Biomedical subjects

B Haddad

Publications and source records attributed to B Haddad.

At least 19 recordsLinked to original sources

PubMed1998

Vulvovaginal involvement in toxic epidermal necrolysis: a retrospective study of 40 cases.

OBJECTIVE: To determine the incidence, features, and surgical treatment of vulvovaginal lesions in toxic epidermal necrolysis. METHODS: Acute genital lesions were studied retrospectively in 40 women hospitalized for toxic epidermal necrolysis in a dermatologic intensive care unit. A questionnaire was sent to evaluate sequelae and their effects on sexual activity. Examination and surgical treatment were proposed to patients with symptomatic sequelae. RESULTS: Twenty-eight of the 40 patients reported genital lesions during the acute phase of toxic epidermal necrolysis. No specific treatment was carried out during the acute period. Sequelae were observed in five cases, of which three involved the lower genital tract and two the vulva exclusively. The two patients with exclusive vulval involvement did not attempt any sexual activity. The other three patients with both vulval and vaginal lesions were unable to have normal sexual intercourse. Two of the three patients were treated surgically. One patient succeeded in having intercourse, but surgery failed to relieve dyspareunia. CONCLUSION: Genital involvement is frequent during toxic epidermal necrolysis but rarely leads to symptomatic sequelae. Surgery for synechiae is sometimes necessary to recover sexual activity because the vulvovaginal canal is stenotic. Because of the partial effect on pain relief after surgery, a preventive approach should be tried.

Adolescent↗

PubMed1997

[Vulvar dysplasia].

The histological picture of severe stage dysplasia or undifferentiated vulvar intraepithelial neoplasia III is similar in three clinical entities, which should be distinguished because they differ with regard to clinical characteristics, development, prognosis and treatment. They are: 1. Bowen's disease in the menopausal female, which is a precancerous state that in 10 to 30% of cases develops to invasive epidermal cancer. Surgical excision is required. 2. Bowen's papulosis in the young female, known only since the last 2 decades, is the most frequent. It is clinically highly polymorphic. Since it can regress spontaneously and short- and mid-term malignant transformation is rare, conservative treatment should be given. 3. Extensive, patchy Bowen's papulosis in the young female is associated with intraepithelial cervical neoplasia in 85% of cases and with immune deficiency in 30% of cases. Fortunately, it is rare because its risk of malignant transformation is high. Its treatment has not been fully defined but should be as conservative as possible. This clinical distinction is not accepted in the English literature but to us seems of major importance given the need to apply appropriate treatment in each case.

Bowen's Disease↗

PubMed1997

Longitudinal vaginal septum: a retrospective study of 202 cases.

OBJECTIVE: To assess issues and management of longitudinal vaginal septum. STUDY DESIGN: The charts of 202 patients referred for a longitudinal vaginal septum over a 24 year period were reviewed. RESULTS: The most common septa were complete and high partial. Associated uterine malformations were frequent (87.8% of the cases), especially in complete or partial high septum (99.4%). The septum was asymptomatic in 56.4% of the cases. Obstetrical concerns are mainly related to a uterine malformation, but a thick septum may be responsible for dystocia. CONCLUSION: Less than half of the vaginal septa are symptomatic enough to require surgical treatment. However, for obstetrical issues management should include a thorough evaluation of uterine anatomy and preventive section of the septum even when asymptomatic.

Adolescent↗

PubMed1997

Creation of a sigmoid neovagina: technique and results in 16 cases.

OBJECTIVE: For correction of the absence of vagina, sigmoidal colpoplasty is believed to provide a neovagina immediately adequate and with permanent patency. We present one of the largest series and discuss advantages and drawbacks of this procedure. STUDY DESIGN: Our personal technique is described and 16 consecutive cases are reviewed. Anatomical (depth and width of the neovagina) and functional (existence of discharge and coital function) aspects are addressed. RESULTS: An adequate neovagina was obtained in every case, however, in nine cases iterative dilatations were previously required. Two prolapses of the nevagina were noticed and required surgical treatment. The follow up ranges from 6 to 36 months. At this point, only nine patients report intercourse. In five cases a psychological brake is strongly suspected to interfere. Four patients experience significant discharge. CONCLUSION: Despite satisfactory anatomical results, the sigmoid neovagina is not always immediately suitable. Complete adequacy for coital function often requires prolonged care and support.

Adolescent↗

PubMed1997

[Pulmonary doppler. Early results in normal pregnancies].

OBJECTIVE: The study of fetal lung circulation by means of pulmonary Doppler investigation. METHODS: Pulmonary Doppler ultrasound obtained with color pulsed-Doppler with a 3.5-5 Mhz probe. Measure of resistance index and pulsatility index. PATIENTS: Forty seven pregnant women with singleton, between 18 and 39.5 weeks gestation, were recruited to have a pulmonary Doppler ultrasound. 7 fetuses had intra uterine fetal growth retardation (IUGR). Overall, 50 Doppler velocity waveforms were measured. RESULTS: Resistance and pulsatility index were measured in all patients and at each examination. Resistance index (0.86 +/- 0.03) and pulsatility index (2.46 +/- 0.34) were found to be stable during pregnancy. Pulmonary pulsatility index in IUGR fetuses (2.71 +/- 0.33) were found to be higher than those in normotrophic infants (p = 0.006), whereas no difference was found in resistance index between the same subgroups. Moreover, no difference was found in pulsatility index measurements between preterm small-for-gestational age fetuses and normotrophic fetuses measured between 36 and 39.5 weeks gestation (2.68 +/- 0.31 vs 2.49 +/- 0.28). CONCLUSION: Pulmonary resistance index is not statistically different between nomotrophic and IUGR fetuses. In contrast pulmonary pulsatility index is significantly higher in IUGR fetuses when compared with normotrophic fetuses. Pulmonary Doppler ultrasound should be evaluated in a larger trial and correlation between Doppler measurements and fetal lung maturation should be studied.

Case-Control Studies↗

PubMed1997

[Celioscopic ovariectomy. Retrospective study of 56 ovariectomies].

OBJECTIVE: To describe a technique of laparoscopic oophorectomy, and evaluate its feasibility, limits and complications. DESIGN: We performed a retrospective study of 34 patients who underwent laparoscopic oophorectomy, from 1 December 1992 to 28 February 1995. SETTING: Centre Hospitalier Intercommunal, Créteil, and Institut Gustave Roussy, Villejuif. SUBJECTS: Mean age was 58 years (range: 42 to 74 years). In post-menopausal patients with ovarian cyst, a systematic oophorectomy was performed (33 patients). Among post-menopausal women, a systematic contro-lateral oophorectomy was done in 77% of cases. Castration was preconized in one woman with previous breast carcinoma. TECHNIC: Removal of the ovary was performed by dessication and division of the utero-ovarian junction and of the mesovarium. RESULTS: Among the 34 women, 32 (94%) had an exclusive laparoscopic procedure, 2 had laparo-conversion. The reasons of laparo-conversion were the presence of adhesions in one case and presumption of ovarian malignancy (Border-line ovarian tumor) in the other case. For the 32 women with laparoscopic treatment, 22 (65%) had bilateral oophorectomy. Per-operative complication rate was 6.2% (an epigastric vessel injury in one case and an hemorrhage during laparoscopic adhesiolysis in an other case). The post-operative time was uneventful. CONCLUSION: This technique of laparoscopic oophorectomy is simple, rapid and has a low rate of per and post-operative complications. In addition, this technique has the advantage to prevent the risk of ureteral injury.

Adult↗

PubMed1996

Mifepristone (RU 486) and its incidence on amniotic fluid volume in near term fetal macaque monkeys.

OBJECTIVE: To evaluate a possible effect of Mifepristone on amniotic fluid volume in near term pregnant macaque monkeys. STUDY DESIGN: Six pregnant near term monkeys (144 +/- 11 days of gestation) were either treated intramuscularly by Mifepristone (10 mg/kg, n = 3) or a placebo (n = 3). Amniotic fluid volumes were measured by a dilution technique using blue Evans, just prior to the injection of Mifepristone or placebo (t0h) and 24 h later (t24h). RESULTS: Amniotic fluid volume (AFV) measured at t0h was found to be statistically the same in placebo and Mifepristone-treated macaque monkeys (95 +/- 31 vs. 126 +/- 25 ml, respectively, P > 0.05). AFV was found to be lower at t24h when compared to AFV at t0h in placebo-treated (88 +/- 31 vs. 95 +/- 31 ml, respectively, P < 0.05) and in Mifepristone-treated macaque monkeys (72 +/- 7 vs. 126 +/- 25 ml, respectively, P < 0.05). Moreover, the ratio of AFV (t24h/t0h) was found to be significantly lower in Mifepristone-treated monkeys when compared to the placebo group (57.9 +/- 5.7% vs. 92.2 +/- 2.1%, P < 0.05) indicating a specific effect of the antiprogestin on AFV. CONCLUSION: In near term macaque monkeys, Mifepristone at 10 mg/kg induces a significant decrease of amniotic fluid volume within 24 h.

Amniotic Fluid↗

PubMed1996

[Value of ultrasonography in utero-vaginal aplasia].

The usefulness of pelvic ultrasound in the diagnosis of Rokitansky-Kuster-Hauser syndrome was evaluated retrospectively in 44 patients. Ultrasonography confirmed the diagnosis in 32%, however was wrong in 68% as a uterus was found, though generally described as hypoplasic. The reasons for the low sensitivity of ultrasonography are discussed.

Abnormalities, Multiple↗

PubMed1996

[Uterine velocimetry and vascular pregnancy pathologies prevented with low-dose aspirin].

Several trials have been published about the usefulness of early uterine Doppler waveform in the prediction of pre-eclampsia and intrauterine growth retardation in nulliparous or low risk patients. We reviewed 3 trials introducing aspirin therapy in patients selected by an early abnormal uterine Doppler waveform. In one trial, serum alpha fetoprotein above 2.5 median at 16 weeks was used as a first selection criterion. In two studies, the incidence of pre-eclampsia was significantly decreased in aspirin treated groups: McParland's trial (odds ratio: 0.08; 95% CI:0.01-0.63) and Campbell's preliminary report (odds ratio: 0.15; 95% CI:0.02-0.91). In contrast, the rate of intra-uterine growth retardation was found similar in aspirin and placebo treated patients. To clarify the usefulness of aspirin therapy in patients with early abnormal uterine Doppler in improving maternal and fetal outcome, other prospective large studies are needed.

Aspirin↗

PubMed1995

Mutations in the sulfonylurea receptor gene in familial persistent hyperinsulinemic hypoglycemia of infancy.

Familial persistent hyperinsulinemic hypoglycemia of infancy (PHHI), an autosomal recessive disorder characterized by unregulated insulin secretion, is linked to chromosome 11p14-15.1. The newly cloned high-affinity sulfonylurea receptor (SUR) gene, a regulator of insulin secretion, was mapped to 11p15.1 by means of fluorescence in situ hybridization. Two separate SUR gene splice site mutations, which segregated with disease phenotype, were identified in affected individuals from nine different families. Both mutations resulted in aberrant processing of the RNA sequence and disruption of the putative second nucleotide binding domain of the SUR protein. Abnormal insulin secretion in PHHI appears to be caused by mutations in the SUR gene.

ATP-Binding Cassette Transporters↗

PubMed1995

Uterine Doppler wave form and the prediction of the recurrence of pre-eclampsia and intra-uterine growth retardation in patients treated with low-dose aspirin.

OBJECTIVE: To examine if early uterine Doppler remains a predictor of vascular complications in pregnant women treated with low-dose aspirin for a poor previous obstetrical history. DESIGN: A study of the uterine diastolic index and the uterine notch with a continuous wave Doppler ultrasound. SETTING: The maternity Hospital Port-Royal Baudelocque Paris, France. SUBJECTS: All pregnant women between 1991-1992 (n = 48) early treated with 100 mg daily of aspirin (15.9 (S.D. = 1) weeks) for a poor previous obstetrical history. METHODS: The 48 patients underwent a uterine Doppler examination at 23.8 (S.D. = 2.6) weeks. A diastolic index was calculated and the presence of diastolic notch was noted. MAIN OUTCOME MEASURES: Vascular complications (pre-eclampsia, intra-uterine growth retardation), birth weight. RESULTS: Twenty six patients (54.2%) had an abnormal early uterine Doppler. Nine patients (18.7%) had a vascular complication, which occurred more frequently in pregnant patients with an abnormal uterine Doppler (8/26 vs. 1/22; P < 0.05). The mean birth weight was lower in patients with a pathological uterine Doppler (2419 (S.D. = 679) vs. 2841 (S.D. = 482) g; P < 0.05). CONCLUSIONS: In pregnant, early treated with low-dose aspirin for poor previous pregnancies, early uterine Doppler predicted patients with a high-risk of recurrence of vascular complications.

Adult↗

PubMed1995

Respiration of amniotic fluid in near-term foetal rabbit.

OBJECTIVE: To examine the existence of amniotic fluid inhalation in foetal rabbit near term. STUDY DESIGN: Rabbit red cells labelled with 51 radio-chromium (Cr51-S1: Injectable solution sodium chromate, volumic activity: 74 MBq/ml; Cis-BioInternational, France) were injected into the amniotic sac of 24 New Zealand White foetal rabbits (mean gestation: 31 days) at day 25 per-laparotomy. At day 26, just prior to caesarean section, human serum albumin labelled with 125 radio-active iode (125I-HSA) (SERALB-125: human serum albumin labelled with radioactive Iode 125, volumic activity: 185 kBq/ml, Cis-BioInternational, France) was injected into each amniotic sac. The lungs, digestive tracts, kidneys and liver were excised separately and radioactivity counted in each organ. RESULTS: On day 26 of gestation, the 51Cr-RC radioactivity rate per gram of tissue in lungs, digestive tract amniotic fluid, liver and kidneys were respectively 1.66 +/- 2.8%, 1.15 +/- 1.6%, 0.015 +/- 0.02% and 0.04 +/- 0.07% of the total amount of radioactivity injected into the amniotic sac at day 25. The lungs' radioactivity was significantly higher than liver (t = 2.94, P < 0.01) or kidneys radioactivity (t = 2.38, P < 0.05). The 125I-HSA injected just prior to caesarean section at day 26 was not found in any foetal organ. CONCLUSIONS: Lung radioactivity is not related to gasps induced by caesarean section, or to a vascular diffusion since lung radioactivity was significantly higher than liver or kidneys' radioactivity. The results of these series of experiments demonstrate that amniotic fluid inhalation does exist in foetal rabbit near term.

Amniotic Fluid↗

PubMed1995

A three-dimensional smooth surface analysis of untreated Crouzon's syndrome in the adult.

This study compares the three-dimensional smooth surface shape of five adult patients with Crouzon's disease with nine normal skulls. A new analysis method is described which is based on smooth surface curvature. Surface samples are subdivided by a common ridge curve structure. Three-dimensional images of an average normal and an average Crouzon skull are illustrated. Comparisons between groups are performed on landmarks, as well as ridge curve and surface patch midpoints. There was as much discriminant information in the ridge curves and surface patches between landmarks as there was at the landmarks themselves. When compared with normal samples, the Crouzon's syndrome sample exhibits the following major characteristics: The midface is concave and wide, with the piriform aperture in the center more recessed than the perifery of the midface. The forehead is recessed above a frontal sinus bulge. The orbits are shallow, wide, concave, and tilted inferiorly with a mild hypertelorism. These data suggest that advancement of large, one-piece osteotomy segments will not produce a normal face, and a multisegment approach should be considered.

Adolescent↗

PubMed1995

Cytogenetic and molecular cytogenetic studies of a case of interstitial deletion of proximal 15q.

A 4-month-old child with multiple anomalies was determined to have an interstitial deletion of chromosome 15, i.e., del(15) (q12q14). The deletion appears not to be a typical deletion of 15q12 such as seen in Angelman and Prader-Willi syndromes, but appears to be more distal, involving either loss of all of 15q12 and part of 15q14, or part of 15q12 and most of 15q14. In either case, 15q13 is missing. Fluorescent in situ hybridization with probes for 15 centromere (D15Z), pericentromeric satellite sequences (D15Z1), and chromosome 15 painting probes shows the deleted chromosome to involve only 15 and no other acrocentric chromosome. Hybridization with probes for the AS and PWS loci (D15S11 and GABAB3, Oncor) show both sites to be intact in the deleted 15. The case is compared with two other reports with overlapping interstitial deletions of proximal 15q, neither of which shows typical features of Angelman or Prader-Willi syndromes.

Abnormalities, Multiple↗

PubMed1995

Mapping segmental imbalances using comparative genomic hybridization and eigenanalysis.

We have tested a new approach to comparative genomic hybridization (CGH) analysis using digital ratio images and eigenanalysis, which allows the recognition of consistent patterns along the chromosomes and discards random (background noise) patterns. We have performed test experiments using genomic DNAs from a patient with a duplication, another with a deletion of a chromosome segment, and a prostate cancer biopsy. Image ratio analysis was performed, and ratio images of the relevant chromosome were subjected to eigenanalysis. The results showed a high-contrast enhancement of the regions corresponding to the unbalanced genomic segment, with clearly defined limits between normal and abnormal fluorescence ratios. The combination of digital ratio images and eigenanalysis allowed the precise mapping of unbalanced regions consistent with other methods of analysis. Because there is no limit to the number of chromosomes that can be analyzed at any one time, the method has the potential of increasing the sensitivity of CGH by reducing the noise component.

Cell Line↗

PubMed1995

[Pelvic myxoid liposarcoma. A case report].

Myxoid liposarcoma is a rare soft tissue tumour. The authors report one case of retroperitoneal tumour discovered during pregnancy, which recurred after initial surgery. Clinical features, clinical course and prognosis of this disease are examined together with management procedures.

Adult↗

PubMed1995

[Orifice dyspareunia: the surgeons point of view].

Various organic lesions can give rise to superficial dyspareunia. Easily surgically treated, they must be recognised: 1) minor hymenal abnormalities: cribriform, microperforate, septate, fleshy or hyperelastic hymens; 2) vaginal abnormalities: longitudinal or transverse septum; 3) post obstetrical or post operative vulvar outlet stenosis; 4) sexual trauma: tears of the vestibular fossa or hymenal tears; 5) stenosing lichen sclerosus, lichen planus, bowenoid papulosis and Bowen's disease; 6) focal vestibulitis associated with more or less obvious psychological outcomes.

Congenital Abnormalities↗

PubMed1995

[Manual rotation of vertex presentations in posterior occipital-iliac or transverse position. Technique and value].

OBJECTIVE: Evaluate of the usefulness of manual rotation of occipito-posterior or transverse presentation. DESIGN: One year retrospective study (1991). SETTING: Maternity hospital, Clinique Universitaire Baudelocque. SUBJECTS: All patients during labour having a spontaneous (n = 160) or a manual rotation (n = 368) of an occipito-posterior or occipitotransverse presentation. The manual rotation could be indicated for a fetal distress, a protracted first stage of labour or prophylactically. INTERVENTION: Manual rotation as described by Tarnier, was performed at least at 7 cm cervical dilatation. MAIN OUTCOME MEASURES: Success rate of manual rotation, cesarean section rate, maternal, fetal and neonatal complications.

Adolescent↗