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Biomedical subjects

C Boutteville

Publications and source records attributed to C Boutteville.

At least 19 recordsLinked to original sources
PubMed1993

[Urodynamic ultrasonography in the management of urinary disorders in women].

The authors report the preliminary results of a study on the use of perineal sonography with a vaginal probe as a complement to urodynamic investigation, in patients with stress urinary incontinence or other urinary symptoms. This technique seems useful especially in stress urinary incontinence to precise the existence and the importance of bladder neck hypermobility, and in the evaluation of post-opérative outcome after surgical suspension of the bladder neck.

Female↗
PubMed1989

[Adjuvant treatment of tubal surgery. Randomized prospective study of systemically administered corticoids and noxythiolin].

The effectiveness of systemic corticosteroids in the prevention of adhesion formation and reformation has been recently questioned, on the grounds of non randomized studies. Noxythiolin has been tried in animal experiments, but never in the human. In this paper, a randomized study of the effect of dexamethasone and/or noxythiolin versus no treatment has been conducted by the Group d'Etude des Adhérences Pelviennes. 126 patients have been operated upon by microsurgery (salpingectomy and/or salpingolysis). Adhesions have been assessed by a score derived from the American Fertility Society endometriosis classification, before operation and by laparoscopy 3 to 6 months later. The mean improvement on adhesion score was 23.2 in the corticosteroid treated group, 19.3 in the noxythiolin group, 15.7 in the noxythiolin and corticosteroid group, 10.2 in the control group. 40% of patients (13 out of 32) in the corticosteroid group, versus 26% (5 out of 29) in the noxythiolin and corticosteroid group and 19% (6 out of 31) in the control group (p less than 0.02) became pregnant. No adverse effect has been noted. These results support the use of corticosteroids in infertility surgery.

Dexamethasone↗
PubMed1989

[Hormonal regulation of GCDFP-15 secretion in breast tumors. Study of cultured cells].

We studied the hormonal regulation of the Gross Cystic Disease Fluid Protein 15 kd (GCDFP-15) which is secreted by mammary epithelial cells. Its precise role is still unknown. For some authors, it is associated with a risk of breast cancer, and for others with a functional differentiation of the cells. We measured the secretion of GCDFP-15 by an immunoenzymatic method in culture media and cytosols of mammary epithelial cells MCF-7, MDA-MB-231 and HBL-100. We also measured the GCDFP-15 secreted by explants of human tumors in organ cultures. We compared the basal values of GCDFP-15 with those obtained after estradiol, dihydrotestosterone and tamoxifen stimulations. Our results show a decrease of GCDFP-15 production with estradiol and an increase with dihydrotestosterone and tamoxifen. These variations are not systematically correlated with variations of cell growth. This study highlights the interest of GCDFP-15 as a tumoral marker; the study of GCDFP-15 level variations could be useful in the monitoring of cancer response to hormonal and/or chemotherapeutic treatment.

Apolipoproteins↗
PubMed1989

[Hysterosalpingographic aspects of ovarian and peritoneal endometriosis. Case-control study].

A clustering of radiologic signs is associated with the presence of ovarian and/or peritoneal endometriosis: some indicate fibrosis of utero-sacral ligaments (isthmic dissection of the uterus, fixed retroversion); others are linked to pathology of the tube (ampullar retention of dye after evacuation, sometimes inducing false aspects of hydrosalpinx); the last ones suggesting peritoneal adhesions (incomplete peritoneal diffusion). All these signs have been systematically studied, independently of the diagnosis, on 154 hysterosalpingograms of infertile patients known to have patent tubes at laparoscopy: in 107 out of these cases endometriosis was diagnosed at laparoscopy; the 47 last cases constituted the control group. The results confirm that all the signs described are significantly more frequent in cases of endometriosis, although non-specific for this condition. On the contrary, neither adenomyosis, tubal diverticulosis, nor intramural polyps are significantly linked to external endometriosis. In conclusion, some radiologic signs suggest the presence of peritoneo-ovarian endometriosis. Their detection is possible only on high quality pictures, including a last one taken after 10 to 20 minutes walking, to feature the anomalies of tubal evacuation and peritoneal diffusion. The clustering of these signs allows the clinician to propose an early laparoscopy in the work-up of an infertility case. Furthermore, some of these salpingograms provide evidence of a functional disorder of tubal motility in endometriosis, possibly responsible for the low fertility associated with the disease.

Endometriosis↗
PubMed1988

[Retrograde section of uterine septa under ultrasonic control].

A new technique for the treatment of uterine septa is described. The septum is divided by the transcervical route, using 4 mm endoscopic scissors. Simultaneously, real-time ultrasonography confirms the diagnosis of septate uterus and ensures the safety of this blind procedure. Ultrasonic guidance also enables the septum to be divided along the medial antero-posterior plane and the distance between the upper limit of the section and the fundus uteri to be measured. The operation is rapid, carries a limited risk, leaves no uterine or abdominal scar and requires no special equipment. The elective indication for section of uterine septa is habitual abortion. This convenient method can also be used in women who have never been pregnant during coelioscopy for sterility or section of a vaginal septum.

Endoscopy↗
PubMed1987

Results of in vitro fertilization attempts in patients with one or two ovaries.

The purpose of this communication is to evaluate the results of in vitro fertilization attempts in women with infertility due to a tubal factor, with one or two ovaries. Four hundred fifteen patients (788 cycles) with two ovaries and 86 patients (162 cycles) with one ovary were stimulated with gonadotropins starting on day 3 of the cycle for multiple follicular development. Although the mean number of preovulatory oocytes per laparoscopy and per transfer was significantly higher (2.33 versus 1.67 and 2.28 versus 1.99, respectively) in patients with two ovaries than in those with one ovary, the pregnancy rates per transfer were almost identical in the two groups (24.4% with two ovaries, 23.9% with one ovary). Results are presented according to different stimulation protocols and different age groups. It is concluded that although fewer fertilizable oocytes may be recruited from patients with one ovary, the potential for achieving a pregnancy is no different from that of patients with two ovaries.

Adult↗
PubMed1987

[Tubal sterility. Attempt at cost-benefit comparison between in vitro fertilization and surgery].

The choice that exists when confronted with a case of tubal sterility that can be operated on between in vitro fertilisation straight off or surgery is an example where an analysis of the cost effectiveness may help to make the medical decision. This should, however, depend on several parameters that can not be calculated, such as the other factors in the infertility, the ability for other techniques to be applied, and what the couple want. When the expected success rate for surgery is less than 25 to 35% at present, given the results that are obtainable by in vitro fertilisation surgery is contra-indicated. On the other hand, when the tubal surgery results are expected to be good, and given the introduction of new surgical techniques above 50% success rate, for the next few years at least there are excellent indications to operate. In the distant future it is probable that reversal of sterilisation which gives good operative results will stay as an operation, while tubal blocks that are due to infection will have to resort to in vitro fertilisation, although if laparoscopic surgery can be carried out that might be preferable.

Cost-Benefit Analysis↗
PubMed1987

[Low transverse laparotomy with rectus abdominus section in gynecology and obstetrics. Apropos of 1,000 cases].

The authors report 1,000 cases (357 cesarean sections, 230 hysterectomies for benign lesions, 157 conservative utero-adnexal procedures, 128 tubal plasties, 58 prolapse or incontinence procedures, 70 cancers) ,of laparotomies performed according to the technique described by Mouchel in 1980, i.e. strictly supra-pubic and transverse, from skin to peritoneum, including section of the rectus abdominis. This incision enables to perform in ideal technical conditions, with a minimal complication rate (3 hematomas, 2 incisional hernias for 1,000), and satisfactory esthetic results, almost all of the gynecological and obstetrical surgical procedures (90% of two among the authors' practice). The only contra-indications are, except for cases of previous median laparotomy, ovarian tumors. Neither the high risk of infection, nor obesity, extended hysterectomy, nor fetal distress, represent contra-indications, which is a definite advantage over the Pfannenstiel incision. As compared with the median incision which at some time offered similar results, the esthetics and mainly the strength of the abdominal wall are markedly superior.

Abdominal Muscles↗
PubMed1987

[New method of estimating iodine overload in the urine from a simple urination].

Iodine research holds an increasing place in thyroid pathology, either to cover a radioisotopic investigation with paradoxal results or to find an iatrogenic cause to an unexplained hypo- or hyperthyroidism in new born children as well as in adults. To determine iodine overloads we may need a urinary iodine estimation, in addition to blood iodine determination (quickly eliminated products) or instead of it (difficult blood taking: new born children, etc.). Classically, the 24 hours urinary iodine estimation (total urinary iodine) covers this need but, in practice, as we generally deal with ambulatory patients, the risks linked to the obtention of a perfect 24 hours urine collecting make us abandon it. This article presents an original and simple way of getting round this difficulty: it demonstrates that an excellent iodine overload estimation can be obtained by measuring simultaneously from a simple miction: on one hand iodine concentration, on the other hand the urinary creatinine.

Adolescent↗
PubMed1987

[Epidemiology of extrauterine pregnancy].

An epidemiological study of ectopic pregnancy shows an increased frequency, a diminution of mortality by ectopic pregnancy. This review of the literature points out the influence of several factors implicated in the increased incidence of ectopic pregnancy: pelvis inflammatory disease (PID), intrauterine device and other contraceptive methods tubal ligation, induced abortions, tubal microsurgery, proximal tubal disease, ovulation induction and in vitro fertilization, diethylstilboestrol (DES) syndrome.

Female↗
PubMed1987

[Lasers in gynecological microsurgery. Comparative experimental study].

Forty Wistar female rats were the subject of a laser resection of the uterine horn with microsurgical anastomosis, comparing the effect of various available lasers with blade section. The animals were divided in four groups. The first group, with 10 animals, underwent a resection of each uterine horn, using the CO2 laser, with a one layer anastomosis using ethilon 10/10, under microscope. Five of them were examined one week later and the five others three weeks later, with evaluation of the adhesions, patency of the anastomosis and its histological examination. The three other groups underwent a resection using an Argon laser, Yag laser or scissors. With the Yag laser, the lumen disappeared completely and the mucosa as well as the musculosa were totally destroyed. In the other groups, adhesions were noted as well as a variable inflammatory reaction, in early and late evaluations. However, this reaction is minimal after a resection with scissors, moderate after CO2 laser, significant after Argon laser. It is concluded that only the CO2 laser is suitable for gynecological microsurgery; however, the only advantage over a scissor resection is a faster operating time and a better hemostasis; the other parameters are in favor of blade resection. Thus, it seems that laser resection is not an ideal procedure in humans, for tubal resection before anastomosis.

Animals↗
PubMed1986

[Serum thyroglobulin is elevated in patients with heterogeneous goiter during radioiodide scintigraphy, but normal in those with homogeneous goiter].

Serum thyroglobulin (Tg) levels were determined in 98 biologically euthyroid patients with a diffuse or nodular goiter, and compared to values observed in 33 control subjects. Based on the results of clinical examination and thyroid scanning with radioiodine, patients were divided into 3 groups: group 1 with homogeneous diffuse goiters, group 2 with heterogeneous diffuse goiters without palpable nodules, and group 3 with solitary hypofunctioning nodules. The control group had a mean Tg of 37 +/- 15 micrograms/l. Group 1 (n = 32) had a mean Tg of 46 +/- 28 micrograms/l; six (19%) had an elevated Tg level (level greater than 74 micrograms/l). Group 2 (n = 30) had a mean Tg of 133 +/- 134 micrograms/l; fourteen (47%) had an elevated Tg level. Group 3 (n = 36) had a mean Tg of 188 +/- 191 micrograms/l; twenty (56%) had an elevated Tg level. The comparison of Tg between patient groups, and between patients groups and the control group, showed a significantly higher value in the groups of hypofunctioning nodules and heterogeneous diffuse goiters. It is concluded that the elevated serum Tg level in patients with a diffuse or nodular simple goiter is commonly associated with heterogeneity of the thyroid scan.

Adolescent↗
PubMed1985

Serum thyroglobulin levels in hypofunctioning nodules before and after surgery.

Serum thyroglobulin (Tg) level was determined in 34 biologically euthyroid patients having benign hypofunctioning nodule, before and after surgery. Based on the results of thyroid scanning with radioiodine, 2 groups of patients were considered. Group 1 (n = 18) had solitary hypofunctioning nodule with an otherwise normal thyroid gland and group 2 (n = 16) had hypofunctioning nodule inside an enlarged and/or heterogeneous thyroid. Results were compared to a group of 30 control subjects. Mean Tg level was significantly elevated in both groups 1 and 2 before surgery. No significant difference was found between group 1 and group 2. After surgical removal of the hypofunctioning nodule (follicular adenoma), mean Tg level was normalized in group 1 and decreased but still remained elevated in group 2. It is concluded that the observed elevated serum Tg level is due to the presence of hypofunctioning nodule and/or heterogeneous thyroid tissue. Thus, Tg determination may be useful in the follow-up of operated hypofunctioning nodules in order to detect abnormality in the remaining thyroid tissue.

Adenoma↗