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Biomedical subjects

G Body

Publications and source records attributed to G Body.

At least 127 records · Page 7Linked to original sources
PubMed1989

Doppler assessment of the intracerebral circulation of the fetus.

Fetal cerebral arteries have been explored during normal pregnancies (n = 40). The index of cerebral resistance (Rc) as defined by Pourcelot (Rc = (S-D)/S where S is the systolic amplitude and D is the diastolic amplitude) shows variations similar to the placental index (Rp). During normal pregnancy, the cerebral index is higher than the placental index and the cerebro-placental ratio (Rc/Rp) is greater than one. This preliminary study of the umbilical and cerebral circulation during 21 pathological pregnancies with hypertension seems to demonstrate that when fetal growth retardation is also present (n = 6) either or both of the indices Rc and Rp may be outside the normal range but the cerebro-placental ratio (CPR) is always less than one. However, a larger number of patients needs to be explored in order to evaluate the clinical usefulness of such an observation.

Adult↗
PubMed1989

[Sarcoma of the endometrium. Epidemiology and prognostic factors. Apropos of a study of 22 cases].

Endometrial sarcomas (sarcomas of the endometrial stroma and mixed mullerian tumors) are rare tumors with a bad prognosis. Because of our experience in treating these tumors we have been able to make an analysis of epidemiology and the prognostic factors. We have treated 22 patients. The mean age was 61 years. There were 15 stage I, 3 stage II, 2 stage III, and 2 stage IV. 21/22 patients had a surgical resection of the primary tumor, 19/22 had pelvic irradiation after surgery with vaginal radiotherapy given for 14 patients. The actuarial survival rates at 3 and 5 years were 51 and 34%. 5/22 patients had pelvic recurrence, 6/22 had distant metastasis. In our study the prognostic factors were the stage and the histological subtype. Pelvic radiotherapy seems to improve the rates for survival. The main points for discussion are the need to have a definite histological diagnosis done after initial surgery. A CT scan of the lungs and a lymphangiogram must be performed before treatment. After surgery it appears necessary to give pelvic and vaginal radiotherapy. At the present time chemotherapy did not appear to improve survival.

Adult↗
PubMed1989

[Carcinoma of the cervical stump. Retrospective analysis of 43 cases].

Seven to eight percent of cervix carcinomas are carcinomas of the cervical stump. The prognosis for these tumors has sometimes been considered more unfavourable than that for carcinomas on intact uterus. From 1976 to 1986 we treated 43 patients with carcinoma of the cervical stump. The mean age was 63.6 years. Staging system used was FIGO classification modified according to the criteria of Institut Gustave Roussy in Villejuif. There were 12 stage IB, 12 early stage II, 5 late stage II and 14 stage III. Twenty-four centropelvic tumors (IB and early stage II) were treated with radiotherapy and surgery, 2 with surgery alone and one with radiotherapy alone. Late stage II and stage III tumors were treated with radiotherapy alone (+ hysterectomy for two patients). Local control rate was 83% for centropelvic tumors and 53% for late stage II and stage III. Seven patients developed distant metastases. Uncorrected 5-year actuarial survival rate was 78% for centro-pelvic tumors and 46% for late stage II and stage III. Three patients developed severe complications (grade 3). Prognostic factors were: stage, nodal status and pathological status of the cervix after radiotherapy. For the same stage the results were similar to those observed for carcinomas on intact uterus treated at our institution during the same time period.

Adult↗
PubMed1989

[Risks of medical complications inherent in technics of assisted procreation (excluding legal incidences)].

Although in France the law is still relatively poor in matters concerning complaints against medical people for accidents and incidents in connection with assisted reproduction, it appeared to the authors that it would be interesting to examine the subjects. There is some French and Anglo-saxon literature about the matter so that the circumstances that can be dangerous for the patients as well as well as for the doctors carrying out the processes can be listed in connection with the medico-legal field. When the legal cases in connection with the manipulation of gametes and of embryos have been excluded, there only remain the risks linked to the complications of the various techniques of assisted reproduction. These include those in connection with induction of ovulation and ovarian hyperstimulation. After having made a list of the risks in connection with In-Vitro Fertilization, with G.I.F.T. and with the various technique similar to it, such as artificial insemination donor, the authors suggest the steps that can be taken to prevent these medical complications and their eventual medico-legal repercussions. These consist of good organisation and improving the facilities dealing with assisted reproduction. The personnel should be well trained, as much information as possible should be given to the patients so that they give informed consent, whether exploratory procedures are being carried out or they are being treated with hormones, or having such manipulations as are necessary to obtain the desired pregnancy for them.

Female↗
PubMed1989

[Carcinoma of the cervix stages Ib, II, III. Results of treatment and prognostic factors. Retrospective analysis of 396 cases].

Between 1976 and 1986 we have treated 396 patients with carcinoma of the uterine cervix, stages Ib, II and III. The mean age was 54.2 years. The staging system used was the FIGO classification, modified according to the Institut Gustave-Roussy criteria. There were in stage Ib 117 cases, in early stage II 124 cases, in late stage II 63 cases and in stage III 92 cases. Treatment methods used were radiotherapy and surgery combined for localised pelvic lesions (stage Ib and stage II) and radiotherapy alone for those cases that were central and going out to the side wall of the pelvis (late stage II and stage III). The actuarial five-year survival rate was 91% for stage Ib, 67% for early stage II, 48% for late stage II and 28% for stage III. The main causes of failure were recurrence in the pelvis in 15% of treated areas and distant metastases in 13%. The state of the lymph nodes was another prognostic factor but the histological subtype and age were not. 7% of cases had severe complications (urinary, digestive and lymphatic).

Carcinoma↗
PubMed1988

Levels and plasma distribution of free and C4b-BP-bound protein S in human fetuses and full-term newborns.

Levels and plasma distribution of protein S were measured on umbilical cord plasmas from 25 normal full-term newborns and 25 normal fetuses which were between 20 and 31 weeks of gestation. Fetal blood samples were obtained by direct puncture of the umbilical vein under high resolution real-time ultrasound. Total and Free protein S levels were found to be lower in all fetuses and newborns as compared to normal adults. The calculated ratio Total protein S/Free protein S and crossed immunoelectrophoresis patterns indicate that protein S circulates essentially in the free form in fetuses and newborns. These data may be explained by the low levels of C4b-binding protein observed at these stages of development.

Adult↗
PubMed1988

Fetal cerebral circulation assessment by Doppler ultrasound in normal and pathological pregnancies.

During normal pregnancies (n = 40) the cerebral index (Rc = S - D/S) (with S = systolic and D-telediastolic amplitudes) is always higher than the placental index (Rp), and the cerebro/placental ratio (Rc/Rp) greater than 1. Of 29 pregnant women with hypertension (including two twins), 17 delivered normally (Rc, Rp and CPR normal), 14 delivered an hypotrophic fetus, in 12 out of these 14 pregnancies one of the two indices (Rc or Rp) was abnormal and the cerebro/placental ratio, CPR, was always less or equal to 1. CPR sensitivity was 86% the specificity 100%. In 11 pregnancies with idiopathic fetal-growth retardation, the CPR was less or equal to 1 in eight cases (73% of the cases), and greater than 1 in three cases (three false-negative results).

Cerebrovascular Circulation↗
PubMed1987

[Doppler examination of the umbilical arteries. Its role in the surveillance of pregnancy].

Pregnancies with a high risk of fetal growth retardation are at present watched by using clinical observations and biological parameters including ultrasound and estimation of the fetal heart rate. The Doppler waveform in the umbilical arteries provides information about circulatory resistance in the placenta. An index of resistance "R" is evaluated on the Doppler trace. The purpose of this study is to describe the score (with its possibilities and limitations) for this parameter "R" to follow-up pregnancies with fetal growth retardation and to compare it with ultrasound, biological and clinical parameters that are commonly used. Two groups of pregnancies have been explored: pregnancies with hypertension and pregnancies with idiopathic fetal growth retardation. Abnormal values of "R" correlate well with failure of fetal growth. Furthermore pathological values of "R" do not correspond to the same population as abnormal values of the other parameters. In some cases "R" is disturbed before the others are. In conclusion, this study shows that the index increases the accuracy of detection and the follow-up of chronic fetal growth retardation, particularly in cases of pregnancies with vascular placental pathology.

Birth Weight↗
PubMed1987

[Doppler examination of the umbilical and cerebral arterial circulation of the fetus].

Umbilical circulation can be explored by Doppler ultrasound methods very easily. The umbilical arteries spectrum provides information on the placental circulation. The diastolic flow is directly related to the vascular resistances of the placenta (Rp). In cases of pathological pregnancies with hypertension the decrease in the diastolic flow and the increase in the resistance index Rp have been correlated with intra-uterine fetal growth retardation. The specificity of this index Rp is of 95% but the sensitivity much more lower (approximately 70%). For that reason Doppler assessment of the fetal circulation in other areas has been recently carried out. Fetal cerebral arteries have been explored during normal pregnancies. The index of cerebral resistances as defined by Pourcelot Rc = S-D divided by S (with S systolic amplitude and D diastolic amplitude) show similar variations to the placental index but later in the pregnancy. During the pregnancy the cerebral index is higher than the placental one and the cerebro placental ratio (CPR) superior to 1. During pathological pregnancy (hypertension) with fetal growth retardation one of the index Rc or Rp may be out of the normal range but the cerebro placental ratio CPR is always lower than 1. The follow up of both the umbilical and cerebral circulation increases notably the accuracy of the Doppler method for the detection of intra-uterine fetal growth retardation.

Cerebrovascular Circulation↗
PubMed1987

[Primary pulmonary sarcoma with spindle-shaped cells. Apropos of a case].

Primary pulmonary sarcoma is a very rare malignant tumour. The authors report a case of a fusiform cell sarcoma simulating a pulmonary metastasis in a woman who previously had a mammary carcinoma. Lymph node invasion is rare. The nature of the tumour was confirmed by histology and aided by immunochemistry or electron microscopy. The primary origin of the tumour can only be confirmed after negative results from careful examination of the marrow, the gastro-intestinal tract, the genito-urinary system and above all the uterus. The prognosis depends on the size of the tumour and the mitotic score. Surgery is the only curative treatment.

Breast Neoplasms↗
PubMed1987

[Cutaneous angiosarcoma of the breast following surgery and irradiation of breast adenocarcinoma].

We are reporting a localised skin angiosarcoma of the breast. As far as we can tell this is only the fourth time this condition has been published. The tumour appeared 6 years after a conservative lumpectomy with removal of lymphatics and follow-up radiotherapy had been carried out for an adenocarcinoma of the breast. This tumour was characterised by the presence of several round blue-coloured nodules in the skin with some inflammation surrounding them. The glandular tissue underneath was normal, as was the opposite breast, and there was no spread. The patient was pyrexial and a syndrome of inflammation persisted until the tumour had been removed by a simple mastectomy. We have discussed the clinical and histological aspects of this case and compared them with those found in the literature. Differential diagnosis with in particular Stewart-Treves syndrome has been emphasized. The treatment consists in wide excision and sometimes followed by radiotherapy or chemotherapy. The prognosis is very poor, survival never having been more than 22 months. Finally the role of irradiation in the causation of this tumour has been discussed. (Our patient is alive after 2 years without any sign of a recurrence).

Adenocarcinoma↗
PubMed1986

[Acute fatty liver of pregnancy].

The authors analyse 115 cases of acute fatty liver of pregnancy, proven histologically. Characteristics of the condition is the finding of central nuclei in the hepatocytes containing microvesicular droplets. The disease occurs more frequently in primiparous women (54 per cent) and usually occurs in the third trimester of the pregnancy. A pre-icteric phase usually precedes the jaundice and during that time there is usually vomiting and/or nausa with abdominal pain or anarexia. In 92 per cent of case there is transient loss of consciousness with hepatic encephalopathy. Further tests show that there is more defective liver function than would be expected from the extent of cell lysis; and there is defective renal function. The worst complications are intestinal haemorrhages (48 per cent of cases)--genital bleeding (43 per cent of cases)--shock--diffuse intravascular coagulation and complications associated with coma. Maternal mortality at present runs at 25 per cent and fetal mortality at 60 per cent. The condition does not recur. Early evacuation of the uterus is recommended by most authors and does probably improve the outlook. The various hypotheses concerning the aetiology are discussed.

Acute Disease↗
PubMed1986

[Postoperative vaginal pseudosarcoma. Apropos of a case].

We report a case of a pseudosarcoma in the scar of an anterior repair operation. The possibility that the lesion could be sarcomatous was raised by the histologists and by the appearance on the hysterogram of a filling defect in the fundus of the uterus which resembled a sarcomatous lesion. The patient was treated by external irradiation and total hysterectomy and colpectomy. The tumour belonged to that entity that is known under the name of "post-operative pseudosarcomatous nodule". The characteristics, clinical and histological, should be better known so that this mistake is not repeated. The treatment is just simple excision.

Aged↗
PubMed1986

[Effect of the etiology of sterility on the results of tubal microsurgery].

The authors have carried out a prospective study from the 1 January 1977 to the 31 December 1981 on 168 women, 89.3% of whom (150/168) had pure distal tubal microsurgery and 10.7% (18/168) had mixed surgery. The results were studied in relationship to the aetiological reason for tubal sterility, which was: salpingitis in 60 cases = 35.7%; appendicitis in 23 cases = 13.7%, endometriosis in 29 cases = 17.3%, termination of pregnancy in 22 cases = 13.1% and unknown causes in 34 cases = 20.2%. The figures for intra-uterine pregnancies were 32.74% after 24 months using a classical method of determining it and 31% using an actuarial method. There was a significant difference between endometriosis and the four other aetiologies. These latter could not be differentiated between one another. The level of ectopic pregnancies was 5.3% at 24 months, or 6.3% using an actuarial method. It was higher after endometriosis. It would therefore appear from the results of this study that endometriosis seems to be poor from a prognostic point of view when compared with the other aetiological causes and the results shown in the literature. Finally the authors discuss in cases of endometriosis whether it is correct to carry out a second operation after the first or to resort to the other possibility, namely in vitro fertilisation.

Adult↗