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Biomedical subjects

B Ducot

Publications and source records attributed to B Ducot.

At least 19 recordsLinked to original sources
PubMed1992

Effect of extended cold ischaemia with UW solution on graft function after liver transplantation.

Studies in animals on the use of UW solution in liver transplantation have shown an inverse relation between cold ischaemia time (CIT) and graft function. There are few clinical data on this relation in human beings. We have investigated the effect of extended cold ischaemia in a prospective study. We assessed early graft function and subsequent outcome for 306 consecutive elective liver transplantations; for analyses, grafts were grouped according to CIT (< 12 h group A, > or = 12 h group B), since a preliminary study identified 12 h as a significant cut-off point. Initial graft function was better in group A than group B, as shown by maximum alanine aminotransferase activity (mean 623 [805] vs 946 [1148], p = 0.02), bile production on days 1-3 (p < 0.05), maximum serum bilirubin by day 10 (206 [166] vs 244 [163] mumol/l, p = 0.04), and frequencies of primary non-function (1 [0.4%] vs 4 [7%], p = 0.006) and hepatocyte necrosis on routine biopsy sample after reperfusion (18% vs 31%, p = 0.04). Long-term outcome was also better in group A than group B; graft and patient survival rates were higher and fewer retransplantations were needed. These findings suggest that cold ischaemia in UW solution for longer than 12 h is a risk factor for graft function and patient survival. We recommend that the limit of the safe CIT be reconsidered.

Adenosine↗
PubMed1992

Risk factors for female and male infertility: results of a case-control study.

In order to evaluate male and female risk factors for infertility in a case-control study, we have compared all couples in a French administrative region consulting for primary or secondary infertility (of more than one year's duration) with couples in which the woman had given birth during the year of the study. For any one couple, a history of varicocele, male genital infections or testis damage multiplies the risk of primary infertility by a factor of 28, 3 and 4 respectively, and previous female infections (salpingitis) multiply the risk by 45. Similarly, a history of ectopic pregnancy, sexually transmitted diseases or salpingitis multiplies the risk of secondary infertility by a factor of 5, 4 and 7 respectively, and a history of varicocele multiplies this risk by 4.

Adult↗
PubMed1992

Influence of sperm parameters on outcome of subzonal insemination in the case of previous IVF failure. off.

Subzonal insemination (SUZI) has been proposed for patients with sperm male factor infertility, and in cases of in-vitro fertilization (IVF) failures. However despite SUZI, there still remain couples with very low fertilization rates and even with fertilization failures. Since sperm parameters are known to influence the IVF fertilization rate, we investigated the relation between sperm parameters and the SUZI issue in cases of previous IVF failures with normal or subnormal sperm. Twenty-seven couples were included in the study and were split into two groups according to whether they had normal or subnormal sperm. In the first part of the study a randomized prospective trial comparing SUZI to classic IVF insemination was carried out (11 cycles). In the second part, all the oocytes had SUZI (35 cycles). None of the control inseminated oocytes fertilized. Including all the cases, the fertilization rate after SUZI was 29.8% with a pregnancy rate of 15.2% per cycle. We concluded that: (i) SUZI is efficient for achieving fertilization in cases of IVF failures; (ii) the post SUZI fertilization rate is inversely correlated to the percentage of acrosome defects in the semen (P < 0.001); and (iii) when the sperm is normal, the oocyte quality might be responsible for the previous IVF failures. In spite of a good fertilization rate for this indication, it seems that the chance of having a baby is low.

Adult↗
PubMed1992

[MRI of malformative syringomyelia. Descriptive and developmental aspect].

132 cases of malformative syringomyelia have been studied at the C.I.E.R.M. (Interdepartmental Magnetic Resonance Center) of Bicêtre Hospital. The authors describe their technique for the exploration on the cord in case of suspected intramedullary cavitation, and emphasize the morphological and evolutive aspects of these abnormalities, whether they have been operated or not.

Adolescent↗
PubMed1991

[Liver transplantation and the major histocompatibility complex].

We have carried out a retrospective study over 308 liver transplant patients (31 of them have had a retransplantation) in Professor Bismuth's Department at Paul Brousse Hospital. The purpose of the study was a search for the possible effect of donor/recipient major histocompatibility complex on the evolution of the transplantation. We chose to study four parameters: early acute rejection; chronic rejection; retransplantation cases and death frequency; graft survival. We observed the following: for HLA A locus: in cases of total or partial compatibility there are more moderate early acute rejections than in the case of incompatibility (p less than 0.02); for HLA B locus: in the case of total compatibility there are more chronic rejections than in cases of partial or total incompatibility (p less than 0.03); for joint A and B locus: the results are similar to those of A locus (p less than 0.03); for HLA class I: we observed no effect either on graft survival or on retransplantation cases or on death frequency; for HLA DR: we did not find any effect on the studied parameters. Considering the low statistical significance of these results and in order to confirm our analysis, we have started a prospective study in collaboration with two other European Transplantation Centers.

Graft Rejection↗
PubMed1991

Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988-1989).

To estimate the prevalence and main causes of infertility, a multicentre survey was conducted over 1 year (July 1988-June 1989) in three regions of France. All the 1686 couples in these regions, who consulted a practitioner for primary or secondary infertility during this period, were included in the investigation. The prevalence rate of infertility was found to be 14.1%, indicating that one woman out of seven in France will consult a doctor for an infertility problem during her reproductive life. The main causes of female infertility were ovulation disorders (32%) and tubal damage (26%), and of male infertility oligo-terato-asthenozoospermia (21%), asthenozoospermia (17%), teratozoospermia (10%) and azoospermia (9%). Infertility was also found to be caused by disorders in both the male and female partners together; thus in 39% of cases both the man and woman presented with disorders. The woman alone was responsible for infertility in one-third of cases and the man alone in one-fifth. Unexplained infertility was found in 8% of the couples surveyed.

Adult↗
PubMed1991

[Difficulties in conceiving. Discussion about methodology concerning the INED-INSERM survey carried out in France in 1988 on 3,181 women aged between 18 and 49].

Different types of enquiries can be carried out in the field of infertility: descriptive ones (to find out the "frequency" of difficulties in conceiving and their causes) or analytical ones (to show and quantify the risk factors). A descriptive one was conducted on a representative national sample of women ages 18 and 49 years by INED and INSERM in 1988. The results shown here deal with the proportions of women who had had difficulties in conceiving as well as those who had consulted doctors for this reason. One notes that 27% of the women who were questioned had had difficulties and of those who had been waiting for more than one year, 62% had consulted a doctor. On the other hand, from the knowledge that has been gained from this enquiry, some methodological points are discussed, as far as the precise definition of infertility, the sample on which the study is carried out as well as the measured variable (prevalence, annual incidence and cumulative incidence). A particular reference is made to another enquiry carried out on patients who consulted because of infertility in three departments of France in 1988-89.

Adolescent↗
PubMed1989

Reevaluation of the utility of mean cell hemoglobin (MCH) screening in infants for iron deficiency.

Iron deficiency (ID) at the stage of latent deficiency (LID) or frank anemia (IDA) is still common in pediatric practice. We have assessed the prevalence of LID and IDA in an infant population with an age range of 9-11 months, in Paris. Red cell indices, hemoglobin level, serum iron, transferrin saturation and serum ferritin levels were assayed. There was considerable prevalence of ID as 82% of the children exhibited low levels in one of the above parameters. We found low mean cell hemoglobin (MCH) to be predictive of LID in one third of cases. Since MCH value is routinely available to the physician, it appears that a close examination of this red cell index should allow for the diagnosis of ID in a large number of children at risk, without the need to resort to more elaborate and expensive laboratory tests.

Anemia, Hypochromic↗
PubMed1988

Male factors and the likelihood of pregnancy in infertile couples. I. Study of sperm characteristics.

A prospective study of 394 infertile men was conducted over 3 years following a primary semen analysis. The cumulative pregnancy rate was 43 and 64% after 1 and 3 years, respectively. The pregnancy rate was significantly higher in the secondary infertile group. The study of various sperm factors and the occurrence of pregnancy showed that they were not of equal significance in predicting male fertility potential. The percentage of pregnancies decreased significantly only when the sperm concentration was less than 5 x 10(6)/ml. The pregnancy rate increased significantly with the percentage of motile sperm. The percentage of sperm with normal morphology was also found to be significantly higher when a pregnancy occurred than when the couple remained infertile (43.6% vs 37.7%). In a detailed morphological analysis of the sperm, six abnormalities (microcephaly, double head, amorphous head, cytoplasmic droplet, bent tail and coiled tail) were found to be significantly more frequent when a pregnancy did not occur. The most predictive value was given by the Multiple Anomalies Index (MAI), which is the mean number of abnormalities observed per abnormal sperm. The pregnancy rate was significantly lower after both 1 and 3 years when the MAI was greater than 1.6. Multivariate analysis showed that the best prognostic indicator of fertility was given by the percentage of motile sperm and the MAI, particularly in patients with primary infertility.

Female↗
PubMed1988

Male factors and the likelihood of pregnancy in infertile couples. II. Study of clinical characteristics--practical consequences.

A prospective study of 394 infertile men was conducted over 3 years following a primary semen analysis. Simple comparisons between the groups of men whose partners conceived and those that did not, showed that the mean duration of infertility in the primary infertile group was significantly shorter when a pregnancy was observed, while age differed significantly between the two populations in the secondary infertile group. Multivariate analyses, taking these variables and sperm characteristics into account, showed that prognostic variables for the occurrence of pregnancy were the duration of infertility, sperm motility and the multiple anomalies index in the primary infertile group, and age of the male partner and percentage of normal sperm in the secondary infertile group. Tables for estimating the probability of observing a pregnancy as a function of these criteria are presented. In this study no positive influence of treatment on the occurrence of a pregnancy was found during the 3 years following the first semen analysis.

Age Factors↗
PubMed1988

Polyadenylic-polyuridylic acid as adjuvant in the treatment of operable breast cancer: recent results.

A randomized trial of polyadenylic-polyuridylic acid (Poly(A).Poly(U) given as an adjuvant in the treatment of operable breast cancer, has included 300 patients of the Institut Gustave-Roussy from September 1972 to December 1979; 145 patients were allocated to conventional treatment alone and 155 to conventional treatment plus Poly(A).Poly(U). Reviews after mean periods of follow-up of 50 and 87 months were previously published. The present review performed after a mean follow-up period of 111 months confirmed a significant increase in the overall survival of patients with invaded nodes treated with Poly(A).Poly(U). The best results were achieved in the subset of patients with up to three affected nodes who showed a significant increase of both overall and relapse-free survival. The benefit seemed to be greater in postmenopausal women (P = 0.07). Present status of other ongoing trials of adjuvant Poly(A).Poly(U) is presented.

Breast Neoplasms↗
PubMed1988

[Use of the concept of fecundity in the prognosis of infertility].

In taking note of the fecundability it becomes possible to calculate the distribution curve for delays in becoming pregnant for couples who want to have a pregnancy. In the first part of the paper tables are presented to correspond to different fecundabilities and contain the delays in conception and other indices that can measure the fertility of such couples. Il the second half the results are applied to concrete situations that go with different causes of infertility, so that couples affected with certain conditions can know their own prognosis as a function of the delay already suffered since starting to try for a pregnancy.

Adult↗
PubMed1987

Interobserver agreement in the physical diagnosis of alcoholic liver disease.

Agreement among six physicians for 18 clinical signs in 50 alcoholic patients was prospectively studied. Twenty patients had alcoholic cirrhosis, 14 noncirrhotic alcoholic liver disease, and 16 alcoholics had no clinical or biochemical abnormalities. Agreement was assessed by kappa index for categorical variables and by intraclass correlation coefficient for the others. A good agreement was observed for ascites (r = 0.75) and splenomegaly (r = 0.75). It was fair for jaundice (r = 0.65), Dupuytren's contracture (r = 0.65), and vascular spiders (r = 0.64). However, it was poor for white nails (r = 0.27) and hepatic consistency (r = 0.11). Agreement was better among senior physician's than junior physicians. In order to assess which signs contributed to differentiate the three groups of patients, a stepwise discriminant analysis was realized; it identified three variables: vascular spiders (P less than 0.001), splenomegaly (P less than 0.001), and abdominal wall collateral veins (P less than 0.01). These results suggest that studies based on physical findings must be cautiously considered.

Adult↗
PubMed1987

Comparative trial of Hexabrix (320 mg iodine/ml), iohexol (300 mg iodine/ml) and iopamiron (300 mg iodine/ml) in cerebral and spinal angiography: a preliminary report.

A comparison has been carried out of results of cerebral and spinal-cord angiography with two non-ionic contrast media, iohexol and Iopamiron, and a low-osmolality contrast medium, Hexabrix. A comparative study of iohexol, Hexabrix, and Iopamiron was carried out in a first group of 41 patients, and Hexabrix was compared with Iopamiron in a second group of 56. Evaluation criteria included local and general safety, as well as quality of angioscopy and angiography. In the first group of patients there were no significant differences in safety between the three agents. On the other hand, quality of visualisation during angioscopy with Hexabrix was clearly better. In the second group, safety and quality of the radiographic images were identical; however, once again, quality of angioscopy was better with Hexabrix than with Iopamiron. We conclude that Hexabrix appears to be the best opacifying agent currently available for cerebral and spinal-cord angiography. While results with Iopamiron were quite similar, the latter agent is slightly more expensive.

Cerebral Angiography↗
PubMed1986

Within-subject variability of the percentage of morphologically abnormal spermatozoa among fertile men: biological and measurement components.

Two groups of men were studied to determine how much an individual's spermatozoal morphology varies and which part of the variability is due to biological and to measurement variation. A first group of ten subjects each provided five ejaculates; the other group of four subjects each provided one ejaculate, from each of which five smears were prepared, and evaluated twice. The slides were examined in random order and blindly by the same experienced technician. The total within-subject variability of the percentage of abnormal forms was large (SD = 8.8%), as was the component of this variability due to biologic fluctuation (SD = 5.8%). The distribution of the various abnormalities also varied greatly from one ejaculate to another. The results indicate that more work is needed to determine why biological variation exists, and that several ejaculates (three if possible, two at minimum) are needed for an accurate evaluation of spermatozoal morphology, whereas the examination of greater than 100 spermatozoa/ejaculate is not advantageous.

Fertility↗
PubMed1985

[Physiologic changes in semen examination].

The normal values of the spermogram can be defined by analyzing the distribution of sperm characteristics among men whose fertility has been proved (donor candidates, vasectomies). The values proposed on the basis of a study of 294 spermograms are the following: volume - 1.8 ml; concentration - 23 million/ml; total number - 72 million; mobile forms - 35 per cent; normal forms - 32 per cent. The most frequent abnormalities are irregularities of the head and microcephalia. Factors of variability: Different sources of variability must be considered in the analysis of the spermogram. These can be of a technical or a physiological nature. In the later case: the length of abstinence preceding sperm collection is the most important. From 1 to 5 days, there is a linear increase in volume and number, which then stabilizes the situation is the opposite in the case of the percentages of mobile and normal forms, which remain stable for 5 days and then decrease linearly. Age must also be considered to be a source of variability, particularly with respect to the percentages of mobile and normal forms, which decrease after the age of 40. Even when these factors are taken into account, there can be large variations in the spermogram of the same subject from one examination to the next, which necessitates a repetition of sperm examinations before any physiopathological interpretation can be considered. Spermogram results also depend on the period during the year when the collection is made: volume and number are at a minimum in September and at a maximum in March and November, whereas mobility and morphology are better in August and September and less satisfactory in March and April.

Adult↗
PubMed1985

[Suicide attempts in adolescent girls. Epidemiological aspects].

The authors report the results of a study undertaken in 27 adolescent girls hospitalized for suicide attempts, interviewed according to the same procedure as 46 adolescent girls hospitalized during the same time period for other reasons. A statistical study of the questionnaire used showed answers significantly different, especially concerning grandparents, intra-familial relationships, parental picture, behaviours of adolescents outside their family, school attendance. The whole of these results suggests a disturbance in the communication systems of the suicidal adolescent.

Adolescent↗