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Biomedical subjects

F Forestier

Publications and source records attributed to F Forestier.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Diffusion of pefloxacin in the aqueous humor and crystalline lens after repeated oral administration in man].

The intraocular penetration of pefloxacin was evaluated in 38 patients undergoing extracapsular cataract extraction. Patients were treated for three days with 400 mg of pefloxacin every twelve hours (the first dose being 800 mg). The mean maximum concentration of pefloxacin reached six hours after the last dose in the aqueous humor was 7.69 +/- 3.50 mg/l and reached twelve hours after the last dose in the lens was 4.59 +/- 3.15 micrograms/g. Antibiotic levels were measured by high performance liquid chromatography. Several doses until plasma steady state were effective in obtaining a higher level than a single dose of 400 mg. The ratio between aqueous humor and serum concentrations ranged between 0.50 and 0.89 (mean 68%). These concentrations in aqueous humor were higher than the MIC90 of pefloxacin for most bacterial pathogens involved in endophthalmitis 24 hours after the last dose.

Administration, Oral↗
PubMed1991

Erythropoietic progenitor cells in human fetal blood.

Ultrasound guided fetal blood sampling performed for diagnostic purposes allowed us to determine the circulating level of erythropoietic progenitor cells (BFU-E) from the 19th to 30th weeks of gestation. Normal fetal blood showed a mean of 160 BFU-E (+/- 107) per 10(5) nucleated cells during the second and third trimesters of pregnancy, which is 3 times higher than in cord blood at birth and 10 times higher than in adult bone marrow. These findings are in keeping with an important circulation of hematopoietic progenitors during fetal life.

Adult↗
PubMed1990

Fetal platelet counts in thrombocytopenic pregnancy.

Fetal platelet counts were assessed by percutaneous umbilical blood sampling in 64 pregnancies (62 women) with maternal thrombocytopenia. In 33 pregnancies associated with chronic immune thrombocytopenia, 11 of the fetuses had platelet counts below 150 x 10(9)/l and 4 were severely thrombocytopenic (less than 50 x 10(9)/l). In 31 pregnancies with symptomless maternal thrombocytopenia as an incidental finding, 4 fetuses were thrombocytopenic, 1 of them severely. Maternal indices, including antiplatelet antibodies, did not correlate with risk of fetal thrombocytopenia; and in those with repeat measurements there was no evidence of benefit from treatment with either corticosteroids (4 cases) or intravenous immunoglobulin (3 cases). Percutaneous umbilical blood sampling, a safe procedure in experienced hands, provides accurate platelet counts in thrombocytopenic pregnancy, as an aid to decisions on mode of delivery and to assessment of treatments.

Blood Specimen Collection↗
PubMed1990

Toxoplasma gondii infection during pregnancy: T lymphocyte subpopulations in mothers and fetuses.

Prenatal diagnosis of fetal toxoplasmosis is possible with the use of fetal blood sampling, amniocentesis and ultrasound examination. The purpose of this study was to describe T lymphocyte subsets (CD3, CD4 and CD8) in mothers and their fetuses when Toxoplasma gondii infection occurred during pregnancy. Maternal and fetal blood samples were obtained in 86 cases and 9 fetuses showed T. gondii infection. Control groups consisted of 30 healthy nonpregnant women and 30 pregnant women. Pregnant women with T. gondii infection showed an increase in the suppressor (CD8) T subpopulation and a significant depression in the total helper (CD4) T cells. These alterations were more important in mothers whose fetus was infected. We showed the progressive maturation of the fetal immune system with a regular increase of all T lymphocyte subsets. Marked alterations were observed in the 9 infected fetuses (depression of CD4 population and lower CD4/CD8 ratio). In the future these differences might be used as a new marker of the severity of fetal lesions and become a useful diagnostic tool.

CD4-Positive T-Lymphocytes↗
PubMed1990

Presence of gamma interferon in human acute and congenital toxoplasmosis.

The production of gamma interferon in acute acquired and congenital toxoplasmosis was studied. Gamma interferon was produced at significant titers (P less than 0.001) in the course of both congenital toxoplasmosis and acquired toxoplasmosis at an early stage of infection, when Toxoplasma gondii was multiplying. Its presence in fetal blood was correlated with the positive inoculation of fetal blood or amniotic fluid into mice (95%). The data suggest that the fetus is able to synthesize gamma interferon as early as week 21 of pregnancy. This test, easily and rapidly performed, could be included among those useful for diagnosing fetal toxoplasmic disease.

Acute Disease↗
PubMed1990

Some new quantitative aspects of fetal erythropoiesis.

Ultrasound guided fetal blood sampling performed for diagnostic purpose has allowed us to determine the evolution of normal hematological parameters i.e. all nucleated cells, red blood cells, platelets, hemoglobin, mean corpuscular volume in 2,680 normal fetuses from the 18th to the 30th week of gestation. Differential blood counts were estimated. We determined normal circulating level of erythropoietic progenitors cells, which is three times higher than in cord blood at birth. Erythropoietin levels were very low and were not modified during the second and the third trimester of pregnancy. All these new data reveal fundamental quantitative differences in the hematopoietic system of fetal on adult subjects.

Blood Cell Count↗
PubMed1990

Prenatal diagnosis in type IIA von Willebrand disease.

A prenatal diagnosis for fetal disease was performed at 20 weeks gestation in a severely affected patient with type IIA von Willebrand disease. In the fetal cord blood sample obtained under ultrasound guidance, the level of von Willebrand ristocetin cofactor activity was similar to that of von Willebrand factor antigen, and all the multimers were present. These results were compared to those obtained in 51 normal fetuses of similar gestational age (19-21 weeks). Normal fetuses showed slightly lower levels of von Willebrand factor than normal adults and in addition to all adult multimers, the presence of unusual large forms. This data compared with the case, allowed the exclusion of the diagnosis of type IIA von Willebrand disease in our patient's fetus. This was confirmed at birth in the cord blood.

Adult↗
PubMed1990

[The passage of fluoride across the placenta. An intra-uterine study].

Until now, transplacental passage of fluoride could only be checked during delivery. Recent developments in fetal blood sampling techniques in utero have made it possible to study its passage in pregnancy. Two tablets of 2.212 mg of sodium fluoride (Zymafluor) were given to 11 women with an average age of 27 1/2 years whose pregnancies on an average had lasted 22 weeks. They were having prenatal diagnosis by ultrasound guided fetal blood sampling in any case. The levels of fluoride were measured by the use of a specific electrode before the mother took fluoride and 40 minutes after she had taken it in both maternal and fetal blood samples. The results were compared with a controlled group of 11 pregnant women with similar characteristics: maternal age, duration of pregnancy and basal maternal fluoride levels. Fetal blood levels of fluorides in mothers who had taken sodium fluoride was statistically higher than in the controlled group (2.6 mumol/l and less than 1 mumol/l); this demonstrates in a statistically significant way that fluoride passes across the placenta in the fifth and sixth months of pregnancy which is the time when the milk teeth start to develop in the uterus.

Adult↗
PubMed1990

[Torpid endophthalmitis in pseudophakia: diagnostic and therapeutic difficulties. Apropos of 4 cases].

The authors report four cases of chronic endophthalmitis following extracapsular cataract extraction with intraocular lens implantation in the posterior chamber. The first attack of intraocular inflammation occurred in the form of recurrent iridocyclitis two to six months after surgery. The first attack usually responded well to local corticosteroids. After many relapses of inflammation, increasingly resistant to medical treatment, a severe attack occurred leading to the decision to treat such endophthalmitis surgically: endocular fluid aspiration, vitrectomy, intraocular injection of antibiotics combined with systemic antibiotics and corticosteroids. It may be very difficult to prove the infectious origin of torpid endophthalmitis. Growing bacteria from endocular fluid aspirates is much more difficult than in acute endophthalmitis. No organisms were found in this series by this method, despite the fact that fluid aspiration was often performed many times in these 4 cases. A bacterium was identified in 3 cases, twice on the implant itself and once after culture of an iridectomy specimen. Intraocular antibiotic injections resulted in the complete recovery of one patient. Following failure of standard treatment, intraocular lens explantation resulted in the disappearance of infectious inflammatory signs in 3 cases. The treatment of chronic endophthalmitis is governed by the same rules as acute endophthalmitis but is not always as successful. Intraocular lens removal is often the only solution and confirms the pathogenic hypothesis that slime production by organisms, their adherence to the intraocular lens and their quiescent state make them less vulnerable to antibiotics and host defences.

Aged↗
PubMed1989

Corticosteroid sulfates in fetus plasma.

The sulfates of deoxycorticosterone (DOCS), corticosterone (BS), cortisone (ES) and cortisol (FS) were radioimmunoassayed in umbilical vein blood plasma samples collected in 97 fetuses between 19 and 32 weeks of gestation after extraction and chromatography on Sephadex LH 20 columns. While DOCS and BS displayed a decreasing pattern until 27-28 weeks, FS and ES did not show important variations throughout the period considered. All sulfates, excepted BS, increased at 29-30 weeks but this rise was only significant for FS and ES. Thereafter BS significantly increased while no significant difference could be displayed for the three others. In view of the difference between the patterns of 17-deoxy- and 17-hydroxycorticosteroids, one can speculate that, during this period of pregnancy, a shift in steroid biogenesis might occur towards a more important production of cortisol. DOCS was correlated with BS and with FS but not with ES. FS was correlated with the three other sulfates and with unconjugated F. ES was correlated with BS and FS but not with DOCS or unconjugated E. The significance of these correlations are discussed according to the origin and the metabolic interrelationships of the four steroid sulfates and unconjugated F and E.

Adrenal Cortex Hormones↗
PubMed1989

Fetal toxoplasmosis: outcome of pregnancy and infant follow-up after in utero treatment.

Eight-nine cases of fetal Toxoplasma infection are reported in women treated with spiramycin during pregnancy. Thirty-four pregnancy terminations were performed (2.7% of the total number of acquired Toxoplasma infections during pregnancy). Fifty-two pregnancies were allowed to proceed (43 being additionally treated with pyrimethamine and sulfonamides), leading to the birth of 54 live infants. After a mean follow-up period of 19 months, 41 infants had evidence of subclinical Toxoplasma infection, 12 had a benign form, and one had severe congenital toxoplasmosis (this infant did not receive the additional treatment during pregnancy). Efficacy of the additional treatment with pyrimethamine and sulfonamides was demonstrated by a significant reduction of severe congenital toxoplasmosis and the relative decrease of the ratio of benign to subclinical forms. We recommended that spiramycin treatment be started as soon as possible once the diagnosis of maternal Toxoplasma infection during pregnancy is proved or strongly suspected, because a prolonged time interval between onset of infection and start of treatment seems to be associated with the presence of severe fetal lesions at the time of prenatal diagnosis.

Female↗
PubMed1989

Prenatal diagnosis of HIV infection: two attempts using fetal blood sampling.

Blood samples were studied, prior to medical terminations of pregnancy, in two second trimester fetuses with HIV-positive mothers. Fetal blood was obtained from the umbilical vein under ultrasound guidance. No evidence of infection was found in either fetus. In particular, lymphocyte subpopulations were at normal levels and cultures yielded no reverse transcriptase activity. Postmortem findings were normal. Reliable means for prenatal diagnosis of HIV infection, with a minimal risk of false-negative results, have yet to be developed. However, further studies using fetal blood sampling should be useful for the management of HIV-positive pregnancies.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Placental transfer of vitamin K1 and its implications in fetal hemostasis.

Vitamin K status was evaluated using coagulation studies and/or vitamin K1 assays in a total of 53 normal fetuses and 47 neonates. Second trimester fetal blood samples were obtained for prenatal diagnosis under ultrasound guidance. Endogenous vitamin K1 concentrations (determined by high performance liquid chromatography) were substantially lower than maternal levels. The mean maternal-fetal gradient was 14-fold at mid trimester and 18-fold at birth. Despite low vitamin K levels, descarboxy prothrombin, detected by a staphylocoagulase assay, was elevated in only a single fetus and a single neonate. After maternal oral supplementation with vitamin K1, cord vitamin K1 levels were boosted 30-fold at mid trimester and 60-fold at term, demonstrating placental transfer. However, these levels were substantially lower than corresponding supplemented maternal levels. Despite elevated vitamin K1 concentrations, supplemented fetuses and neonates showed no increase in total or coagulant prothrombin activity. These results suggest that the low prothrombin levels found during intrauterine life are not due to vitamin K deficiency.

Female↗
PubMed1988

Prenatal management of 746 pregnancies at risk for congenital toxoplasmosis.

When infection with Toxoplasma gondii occurs during pregnancy, there is a risk that the parasite will cause severe congenital toxoplasmosis. We developed a method of diagnosing and treating congenital toxoplasmosis in utero. Diagnosis was based on the identification of maternal acute infection, followed by culture of fetal blood and amniotic fluid, testing of fetal blood for toxoplasma-specific IgM and nonspecific measures of infection, and ultrasound examination of the fetal brain. Treatment included the administration of antibiotics to all mothers with confirmed acute infection during pregnancy, with more intensive antibiotic treatment of those who had infected fetuses and who chose to continue the pregnancy. We report a prospective study of 746 documented cases of maternal toxoplasma infection, in which the infants were followed for at least three months. Infection was diagnosed antenatally in 39 of 42 fetuses. Twenty-four of the 39 pregnancies were terminated, and 15 were continued. All the mothers were treated with spiramycin throughout pregnancy; if fetal infection was demonstrated, pyrimethamine and either sulfadoxine or sulfadiazine were added to the regimen. Of the 15 fetuses with congenital toxoplasmosis who were carried to term, all but 2, who had chorioretinitis, remained clinically well during follow-up. We conclude that prenatal diagnosis of congenital toxoplasmosis is practical and that prenatal therapy in women who wish to continue their pregnancies reduces the severity of the manifestations of the disease.

Abortion, Induced↗
PubMed1988

Fetal curarization for prenatal magnetic resonance imaging.

Fetal magnetic resonance (MR) imaging was performed at 33 weeks of gestation for investigation of a posterior fossa abnormality found at ultrasound screening. Fetal movements were abolished by vecuronium injected under ultrasound guidance into the umbilical vein. MR images showed atrophy of the left cerebellar lobe with cisternal dilatation. These were confirmed postnatally by CT scan.

Adult↗
PubMed1988

Prenatal diagnosis with biotinylated chromosome specific probes.

We have used a Y-chromosome specific DNA probe in a controlled study to determine the presence of Y-chromosome material and to detect numerical abnormalities in uncultured amniotic fluid cells by fluorescent hybridization. Using this non-radioactive method, we correctly predicted fetal sex within 48 h in all but 3 of 54 cases and identified an XYY syndrome. The technique was previously tested with no false-positive or false-negative results on cultured interphase or metaphase nuclei of fetal fibroblasts and adult T-lymphocytes. Fluorescent in situ hybridization was applied to long-term fixed cytogenetic preparations up to 44 months old and was shown to be reliable.

Amniocentesis↗