[Role of abstention in the treatment of extra-uterine pregnancy].
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Biomedical subjects
Publications and source records attributed to D Raudrant.
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Microcalcifications previously located by radiography were extracted from 25 fresh specimens obtained from patients who had undergone tumorectomy or systematized mammary exeresis. Two principal types of microcalcifications were distinguished: Type I microcalcifications were amber in color and generally crystalline on scanning electron microscopy, with only one calcium peak on microprobe analysis; x-ray diffraction revealed that weddellite was involved. Type II microcalcifications were whitish, nonbirefringent under polarized light, and generally ovoid or fusiform, with two peaks, one calcium and the other phosphorus, on microprobe analysis; these microcalcifications were composed of calcium phosphate, the most characteristic form of which is hydroxyapatite, in the form of needles arranged in rosettes on transmission electron microscopy. Type I microcalcifications were observed in four of eight benign breast lesions, in two of three in situ lobular carcinomas, and in no intraductal adenocarcinomas or infiltrating carcinomas. Type II microcalcifications were present in all infiltrating carcinomas and intraductal adenocarcinomas; they were also found in benign lesions (four of eight) and even associated with type I microcalcifications in one in situ lobular carcinoma. There are, therefore, no "benign" or "malignant" microcalcifications; however, the presence of weddellite is a strong indication that a lesion is benign or, at most, an in situ lobular carcinoma.
The authors report a case of a partial trisomy for the long arm of chromosome 3. The associated morphotypic anomalies are compared with the 31 cases already reported, and allow to further outline a well recognizable morphotype which has similarities with the Brachmann Cornelia de Lange Syndrome. The chromosomal mechanisms which may result in this unbalanced caryotype dup 3 q are discussed, and among them the possible role of a paternal chromosome 9 pericentric inversion, most commonly termed as a normal variant.
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Although tumours of the ovary are rare in woman under the age of 35 they are not exceptional and they form 15 p. 100 of the cases (17 patients) out of a series of 112 tumours of the ovary which were collected in 7 years. 11 of these patients had only one ovary affected and were able to be treated conservatively. In this way 5 of them were able to carry one or more pregnancies to term and another patient who was lost from observation for two years had to have a second operation to deal with a recurrence in the opposite ovary. Conservative treatment is only permissible if one is absolutely sure that the contro-lateral ovary is normal, and if there is the slightest doubt ovariotomy should be carried out to perform a biopsy. Furthermore the authors suggest that in view of the difficulties of strict supervision for a long term the opposite ovary and tube should be removed and hysterectomy carried out once the patient has had one or two children or when they have reached the age of 40.
Toxemic and normotensive pregnant women were compared for plasma renin activity (PRA), aldosterone (PA), and dopamine-beta-hydroxylase (DBH). At term, hypertensive patients exhibited higher levels of PRA and PA, but similar levels of DBH, progesterone, and estradiol. Their elevated blood pressure was significantly correlated to their levels of PRA. During the delivery levels of PRA increased significantly in toxemic patients in spontaneous labor. Venous and arterial cord PRA levels were higher in babies born to hypertensive mothers than in babies born to normotensive mothers. Three days postpartum, maternal PRA level was lower than at term. Seven days postpartum, PRA levels remained higher in toxemic than in normal women. Maternal DBH levels did not change during and after delivery. Levels of DBH were undetectable in cord blood. We conclude that the renin-angiotensin system is involved in the pathogenesis of toxemia.
The authors studied the variations in levels of copper and ceruloplasmin in the mother and in products of conception during the first trimester of pregnancy, during the 4th month of pregnancy and near term, having a series of 12 pregnancies with the copper I.U.D. in position. No change was observed between the levels of copper and ceruloplasmin in comparison with a control series.
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When engrafted with donor stem cells and lymphoid cells, patients develop transplantation tolerance to donor antigens. We analyzed the mechanism of tolerance induction in immunoincompetent recipients whose immunity has been reconstituted by transplantation of mismatched stem cells. Seven infants or human fetuses received fetal liver transplants as a treatment for severe combined immunodeficiency disease. After reconstitution of immunity by lymphocytes developed from donor stem cells, T-cell clones were produced and analyzed. Because donors and recipients were HLA mismatched, it was easy to demonstrate the donor origin of the T-cell clones. These clones were shown to have developed tolerance to histocompatibility antigens of the stem cell donor via a process of clonal deletion (probably as a result of contact with donor-derived macrophages and dendritic cells). They were also tolerant to histocompatibility antigens of the host but through a different mechanism: many clones recognized these antigens but had no detrimental effect on the target cells exhibiting host antigens, either in vitro or in vivo. Clonal anergy was therefore the cause of this tolerance to host determinants, resulting in a lack of graft-versus-host disease and of autoimmunity. The contact between developing T cells of donor origin and host epithelial cells within the host thymus may explain this colonal anergy. It should be noted that all patients had high serum levels of interleukin-10, which might have contributed to the persistent engraftment and tolerance.
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Acid-base state and oxygenation of fetal blood were evaluated in a group of 73 appropriate for gestational age fetuses between 17 and 41 weeks of gestation; fetal blood was obtained by cordocentesis. We measured, on umbilical venous blood, pH, pCO2, bicarbonates and total CO2, pO2 and percent oxygen saturation; we obtained following results: pH = 7.309 +/- 0.054; pCO2 = 5.99 +/- 0.85 kPa; HCO3 = 22.16 +/- 1.90 mmol/l; total CO2 = 22.53 +/- 1.97 mmol/l; pO2 = 6.02 +/- 1.68 kPa; SaO2 = 0.71 +/- 0.18. In comparison with adult normal values, our results report in fetuses a frequent state of mild and mixed acidosis (in about 80% of cases), rather gazeous; pH is significantly correlated with pCO2 (r = -0.799), moreover there is also a metabolic origin in acidosis. We observed progressive modifications of acid-base state and oxygenation in fetal blood with advancing gestational age: decrease of pH and pO2, increase of pCO2 and bicarbonates; these changes appear mainly from 35th week of gestation, except for bicarbonates, which increase regularly during gestational period we have studied. Fetal acid-base state may be explained by physiological differences due to fetal life conditions, in comparison with adult life conditions. Results obtained in this population of normal fetuses can be considered as reference values for studied parameters.