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G Body

Publications and source records attributed to G Body.

At least 91 records · Page 5Linked to original sources

[Modeling of feto-placental circulation. Clinical applications apropos of 21 patients having no or inverse diastolic umbilical flow].

The placental resistance index: (S-D)/S (S: represents the amplitude of the systolic peak and D: the amplitude of the telediastolic peak) is constantly inferior to one from the 14th-16th week of amenorrhea during a normal pregnancy. The diastolic umbilical arterial blood flow is continuous because of low placental vascular resistance. From a clinical study of 21 patients with an absent or reversed end diastolic flow in umbilical artery waveforms, an obliterative process in the placental vascular tree was observed. A computer model was used to stimulate the reversed end diastolic flow in umbilical artery waveforms when the placental resistance increased. This haemodynamic approach shows that the placental blood flow decreased, and that the arterial blood pressure, as well as the pulse wave velocity increased when the placental resistance increased. The increase in the difference between the umbilical resistance and the placental resistance caused a reduction of the diastolic flow owing to a progressive increase of the pulse wave velocity reflected. It was concluded that there is a relation between perturbations in placental vascular bed and the flow in umbilical artery waveforms.

Adult↗

[Essential thrombocythemia and pregnancy. A review of the literature].

Essential thrombocythemia is a myeloproliferative syndrome confined to platelet production. Once the character of a megakaryocyte abnormality has been confirmed, the prognosis is good depending on thrombotic and haemorrhagic complications. The authors report the outcome of a pregnancy in a patient who had essential thrombocythemia treated by anti-aggregating drugs from the 10th week of amenorrhoea. In the previous history there were two obstetrical complications of the illness (one spontaneous abortion and one intrauterine fetal death). A caesarean section carried out after 32 weeks of amenorrhoea led to the birth of a baby weighing 1890 gm. Only a few cases have been reported in the literature. There is always a drop in the number of platelets in pregnancy. After delivery the number of platelets becomes pathological within a few weeks. The prognosis for the fetus is linked to the risk of placental thrombosis, not to the numbers of platelets. The problem lies in the choice of indications for the use of acetylsalicylic acid in low dosage, particularly since cases of pregnancy taken to term without any specific type of treatment have been reported.

Adult↗

[Intraepithelial lesions of the cervix uteri and human papillomaviruses: comparative study of histological data and in situ hybridization. Apropos of a series of 77 cervical biopsies].

Seventy seven biopsy samples of cervical mucosa were tested for the presence of human papillomavirus (HPV) by immunohistochemistry and in situ hybridization. From the 38 samples identified as condyloma or cervical intraepithelial neoplasia (CIN), 31 were positive after in situ hybridization and 14 after immunochemical analysis. HPV 6 was found exclusively in condyloma acuminata (2 samples) whereas the HPV 16 probe essentially hybridized with high grade intraepithelial lesions (CIN II, CIN III). Low grade intraepithelial lesions (flat condyloma, CIN I) demonstrated a larger diversity of HPV types (HPV 16, 18, 31, 33). A close correlation was demonstrated between the histologic features of lesions and their HPV 6 or HPV 31 content but not for other HPV types. HPV 31 containing lesions showed a peculiar architecture with numerous, elongated papillae resulting in a spiked appearance.

Biopsy↗

For a systematic policy of i.v. oxytocin inducted placenta deliveries in a unit where a fairly active management of third stage of labour is yet applied: results of a controlled trial.

The authors analysed the effect of the i.v. oxytocin induced third stage of labour in a controlled trial concerning 1000 patients. The appliance of such an policy in a unit that already had a fairly active management of delivery was very encouraging. The incidence of post-partum haemorrhage (greater than 500 ml) is significantly (P less than 0.001) less than in the control group; and the same for severe haemorrhage. The third stage is significantly (P less than 0.001) shorter in the oxytocin-injected group than in the control group. Moreover, there is no significant difference between the two groups for retained placenta. The economy of blood transfusion, which is a major concern nowadays, could be the real interest of this active management of the third stage of labour.

Female↗

Prognostic significance of tumor phosphatidylcholine stearic acid level in breast carcinoma.

The involvement of lipid enzymes in the action of oncogenes at the cell membrane level has suggested that membrane lipids could play a role in modulating the growth of tumors. We previously found that breast cancer patients with a low level of polyunsaturated fatty acids in their primary tumor's phosphatidylethanolamine had a high risk of early occurrence of visceral metastasis. In the present study, we prospectively examined whether fatty acid composition of tumor membrane phosphatidylcholine had a prognostic significance in a series of 63 patients with a localized presentation of breast cancer. Membrane phospholipids were extracted from the carcinoma tissue obtained at the time of surgery, phosphatidylcholine was purified, and its fatty acids were analyzed by capillary gas chromatography. During the follow-up period, 20 patients developed metastasis. In these patients, the proportion of stearic acid containing phosphatidylcholine was significantly lower than it was in the tumors of the 43 patients who remained metastasis-free. Multivariate analysis according to Cox showed that low stearic acid level in tumor phosphatidylcholine and high mitotic index were independently predictive of subsequent metastasis. The predictive value of stearic acid level on metastasis risk was higher in node-positive patients than in node-negative patients, allowing individualization of a subgroup of low stearic acid level, node-positive patients with very poor prognosis. We concluded that stearic acid level in tumor membrane phosphatidylcholine is an independent intra-tumor marker of breast cancer prognosis. This finding is new evidence that tumor's structural lipids are linked to the growth of breast cancer.

Adult↗

Disappearance of the in situ component: a criterion predictive of metastasis in breast cancer after local relapse.

Local recurrence after conservative treatment of breast cancer is associated with a significant risk for metastasis. In order to identify criteria predictive of metastasis in this subset of women, we analyzed a series of 35 patients with local relapse among 512 consecutive patients treated with tumorectomy and radiotherapy. When relapse occurred within 2 years of initial treatment, overall 2-year survival from the time of local relapse was 39.5%. When local relapse occurred more than 2 years from initial therapy, 2-year survival was 80.5% (p < 0.001). Pathological slides of both initial and recurrent tumors were reviewed and compared. In 17 patients, local relapse and initial tumor had the same morphological features, with an in-situ component either absent or present in the same proportion. Metastasis occurred in two of these patients. In contrast, 9 of 12 patients in whom the proportion of non-invasive carcinoma had decreased at the time of local recurrence developed metastasis. Overall 2-year survival from the time of relapse was significantly better in the former group of patients (93.3% versus 52.5%, p < 0.05). We concluded that early relapses have a poor prognostic significance and that disappearance of the in-situ component or increase of the invasive component at the time of relapse is a feature predictive of tumor-related death and that more intensive therapy might benefit to this subset of women.

Adult↗

[Are there still indications for an abdominal hysterectomy? 340 cases].

This retrospective study of 340 hysterectomies carried out abdominally concern cases only where the pathology was benign and strictly limited to the body of the uterus. This has made it possible to review the 240 cases carried out for fibroids (70.6%), 63 for simple endometrial hyperplasia (18.5%), 28 for adenomyosis (8.2%) and 9 for atrophy of the endometrium (2.6%). We looked for lesions that could have been treated laparoscopically among these pathologies: submucous fibroids with a diameter of less than 4 cms and where the uterus was less than 10 cms in height and weighted less than 200 g, simple endometrial hyperplasia (the height of the uterus less than 10 cms and the weight less than 200 g, adenomyosis (uterus less than 10 cms in height and less than 200 g weight), this last criteria still "debatable", We found that 110 lesions were selected because they could have been treated conservatively. This means that 32.5% where there seemed to have been indications for hysterectomy out of 340 cases, could have been treated otherwise. These can be divided aetiologically in to: 54 cases of simple hyperplasia of the endometrium (15.9%), 34 cases with submucous fibroids (10.6%), 26 cases of adenomyosis (5.9%). If the cases of adenomyosis are excluded 90 out of 340 hysterectomies carried out abdominally (about a quarter) could have been treated conservatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

[Primary adenocarcinoma of the fallopian tube. Retrospective study of 16 cases. Prognostic factors].

The authors report the result of a study carried out on 16 cases of tubal adenocarcinoma treated between the years 1975 and 1988. This is a rare gynaecological cancer with a poor prognosis. The mean age of the patients was 57 years, 64.5% of them were menopausal. 25% had had a history of sterility. 29% were nulliparous and 37.5% had previous salpingitis. In 44% of cases the principal clinical signs were a watery discharge and a blood stained discharge. Pelvic pain occurred in 37% of the cases and CT scan showed a pelvic mass in 50% of cases. Hysterosalpingography and ultrasound were two complimentary investigations. The relatively early stage at which first signs of the condition were noted, show the stages of the disease: stage I 68.7%, stage II 25%, stage III 6.2%, stage IV 0%. Surgery above all was the basis of treatment carried out in all cases, and supplemented in 15 out of the 16 cases by added treatment (radiotherapy, chemotherapy of hormone therapy). As far as histology was concerned, well or moderately well differentiated forms were found to predominate (there were 37.5% grade I and 37.5% grade II) against only 26% for grade III. More than half of the tube wall was infiltrated in 50% of cases. The actuarial survival rate after 5 years was 33%. The authors examine the principal factors responsible for the prognosis, the tissue, the early diagnosis and the possibility of removing the tumour completely at the first operation as well as the histological grading and above all the degree of depth of infiltration of the wall of the tube.

Adenocarcinoma↗

Comparative study of the fibrinolytic system in human fetuses and in pregnant women.

Levels of major parameters of fibrinolysis were measured in 50 normal human fetuses between 19 and 39 weeks of gestation and compared to those of 50 healthy normal pregnant women and 30 adult controls. In fetuses, euglobulin clot lysis time (ECLT) was significantly shortened, plasminogen level was low and histidine-rich glycoprotein undetectable. While t-PA and u-PA levels were slightly lower than in adult controls, a significant decrease in PAI activity was demonstrated and no PAI-2 could be detected in fetal plasma. In contrast with these findings, the fibrinolytic equilibrium of pregnant women exhibited a prolonged ECLT and a strong increase in both PAI activity and PAI-2 antigen levels, while only a moderate elevation in u-PA and t-PA levels was measured.

Adult↗

[Prognostic value of local recurrence after conservative treatment of cancers of the breast ].

To determine the prognostic significance of local relapse after conservative treatment of an invasive carcinoma of the breast, we analysed the results obtained in a series of 512 patients. All patients had a lumpectomy with axillary dissection followed by irradiation. Adjuvant medical treatment was administered to 168 patients. The actuarial 5 years and 10 years overall survival rates were respectively 92.5% and 79.7%. Local relapses occurred in 35 patients (6.8%). The actuarial 5 and 10 years local control rates were respectively 91.2% and 83.6%. In these patients, risk of metastasis was significantly increased as compared with patients without a local relapse. Recurrence in the breast within 2 years of initial treatment several affected the risk of metastasis occurring as compared to later relapses. We conclude that the occurrence of a breast relapse after successful local conservative treatment is a bad prognostic factor, predictive of a high risk for the development of distant metastases.

Adult↗

[Reinhardt-Pfeiffer mesomelic dysplasia or dyschondrosteosis? Is the distinction well-founded? Apropos of a familial case with variable expression].

A familial observation of Reinhardt-Pfeiffer type mesomelic chondrodysplasia spanning three generations is reported. This case clearly shows that expression of the disease can vary widely within a given family. One member affected as a fetus had a severe form suggesting Langer mesomelic dwarfism syndrome, whereas his mother was free of clinical symptoms and his maternal aunt had a typical form of Reinhardt-Pfeiffer syndrome. Clinical manifestations in the other affected family members were perfectly consistent with dyschondrosteosis syndrome. The very broad spectrum of clinical patterns in this family suggests that there may be connections between the various types of mesomelic dysplasia. Establishing clear-cut distinctions between these entities, although useful in practice, may not accurately reflect molecular anomalies. Furthermore, the family member affected as a fetus also had Turner syndrome, which may have contributed to the severity of his condition. The possibility of identifying severe mesomelic dysplasias antenatally by ultrasonography should be pointed out.

Acrocephalosyndactylia↗

[Adenocarcinoma of the endometrium. The role of vaginal brachytherapy in the therapeutic sequence].

Surgery is the traditional treatment for endometrial carcinoma stage I and II. Radiotherapy is given to improve local control rate. Vaginal vault curietherapy can reduce vaginal recurrences rate. Chronology of curietherapy (pre or post operative) is under discussion. We have retrospectively analyzed treatment results of patients treated either with pre operative curietherapy (60 Gy) and then radical hysterectomy with bilateral salpingo oophorectomy (RH-BSO) (group 1), or with RH-BSO and then vaginal curietherapy (60 Gy) (group 2). Patients with bad prognostic factors (grade 3 and deep tumor invasion into the myometrium) received pelvic external irradiation and were excluded. 121 patients were in group 1, 63 patients were in group 2. All patients received curietherapy using Cesium 137 sources (one uterine and two vaginal sources in group 1, three vaginal sources in group 2). Total dose delivered to the reference volume was 60 Gy. Doses delivered to some reference points (vagina, rectum, bladder, pelvic wall) were calculated according to the ICRU recommendations. Surgery was at least RH-BSO performed either before or after curietherapy. 82 patients in group 1 and 44 in group 2 had a pelvic lymphadenectomy. Curietherapy data were comparable in the two groups according to the dose distribution to the vagina, rectum and bladder. Reference volume was smaller in the group 2. Local failure rate was 13% in group 1 and 10% in group 2. Distant metastases rate was 12% in group 1 and 9% in group 2. Five year actuarial survival rate was not statistically different between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗