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Biomedical subjects

D Cabrol

Publications and source records attributed to D Cabrol.

At least 91 records · Page 5Linked to original sources
PubMed1990

Mechanical properties of the pregnant human uterine cervix use of an instrument to measure the index of cervical distensibility.

An instrument has been designed and manufactured to measure precisely in clinical practice the distensibility index of the human uterine cervix expressed as centimeters per kilogram. Operation of the instrument and possible errors measuring the cervical distensibility index in nonpregnant patients, during gestation and during the postpartum period, are presented. The ability to easily quantify the mechanical characteristics of the uterine cervix in humans throughout gestation will now allow one to carry out precise studies concerning pharmacologically induced cervical maturation or pathological modifications of the uterine cervix in cervical incompetence or threatened premature labor.

Biomechanical Phenomena↗
PubMed1989

Disappearance of beta-adrenergic response of human myometrial adenylate cyclase at the end of pregnancy.

The density of beta-adrenergic receptors in both the outer and inner layers of the human myometrium decreases during the last weeks of pregnancy. Although in preterm myometrium (32-35 weeks of pregnancy) beta-adrenergic receptors are positively coupled to adenylate cyclase, we found that isoproterenol, epinephrine, and norepinephrine did not stimulate the enzyme in the inner or outer myometrial layer at term (39-40 weeks of pregnancy). At this stage, the addition of 10(-4) mol/L guanyl-5'-imidodiphosphate increased (from 10(-8) to 10(-4) mol/L) basal adenylate cyclase activity in a dose-dependent manner, indicating that the catalytic component of the enzyme remains linked to the stimulatory guanyl nucleotide binding protein (Gs). Compared to the preterm response, at term the myometrial adenylate cyclase response to 10(-4) mol/L guanyl-5'-imidodiphosphate was decreased, which may reflect a decrease in the amount of functional Gs. Altogether these changes are consistent with reduced Gs coupling to the catalytic component. However, the similarity of the responses of preterm and term myometrium to forskolin excluded the possibility of an alteration of the catalytic component of adenylate cyclase during the last weeks of pregnancy. The fact that a stimulatory effect of isoproterenol on adenylate cyclase was found after islet-activating protein pretreatment indicates that human term myometrium contains a functional inhibitory guanyl nucleotide binding protein which is involved in the modulation of the beta-adrenergic adenylate cyclase response. Our data suggest that modifications in the coupling mechanisms between receptors and the catalytic component are implicated in the loss of beta-adrenergic adenylate cyclase stimulation in the myometrium at the end of pregnancy.

Adenylyl Cyclases↗
PubMed1989

[Ovarian seminoma and pregnancy. Apropos of a new case].

The case of a 35-year-old primigravida with a 21-week intrauterine gestation and concurrent dysgerminoma of the ovary (stage Ic) is presented. A total hysterectomy with bilateral salpingo-oophorectomy was performed, followed by postoperative chemotherapy using cisplatin, bleomycin and vinblastine. The patient has done well since treatment, and is without evidence of recurrent disease 19 months later. Both radiation and chemotherapy are highly effective treatment modalities for dysgerminoma. For those patients with disease presenting in stages Ib, Ic, II and III who wish to maintain fertility, unilateral oophorectomy followed by combination chemotherapy may be curative and spare ovarian function.

Adult↗
PubMed1988

Acute fetal distress after fetal blood sampling (case report).

The authors report a case of acute fetal distress after fetal blood sampling, performed for fetal karyotype because of a precocious and symmetrical fetal growth retardation without maternal hypertension or ultrasonographic evidence of fetal malformation. A cesarean section performed because of acute fetal distress showed the newborn to be hypotrophic, with a major acidosis and a refractory hypoxemia. The new born died despite intensive care. Acute fetal anemia was assumed to be the cause of acute fetal distress. The authors emphasize the use of FHR in fetal survey after fetal blood sampling.

Adult↗
PubMed1988

[Ripening of the cervix uteri at term by a single intracervical application of prostaglandin E2 gel].

The efficacy and the side effects of an intracervical PGE2 gel application, as compared to placebo, for priming of the cervix have been studied in 208 patients at term (104 PGE2 and 104 placebo) with an unripe cervix (Bishop score less than 5) and with a medical indication for induction of labour. The cervical ripening success rate (as defined in methodology) is significantly higher in the treated group (58.6%) than in the control group (27.8%; p = 0.0001): 38.5% out of the PGE2 treated patients delivered within 12 hours after the gel application; 12 hours after PGE2 or placebo gel application labour was induced in the remaining patients with intravenous oxytocin infusion. Under these conditions there were 13.5% failures in the PGE2 treated group and 16.3% in the placebo group. We observed a statistically significant decrease in the length of labour of the PGE2 treated patients as compared to the control group. Since signs of myometrial hypercontractility were observed in the PGE2 treated group as compared to the control group (p = 0.01), the authors advocate careful cardiotocographic monitoring for at least three hours after the gel application. It is concluded that intracervical application of Prostaglandin E2 followed by intravenous infusion of oxytocin in an effective and safe method for induction of labour with an unfavorable cervix at term.

Adult↗
PubMed1988

[Cerebral Doppler technic during labor using signal monitoring at the level of the fetal scalp].

The purpose of modern obstetrics is to obtain tracers of the fetal cerebral risk during labor, enabling to deliver the child before cerebral ischemia occurs. Recording of the fetal heart and measurement of acid-base balance are remarkable tracers; however, a much better precision is desired to avoid unnecessary or too late caesarean sections. Blood velocity measurement by Döppler at the level of the vessels at the base of the fetal skull is technically possible during labor; this has been demonstrated in 8 fetuses. The major cerebral index D/S during labor is 0.40 +/- 0.04, i.e. slightly lower than the mean index measured at the cord (0.50 +/- 0.07). In case of decelerations, it decreases to a mean value of 0.22 +/- 0.02. These preliminary results permit to hope that long-term measurements with continuous Döppler, of the arterial fetal cerebral flow, provide a direct and accurate tracer of the risk of cerebral ischemia during labor.

Blood Flow Velocity↗
PubMed1987

Prostaglandin E2-induced changes in the distribution of glycosaminoglycans in the isolated rat uterine cervix.

In order to study the hormonal control mechanisms of cervical ripening, we investigated the prostaglandin E2 (PGE2)-induced changes in the distribution of glycosaminoglycans (GAG) using hysterectomized and ovariectomized rats, leaving the vascularized uterine cervix in situ, as an animal model. In the first series of experiments, the GAG were measured in a control (n = 22 Wistar rats) and in a PGE2-treated group (n = 20 Wistar rats) without steroid supplementation. In the second series of experiments, the GAG were measured in a control (n = 19) and in a PGE2-treated group (n = 18) receiving estradiol and progesterone supplements. After PGE2 treatment in the two series of experiments, and despite being surgically isolated from the uterine corpus, the cervix was still able to undergo some of the structural changes associated with normal ripening (increased hydration and hyaluronic acid concentration). This suggests that PGE2, acting directly on the cervix, could be, at least in part, a modulator of biochemical events which underlie normal cervical maturation. The animal model described here seems to be suitable for studying the hormonal mechanisms of cervical ripening and the regulatory relationship between cervical maturation and myometrial contractility, which are probably subject to concordant endocrine regulation.

Animals↗
PubMed1987

Treatment of polyhydramnios with prostaglandin synthetase inhibitor (indomethacin).

Polyhydramnios, which is caused by an excess of amniotic fluid, was diagnosed uniformly in eight patients by ultrasound examination and clinical symptoms, namely, premature uterine contraction, abdominal pain, and respiratory discomfort that resulted from excessive pressure on the diaphragm. Fetal anomalies incompatible with extrauterine existence were excluded by serum alpha-fetoprotein levels, repeated sonography, amniocentesis, and chromosomal analyses. Patients were treated with 2.2 to 3.0 mg of indomethacin/kg body weight/day. The treatment was started at an average gestational age of 24 +/- 0.5 weeks and continued for 2 to 11 weeks. All patients had significant improvement with a simultaneous reduction in amniotic fluid volume, fundal height, and umbilical perimeter. All patients were delivered satisfactorily at an average of 39 weeks' gestation. The fetuses were within the normal body weight range of 2750 to 3600 gm and showed normal development during the neonatal period of 2 to 6 months. Before delivery without indomethacin, the polyhydramnios reformed. Adverse effects or intolerance to the drug was avoided by either a reduction in the dose or cessation of indomethacin therapy. Our studies suggest that indomethacin therapy is an effective way to manage pregnancy complicated by polyhydramnios.

Adult↗
PubMed1987

Conformational studies on polypeptide models of collagen. Poly(Gly-Pro-Val), poly(Gly-Pro-Met), poly(Gly-Val-Pro) and poly(Gly-Met-Pro).

The title polytripeptides were synthesized and studied experimentally, by circular dichroism, and theoretically, by quantum mechanical methods. With the exception of poly(Gly-Pro-Val), which was found to be essentially structureless in solution, the other polymers adopt folded conformations, most probably of type II beta-bends. Conclusions from theoretical studies were generally in agreement with the experimental results. In particular, it is noteworthy that the optimized (phi, psi) maps for poly(Gly-Pro-Met) showed the absolute minimum (phi = 60 degree, psi = 0 degrees) located inside the beta II bend space.

Circular Dichroism↗
PubMed1987

Incidence of placental sulfatase deficiency on the mode of termination of pregnancy.

The mode of termination of pregnancy in case of placental sulfatase deficiency (PSD) has been considered in a 28-case series from our laboratory. After comparison with 75 other cases collected from the literature and also with reports concerned with normal pregnancies it appears that in the case of PSD: first, the gestation length is not increased; second, the parity of the patients has no influence on the mode of delivery; third, spontaneous vaginal delivery can occur (67.8% in our series, 43% in the literature series); fourth, the failure rate of labor, especially when induced, is higher than in a normal population; fifth, the high rate of C-section, largely due to the failure of labor, is enhanced by untimely interventions mostly in case of isolated PSD. If a pejorative incidence of PSD on the mode of delivery exists it must be at a moderate level, and intervention is unnecessary in absence of associated fetal and/or maternal complications.

Amenorrhea↗
PubMed1987

[Improvement in the prenatal etiologic diagnosis of severe 2d trimester oligo-amnios by intra-amniotic injection of physiologic solution].

In reference to 4 severe cases of oligo-amnios of the second trimester of pregnancy, the authors advocate a method in order to improve the pre-natal diagnosis by intra-amniotic injection of a normal saline solution. This method facilitates the morphological exploration of the fetus by sonogram and enables to obtain a fetal karyotype by umbilical or amniotic tap. The potential risk of this technique are described.

Amniocentesis↗
PubMed1987

[Termination of pregnancy and evacuation of the uterine contents in the second trimester. Use of a prostaglandin E2 analog: sulprostone].

The authors used sulprostone on 165 women whose pregnancies had lasted more than 12 weeks. The principal indications were: intra-uterine fetal deaths in 65 cases and an antenatal diagnosis of fetal malformations in 75 cases. Three routes of administration of the drug were employed: extra-amniotic in 15 women; intravenous in 62 women; intramuscular in 88 women. The doses used (adding together the intramuscular and intravenous routes) were: ampoule of 500 micrograms of sulprostone in 25% of cases; ampoules in 50% of cases; ampoules in 25% of cases. It was found to be very effective: by the intravenous route 88.70% expelled the fetus in 24 hours with a mean induction delivery time of 11 hours; by the intramuscular route 89.77% expelled in 24 hours with a mean induction delivery time of 11 hours 45 minutes. The side effects were not common: nausea in 17.6%; vomiting in 16.4% and diarrhoea in 6%. Ther marked effectiveness of sulprostone on the one hand and the good tolerance on the other indicate the effects of this product, which are a strong action on the uterus and a feeble action on the smooth muscle of other organs.

Abortifacient Agents↗
PubMed1986

Cyclic AMP metabolism in the inner and outer layers of human myometrium near term.

The metabolism of cAMP which appears to be the intracellular mediator of various relaxing agents was studied in biopsies obtained during elective caesarean section from inner and outer myometrial layers outside the placental insertion. In the inner layer, L-epinephrine, PGE1, PGE2, PGF2 alpha and PGI2 stimulated the cAMP formation process while 6-keto PGF1 alpha was ineffective. The fact that some of these prostaglandins are well-known to promote contraction, confirms that the effects of drugs on uterine motility are not necessarily related to changes in the cAMP level. On the other hand, L-epinephrine and prostaglandins did not strongly influence the cAMP formation process in the outer layer. Kinetic analysis and purification assays of phosphodiesterase (PDE) which catalyzes the degradation of cAMP revealed the presence of multiple molecular forms of the enzyme in human pregnant myometrium. Qualitative and quantitative differences between the two layers appeared in the two forms separated from the soluble fraction by DEAE-cellulose chromatography. An unequal distribution of calmodulin was also observed in the inner and outer layers. Our results support the concept of the regulatory heterogeneity of the pregnant human uterus and suggest that the myometrial inner layer plays an important role in the regulation of uterine motility at the end of pregnancy.

Calmodulin↗
PubMed1986

A comparison of uterine motility in the pregnant and non-pregnant cynomolgus monkey (Macaca fascicularis) and pregnant woman: a manometric and electromyographic study.

The use of a combination of manometric and electromyographic methods provided a reliable technique for evaluating variations in uterine activity in conscious macaque monkeys and women. The technique was particularly useful for obtaining data on the influence of steroid hormones. During the spontaneous menstrual cycle of the macaque, uterine motility, after being weak and poorly synchronized during the follicular phase, became still weaker with impaired synchronization during the luteal phase and then much stronger and well-synchronized at the time of menstruation. There was no evidence in vivo of any relationship between the existence of gap junctions in the myometrium of non-pregnant animals and the various patterns of uterine motility. During the last third of pregnancy in macaques, the initiation of electrical activity in various uterine areas was always synchronous with and related to mechanical contraction. The same results were obtained in preparturient women. Thus, improved uterine coordination does not appear to be the mechanism by which the uterine contractile strength increases to expulse the foetus at the end of pregnancy. Apart from the particular situation of non-pregnant animals under progestative influence, in which activity was constantly non-propagated, we could not find any evidence of a general pattern which would indicate only one site for the initiation of activity and its extension to the whole uterus.

Animals↗
PubMed1985

Pregnancy-related changes in the distribution of glycosaminoglycans in the cervix and corpus of the human uterus.

We investigated the variations in the distribution of glycosaminoglycans (GAG) in the cervical, isthmic and corporeal stroma of the pregnant and non-pregnant human uterus. The GAG were measured in non-pregnant (n = 9) and pregnant (n = 14) cervices, in non-pregnant (n = 8) and pregnant (n = 6) uterine isthmus, and in non-pregnant (n = 12) and pregnant (n = 5) uterine corpus. Heparan sulfate is abundant in the isthmic and corporeal stroma. This has to be related to a larger content in blood vessels and muscular cells at this level than in the cervix. The distribution of hyaluronic acid and dermatan sulfate is the same in the cervix as in the corpus, but the amount of these GAGs is lower in the former, which could be due to a lower connective tissue content. Two of the main features of cervical maturation, increased hydration, and decreased dermatan sulfate concentration, were found also in the pregnant corporeal stroma. These results suggest that connective tissue maturation is not only a cervical phenomenon and could play a role in active and/or passive mechanical properties of the myometrium during late pregnancy and labor.

Adult↗
PubMed1985

Cyclic 3':5'-nucleotide phosphodiesterase in human myometrium at the end of pregnancy: partial purification and characterization of the different soluble isoenzymes.

Most of the cyclic nucleotide phosphodiesterase (PDE) activity of pregnant human myometrium was found in the soluble fraction. Chromatography of this fraction on DEAE-cellulose resolved two peaks of PDE activities. Peak I hydrolyzed both cAMP and cGMP and was activated by the Ca2+-calmodulin complex. Peak II, insensitive to this complex, hydrolyzed specifically cAMP. Sucrose gradient centrifugation of the soluble fraction resolved three peaks (A, B, C) of cAMP PDE activities, and only the first two peaks (A, B) were active towards cGMP. A subsequent sucrose gradient centrifugation of peak I, previously determined by DEAE-cellulose, allowed us to restore two peaks A and B identical to those directly obtained from the soluble fraction: peak A hydrolyzes both substrates, while peak B is specific to cGMP hydrolysis. For peak II, a single large cAMP PDE activity peak is generated. Considering Ca2+ and cAMP as intracellular messengers in the control of uterine motility, the characterization of the different forms of PDE in pregnant human myometrium will be of importance in developing improved tocolytic therapy.

3',5'-Cyclic-AMP Phosphodiesterases↗