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F Arnal

Publications and source records attributed to F Arnal.

At least 19 recordsLinked to original sources
PubMed1992

[Consistency of the histologic diagnosis of Lauren's classification of gastric cancer].

BACKGROUND: Lauren's classification of gastric cancer is usually followed in epidemiological studies thus requiring evaluation of its reproducibility. This classification defines 2 principal histological types: intestinal and diffuse with different proportions in high and low risk areas possibly being associated to different causal factors. METHODS: The concordance diagnosis in an aleatory sample of 81 gastric carcinomas stratified according to the participation of 14 hospitals in an epidemiological study of 354 cases and 354 controls was analyzed. The initial diagnosis carried out was compared by more than 20 pathologists with the reclassification diagnosis by consensus of 2 pathologists by the proportion of agreement or concordance observed in the kappa index. Keeping the final reclassification by consensus as a reference, sensitivity, specificity and predictive values were also calculated. RESULTS: The proportion of concordance observed was of 78% for the intestinal and 90% for the diffuse with a kappa index of 0.55 and 0.74, respectively. Sensitivity for the intestinal type was of 88% and for the diffuse 81% with specificity being of 67% in the intestinal and 93% in the diffuse. CONCLUSIONS: Subjectivity in the interpretation of certain parameters necessary for histological diagnosis may be reduced by the elaboration of protocols in which the principal histological criteria to follow are detailed. Nonetheless, the distinction made between the two principal types, intestinal and diffuse, is valid enough to be used in multicenter epidemiological studies and in comparative studies.

Case-Control Studies↗
PubMed1992

Favourable outcome in 33 triplet pregnancies managed between 1985-1990.

In this paper, we describe the outcome of 33 triplet pregnancies referred to us between 1985 and 1990. They were managed as follows: management at home as soon as the diagnosis was made, then hospitalization at 28 weeks' gestation. Progesterone and beta-mimetics were administered daily, a cesarean section was always performed. One late abortion occurred at 21 weeks. The rate of prematurity was 90.6%, mean gestational age at delivery was 34.1 +/- 3 weeks, and 62.5% of deliveries occurred between 34 and 37 weeks. Ninety-four fetuses were delivered alive. Mean birth weight was 1880 +/- 410 g. Fetal growth retardation rate was 61.8%, including 28 infants under the third centile and 31 under the 10th centile. Perinatal death rate was 4.16% including 2 in utero deaths and 2 neonate deaths. All infants are healthy except for one child with severe mental retardation. These results show that triplet pregnancies can be safely managed, and that selective first-trimester reduction in triplet pregnancies does not appear to be necessary.

Adult↗
PubMed1992

Multiple linear cylindromas.

We report a case of multiple cylindromas with a linear arrangement on the lower right extremity. The patient had more than 100 tumors, but the scalp was spared. Some tumors showed overlapping features with eccrine spiradenoma. We believe this is the first report of multiple linear cylindromas.

Adenoma, Sweat Gland↗
PubMed1991

[The use of LHRH analogs in ovulation induction].

The use of LH-RH agonists is appropriate for the stimulation of ovulation. In contrast, in the case of induction of ovulation in a patient with deficient ovulation, suppression of influences of the hypothalamo-pituitary axis does not modify the pathological condition responsible for the ovulatory anomaly.

Clinical Protocols↗
PubMed1991

Therapeutic strategies in tubal infertility with distal pathology.

Since 1980, various treatments have been proposed for patients suffering from distal tubal infertility. Difficult choices between surgical (microsurgery/laparoscopy) treatments and in-vitro fertilization (IVF) still confront many workers. In this study, we evaluated the cumulative results of both therapeutic methods for this group of patients. From 1979 to 1990, 266 patients with distal tubal infertility were operated in our programme (group M: microsurgery, n = 211; group L: laparoscopy, n = 55). In group M, pathological findings were hydrosalpinges (n = 135) and incomplete distal tubal occlusion, (n = 76) and in group L hydrosalpinges (n = 31) and incomplete distal tubal occlusion (n = 24). After differing time intervals, IVF was proposed for these patients when no pregnancy occurred. The results were as follows: in group M, 35.5% intra-uterine pregnancy (IUP) and 6.6% ectopic pregnancy (EP) after fimbrioplasties versus 28.1% IUP and 11.9% EP after salpingostomy; in group L, 16.6% IUP and 4.2% EP after fimbrioplasty versus 12.9% IUP and 6.5% EP after salpingostomy. Following IVF, 55.7% of patients in group M and 14.5% in group L became pregnant. The cumulative results including both treatment techniques (surgery and IVF) show an average of 70% and 65% pregnancy rates in groups M and L respectively. The best results after surgery and throughout IVF were obtained during the first year. It is concluded that a short delay after surgery, averaging 6 months to 1 year, before involving patients in IVF, is very important.

Adult↗
PubMed1991

[Evaluation of results of a series of 58 breast reconstruction after cancer].

The evaluation of 58 breast reconstructions operated in Boucicaut Hospital demonstrated positive result. The authors review the techniques used for contralateral breast symmetrization. The policy generally adapted has been to perform two sequential operations: 1st step: implantation of a prefilled prosthesis and contralateral breast symmetrization; 2d step: reconstruction of areolo-nipple complex and refinement of contralateral breast. Radiotherapy seems to be a problem in reconstruction. A 12% recurrence rate has been quoted in this group. Tram flap has been exceptionaly used by our team, as we tend to prefer the latissimus dorsi myocutaneous flap. Very few expanders have been implanted.

Breast Neoplasms↗
PubMed1991

[Techniques, results and indications of embryonic reductions in multiple pregnancies. Review of the literature].

The authors report, after a review of the literature, the evolution of ideas concerning first-trimester terminations in multiple pregnancies. Different techniques are performed including transabdominal approach or transvaginal approach at the mean gestational age of 9 or 11 weeks of amenorrhea. Analysis of obstetrical results obtained after these procedures (rates of early or late abortions, preterm labor or in utero growth retardation) shows a high rate of abortions and demonstrate also that reductions are unable to prevent premature births. Indications are discussed: concerning pregnancies of high order (four or more), most part of authors agree with the procedure and also when a triplet pregnancy occurs on a scarred or malformed uterus. Concerning triplet pregnancies, the procedure remains considered by some teams as an unethical approach of theses gestations, specially when considering the recent advances in perinatal medicine. In all cases, a clear and complete information about the risks of these procedures should be given to couples faced with multiple pregnancies.

Abortion, Induced↗
PubMed1991

[Caroli's disease. Presentation of 8 cases studied with ERCP].

Eight patients with Caroli's Disease are presented, studied by Endoscopic Retrograde Cholangiopancreatography (ERCP) from January 1976 through January 1990. In this period of time 1,525 procedures were carried out, this entity thus representing 0.52% of patients submitted to ERCP in our population. Six patients were females, being female: male ratio 3:1. Mean age was 52 years (range: 40-75). All patients presented a clinical history of recurring episodes of abdominal pain and/or crisis of cholangitis. In the ERCP carried out in these eight patients, cystic dilatation of intrahepatic left lobe bile ducts were confirmed in five patients, dilatation generalized to both lobes in two, and affecting exclusively the right lobe in one patient.

Adult↗
PubMed1991

[Spontaneous rupture of the liver during triplet pregnancy following in vitro fertilization].

The authors present an observation of a spontaneous rupture of the liver happening during the 8th month of gestation of a triple pregnancy obtained by in-vitro fertilization. The diagnosis was done with some delay but evolution was successful for the mother and all her children. It is elective ligation of the right branch of the hepatic artery which produced the hemostasis.

Adult↗
PubMed1990

[Biology of medically assisted reproduction].

The biological techniques utilized in IVF are divided into several stages: conditioning of the gametes, in vitro fertilization proper, culture of ova and embryos, freezing of gametes and embryos. Conditioning oocytes obtained by follicular fluid aspiration is extremely simple, but oocyte maturity can neither be diagnosed very accurately nor improved in vitro. Several methods can be used to condition spermatozoa, but these methods have limitations: normospermia, for instance, cannot be obtained with sperms of poor quality. In vitro fertilization proper is relatively easy to perform, at least with mature oocytes, but the diagnosis of fertilization, especially abnormal fertilization, is not always reliable. The quality of the embryos obtained raises a major problem: their equipment in chromosomes is unassessable, and their viability can only be roughly evaluated.

Female↗
PubMed1990

Studies on new, centrally active and reversible acetylcholinesterase inhibitors.

We have synthesized the tertiary amines of pyridostigmine and neostigmine, 3-pyridinol dimethylcarbamate (norpyridostigmine) and 3-dimethylaminophenol dimethylcarbamate (norneostigmine) respectively, and we have tested their abilities to cross the blood-brain barrier and inhibit mouse brain AChE activity. The in vivo inhibition of AChE activity by norpyridostigmine reaches 72% at 10 minutes which is comparable to that seen with physostigmine (73% at 10 minutes). Inhibition by norneostigmine is less effective (50% at 10 minutes) and approaches that obtained with tetrahydroaminoacridine (57% at 10 minutes). These data show that both norpyridostigmine and norneostigmine cross the blood-brain barrier and that they are effective inhibitors of mouse brain AChE activity. These drugs could be useful in the treatment of memory impairment associated with Alzheimer's disease, and other memory disorders.

Acetylcholinesterase↗
PubMed1990

Early or late monitoring of stimulation of ovulation for in-vitro fertilization? A methodological discussion of a randomized study.

Two GnRH agonist long-stimulation protocols, in association with HMG, are compared on a random basis. Group A (n = 53) was monitored daily from the 6th day of stimulation, whereas monitoring in group B (n = 55) began on the 11th day of stimulation. There was no significant difference in the numbers of follicles which matured, the numbers of collected oocytes, the numbers of embryos obtained in vitro and the clinical pregnancy rate. But the power of such a study is very weak (6%). It would have been necessary to include greater than 1000 patients in each group to obtain a bioequivalence test. Such a study is unrealistic for a single centre and multicentric studies are very difficult to achieve because of practical difficulties. A pooled analysis is perhaps the methodological answer.

Chorionic Gonadotropin↗
PubMed1990

Obstetrical results after embryonic reductions performed on 34 multiple pregnancies.

Thirty-four women with multiple pregnancies (three or more fetuses) underwent embryonic reduction in order to reduce abortions, premature births or fetal growth-retardation by obtention of twins. Four early abortions occurred. Thirty pregnancies reached term and out of 60 fetuses, 58 infants were born alive. Fetal death in utero of one twin occurred in two pregnancies. The mean term until delivery was 36 +/- 2.8 weeks gestation and the prematurity rate was 51.7%. Of 55 neonates, 25 were underweight within the 10th percentile and 10 out of 55 neonates were underweight below the 3rd percentile. There were three deaths in the early neonatal period. The rate of perinatal mortality was 8.3%. Fifty-four children are currently healthy and one child has a mild axial hypotonia. A reduction in prematurity was observed with a gain of 2 weeks on reported data concerning triplet pregnancies. The rate of low-birth-weight infants was high, 63.5% being underweight at birth.

Abortion, Incomplete↗
PubMed1989

Results of IVF attempts in patients with unexplained infertility.

From January 1986 to July 1987, 143 patients with unexplained infertility (UI) following 217 IVF attempts were studied and randomly assigned for statistical analysis to be compared with 434 tubal infertility (TI) patients undergoing 748 IVF attempts. The age of patients, previous pregnancy history and stimulation protocols were identical in both groups. In comparison with tubal patients, IVF attempts on the UI group were characterized by the same rates of cycle failure, mean number of oocytes retrieved per cycle, a lower fertilization rate (45.7% UI/59.8% TI) (P less than 0.01) and no difference in cleavage and nidation rates. However, a decrease in the pregnancy rate/attempt (13.8% UI/19.5% TI) tended towards a significant value (P = 0.06). Although the semen parameters were found to be in the normal range during the previous fertility screening in both groups, the incidence of at least one abnormality (count less than 20 X 10(6)/ml, and/or total motility less than 30% and/or abnormal forms greater than 75%) on the day of insemination was found to be significantly higher in UI (20%) than in TI (11%) patients. Moreover, 25% of UI patients did not fertilize any oocytes inseminated, whatever the number of oocytes retrieved. This rate of failed fertilization was significantly lower (9%) in tubal patients. The oestrogen response profiles were similar in both groups, analyzed according to the stimulation protocols.(ABSTRACT TRUNCATED AT 250 WORDS)

Buserelin↗
PubMed1989

[Use of a technic of bioluminescence for determining estrogens and LH during static and dynamic study of the ovary].

Estrogens and LH are necessary among other assays for ovulation diagnostic and ovarian monitoring during stimulations. They can be both measured with a method based on a bioluminescent reaction. This method measures, with a standard luminometer, the reduced NAD produced and accumulated by the reaction of two dehydrogenase enzymes: the estradiol dehydrogenase for direct assay of estrogens (estrone + estradiol), the glucose-6-phosphate dehydrogenase for gonadotrophin determination. These techniques can be applied to all biological fluids. They are simple and straightforward, do not need extraction and can be automated. Urinary assays are very useful in clinical practice to appreciate ovarian function, either during a spontaneous cycle or under stimulation, and are mandatory to decide the timing of hCG injection. The reported studies can be listed as follows: determination of preovulatory LH rise (LH greater than 10 Ul/g of creatinine) prior to embryo transfer after cryopreservation and thawing, detection of LH surges during ovarian stimulation, either premature surges causing premature luteinization, either normal surges when follicular maturation is adequate (296 cycles), confirmation of pituitary desensitization when using GnRH agonists (43 cycles), study of the initial stimulatory effect of GnRH agonists (13 patients). This effect can be responsible for the inadequate results obtained with the so-called "short protocol" in this experience when compared with the "long protocol" in the author's experience with compared with the "long protocol" (8 p. cent pregnancy rate per stimulation cycle versus 20 p. cent respectively, intrafollicular LH in 129 follicular fluids (86 with GnRH agonists and 43 without) has no correlation with the fecundability of the ovum. These results lead to extend bioluminescent techniques to the study of other parameters, and in particular FSH.

Buserelin↗
PubMed1988

Infection by Mycobacterium avium intracellulare in AIDS: endoscopic duodenal appearance mimicking Whipple's disease.

We report the case of a 24-year-old woman who presented with diarrhea, weight loss and abdominal lymph node enlargement. A diagnosis of infection by Mycobacterium avium intracellulare with a clinical picture similar to Whipple's disease was established. The endoscopic study of the duodenum revealed multiple yellow nodules that became confluent in the second portion, entirely replacing the normal mucosa. These endoscopic findings have not been described previously in intestinal infection by Mycobacterium avium intracellulare.

Acquired Immunodeficiency Syndrome↗