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Biomedical subjects

J L Voluménie

Publications and source records attributed to J L Voluménie.

7 recordsLinked to original sources
PubMed2002

[Isolated antenatal pyelic dilatation: postnatal follow-up and care for vesico-ureteral reflux].

OBJECTIVE: To assess the risk of aneuploidia in case of isolated antenatal pyelic dilatation and to detail urological care for these children. METHODS: Prenatal and postnatal follow-up was analyzed in 350 cases. RESULTS: The overall rate of chromosome anomalies was 1.3%. Trisomy 21 was found alone in one case (0.3%). The sex ratio was 26% girls and 74% boys. Vesico-ureteral reflux was similar in both sexes (13%). CONCLUSION: The question of proposing karyotyping in case of isolated pyelic dilatation remains unsolved because minimal subjective signs such as slightly excessive amniotic fluid can completely change the assessment of the risk of aneuploidia. The frequency of postnatal vesico-ureteral reflux associated with prenatal pyelic dilatation warrants complete prenatal ultrasound screening.

Adult↗
PubMed2001

Neonatal group B streptococcal infection. Results of 33 months of universal maternal screening and antibioprophylaxis.

OBJECTIVE: To assess the efficacy and pitfalls of a protocol of generalized screening for group B Streptococcus (GBS) and intra-partum treatment of all carriers in a clinical setting. DESIGN: A descriptive study and comparison with an historical group. SETTING: A tertiary perinatal center. POPULATION: All women attending prenatal care in our center and delivered after 37 weeks were eligible. Study period ranged from January 1994 to September 1996. Comparison group consisted in deliveries of years 1992 and 1993. METHODS: Vaginal cultures were performed at 36 weeks on non-selective medium followed by intra-partum treatment of all carrier mothers. Rate of carriage, incidence of neonatal GBS sepsis, influence of risk factors and the reasons for failures were analysed. Comparison was made with an historical group. Statistical analysis was performed using a Chi-square test. RESULTS: There were 5374 term deliveries during the study. 3906 were screened (72.7%) and 559 of them found positive for GBS (14.3%). We observed 46 early-onset GBS diseases (0.86% of term-births). 43.5% of infections occurred in babies born from mothers without risks factors at delivery. Negative GBS cultures at sampling accounted for 43.5% of protocol failures. Comparison of the incidence of early-onset GBS disease with the previous two years showed a significant drop (1.45-0.86%, P<0.05). CONCLUSIONS: Our protocol revealed feasible and effective in reducing the incidence of early-onset GBS disease. Improvements must be studied particularly as to the predictive value of screening cultures.

Amoxicillin↗
PubMed2001

Failure of cervical fibronectin to predict premature delivery in a population of monofetal pregnancies with idiopathic preterm labor.

OBJECTIVE: The purpose of the study was to evaluate the correlation between the presence of cervical fibronectin in a high-risk population of women with symptoms of preterm labor and the occurrence of preterm delivery or the need for aggressive tocolysis. STUDY DESIGN: One hundred and thirty women presenting with symptoms of threatened preterm labor were included. Cervical sampling for detection of fibronectin was performed on admission and every day until discharge or delivery. Time to delivery, length of hospital stay, use of indomethacin, delivery before 37 weeks of GA, mean term of delivery and failure of tocolysis to prevent delivery were compared to fibronectin test results. Data were analyzed using Student's t-test for continuous variables and the chi(2) test or Fisher exact test for discrete variables. RESULTS: No correlation could be found between the results of fibronectin cervical sampling on admission and any of the outcome parameters studied. Test performances were low (sensitivity 28%, specificity 57%, positive predictive value 19%, negative predictive value 69%). Results were not modified when the findings of repeated tests were taken into account. CONCLUSION: Cervical fibronectin failed to discriminate a subgroup of symptomatic women delivering prematurely. The prognostic value of fibronectin testing was not better than clinical data in our series. This observation is in disagreement with previous studies on the diagnostic value of vaginal or cervical fibronectin in preterm labor.

Cervix Uteri↗
PubMed2001

Biochemical investigation of foetal and neonatal thyroid function using the ACS-180SE analyser: clinical application.

Despite sonographic detection of foetal goitre, uncertainty persists in the initial diagnosis of thyrotoxicosis and hypothyroidism. The aim of this study was to establish foetal and neonatal iodothyronine and thyrotrophin reference values for the ACS-180SE analyser. From 22 to 36 weeks of gestation, median foetal serum free thyroxine (FT4) levels increased from 6.0 pmol/L to 143 pmol/L, while free tri-iodothyronine (FT3) levels increased from 0.7 pmol/L to 1.9 pmol/L and mean thyrotrophin (TSH) levels remained stable (10.2 +/- 3.8mU/L; n = 33). At birth, concentrations were independent of gender and gestational age. Among the 10 cases of sonographically detected foetal goitre, serum TSH and FT4 were measured in five, showing hypothyroidism (3/5) or hyperthyroidism (2/5). Cord blood TSH levels reflected the efficacy of prenatal therapy. Measurement of foetal FT4 and TSH can be used to confirm foetal thyroid dysfunction, whereas treatment efficacy can be assessed sonographically and confirmed by measurement of TSH assay at birth.

Female↗
PubMed1998

[Indications for axillary node dissection in breast cancers].

Axillary lymph node dissection is in theory of both therapeutic and prognostic benefit for patients with breast cancer. For several authors, its therapeutic function, which consists in surgical dissection of potentially metastatic nodes, may be assured effectively by radiotherapy, but results of different comparative studies are contradictive. However, axillary dissection should be eliminated for small tumors (< 5 mm) because of the low yield of positive nodes (< 3%). Even if new histologic prognosticators are currently in evaluation, axillary node stagging is the single most important prognostic variable, and determines the indication for chemotherapy for premenopausal patients. Morbidity remains high, even if rarely severe, and new technologies are studied to try to locate the first node draining the tumor, in order to pick it out electively for histologic examination.

Axilla↗
PubMed1997

Induction of transient murine T cell anergy by a low molecular weight compound obtained from supernatants of human placental cultures is linked to defective phosphorylation of TCR CD3 chain.

PROBLEM: Allopregnancy induces specific transient tolerance to paternal grafts, and we know that a low molecular weight material ("filtrate") present in a human placental supernatant can do so in vitro (specific unresponsiveness) as well as in vivo, such as when preventing graft-versus-host reaction (GVH) produced by A cells injected into irradiated A x B F1s recipient. We also know by studies carried out using specific anti-V beta-specific stimulation as well as secondary and primary mixed lymphocyte reaction in major histocompatibility complex (MHC) only incompatible combinations that the material acts by inducing T cell anergy rather than clonal deletion. We explored the mechanism of such an anergy, which we know was not dependent on calcium fluxes, cyclic adenosine monophosphate (cAMP) levels, or PkC by studies of protein phosphorylation. Having observed in previous studies that expression of T cell reactivity (TcR) in anergic cells was enhanced, but that the numbers of cells expressing a given reactivity (TcR) V beta after specific stimulation in the presence of a filtrate was much higher than it should be, we monitored the receptor expression by fluorescence-activated cell sorter (FACS). METHOD OF STUDY: We used short-term stimulation of the T-cell-derived Jurkat E6-1 cells by anti-CD3 monoclonal antibody (mAb) or phorbol myristite acetate plus calcium ionophore in the presence or absence of human placental low molecular weight suppressor factors, followed by Western blotting. Transfer on nitrocellulose filters so as to allow the revelation of the phosphorylations was realized by means of a specific antiphosphotyrosin mAb. The final revelation was obtained by chemiluminescence. Similar experiments were performed on anti-V beta-stimulated BALB/c splenocytes, as well as cyproflaxin-treated cells, which are hyper-responsive in cell proliferation assays in the presence of the filtrate. In parallel, cells that were stimulated by a specific anti-V beta and were rendered specifically anergic were studied by a specific anti-V beta and were rendered specifically anergic were studied for other TcR expression using an FACS and both fluorescein isothiocyanate (FITC) and phycoerythrin (PE)-labelled, related and unrelated anti-V beta mAbs. RESULTS: The phosphorylation of the zeta chain homodimer quantitatively defective in filtrate-treated, anti-V beta 6-stimulated splenocytes as well as in Jurkatt cells. In parallel, cells from cyproflaxin-treated Jurkatt cells were showing enhanced phosphorylation of all bands. The labelling of filtrate-treated anti-V beta 6-stimulated cells by an unrelated anti-V beta (anti-V beta 8) showed double expression of V beta chains. The percentage of cells expressing this unrelated V beta (V beta 8) was normal. CONCLUSIONS: T cell anergy induced by a filtrate is linked to defective phosphorylation of the zeta-chain homodimer. The abnormal percentage of the cells expressing TcR after filtrate treatment might be due to adsorption by unstimulated cells of soluble TcR V beta-chain, possibly as a result of excess synthesis followed by membrane protease cleavage, allowing release in a soluble form of TcR V beta-chain nonspecifically captured by other cells.

Animals↗