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Biomedical subjects

Jacques Donnez

Publications and source records attributed to Jacques Donnez.

At least 19 recordsLinked to original sources
PubMed2006

Laparoscopic ovariectomy for whole human ovary cryopreservation: technical aspects.

OBJECTIVE: To describe the technique of laparoscopic ovariectomy with a view to cryopreservation of a whole ovary with its vascular pedicle. DESIGN: Descriptive study. SETTING: Gynecology research unit in a department of gynecology in a university hospital. PATIENT(S): Women with indications for chemotherapy or radiotherapy who are at high risk of premature ovarian failure. INTERVENTION(S): Laparoscopic ovariectomy for whole ovary cryopreservation in nine patients. MAIN OUTCOME MEASURE(S): Feasibility of laparoscopic ovariectomy for whole ovary cryopreservation and later autotransplantation without delaying chemotherapy. RESULT(S): The whole ovary was successfully removed by laparoscopy and cryopreserved by arterial catheterization in all nine patients. CONCLUSION(S): Ovariectomy with a view to whole ovary cryopreservation for future transplantation may be performed by laparoscopy. Great care must be taken to remove the ovary, together with a large part (> or =5 cm) of the infundibulopelvic ligament, allowing dissection of the ovarian vessels, perfusion with a cryoprotective medium, and cryopreservation for subsequent autografting of the whole ovary. The period of ischemia between ligation of the ovarian pedicle and ovarian cryopreservation must be as short as possible.

Cryopreservation↗
PubMed2006

Clinical evaluation of endometriosis and differential response to surgical therapy with and without application of Oxiplex/AP* adhesion barrier gel.

OBJECTIVE: To correlate parameters of endometriosis obtained during routine clinical evaluation with the subsequent formation of adhesions following surgical treatment by laparoscopy. DESIGN: Randomized, controlled, double-blind, clinical trial. SETTING: Tertiary referral centers for the treatment of endometriosis. PATIENT(S): Thirty-seven patients (65 with adnexa) with stage I-III endometriosis; endometrioma-only patients were excluded. INTERVENTION: Laparoscopic surgical treatment of endometriosis, followed by randomization to Oxiplex/AP (FzioMed, Inc., San Luis Obispo, California) gel treatment (treated group) of adnexa, or surgery alone (control group); follow-up laparoscopy 6-10 weeks later. MAIN OUTCOME MEASURE(S): Adnexal Americn Fertility Society score, correlated with color and location of endometriosis, as well as stage of disease determined by masked review of videotapes. RESULT(S): Control patients with at least 50% red lesions had a greater increase in ipsilateral adnexal adhesion scores than patients with mostly black or white and/or clear lesions. Treated patients with red lesions had a greater decrease in adnexal adhesion scores than control patients. There was a correlation between baseline endometriosis stage and postoperative adhesion formation in control patients, but not treated patients. CONCLUSION(S): Patients with red endometriotic lesions had greater increases in their adhesion scores than patients with only black, white, and/or clear lesions. Oxiplex/AP gel was effective in reducing adhesions, compared to surgery alone, in all groups.

Cellulose↗
PubMed2006

Serum dioxin-like compounds and aromatase (CYP19) expression in endometriotic tissues.

Dioxin-like compounds (DLCs) are suspected etiological factors of endometriosis but their potential mechanisms of action remain elusive. Because endometriosis is an estrogen-dependent disease and since aromatase (CYP19), a key enzyme in estrogen biosynthesis, was recently demonstrated to be expressed in endometriotic lesions, we hypothesized that dioxin-like compounds could modulate local estrogen production through an up-regulation of aromatase. We tested this hypothesis by examining the correlation between serum DLC levels and CYP19 expression in endometriotic tissue obtained from 47 patients with peritoneal, ovarian endometriosis and/or deep endometriotic nodules of the rectovaginal septum. Aromatase expression was assessed by real-time RT-PCR in biopsied endometriotic tissues [peritoneal (n=19), ovarian (n=17) endometriosis and deep endometriotic nodules of the recto-vaginal septum (n=29)]. The relationship between aromatase expression and DLCs was traced by simple regression analysis. DLCs did not appear to be significant determinants of aromatase expression. CYP1A1 expression, measured as a positive control, was found associated with current smoking but not with DLCs. We conclude that DLCs do probably not facilitate the growth of endometriotic lesions by up-regulating the local expression of aromatase.

Adult↗
PubMed2006

Didelphic uterus and obstructed hemivagina: recurrent hematometra in spite of appropriate classic surgical treatment.

We report the case of a young girl with uterus didelphys, obstructed vagina and ipsilateral renal agenesis treated by diagnostic laparoscopy and resection of the vaginal septum by a vaginal approach in order to drain the distended uterus. Despite classic surgery, the myometrium on the treated side never recovered its normal function, with subsequent persistence of recurrent hematometra. Laparoscopic subtotal hemihysterectomy had to be performed to avoid retention of hematometra and secondary pelvic inflammatory disease.

Abnormalities, Multiple↗
PubMed2006

Iron overload enhances epithelial cell proliferation in endometriotic lesions induced in a murine model.

BACKGROUND: Iron deposits are characteristic of endometriotic lesions, and pelvic iron concentrations are higher in endometriosis patients than in women without endometriosis. In this study, the effect of iron overload and iron chelation on the development of endometriosis in a murine model was investigated. METHODS: Human menstrual endometrium was injected i.p. into nude mice, either alone (controls) or supplemented with erythrocytes or desferrioxamine (DFO), an iron chelator. After 5 days, the iron load of endometriosis-like lesions and peritoneal macrophages and fluid was evaluated. Lesions were quantified by immunohistochemical morphometry, and their proliferative activity was assessed. RESULTS: Injection of erythrocytes into the pelvic cavity caused iron overload in lesions (P < 0.025) and peritoneal macrophages (P < 0.01) and fluid (P < 0.05), whereas DFO effectively reduced iron status in lesions (P < 0.05) and macrophages (P < 0.01) compared with controls. No difference was observed in the number or surface area of lesions between the three groups. Erythrocytes increased (P < 0.05) and DFO significantly decreased (P < 0.01) the proliferative activity of lesions. CONCLUSIONS: Iron overload does not appear to affect lesion establishment but may contribute to the further growth of endometriosis by promoting cell proliferation of lesions. Iron chelator treatment could therefore be beneficial in endometriosis to prevent iron overload in the pelvic cavity and decrease cellular proliferation of lesions.

Animals↗
PubMed2006

Ovarian tissue cryopreservation and transplantation: a review.

The review covers current options for ovarian tissue cryopreservation and transplantation and provides a systematic review of the existing literature from the last 10 years, taking into account all previously published reviews on the subject. The different cryopreservation options available for fertility preservation in cancer patients are embryo cryopreservation, oocyte cryopreservation and ovarian tissue cryopreservation. The choice depends on various parameters: the type and timing of chemotherapy, the type of cancer, the patient's age and the partner status. The different options and their results are discussed, as well as their putative indications and efficacy. The review concludes that advances in reproductive technology have made fertility preservation techniques a real possibility for patients whose gonadal function is threatened by premature menopause, or by treatments such as radiotherapy, chemotherapy or surgical castration.

Antineoplastic Agents↗
PubMed2006

Breast tuberculosis imaging.

We report unusual magnetic resonance images of breast tuberculosis before and after treatment. Magnetic resonance imaging may assess the efficiency of treatment of breast tuberculosis.

Adult↗
PubMed2006

Environmental and host-associated risk factors in endometriosis and deep endometriotic nodules: a matched case-control study.

Peritoneal endometriosis (PE) and deep endometriotic nodules (DEN) are gynecological diseases recently shown to be associated with elevated serum concentrations of organochlorines. The objective of the present study was to compare risk factors associated with both forms of the disease, with a particular attention to potential sources of organochlorine exposure. This matched case-control study with prospective recruitment included 88 triads (PE-DEN-control). All women were face-to-face interviewed with a standardized questionnaire, and serum dioxin and polychlorinated biphenyl measurements were available for 58 of them. Alcohol consumption (odds ratio (OR): 5.82 [confidence interval at 95% (95%CI) 1.20-28.3]) in DEN and low physical activity at work for DEN (OR: 4.58 [95%CI 1.80-11.62]) and PE (OR: 5.61 [95%CI 1.90-16.60]) were traced as significant risk factors. Organochlorine-related factors (use of tampons, occupational or environmental exposure) were not related to the disease. The current consumption of foodstuffs that were more likely to contribute to organochlorine body burden did not differ among the groups. Only some of these fatty foodstuffs (marine fish, pig meat) were traced by multiple regression analysis as significant determinants of organochlorine body burden, explaining only a small fraction (20%) of the interindividual variation of organochlorine body burden. We conclude that PE and DEN share similar patterns of risk or protective factors.

Adult↗
PubMed2006

Expression of aromatase (P450 aromatase/CYP19) in peritoneal and ovarian endometriotic tissues and deep endometriotic (adenomyotic) nodules of the rectovaginal septum.

We found, by reverse transcription--real time--polymerase chain reaction, that the expression of aromatase (CYP19) in ovarian, peritoneal endometriosis, and deep endometriotic nodules is significantly different, which strengthens the theory of three distinct clinical entities. Compared with peritoneal endometriosis, ovarian endometriosis exhibits an 8-fold higher expression of aromatase, which suggests that aromatase inhibitors may be particularly active in this form of endometriosis.

Aromatase↗
PubMed2006

Effect of an oral contraceptive pill on follicular development in IVF/ICSI patients receiving a GnRH antagonist: a randomized study.

This randomized controlled study compared the effectiveness of a gonadotrophin releasing hormone (GnRH) antagonist protocol with or without oral contraceptive (OC) pretreatment on the number of oocytes retrieved in IVF or intracytoplasmic sperm injection (ICSI) patients. Sixty-four patients were randomized to start recombinant human FSH (r-hFSH) on day 2 or 3 after OC withdrawal (OC group) or on day 2 of a natural cycle (control group). From stimulation day 6 onwards, all patients were treated with daily (0.5 mg/ml) GnRH antagonist (Antide). OC pretreatment resulted in significantly lower starting concentrations of FSH, LH and oestradiol (P < 0.001) and a thinner endometrium (P < 0.0001). In the early stimulation period, fewer large follicles were found after OC pretreatment, leading to a significantly extended stimulation period (11.6 versus 8.7 days, P < 0.0001) with more follicles on the day of recombinant human chorionic gonadotrophin administration (15.4 versus 12.5, P = 0.02) and more oocytes retrieved (13.5 versus 10.2, P < 0.001) as compared with the control group. GnRH antagonist regimen, pretreated with OC, prevented the early endogenous FSH rise and improved follicular homogeneity, resulting in more oocytes. As a consequence of the extended treatment period, more rhFSH was required.

Adult↗
PubMed2005

Quantification of endometriotic lesions in a murine model by fluorimetric and morphometric analyses.

BACKGROUND: In animal models of endometriosis, the identification and quantification of lesions originating from human endometrium is often hampered by the small size of the implants and their embedding in murine tissue. The purpose of the present study was to develop two new methods of quantifying endometriosis-like lesions in a nude mouse model: fluorimetry and morphometry. METHODS: Human menstrual endometrium was labelled using a fluorescent tracker, carboxyfluorescein diacetate, succinimidyl ester (CFDA-SE), and transplanted into the pelvic cavity of mice by injection through the peritoneum after performing a cutaneous incision. After 5 days, lesions were recovered by laparotomy. The fluorescence of the recovered endometriotic lesions was measured. Endometrial stroma and glands were immunostained in lesion sections with anti-CD10 and anti-CK22 antibodies, and their surface area was evaluated by morphometric analysis. RESULTS: Fluorescent labelling allows identification of lesions not visible macroscopically. A good correlation was observed between fluorimetry and morphometry (r=0.88) applied for lesion quantification. CONCLUSIONS: Fluorimetric evaluation combined with morphometric analysis of endometriosis-like lesions allows objective and reliable recording of endometriosis development in a nude mouse model. This quantification method could therefore be useful for future pharmacological and toxicological studies.

Animals↗
PubMed2005

Evaluation of Liberase, a purified enzyme blend, for the isolation of human primordial and primary ovarian follicles.

BACKGROUND: The purpose of this study is to evaluate the effectiveness of a standardized mixture of purified enzymes (Liberase), for the isolation of human ovarian follicles. METHODS: This is an experimental prospective study. Ovarian biopsies were obtained from eight young women undergoing laparoscopy for benign gynaecological disease. Follicles were isolated by Liberase or collagenase enzymatic digestion. Follicle quality was assessed by evaluating their general morphology and viability after fluorescent staining, and the ultrastructure by electron microscopy. RESULTS: The number of fully isolated follicles recovered from the Liberase-treated group was lower than from the collagenase group (156 versus 263) despite equal-sized biopsies being taken. A high proportion of follicles (98.6%, 70/71) were viable after Liberase isolation and most follicles were of good morphology with a complete granulosa cell layer (70.4%, 31/44). Ultrastructural studies indicated that Liberase-isolated follicles showed signs of atresia only occasionally and that the oolemma-follicular cell interface was well preserved. CONCLUSIONS: Liberase treatment allows the isolation of highly viable follicles from human ovarian tissue, with an unaltered morphology and ultrastructure. This purified endotoxin-free enzyme preparation is a promising alternative to impure collagenase preparations for the reproducible isolation of intact primordial and primary follicles for culture and grafting purposes.

Collagenases↗
PubMed2005

Efficacy of in vitro fertilization after chemotherapy.

OBJECTIVE: To evaluate if in vitro fertilization (IVF) with embryo cryopreservation can be proposed to patients immediately after one or two regimens of chemotherapy. DESIGN: Retrospective study. SETTING: Academic research center and IVF unit. PATIENT(S): Eleven young patients diagnosed with cancer between September 1999 and April 2003 who wanted to preserve their fertility via IVF. INTERVENTION(S): Stimulation and IVF before or soon after chemotherapy treatment. MAIN OUTCOME MEASURE(S): The number and quality of embryos obtained after stimulation in cancer patients undergoing IVF before or soon after chemotherapeutic treatment. RESULT(S): Four patients underwent IVF in the interval between two regimens of chemotherapy. Two of them had no follicular development; one underwent follicular puncture but no oocytes were retrieved; and, in one, six oocytes were harvested but only one good quality embryo was obtained. In the seven patients who underwent IVF before starting chemotherapy, between 4 and 11 embryos were obtained per patient, the majority being good quality embryos. CONCLUSION(S): Because the efficacy of IVF is dramatically reduced after even one round of chemotherapy, IVF should be performed before chemotherapy. For those who require immediate chemotherapy, ovarian tissue cryopreservation and/or oocyte cryopreservation could be used before treatment.

Adult↗
PubMed2005

Time course of pelvic endometriotic lesion revascularization in a nude mouse model.

OBJECTIVE: To assess the timing of endometrial lesion revascularization in a murine model. DESIGN: Prospective experimental study. SETTING: An academic research environment. ANIMAL(S): Twenty-six nude mice. INTERVENTION(S): Endometriosis was induced in mice by intraperitoneal deposition of human menstrual endometrium. Endometrial implants were recovered on days 1, 3, 5, 8, 10, 15, and 21 after implantation. MAIN OUTCOME MEASURE(S): Sections from the endometrial implants were immunostained with species-specific antiplatelet endothelial cell adhesion molecule-1 (PECAM-1) antibodies and vessels of murine and human origin were counted. RESULT(S): Endothelial cells of human origin in the implant progressively disappeared between day 3 and day 10. Seventy-eight percent of the vessel sections were positive for human PECAM-1 on day 5, 40.1% on day 8, and only 14.1% on day 10. However, there was a marked increase in murine PECAM-1-expressing vessels in endometrial stroma between day 5 (1.4%) and day 8 (68.0%), 10 (69.5%), and 15 (87.2%). CONCLUSION(S): Our study demonstrates that PECAM-1 is a reliable endothelial cell marker to evaluate the role of angiogenesis in the nude mouse model. It also indicates that revascularization of human endometrial implants occurs between 5 and 8 days after implantation and involves the disappearance of native graft vessels, coinciding with the invasion of the interface and then the stroma by murine vessels.

Animals↗
PubMed2005

Increased dioxin-like compounds in the serum of women with peritoneal endometriosis and deep endometriotic (adenomyotic) nodules.

OBJECTIVE: To investigate the possible association between the body burden of dioxin-like compounds and endometriotic disease. DESIGN: Case-control study. SETTING: Gynecology ward in a university hospital. PATIENT(S): Seventy-one women with peritoneal endometriosis (n = 25) or deep endometriotic (adenomyotic) nodules (n = 25) and controls (n = 21). INTERVENTION(S): Collection of 200 mL of blood (fasted) and face-to-face interview. MAIN OUTCOME MEASURE(S): Assessment of dioxin (PCDD), furan (PCDF), and dioxin-like PCB serum concentrations (picograms toxic equivalent [TEQ]/g lipids). RESULT(S): Age and body mass index were traced by linear multiple regression as determinants of total TEQ levels. After standardization for these variables (30 years and 22.5 kg/m2), the mean TEQ levels were 24.21 (controls), 30.62 (peritoneal endometriosis), and 37.60 (deep endometriotic [adenomyotic] nodules) pg TEQ/g lipids. Logistic regression analysis indicated a significantly increased risk of deep endometriotic (adenomyotic) nodules (odds ratio [OR], 3.3; 95% confidence interval [CI], 1.4-7.6) for an increment of 10 pg in total TEQ levels/g lipids. An increased risk was also found for peritoneal endometriosis (OR, 1.9; 95% CI, 0.9-3.8) for total TEQ levels and for dioxins alone (OR, 3.2; 95% CI, 1.0-9.9). CONCLUSION(S): The results provide the first epidemiological evidence of an association between increased PCDD/PCDF and PCB body burden and endometriosis.

Adult↗
PubMed2005

Orthotopic transplantation of fresh ovarian cortex: a report of two cases.

OBJECTIVE: To report two cases of orthotopic transplantation of fresh ovarian tissue. SETTING: Academic hospital. PATIENT(S): Two patients with severe endometriosis, who underwent left oophorectomy for recurrent endometriosis. INTERVENTION(S): Ovarian cortex was reimplanted in the heterolateral orthotopic site. RESULT(S): Biopsies of the grafted tissue were taken 3 months after reimplantation. Viable primordial follicles were found. The presence of a neovascular capillary network was demonstrated. CONCLUSION(S): Reimplantation of fresh ovarian cortex allows the survival of primordial follicles and may represent an alternative method for the preservation of ovarian cortex when oophorectomy is mandatory.

Adult↗