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Biomedical subjects

J Leveque

Publications and source records attributed to J Leveque.

At least 19 recordsLinked to original sources
PubMed2006

[Subtotal hysterectomy: evolving concepts with implications for practice].

INTRODUCTION: The advantages and drawbacks of total and sub-total hysterectomy remain a topic of debate. Our study reviews the literature concerning recent comparative and prospective studies regarding the options of total and subtotal hysterectomy. RESULTS: Subtotal hysterectomy may be useful in preventing severe complications when total hysterectomy is technically difficult. Furthermore, conservation of the uterine cervix may decrease vaginal erosion in genital prolapse repair when synthetic meshes are used. The type of technique does not appear to determine the persistence or development of problems related to sexual activity (frequency of intercourse, sexual desire, and achievement of orgasm). There are no apparent advantages to subtotal hysterectomy compared with total hysterectomy with respect to bowel or bladder function. Some women (5-20%) who had the subtotal procedure continued to have genital bleeding, although this can be avoided with endocervical electro-coagulation or resection. Cervical stump prolapse is uncommon (1.5-2%), 12 months after subtotal hysterectomy. The risk of carcinoma of the cervical stump is low, and treatment results are similar in both patients with carcinoma of the cervical stump and in patients with carcinoma of the intact uterus. CONCLUSION: When subtotal hysterectomy is necessary, it can be performed with a low rate of long term complications. Furthermore, for women undergoing hysterectomy for benign disease, it should be reasonable to discuss advantages and drawbacks of both procedures and offer a choice. Nevertheless, sub-total hysterectomy should be avoided in populations with restricted access to screening programs for cancer of the uterine cervix.

Female↗
PubMed2002

Assessing the transfer of pentachlorophenol through soil columns using 13[C]isotope.

The transfer of organic pollutants was studied through soil columns using 13[C]-labelled pentachlorophenol (PCP) as a model compound. The organic carbon content and the 13[C]/12[C] ratio were measured in two soil sections, 0-3 cm and 3-6 cm, and in percolated water using an Elemental Analyser coupled with a Magnetic Mass Sector. The mass balance of carbon was evaluated and the amount of PCP was calculated in each compartment of the soil-water systems. The results show that more than 80% of the PCP-derived 13[C] remained in the upper layer of the soil column. Approximately 20% was transferred to the lower soil layer, and less than 1% was found in the water leachates. The 13[C]-labelled tracers may thus be used as an alternative to radioactive compounds to follow the fate of organic pollutants in soil and water under field conditions.

Carbon Radioisotopes↗
PubMed1998

Molecular components of striatal plasticity: the various routes of cyclic AMP pathways.

Neuroplasticity serves an important role for normal striatal function and in disease states. One route to neuroplasticity involves activation of the transcription factor cyclic 3', 5'-adenosine monophosphate (cyclic AMP) response element binding protein (CREB) by phosphorylation of the amino acid 133Ser. Dopamine and glutamate, the two predominant neurotransmitters in the striatum, induce CREB phosphorylation in primary cultures of rat striatum through cyclic AMP and Ca2+ pathways. Here we present the role of N-methyl-D-aspartate receptors and Ca2+ in cyclic AMP-mediated CREB phosphorylation.

Animals↗
PubMed1997

Preoperative color-Doppler assessment of vascularisation of the rectus abdominis: anatomic basis of breast reconstruction with a transverse rectus abdominis myocutaneous flap--a prospective study.

The unipedicled TRAM flap is an useful alternative to breast reconstruction after mastectomy in patients who refuse mammary implants. There is however the risk of unpredictable partial skin necrosis even after rigorous surgical procedures. Certain authors have proposed color flow doppler assessment before reconstructive surgery better to identify the vascular network and optimise patient selection. We performed a prospective study in 20 outpatients in order to compare preoperative assessment of the blood supply to the abdominal flap with the operative findings. An Ultramark 9 HDI (Advanced Technology Laboratories) equipped with a high frequency (10 Mhz) linear probe was used to measure blood flow and vessel caliber in the epigastric a. and perforating vessels (localisation, number; peak flow). Despite three limiting factors (anatomic, technical, morphologic) the results obtained in this series could be used to determine the indications for a TRAM flap.

Female↗
PubMed1997

[Uterine leiomyosarcoma. Nine case reports, review of the literature].

OBJECT OF THE STUDY: To evaluate management and outcome of the treatment of uterine leiomyosarcoma. PATIENTS AND METHODS: Retrospective study of a series of 9 patients treated for uterine leiomyosarcoma in this hospital from 1982 to 1994. RESULTS: The condition is rarely suspected preoperatively, diagnosis is usually made on histological examination of the operative specimen. The outcome is related to the mitotic activity of the tumour and to the infiltration of nearly structures. Surgery is the only effective treatment, chemotherapy is ineffective, adjuvant radiotherapy improves local control of the tumour but has no incidence on survival. CONCLUSION: In the absence of an effective adjuvant treatment uterine leiomyosarcoma bears a poor prognosis with the only exception of small non infiltrating tumours with a low mitotic activity.

Adult↗
PubMed1996

[Müllerian mixed tumors. Experience of the Rennes Regional University Hospital].

Seventeen cases of mixed Muller tumours (tumours of the uterus with malignant epithelial and mesenchymal components) are presented. These recently described tumours are rare and occur in menopaused women. Bloody discharge is the usual clinical manifestation, together with an increase of the volume of the uterus. Pathology examination of the surgical specimen is required for diagnosis using immunolabeling to distinguish between homologous tumours (the sarcomatous component occurs in the primary mesenchyma) and heterologous tumours (the mesenchymatous component results from a metastasis). Prognosis, usually poor, depends on the stage of the tumour. Overall survival at 5 years is about 30%. Survival in early stage I and state II tumours is no greater than 50% at 5 years. Treatment is based on radiosurgical techniques in less advanced tumours and requires radiochemotherapy in more advanced stage tumours. Recurrence is usually seen within 2 years, involving the pelvis alone in 10% of the cases and metastasis in most of the others. Because of their rapid development and poor prognosis, these tumours should be identified separately as a separate entity within a larger group of mixed mesodermic tumours.

Aged↗
PubMed1995

Per operative localization of a carcinoid tumour of the breast using indium-111 pentetreotide and a nuclear surgical probe.

A 69-year-old woman presented with a single enlarged lymph node in the left axilla. Clinical examination and other investigations, including various imaging methods, failed to reveal the primary tumour. However, indium-111 pentetreotide scan revealed a site of uptake in the anterior region of the left thorax. Peroperative imaging with 111In-pentetreotide confirmed the tumour uptake and use of a nuclear surgical probe allowed precise localization of the tumour, which was completely resected.

Aged↗
PubMed1994

[Breast reconstruction in Poland syndrome. Apropos of 9 cases].

The authors describe their experience of breast reconstruction in Poland's syndrome and analyse 9 cases (eight females, one male) between 1981-1991. The mean age was 25 years (17-53 years). Three women were operated by the Mouly-Dufourmentel surgical procedure: translation of the homolateral latissimus dorsi muscle flap with a mammary prosthesis. The muscle flap was used alone in the male. Mammary prostheses were performed alone in four other women. Breast asymmetry was corrected by mammaplasty alone in one woman. In three cases, in order to achieve optimal symmetry, the controlateral ptosed hypertrophic breast was corrected (two cases in the same procedure, one case later). In three cases, a nipple-areolar restoration was performed at the patient's request. These results are analysed with an average follow-up of 5.4 years (2-11 years) and are compared to the literature data.

Adolescent↗
PubMed1994

[Pregnancy in the uterine horn after total salpingectomy].

The authors report a case of pregnancy of the uterine horn occurring after total salpingectomy, i.e. including resection of the intramural portion of the tube. They identify the epidemiological, pathophysiological and clinical features of this complication with the help of a review of the literature of cases occurring after partial salpingectomy and total salpingectomy. They discuss the usefulness of resection of the interstitial portion of the tube and feel that prophylactic cesarean section is justified in patients who have remained fertile.

Adult↗
PubMed1990

Nonsurgical management of breast infections in nonlactating women. A word of caution.

UNLABELLED: Management options for infectious mastitis have traditionally been limited to surgical drainage. With the advent of percutaneous fine needle aspiration (FNA), nonoperative treatment may be an alternative, though criteria for use have not been defined. During a 30-month period, 22 women presented with breast infection. Treatment was instituted based upon the clinical stage of infection. Patients with cellulitis (n = 8) were managed with diagnostic FNA/antibiotics. Those with focal abscess (n = 10) underwent FNA of the cavity/antibiotics. Patients with multiloculated abscess (n C = 3) underwent urgent surgical drainage. Of the 19 patients initially treated nonoperatively, resolution occurred in nine (47%); stage of infection did not effect outcome. Surgical drainage was required in the remainder; two cancers were found. FNA cytology in these (and all) patients was negative for malignancy. All underwent mammography during treatment. In 17 (77%) cancer was considered of low probability. The only patient with a mammogram highly suspicious for cancer had fat necrosis on biopsy. Bacterial cultures were positive in 79 per cent, virtually all with Gram (+) cocci. Four patients harbored Gram (-) organisms as well, two in concert with breast cancer. CONCLUSIONS: 1) select breast infections can be successfully managed nonoperatively, 2) the accuracy of FNA and mammography in the diagnosis of breast cancer may be impaired by coincident infection, 3) the finding of a Gram (-) breast infection warrants abandonment of nonoperative management in favor of tissue confirmation of the disease process.

Abscess↗
PubMed1989

[A new case of cystic lymphangioma of the pancreas].

The authors describe a new case of cystic lymphangioma of the pancreas treated surgically by cephalic duodeno-pancreatectomy associated with right hemicolectomy. Following a review of the literature, they recall the anatomo-pathological and clinical characteristics of vascular connective tissue tumors of the pancreas. From a therapeutic viewpoint, they conclude on the necessity for complete removal of these unusual tumors, either by tumor resection or by appropriate pancreatic resection, which are the only guarantees of a definitive curve.

Abdominal Pain↗
PubMed1987

Proton NMR examination of tumor cells of high or low metastatic potential.

Three rat 13762NF mammary adenocarcinoma clones and cell lines of different metastatic potentials (MTLn3, MTC, and MTPa) were studied for their proton nuclear magnetic resonance spectral characteristics as intact cells in vitro and after chloroform/methanol, neuraminidase, or ethanol treatments. The intact-cell spectral characteristics of the highly metastatic tumor cell clone MTLn3 were clearly distinguished from the less metastatic clone MTC or the parental MTPa cell line on the basis of spectral peaks in the range of 0.9 to 1.45 p.p.m. broad peaks near 2.0 p.p.m., and peaks in the range of 2.75 to 3.2 p.p.m. Glycoproteins are among the molecules known to have resonances in these upfield spectral regions, and these tumor cell subpopulations have previously been shown to possess characteristic quantitative differences in cell surface, metastasis-associated glycoproteins. Treatment of the cells with neuraminidase or ethanol, or extraction with chloroform/methanol increased spectral detail and also revealed characteristic differences in spectral peaks between the tumor cell subpopulations. The identity of the cellular components responsible for these spectral characteristics are unknown, but some clearly arise from differences in the extractable lipids present in the tumor cell subpopulations. Further study will be required to determine if the spectral differences described in this preliminary report are directly related to the known biochemical characteristics of the highly metastatic clone, and if the observations have general relevance to metastatic potential or are a singular feature of these cells. However, these initial results suggest that manipulation of factors which allow unmasking of spectral detail combined with the use of prescribed tumor cell subpopulations may aid in using proton NMR to identify and define biochemical or structural differences related to the metastatic potential of tumor cells.

Adenocarcinoma↗