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Biomedical subjects

J Testart

Publications and source records attributed to J Testart.

At least 145 records · Page 8Linked to original sources
PubMed1989

[Severe lower gastrointestinal tract hemorrhage in adults. Apropos of 38 cases].

Retrospective study of 38 cases of serious intestinal or rectal hemorrhage in the adult occurring between 1974 and 1987 demonstrated a wide variety of lesions responsible. Malignant tumours (21%) and ischemic lesions (13%) were most often implicated. Colonic diverticulosis and angiodysplasia were each responsible for 8% of cases. The most effective means of exploration were rectosigmoidoscopy and coelio-mesenteric arteriography together with per-operative endoscopy. The diagnosis remained uncertain in only 8% of cases. Treatment was essentially surgical (32 patients). Post-operative mortality (26%) was high, in keeping with the severity of the lesion responsible for the hemorrhage. Serious lower intestinal hemorrhage requires a two-fold management: the institution of intensive care resuscitation and as soon as the patient state permits, etiological investigation. After recto-sigmoidoscopy, which generally allows lower intestinal hemorrhage to be eliminated, arteriography and per-operative colonoscopy have in our experience a high diagnostic yield in cases of persistent hemorrhage. Where bleeding stops spontaneously, colonoscopic examination, after suitable preparation, remains a worthwhile investigation.

Adolescent↗
PubMed1988

Human sperm injection into the perivitelline space (SI-PVS) of hamster oocytes: effect of sperm pretreatment by calcium-ionophore A23187 and freezing-thawing on the penetration rate and polyspermy.

Calcium-ionophore A23187 and freezing-thawing were used as sperm treatments before human sperm injection into the perivitelline space (SI-PVS) of hamster oocytes. The penetration rate (PR) was higher when SI-PVS was performed with calcium-ionophore-treated (28%) or frozen-thawed (51%) sperm than with untreated sperm (8%). Optimal PR occurred when five calcium-ionophore-treated (57%) or frozen-thawed (71%) sperm were injected under the zona pellucida. When the sperm:egg ratio was 1:1, PR was higher for calcium-ionophore-treated (18.5%) or frozen-thawed (27.8%) sperm than for untreated sperm (0.0%). Calcium-ionophore sperm treatment had no effect on the polyspermic oocyte rate (POR) or the mean number of swollen sperm nuclei per penetrated oocyte (Pd) or per injected sperm (SR). This may result from premature oocyte activation induced by Ca-ionophore. However, POR was higher with frozen-thawed (74%) than with untreated (50%) or Ca-ionophore-treated (50%) sperm. Whatever the sperm treatment, there was a trend toward a lower SR as the number of injected sperm increased. Cytoplasmic regulation of polyspermy in the hamster oocyte is discussed.

Animals↗
PubMed1988

A gonadotropin-releasing hormone agonist and an activator of protein kinase C improve in vitro oocyte maturation in Macaca fascicularis.

Cynomolgus monkey oocytes were recovered from follicles greater than 1,000 microns in diameter at day 8 in gonadotropin-stimulated cycles and cultured in vitro for 2 days. Germinal vesicle breakdown (GVBD) occurred in 30.3% of control oocytes (n = 76) compared with 54.0% and 55.0% of oocytes cultured in presence of a gonadotropin-releasing hormone agonist (GnRHa), Buserelin (n = 50), or a protein kinase C activator, 1-oleoyl-2-acetyl-racglycerol (OAG, n = 40), respective (P less than .01). As similar results were obtained using OAG or Buserelin, we hypothesize that the action of Buserelin upon the primate oocyte is protein-kinase-C dependent. The possible effects of Buserelin on in vivo oocyte maturation have to be determined.

Animals↗
PubMed1988

Rectal peptic ulceration--a rare cause of rectal bleeding. Report of a case.

Analysis of the 27 cases of heterotopic gastric mucosa reported in the literature and a new case described here elucidates the main features of this disease: 1) all but one asymptomatic case were diagnosed in infants or in adults under 26 years old; 2) although rectal bleeding occurred in 24 patients, rectal peptic ulceration was found in only 13; 3) six of the patients also had rectal duplication; and 4) 19 times the limited extension of the heterotopic gastric mucosa was compatible with a complete excision by a transanal approach.

Adolescent↗
PubMed1988

Evidence for an adverse effect of elevated serum estradiol concentrations on embryo implantation.

Multiple follicular stimulation for IVF may be associated with greatly elevated serum E2 concentrations that are presumed to be antinidatory. This factor was analyzed in 825 consecutive embryo transfer cycles. The pregnancy rate decreased significantly after the transfer of one and two embryos in association with preovulatory E2 levels greater than the 90th percentile for the group (2320 pg/ml). The pregnancy rate did not vary with preovulatory E2 concentration following the transfer of three embryos. Highly significant correlations were noted between preovulatory E2 and early luteal phase concentrations of E2 and P. In a subgroup of 245 cycles, there were no significant relationships between implantation and early luteal phase levels of P or the ratio of E2/P. There was a small but nonsignificant tendency for the pregnancy rate to decrease in association with raised luteal E2. It is concluded that excessive E2 levels at the time of ovulation induction with hCG had an adverse effect on implantation when one or two embryos are transferred, but this may be overcome by the transfer of three embryos. The consequences for embryo transfer are discussed.

Embryo Implantation↗
PubMed1988

Results of in vitro fertilization with embryo cryopreservation and a recommendation for uniform reporting.

The analyzed data from 295 cycles in which certain embryos were frozen demonstrate a comparable aptitude for development of embryos either fresh or frozen-thawed in cycles yielding four or more embryos. This supports the clinical advantage of freezing certain embryos in this situation. However, there was no advantage in freezing embryos if only one to three were available in the IVF cycle. A formula is proposed to give the current outcome and to compare the success rate of IVF-ET according to various parameters, including the policy for embryo cryopreservation. This formula enables all teams to present their data in an identical manner.

Embryo Transfer↗
PubMed1988

An assessment of alternative policies for embryo transfer in an in vitro fertilization-embryo transfer program.

Conventionally, in in vitro fertilization (IVF) programs, all embryos obtained up to three are freshly transferred in the IVF cycle and supernumerary embryos frozen if cryopreservation facilities exist. This study was concerned with assessing alternative policies for embryo transfer (ET). When three or fewer embryos were obtained in the IVF cycle, fresh embryo transfer was either excluded (group I, n = 69) or only one embryo was immediately transferred (group II, n = 46), the remainder being transferred after freezing and thawing. The pregnancy rate in these two policies was compared to that in a control group of patients (group III, n = 115) in whom all the embryos were transferred in the IVF cycle. The ongoing pregnancy rate was similar in all three groups. No multiple pregnancies occurred in groups I and II compared with one in the controls. The consequences of these policies for pregnancy rates and the incidence of multiple gestation are discussed. It is concluded that the deliberate limitation of fresh ET to a maximum of one embryo followed by one or more cycles of thawed frozen ET is not detrimental to the pregnancy rate and is less likely to be associated with multiple gestations. Conversely, this policy increases the workload of the laboratory staff and raises certain ethical questions.

Chorionic Gonadotropin↗
PubMed1988

Comparison between flare up and down regulation effects of luteinizing hormone-releasing hormone agonists in an in vitro fertilization program.

Luteinizing hormone-releasing hormone (LH-RH) agonists are being increasingly used in ovulation stimulation protocols in IVF programs. The results of two methods of utilization of LH-RH agonists are compared. In the long protocol, gonadotropin stimulation was commenced only after a preliminary period of pituitary desensitization with LH-RH agonist. In the short protocol, exogenous gonadotropins were administered shortly after the start of LH-RH agonist therapy, benefiting from the gonadotropin flare up effect. One hundred eighty-six patients were equally divided between the two treatments. There was no difference in the ovarian response on the day of human chorionic gonadotropin (hCG) or the number of mature oocytes recovered. The cleavage rate of mature oocytes was higher in the short protocol (70% versus 56% P less than 0.01). The ongoing pregnancy rate per treatment cycle was similar in both groups (18% in the long protocol and 16% in the short protocol). Analysis of the luteal phases revealed a trend for higher progesterone values in the long protocol although this was only significant on the 2nd day following oocyte retrieval. As the clinical results were similar, other factors should be taken into account when deciding therapy. These include patient convenience, cost, and side effects. Other schedules of ovulation stimulation with LH-RH agonists are discussed.

Adult↗
PubMed1988

Selective oocyte retrieval: a new approach to ovarian hyperstimulation.

Selective oocyte retrieval is a new approach to ovarian hyperstimulation (OHS) that prevents side effects of OHS and multiple pregnancies by puncturing most of the ovarian follicles 35 hours after hCG administration as in an IVF program. The remaining intact follicles can still result in a singleton or twin pregnancy. In three patients who presented a multiple follicular development, this technique resulted in two pregnancies; moreover, the retrieved oocytes were fertilized and the embryos frozen.

Female↗
PubMed1988

Visceral revascularization by anastomosis between the left renal and Drummond's marginal artery.

Drummond's marginal artery was revascularized by anastomosis with the left renal artery in two patients with visceral ischemia due to occlusion of the celiac and superior mesenteric arteries. In this manner, the authors avoided entering an infected abdominal cavity, interposition bypass and aortic clamping. In both cases, visceral arterial supply was improved. In one case, a left renal steal syndrome was observed. Because of possible renal involvement, indications for this technique should be carefully chosen.

Aged↗
PubMed1988

LHRH agonists in IVF: different methods of utilization and comparison with previous ovulation stimulation treatments.

LHRH agonists are being increasingly used in ovulation stimulation protocols in IVF programmes. We have compared the results of two methods of utilization of LHRH agonists. In the long protocol, gonadotrophin stimulation was only commenced after a preliminary period of pituitary desensitization with LHRH agonist. In the short protocol, exogenous gonadotrophins were administered shortly after the start of LHRH agonist therapy, benefiting from the gonadotrophin flare-up effect. One-hundred-and-eighty-six patients were divided equally between the two treatments. There was no difference in the ovarian response on the day of HCG or the number of mature oocytes recovered. The cleavage rate of mature oocytes was higher in the short protocol (70, versus 56, P less than 0.01). The ongoing pregnancy rate per treatment cycle was similar in both groups (18, in the long protocol and 16, in the short protocol). Analysis of the luteal phases revealed a trend for higher progesterone values in the long protocol although this was only significant on the second day following oocyte retrieval. As the clinical results were similar other factors should be taken into account when deciding therapy. These include patient convenience, cost and side-effects. Other schedules of ovulation stimulation using LHRH agonists are discussed.

Female↗
PubMed1988

Effect of cumulus cell mass and follicle quality on in-vitro maturation of cynomolgus monkey oocytes.

Cynomolgus monkey oocytes were recovered from healthy or atretic follicles greater than 1000 micron in diameter at day 8 of gonadotrophin stimulated cycles and cultured in vitro, cumulus enclosed or cumulus free, for 2 days. Germinal vesicle breakdown (GVBD) occurred in 26.7% of healthy cumulus enclosed oocytes (n = 60) compared to 52.6% of atretic cumulus enclosed oocytes (n = 38). The mechanical removal of the cumulus cell mass increased the GVBD rate of the healthy oocytes (56.5%, n = 23) and accelerated the passage of the atretic oocytes (n = 23) from metaphase I (4.3%) to metaphase II (47.8%). In the healthy primate follicle, the dictyate stage could be maintained by an inhibitory substance secreted by the cumulus; follicular atresia could either decrease the synthesis of this substance and/or induce the metabolism of a stimulatory substance.

Animals↗