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J Testart

Publications and source records attributed to J Testart.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Manometric study of two Roux-en-Y hepatico-jejunostomy].

The aim of this study was to describe (during the fasting state in two patients the motor activity of the limb in Roux-en-Y hepatico-jejunostomy). In the two patients, the limb was created 15 years and 15 days prior to the study respectively. Recordings were performed with a low compliance pneumohydraulic system below the jejuno-jejunal anastomosis then in the limb. Motor studies in the limb were coupled with recordings carried out in the duodenum. In both patients, the regular occurrence of a typical phase III (PIII) activity was demonstrated in the limb whereas no retrograde or abnormal motor patterns were found. PIIIs in the limb were uncoordinated with duodenal PIIIs. Trimebutine, given intravenously, induced a typical PIII activity in the duodenum and the limb simultaneously. Spontaneous or trimebutine-induced PIIIs in the limb had a slower migration velocity (p less than 0.01) than duodenal PIIIs. Lastly, we were unable to record PIIIs in the distal jejunum below the jejuno-jejunal anastomosis despite the lack of associated abnormal motor patterns. This study demonstrates that a normally propagated PIII activity can be observed in the limb in Roux-en-Y hepatico-jejunostomy immediately or several years after the surgical procedure.

Anastomosis, Roux-en-Y↗
PubMed1990

[Pancreatico-pleural fistula in chronic pancreatitis].

Seven patients presented with a pancreatic pleural fistula in the context of chronic pancreatitis. The diagnosis was made by analysis of the pleural effusion and by endoscopic retrograde pancreatography which opacified the fistula in six cases. Surgical procedure (five resections, one Roux-en-Y drainage and one resection associated with Roux-en-Y drainage) was guided by the morphology of the pancreatic duct and the presence of pseudocysts. All patients were successfully treated by surgery.

Adult↗
PubMed1990

[Cysts of the parathyroid glands. Apropos of 6 cases].

Parathyroid cysts are rare lesions. Pathological examination distinguishes the "true" parathyroid cysts (non functional) most often present and cystic degeneration of a parathyroid adenoma (rare) with clinical or biochemical evidence of hyperparathyroidism. With the increased use of ultrasound and fine needle aspiration biopsies, the diagnosis of these cysts can be confirmed by an elevated parathyroid hormone (PTH) assay. The non-functioning parathyroid cysts can be successfully treated by total aspiration of the cyst fluid. Surgical exploration of all parathyroid glands is the treatment of choice for hyperparathyroidism. The different proposed etiologies for parathyroid cysts are discussed.

Aged↗
PubMed1990

[Constipation symptoms studied by a standard questionnaire and anorectal manometry before and after promontory rectopexy (Orr-Loygue technic) in 25 female patients].

Intractable constipation is frequently observed after rectopexy. The aim of our study was to look for clinical and manometric data, which could help to predict postoperative constipation. Twenty-five consecutive female patients treated by Orr-Loygue rectopexy were asked to answer a standard questionnaire and underwent anorectal manometry pre- and postoperatively. Nineteen patients complained of constipation after surgery. Preoperative constipation was significantly more frequent in patients who complained of postoperative constipation, than in patients who did not. Preoperative colonic transit time study in 8 patients was not useful in predicting postoperative constipation. Moreover, symptoms of constipation were quite similar pre- and postoperatively in the 19 patients complaining of postoperative constipation. Anorectal manometric data were not different between patients who complained of postoperative constipation and patients who did not. Therefore preoperative complaints of constipation are most important to consider before rectopexy.

Adult↗
PubMed1989

[Axillary-distal bypass of the upper limb using in situ veins].

Revascularization of ischaemic upper limbs by means of the patient's superficial veins in situ is a little known technique which has many advantages. Not only is the internal saphenous vein spared, but the technique is easily adaptable to all situations (e.g. length of the bypass, diameter of the arteries).

Arm↗
PubMed1989

Effects of glutathione (GSH and GSSG) and glutathione reductase (GR) on zona-free hamster oocyte ability to decondense human sperm.

Effects of reduced glutathione (GSH), oxidized glutathione (GSSG), or glutathione reductase (GR) supply were studied on the ability of hamster oocytes to be fertilized by human sperm. Zona-free oocytes were pretreated with these compounds prior to sperm insemination. Oocyte pretreatment with high concentrations of GSH or GSSG (50 or 100 mM, 30 min) significantly increased the penetrated oocyte rate (PR). Polyspermy was not increased except when high concentrations of GSH (100 mM) were used. Incubation of oocytes with GR (1 or 10 IU/ml) prior to sperm insemination induced increasing dose-dependent PR. Polyspermy increased significantly with 10 mM GR in oocyte incubation medium. Oocyte incubation for 30 min with the sulfhydryl blocking agent iodoacetamide (1 mM) led to a drastic decrease in oocyte penetration and in polyspermy. Our results demonstrate an original way to increase the efficacy of human-hamster heterospecific fertilization. Various hypotheses are discussed explaining these observations which open new investigations for heterospecific and homospecific in vitro fertilization.

Animals↗
PubMed1989

An obstetric analysis of fifty consecutive pregnancies after transfer of cryopreserved human embryos.

This report describes the obstetric outcome in 50 pregnancies resulting from the transfer of human embryos that had been cryopreserved for up to 2 years. The duration of cryopreservation did not influence the pregnancy rate after thawed embryo transfer. Thirty-one babies have been born from 28 pregnancies and a further seven pregnancies are currently in the second and third trimesters. Twenty-eight percent of the pregnancies failed to progress beyond the first trimester. One pregnancy was terminated at 22 weeks' gestation because of severe fetal malformation. Important antenatal events included premature uterine activity in six patients although only one patient with a singleton pregnancy ultimately was delivered prematurely. Retroplacental hemorrhage occurred in four patients but was of clinical consequence in only one. There was a high incidence of breech presentation at term in singleton pregnancies (12%). The cesarean section rate in this series was 21%. An international registry of cryopreserved pregnancies would facilitate data collection in this relatively new clinical field.

Adult↗
PubMed1989

Endoaortic calcific proliferation of the upper abdominal aorta.

Endoaortic calcified proliferation, also known as coral reef atherosclerosis represents a rare form of atherosclerosis characterized by a gross appearance and location in the thoracic and celiac aorta. We report two new cases of calcified obstruction of the aorta. In the first case, clinical examination revealed hypertension, abdominal angina associated with abdominal bruit, and diminished femoral pulses. The second case was diagnosed postoperatively when intractable hypertension and renal failure ensued following reconstruction of an abdominal aortic aneurysm. Accurate evaluation of lesions was possible through Doppler sonography, CT scan, and aortography. Because of hypertension and visceral ischemia, surgical treatment was required. Hypertension and intestinal angina were completely relieved in the first case, while hypertension and renal failure improved greatly in the second.

Adult↗
PubMed1989

In vivo changes in oocyte germinal vesicle related to follicular quality and size at mid-follicular phase during stimulated cycles in the cynomolgus monkey.

Histological examination of gonadotrophin stimulated Macaca fascicularis ovaries removed at mid-follicular phase showed that germinal vesicles (GV) could exhibit different configurations in follicles greater than 1000 microns in diameter. We describe 3 types of nuclear organization called GV1 (dispersed and filamentous chromatin), GV2 (clumped and filamentous chromatin) and GV3 (perinucleolar chromatin condensation). Gonadotrophin stimulation and follicular atresia induced modifications in GV chromatin dispersion. Such modifications were of a higher degree in the case of atresia which could even induce in vivo germinal vesicle breakdown (GVBD). Our findings were as follows. The frequency of GV1 oocytes was always low, but was higher in healthy than in atretic follicles, whereas GV3 oocytes were more frequent in atretic compared to healthy follicles; the oocytes which resumed meiosis in vitro were most probably those which were at the GV3 stage at the time of recovery; GV nuclear changes were related to follicle size and quality, but not to oocyte size. The mean follicular size increased from GV1 to GV3 oocyte stages whatever the follicle quality; the nucleus was often observed in a peripheral position even in GV1 oocytes; zona pellucida appearance was related to GV stage and follicle quality and was more often observed to be abnormal or absent in case of GV3 oocytes included in atretic follicles. Oocyte nuclear modifications therefore appear to be a prerequisite to resumption of meiosis.

Animals↗
PubMed1989

Utilization of GnRH agonists for poor responders in an IVF programme.

Thirty-four patients in whom conventional ovarian stimulation had previously failed twice due to low levels of oestradiol, received ovarian stimulation by pure FSH for 5 days, followed by a combination of FSH and HMG, after a preliminary period of pituitary de-sensitization with LHRH agonist. Oocytes were recovered from 33 patients and 28 embryos replaced, 10 became pregnant and eight pregnancies were ongoing and resulted in the birth of 13 healthy babies. This ongoing pregnancy rate of 23.5% per treatment cycle is identical to that reported for normally responding patients. The use of LHRH agonists in so-called poor responders is of obvious interest.

Adult↗
PubMed1989

In-vitro processing of sperm with autoantibodies and in-vitro fertilization results.

In-vitro fertilization and embryo transfer were carried out in twenty infertile couples with significant levels of anti-sperm antibodies on the ejaculated spermatozoa. Over 21 cycles (15 couples), 95 mature oocytes were collected and inseminated with spermatozoa obtained by swim-up migration after rapid dilution and washing of the ejaculates. An overall fertilization rate of 38.9% was obtained with these post-migration (PM) preparations. When greater than 70% of the inseminated spermatozoa were covered with both IgG and IgA antibodies, only 14% of the 43 oocytes were fertilized. A higher fertilization rate was obtained with the PM preparations containing less than 70% of spermatozoa coated with one or both classes of antibodies. Under these conditions 60% of the 52 oocytes were fertilized. Fertility rate correlated better with IgG than with IgA antibody levels. In order to decrease the proportion of antibody-coated spermatozoa in the inseminated populations, washed spermatozoa were immuno-adsorbed on Mage's plates before swim-up migration. Over 11 cycles (10 couples) 52 mature oocytes were inseminated with these post-migration immuno-depleted sperm preparations (PMP) containing less than 65% of antibody-coated spermatozoa: 31% of the oocytes were fertilized. This rate compares favourably to IVF results obtained with the PM preparations with greater than 70% of spermatozoa coated with both classes of antibodies. In five couples who had different IVF attempts with the two sperm preparations, the immuno-depletion resulted in a slight increase in the fertilization rates: 10% for the PM preparations versus 26% for the PMP preparations. Sperm binding to the zona pellucida was decreased in the majority of unsuccessful attempts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Influence of different stimulation treatments on oocyte characteristics and in-vitro fertilizing ability.

A retrospective analysis was performed in order to compare the number and quality of oocytes recovered in in-vitro fertilization cycles according to different protocols for ovarian stimulation. Treatments including a gonadotrophin-releasing hormone agonist (GnRHa), either decapeptyl or buserelin, were associated with the recovery of more oocytes (6.0-7.2%) than treatments without GnRHa (3.7-4.8%). However, the mean number of normal embryos per patient yielding oocyte(s) was comparable between cycles stimulated with or without GnRHa (2.4-2.7), except in those cycles programmed with norethisterone and gonadotrophins (1.7). There was no difference in the rates of immature or atretic oocytes between stimulation treatments. Following clomiphene and human menopausal gonadotrophin treatment there was a lower rate of fractured zona oocytes, higher rates of fertilization and normal growth of fertilized eggs than after any other treatment. The proportion of normal embryos per recovered oocyte was inversely related to the degree of ovarian response in most of the stimulation treatments. Most of the abnormal embryos contained more than two pronuclei in cycles without GnRHa administration and exhibited polynucleated blastomeres in cycles treated with buserelin or decapeptyl. In conclusion, the use of GnRHa and gonadotrophins for ovarian stimulation increased the mean number of recovered oocytes, but did not increase the mean number of embryos able to develop.

Adult↗
PubMed1989

Embryo quality and uterine receptivity in in-vitro fertilization cycles with or without agonists of gonadotrophin-releasing hormone.

The proportion of abnormal oocytes or embryos per recovered oocyte in in-vitro fertilization (IVF) cycles had no influence on the occurrence of pregnancy following the transfer of normal embryo(s) derived from oocytes capable of fertilization. There were more implantations per transferred embryo in stimulated IVF cycles using long-acting buserelin (30.0%) compared with short-acting decapeptyl (17.3%) or no gonadotrophin-releasing hormone agonist (GnRHa, 15.2%) treatments. However, the chances of implantation per embryo transferred being in excess of one in patients who became pregnant tended to be higher in non-GnRHa (23.5%) compared to buserelin- (16.4%) or decapeptyl- (13.3%) treated IVF cycles. Moreover, frozen--thawed embryos had a higher implantation rate (P less than 0.05) when originating from IVF cycles without GnRHa (11.7%) compared to GnRHa-treated cycles (buserelin, 4.3%; decapeptyl, 5.9%). It can be concluded that GnRHa associated with gonadotrophins produced embryos of a poorer aptitude for development than stimulation treatments without GnRHa. The clinical efficacy of GnRHa in IVF--ET cycles could be the result of an improved uterine receptivity to the transferred embryos.

Adult↗
PubMed1989

Platelet aggregating activity in human embryo culture media free of PAF-acether.

A factor activating human platelets and liberated by the embryo was sought in the culture media of human embryos using two bioassays. The first bioassay demonstrated the existence of a thrombocytopaenic factor after the i.p. injection of culture media into splenectomized mice. This factor was found more frequently in media which contained an embryo compared to those which contained a non-fertilized oocyte. PAF-acether (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine) was searched for with a specific bioassay, using washed rabbit platelets. This remained negative for all the media studied, including those which had contained an embryo giving rise to a pregnancy. In these experiments it was not possible to relate embryo-derived platelet activating factor (EDPAF) to PAF-acether. Neither were we able to use the detection of EDPAF to test embryonic viability, or attempt to identify those embryos which were susceptible to lead to a pregnancy after intrauterine transfer from among all the embryos transferred.

Animals↗
PubMed1989

Human sperm--egg interactions and their disorders: implications in the management of infertility.

The present era of infertility management is characterized by an increasing interest in defects of sperm--egg interactions. When the spermatozoon meets the egg, it must first react with the enveloping coat which controls sperm access to the cell surface of the oocyte. Adequate sperm motility is a major condition for penetration through the egg investments. The ability of spermatozoa to respond to physiological stimuli by a timely acrosome reaction is another necessary prerequisite for this event, as well as for sperm fusion with the oocyte. The clinical significance of current laboratory tests evaluating different aspects of gamete function is discussed and a practical guide is given for their indication and interpretation and for the use of their results in choosing rational therapy.

Acrosome↗
PubMed1989

[Cystic duplications of the esophagus in adults. Report of 2 cases].

Oesophageal duplications account for less than 10% of the benign tumors of the oesophagus and for 20% of intestinal duplications. They are most often seen during childhood. In the adult it is more often the non communicating cystic forms, which are prone to complication, which have been reported. Cervical localization is rare and up to now no case has been described in the adult. We report here an asymptomatic case. Our second patient, who had a duplication in the mediastinal region, presented with a cough and dysphagia which completely regressed after excision.

Adult↗