumors, and tumors of low malignant potential and malignant tumors in 23 of 27 tumors. Accuracy for overall characterization of benign versus malignant tumors was 86% with MR imaging and 92% with computed tomography. There was no difference in sensitivity (P = 1) or specificity (P = .5).

Carcinoma↗
PubMed1989

Cystic teratoma of the ovary: CT detection.

Computed tomography (CT) was performed in 38 patients with 41 benign cystic teratomas of the ovary and two patients with malignant transformation. CT depicted all tumors. The presence of fat in 40 of 43 cases (93%), tooth or calcification in 24 of 43 (56%), Rokitansky protuberance in 35 of 43 (81%), tufts of hair in 28 of 43 (65%), and a fat-fluid level in five of 43 (12%) allowed a definite diagnosis of ovarian cystic teratoma in 42 of 43 cases (98%). In the two cases of malignancy, single large (greater than 10 cm) plugs (with uptake of contrast medium in one) with a cauliflower appearance and an irregular border forming an obtuse angle with the inner wall of the cyst suggested malignant transformation. In three cases of benign cystic teratoma, a mucinous tumor (one benign, one borderline, one malignant) arising in the same ovary was seen at pathologic examination but was only diagnosed with the help of CT in two of three cases. Thickening of the tube was noted in two cases of torsion of the adnexa. CT findings were compared with findings at radiography of the abdomen and hysterosalpingography in 30 cases, ultrasound in 31, and magnetic resonance imaging in three. This study demonstrated that CT was the best procedure for imaging cystic teratomas of the ovary.

Adnexal Diseases↗
PubMed1989

[X-ray computed tomographic aspects of dermoid cysts of the ovary].

155 patients with 210 ovarian tumours were examined pre-operatively by CT from December 1984 to February 1988. 27 patients had dermoid cysts, unilateral in 25 cases and bilateral in 2 cases. These cystic teratomas were benign in 26 patients. In one case, malignant transformation occurred. CT detected 29/29 tumours (100%). Presence of fat (26/29, 90%), calcification (20/29, 69%), Rokitansky protuberance (25/29, 86%), tufts of hair (20/29, 69%), or fat fluid level (4/29, 14%), allowed to make a definite diagnosis in 28/29 cases (96%). These findings and especially demonstration of fat, appeared to be specific for dermoid cysts in our series. The diagnosis of torsion of the cyst associated with torsion of the adnexa was made in 2 patients. No abdomino-pelvic extension occurred in 26/26 patients presenting with a benign dermoid cyst and CT correctly diagnosed the lymph node and hepatic spread in the single case of cancer.

Adolescent↗
PubMed1987

[Autoimmune thrombocytopenia and pregnancy].

Idiopathic thrombocytopenic purpura is an auto-immune disease that carries a risk of haemorrhage when the number of platelets drops to lower than 50 X 10(9)/l and particularly when the bleeding time is prolonged. Thrombocytopenic purpura and pregnancy can be associated with one another and the frequency of that is about 1/5000. Maternal mortality and morbidity are, however, practically nil when proper therapeutic measures are taken. Since 1981 IG IV, which is expensive but rapidly effective, is available to overcome corticotherapeutic failures and to avoid splenectomy in acute cases. Since the maternal anti-platelet factor can cross the placenta, the fetus may become thrombocytopenic like the mother and at risk of the complications of haemorrhage and particularly intra-cranial haemorrhage during delivery vaginally. Screening for fetuses that are affected (52% of the cases) is now possible, not by relying on the maternal platelet count, which is without any prognostic value for the fetus, nor on the levels of anti-platelet antibodies but on the use of examining fetal scalp capillary blood at the onset of labour. This test may make it possible to carry out a vaginal delivery safely when the fetal platelet count is higher than 50 X 10(9)l, whereas if it is lower than this figure a prophylactic caesarean operation should be carried out. There is much promise in the possibility of sampling blood in the fetal cord using ultrasound techniques. In a small number of cases that has already made it possible to diagnose the condition of thrombocytopenia in the fetus even before labour has started. It may in the future even make it possible to carry out treatment of the fetus in utero followed by a normal delivery, whether the treatment is carried out by treating the mother or directing platelets or better still IG IV directly into the fetal circulation.

Adrenal Cortex Hormones↗
PubMed1986

[Uterine rupture causing acute defibrination syndrome. Apropos of 3 cases].

The authors report three cases of rupture of the uterus during delivery, complicated by an acute defibrination syndrome. Death resulted in two cases. The sequence of rupture of the uterus----shock----pathological condition of coagulation----great increase in the shock occurred in all three patients. This sequence could only be arrested in one of the three patients who had a total hysterectomy. Partial hysterectomy in the other two was ineffective. These three case histories suggest that total hysterectomy after even partial correction of the haemorrhagic state can be the best treatment in this very serious condition.

Adult↗
PubMed1985

[110 cases of longitudinal septa of the vagina].

A retrospective analysis of 110 longitudinal septa ov the vagina which were seen at the Hotel-Dieu in Paris, demonstrated the following features: They were well tolerated and were discovered by chance in nearly 60% of cases, causing symptoms in 40% of cases. These symptoms were: dyspareunia, apareunia, haemorrhage at the first act of intercourse and more recently signs connected with the increasing use of tampons for the periods. They were complete in 49% of cases and incomplete in 51% of cases mainly in the upper part of the vagina. They were associated: in 26% of cases with a bicornuate-bicervical uterus, in 64% of cases with a septate uterus, the septum being total in 54% of the cases, in almost 10% of cases there was either a normal uterus or communicating uteri. There were fewer than 1% of normal uteri above septa that included the cervix and the vaginal vault. Clinical study of these malformations of the uterus and the vagina lead one to be able to make a hypothesis about the embryology: the fusion of the Müllerian canals and then the absorption of the septum where they join starts at the level of the isthmus. All morphological abnormalities of the uterus occur between the 55th and the 68th day of fetal life. The treatment is surgical, which is simple but has to be carried out very carefully. It consists of division or removal of the septum and should be done when the symptoms make it necessary, or during delivery when it gives rise to a dystocia or to a tear, which occurs but rarely.

Abnormalities, Multiple↗
PubMed1985

[Rectocolic endometriosis].

The authors distinguish two major varieties of rectocolonic endometriosis: the isolated benign sigmoid endometrioma which is difficult to distinguish from malignant lesions of the mucosa; the tendency to progressive stenosis is an indication for surgical excision of this lesion. Genital endometriosis which has spread to the intestinal tract. The genital and peritoneal lesions facilitate the diagnosis of the recto-sigmoid lesion. On the other hand, the intestinal involvement complicates the therapeutic. Low rectal involvement usually consists of endometriosis grafted to a perineal scar.

Endometriosis↗
PubMed1984

[Vulvoperineoplasty].

Vulvoperineoplasty is a surgical operation consisting of: (1) wide cleavage of the posterior vaginal wall, as in posterior colpoperineorrhaphy; (2) excision of a triangular segment of perineal skin, the summit of which touches the margin of the anus; (3) full exposure of the perineal central fibrous core and reduction of its relief by radial incisions and digital dissection; (4) lowering and eversion of a posterior vaginal flap with good blood supply in order to reconstruct the fourchette of the enlarged vaginal opening. This technique is applicable not only to congenital or acquired vulvar stenosis but also to the treatment of sclerous or dystrophic lesions of the fourchette. It was used on 43 occasions between 1978 and 1983, viz. in 6 patients after surgical treatment of prolapse, in 14 patients after obstetrical injury, in 17 cases of lichen sclerosus of the vulva and in 6 cases of Bowen's disease. The results were anatomically perfect in all cases, cosmetically good in 40 cases and functionally satisfactory in 40.

Adult↗
PubMed1984

[Cervical intraepithelial neoplasms and flat condylomata. Study of 165 cases].

205 cervix biopsies and diagnostic conisations performed among 165 women with dysplasias and carcinomas in situ (CIS) where revised with actual concepts of flat condylomata (FC) and cervical intraepithelial neoplasias (CIN). Usual statistical tests were used to analyse the signification of the average age of the different group (FC alone, FC + CIN, CIN alone) and according to the different grades of CIN. The association between FC and the different grades of CIN was studied with the X2 test. In 66.8% of the cases, FC was present, associated or not with CIN. That ends up to a modification of the diagnosis in 37.6% of the cases (reduction of a grade of CIN, substitution of a mild dysplasia CIN I by a FC). In 33.8% of the cases, FC was associated with CIN. In this work, the average age between CIN associated with FC was 8 years less than CIN alone. The X2 test applied to the frequency of association between FC and CIN according to the grade of CIN have shown that it exists a statistically valid difference between the grades. More the grades is high, more the morphological characters of the FC are rare. These observations suggest an integration of the viral genome in the host genome as it has been proved for the shope papilloma and the verruciformis epidermodysplasia.

Adult↗
PubMed1984

[Vulvo-perineal surgery].

Vulvo- perineoplasty consists of: Splitting the posterior vaginal wall widely as is done for a posterior colpoperineorrhaphy operation. Excising a triangle of perineal skin the apex of which coincides with the margin of the anus. Thinning down the central fibrous nodule of the perineum which is completely exposed by radial incisions and digital dissection. Bringing down a well vascularised flap of the posterior vaginal wall so as to reconstitute an enlarged vaginal opening. This technique can not only be used to cure congenital and, especially, acquired narrowing of the vulva but also sclerotic and dystrophic conditions of the fourchette .

Adolescent↗
PubMed1984

[Surgical treatment of congenital transverse septum below the cervix of the vagina].

Transverse septa underneath the cervix are thick and have above them a funnel-shaped vault covered by pathological mucous membranes. The surgical procedures that are normally used to try to treat the condition and to avoid soft tissue dystocia by carrying out V-Y plasties using Garcia's technique or Z-plasties, or even radial incisions followed by the insertion of a pack, are all somewhat unsatisfactory. The authors, confronted with a similar case, decided to cut out the dome of the vagina and the diaphragm and followed that by a small amputation of the cervix, with anastomosis of the uterus and the remaining vagina.

Cervix Uteri↗