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F De Bruyne

Publications and source records attributed to F De Bruyne.

17 recordsLinked to original sources

An application of linear output error modelling for studying lymphocyte migration in peripheral lymphoid tissues.

Lymphocyte recirculation between lymphatic and blood vessels and migration through tissues are essential mechanisms underlying immunological surveillance. However, the kinetics of lymphocyte migration through lymphoid tissues remains poorly understood. The present study of lymphocyte migration, based on a sheep model and entailing the long term cannulation of blood vessels and lymphatic vessels efferent from lymph nodes, represents the first attempt to apply control engineering based models to overcome some of the experimental impediments to understanding the complex phenomena involved in lymphocyte migration. An output error model order (1,2,nk) was systematically selected under given criteria from four classes of Linear Time-Invariant Single-Input Single-Output, (LTI-SISO) systems to represent the peripheral lymph node system. The unit impulse responses were simulated under noise free conditions and their features were extracted to describe the dynamics of the system. The findings from this study revealed novel information about several aspects of the dynamics of lymphocyte migration.

Animals↗

Modelling of peripheral lymphocyte migration: system identification approach.

This is the first application of the prediction error method (PEM) of system identification to modelling lymphocyte migration through peripheral lymphoid tissue. The PEM was applied to the emergence of labelled lymphocytes from the efferent lymphatic of a lymph node following their intravenous administration. Advantages of PEM included the capacity to calculate the response to a unit impulse stimulus, unavailable to direct observation, and to allow for the return to the node of labelled cells that had already recirculated once. Calculation of the system delay (time between introduction of cells into the blood and their first appearance in lymph) indicated 4.67 +/- 1.05 h for the total lymphocyte population. The peak in efferent lymph occurred at 11.91 +/- 4.68 h, much earlier than previous reports, which were affected by cells that had already recirculated. While 75% of labelled cells had emerged in efferent lymph by 20.77 +/- 5.62 h, 86.38 +/- 29.44 h was required for 100% emergence. The considerable heterogeneity in migratory behaviour is likely to reflect frequency and duration of binding of lymphocytes by dendritic cells in paracortical cord corridors. It is proposed that differences in the speed with which lymphocytes pass along corridors depend on their functional status, in particular whether they are naïve or memory cells.

Animals↗

Hysteroscopy in infertility--diagnosis and treatment including falloposcopy.

Diagnostic hysteroscopy should be included routinely in the work-up of invasive examinations for infertility patients. Anyhow, one can rarely expect to find the definite underlying reason for infertility. In infertile patients about 20% of hysteroscopic examinations show some grade of intrauterine abnormalities. Congenital uterine malformations are the most frequently found disorders. In the group of patients with habitual abortions abnormalities are found much more often and can also be more often interpreted as the mainly underlying factor for the repeated abortions. Operative hysteroscopy has become the surgical method of first choice for the treatment of uterine septa, submucous myomas, polyps and synechia. After septum dissection results are excellent. Myoma removal also shows beneficial effects on fertility; nevertheless, cases are not too frequent among infertility patients. In cases of high-grade Asherman's syndrome, the prognosis after hysteroscopic surgery is still often poor.

Abortion, Habitual↗

A decade of salpingoscopy.

With the introduction of the salpingoscopy of the tubal ampullary mucosa in the 1980s, this diagnostic endoscopic examination not only disclosed an exciting world of sharp and detailed in vivo images of the actual site of human fertilization. Its systematic use in the assessment of the tubal factor in subfertile couples also provides specific, clinically relevant and prognostically valuable information, since it clearly demonstrates the presence or absence of anatomical distortions, especially adhesions between and destruction of mucosal folds, on a micro-endoscopic, i.e., mucosal level. The routine salpingoscopy of a free, patent tube is easy to perform and the procedure then takes about 10 min for both sides. In contrast with hysterosalpingography, a proximal (e.g., tubocornual or isthmic) block does not prevent us from examining the ampullary mucosa with the salpingoscope, whereas a small incision at the site of the occlusion with one of the techniques of operative laparoscopy, enables the inspection of the mucosa of a hydrosalpinx. With salpingoscopy, and using a simple classification system, a trained endoscopist can evaluate the sequelae of tubal inflammatory disease and their impact on fertility nearly as efficiently as with mucosal microbiopsies and they can direct their patients accordingly, either towards reconstructive (micro)surgery or towards medically assisted reproduction. In case of a tubal pregnancy, the effort to salpingoscopically evaluate both the affected and unaffected side may help to understand the underlying ethiology of the ectopic. Since patency and a normal appearance of the fimbriated end surely do not imply the absence of endoluminal pathology, it is advisable to select only salpingoscopically normal tubes to perform tubal transfers of gametes, zygotes or embryos. In the still ongoing discussion regarding preventive salpingectomy prior to IVF-ET in case of a uni- or bilateral hydrosalpinx, blind victimization of the Fallopian tube can in our opinion be avoided by a proper endoscopic selection of cases.

Endoscopy↗

Interstitial pregnancy treated with local and systemic methotrexate.

We present a case of an intact interstitial pregnancy at 6 postmenstrual weeks and 4 days, which was successfully treated by combined local and systemic methotrexate administration. The embryonic cardiac activity stopped within 1 min after uneventful ultrasound-guided puncture and methotrexate instillation of the chorionic sac. While the beta-hCG serum values returned to normal 59 days after local, and 52 days after systemic treatment, the echogenic lesion has reduced in size by 50%, but is still sonographically detectable 7 months after the procedure. This report shows that medical treatment of interstitial pregnancy may be an effective alternative to the surgical approach.

Adult↗

The prognostic value of salpingoscopy.

Salpingoscopy enables the visual inspection of the ampullary mucosa during either laparotomy or laparoscopy. This prospective study correlates the salpingoscopic results with the postoperative pregnancy rates and evaluates the value of salpingoscopy against already existing classification systems. A total of 226 women diagnosed as having pelvic inflammatory disease were treated by microsurgery. There were no other causes of infertility in these patients. The collective was divided into patients with pure adhesive disease and those with supplementary distal tubal occlusion. Salpingoscopy was performed at the end of a microsurgical laparotomy. All laparotomies were performed between 1989 and 1992. The occurrence of pregnancy was checked after 42 months follow-up. A correlation between salpingoscopy and the American Fertility Society classification for each tube is discussed. The crude and cumulative intrauterine pregnancy rates are reported for the two patient groups.

Female↗

Metastatic choriocarcinoma in a postmenopausal woman.

Trophoblastic disease is usually related to pregnancy and occurs in about 1 in 1300 pregnancies in Western countries. Since the advent of methotrexate therapy, trophoblastic tumors have become one of the most curable malignancies. Trophoblastic disease can develop independently of gestation, but this is very rare. We report the unusual case of a 58-year-old woman who had a metastatic choriocarcinoma 6 years after menopause and 29 years after her last pregnancy. The tumor proved to be primarily resistant to monochemotherapy and developed chemoresistance to three different polychemotherapeutic regimens. Eleven months after the diagnosis of uterine choriocarcinoma the patient died from advanced metastatic disease.

Choriocarcinoma↗

[Hysteroscopic resection of submucous myoma].

Between 1988 and 1991, 39 patients with intrauterine submucous fibroids were treated at the University of Düsseldorf, Department of Gynaecology and Obstetrics, by hysteroscopic resection. Myoma diameter ranged from 1 cm to 6 cm with a median of 2.6 cm. 29 patients had bleeding problems in form of meno-metrorrhagia; 14 patients suffered from infertility, 2 patients were treated by combined transabdominal-transcervical approach because of multiple myomata. One severe intraoperative complication occurred as an uterine perforation with injury to the small bowel. No other complication was seen. All patients with bleeding problems returned to normal menses after the operation. Four women became pregnant, one had an early abortion, one an ectopic pregnancy, two women delivered at term. Hysterectomy could be avoided in all cases.

Adult↗

[Pregnancy after combined microsurgical and hysteroscopic surgical procedure in a patient with uterus septus and vagina septa].

Disturbances in the development of the Müllerian duct system may cause different forms of genital anomalies. We report on a patient with uterus septus and vagina septa, undiagnosed for years, and consequently successfully treated for infertility, who became pregnant immediately after combined microsurgical and operative-hysteroscopic treatment. The pregnancy proceeded without any complications. The patient delivered a healthy girl in the 41st week of gestation.

Adult↗

[Experience with hysteroscopy or ultrasound-controlled removal of an intrauterine spiral with no visible thread in early pregnancy].

In case of intrauterine pregnancy with an intrauterine device (IUD), it is recommended, to remove the device because of the risk of abortions or septic complications. If the thread of the IUD is not visible, which often occurs because of growth of the uterus in pregnancy, it is advisable, to perform extraction by hysteroscopy or ultrasonic guidance. We report on 13 cases with hysteroscopic or ultrasonic guided IUD extraction in early pregnancy. 11 resulted in healthy infants, two pregnancies are continuing without complications.

Female↗

The clinical value of salpingoscopy in tubal infertility.

A specially designed rigid salpingoscope has been developed to allow inspection of the tubal mucosa during laparoscopy. The presence and extent of intratubal adhesion formation can be evaluated more accurately by this technique than by either HSG or laparoscopy. In 22 patients with bilateral hydrosalpinges, an intrauterine pregnancy rate of 59% was achieved in the group of patients with very mild mucosal lesions and absence of mucosal adhesions.

Fallopian Tubes↗