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Jacques Donnez

Publications and source records attributed to Jacques Donnez.

At least 37 records · Page 2Linked to original sources
PubMed2005

The role of cryopreservation for women prior to treatment of malignancy.

PURPOSE OF REVIEW: The purpose of this review is to investigate recent advances in xenografting, as well as in orthotopic and heterotopic autotransplantation of human cryopreserved ovarian tissue. RECENT FINDINGS: The first livebirth after orthotopic transplantation of cryopreserved ovarian tissue was reported recently. We discuss this case and other cases of reimplantation of cryopreserved ovarian tissue, bearing in mind that many questions remain. SUMMARY: Finally, we report the latest developments in research on the transplantation of an intact ovary and the reimplantation of isolated follicles.

Animals↗
PubMed2005

Human endometrial epithelial cells (EEC) constitutively express more intercellular adhesion molecule (ICAM)-1 than endometrial stromal cells (ESC) in culture.

PROBLEM: Intercellular adhesion molecule-1 (ICAM-1) is thought to play an important role in pathophysiological processes in endometrial tissue. The aim of this study was to quantify and compare the expression of ICAM-1 mRNA and protein in cultured endometrial epithelial cells (EEC) versus endometrial stromal cells (ESC). METHOD OF STUDY: EEC and ESC were isolated from human endometrium and cultured. At confluency, ICAM-1 mRNA was measured by real-time reverse transcriptase-polymerase chain reaction, the membrane-bound form (mICAM-1) by immunocytodensitometry, and the soluble form (sICAM-1) by enzyme-linked immunosorbent assay. RESULTS: At the transcriptional level, we observed a 1.7-fold increase in ICAM-1 expression in EEC versus ESC. mICAM-1 immunostaining in EEC [cell-relative membrane-bound signal-specific optical density (CR-M-SOD): 0.056 +/- 0.05] was stronger (P < 0.05) than in ESC (CR-M-SOD: 0.009 +/- 0.07). EEC were found to secrete more (P < 0.01) sICAM-1 ([sICAM-1] = 15.59 +/- 2.96 ng/mL) than ESC ([sICAM-1] = 5.14 +/- 2.61 ng/mL). CONCLUSIONS: Cultured EEC constitutively express significantly more ICAM-1 mRNA and protein than ESC.

Adult↗
PubMed2004

Assessment of cadmium impregnation in women suffering from endometriosis: a preliminary study.

Environmental chemicals with oestrogen-like activity are suspected aetiological factors of endometriosis. In animal experiments, cadmium was recently shown to possess oestrogen-like properties. In the frame of a case-control study designed to investigate environmental risk factors for endometriosis, we compared cadmium urinary excretion (CdU) and blood concentration in 59 patients with peritoneal endometriosis, deep endometriotic (adenomyotic) nodules of the recto-vaginal septum and controls. After standardisation for age (30 years) and smoking status, the mean levels of cadmium in urine were (geometric mean [geometric S.D.]) 0.25 [1.50], 0.29 [1.76] and 0.26 [1.46] microg/g creatinine, respectively. Cadmium concentrations in blood did not differ among the three groups. These data, therefore, do not support a role for cadmium in the onset or the growth of endometriosis or deep endometriotic (adenomyotic) nodules of the recto-vaginal septum.

Adult↗
PubMed2004

Characterization of iron deposition in endometriotic lesions induced in the nude mouse model.

BACKGROUND: Pelvic endometriotic lesions are often laden with hemosiderin. In order to investigate the potential source of such iron deposits, we examined whether the seric and erythrocyte fractions of menstrual effluent might influence the occurrence of iron deposition within lesions in a murine model of endometriosis. METHODS: Endometriosis was induced in 57 nude mice by intraperitoneal injection of unfractionated human menstrual effluent, endometrial fragments plus serum, endometrial fragments plus erythrocytes or endometrial cell fraction alone. The number of implants, histologic aspect, proliferative activity and iron deposition in lesions was assessed. RESULTS: On day 5, lesions were evidenced in all 10 mice receiving menstrual effluent, in 9/13 of those injected with the cellular fraction, in 10/13 with the cellular fraction plus serum and in 10/12 with the cellular fraction plus erythrocytes. Iron conglomerates were observed at the interface between the lesion and peritoneum when menstrual effluent (47 deposits/mm(2)) and the cellular fraction with erythrocytes (20 deposits/mm(2)) were injected, but were scarce when the cellular fraction was injected without erythrocytes, either alone (4 deposits/mm(2)) or with serum (2 deposits/mm(2)) (P < 0.05). CONCLUSIONS: Iron conglomerates, typically found in the stroma of endometriotic lesions, were induced by erythrocytes present in menstrual effluent. This may be one of the factors triggering oxidative damage and chronic inflammation.

Adult↗
PubMed2004

Dioxin-like compounds and endometriosis: a study on Italian and Belgian women of reproductive age.

Compounds with dioxin-like toxicity are suspected to adversely affect human reproduction even at current background exposures. Endometriosis, a gynecological disorder often associated with infertility, has been hypothesized to be linked to dioxins and similar chemicals, a hypothesis supported by the outcome of experimental studies on animal models. Endometriosis severity and incidence in Belgium is one of the highest of the world: in this country, the general population exposure to dioxin-like compounds has been, on average, higher than in most industrialized countries. Here we show the results of a pilot case-control study carried out on 22 Italian and 18 Belgian women of reproductive age, with and without endometriosis. No significant differences were found in dioxin-like compound body burdens between cases and controls on a country basis, whereas the body burdens of the Italian women resulted to be significantly lower than that of the Belgian. In particular, total TEQs in Italian and Belgian women without endometriosis were respectively 18 and 45 pg WHO-TE/g lb.

Adolescent↗
PubMed2004

Surgical management of endometriosis.

The efficacy of medical and surgical treatment of endometriosis-associated infertility and pelvic pain is a source of ongoing controversy. Complete resolution of endometriosis is not yet possible and current therapy has three main objectives: (1) to reduce pain; (2) to increase the possibility of pregnancy; and (3) to delay recurrence for as long as possible. It is possible that a consensus will never be reached on the optimal treatment of minimal and mild endometriosis. In case of moderate and severe endometriosis-associated infertility, the combined approach (operative laparoscopy with a gonadotropin-releasing hormone (GnRH) agonist) should be considered as 'first-line' treatment. The mean pregnancy rate of 50% reported in the literature following surgery provides scientific proof that operative treatment should first be undertaken to give our patients the best chance of conceiving naturally. In case of rectovaginal adenomyotic nodules, surgery must be considered as first-line therapy, medical therapy being relatively in-efficacious.

Endometriosis↗
PubMed2004

Equivalence of the 3-month and 28-day formulations of triptorelin with regard to achievement and maintenance of medical castration in women with endometriosis.

OBJECTIVE: The present study aims at demonstrating the equivalence of the 28-day and 3-month formulations of triptorelin SR (sustained release) in terms of percentage of patients achieving castration levels of estradiol (<==50 pg/mL) 84 days after treatment initiation. DESIGN: A phase II, prospective, randomized, multicenter, open study was conducted in two parallel groups of women with endometriosis. SETTING: Academic hospitals. PATIENT(S): Seventy-two women with endometriosis. were treated with a single intramuscular injection of 3-month triptorelin SR, and 74 patients were treated with one intramuscular injection of 28-day triptorelin SR every 28 days for 3 months. INTERVENTION(S): As part of two parallel treatment groups, 72 women were given a single intramuscular injection of 3-month triptorelin SR, and 74 women were given one intramuscular injection of 28-day triptorelin SR every 28 days for 3 months. MAIN OUTCOME MEASURE(S): Percentage of patients achieving castration levels of estradiol at the end of the treatment period. RESULT(S): Patients participated in the study until resumption of menses. Ninety-seven percent of patients given the 3-month formulation and 94% of those given the 28-day formulation were in a state of medical castration on day 84. The mean time to achieve castration was shorter for the 3-month formulation, and the duration of castration was significantly longer. The FSH and LH parameters were comparable, though not always identical. CONCLUSION(S): The pharmacodynamic effects of the Decapeptyl SR 3-month formulation are equivalent to those of the 28-day formulation. The 3-month formulation provides the added advantage of a longer maintenance of medical castration in women who have endometriosis.

Adult↗
PubMed2004

Expression of platelet endothelial cell adhesion molecule-1 in red and black endometriotic lesions.

This immunohistochemical study shows that platelet endothelial cell adhesion molecule-1 (PECAM-1), known to play a role in neoangiogenesis and vascular development, is strongly and homogeneously expressed in endothelial cells lining blood vessels from red and black pelvic endometriotic lesions. The distribution of PECAM-1 within the stroma of the lesions was similar to that found in the corresponding eutopic endometrium, regardless of the phase of the cycle.

Endometriosis↗
PubMed2004

Ficoll density gradient method for recovery of isolated human ovarian primordial follicles.

OBJECTIVE: To develop a simple and efficient technique to allow rapid recovery of a maximum number of good quality isolated follicles. DESIGN: Prospective experimental study. SETTING: Academic research unit of the department of gynecology in a university hospital. PATIENT(S): Biopsies were obtained from five women (between 26 and 31 years of age). INTERVENTION(S): Biopsies were cut with a tissue sectioner. Enzymatic digestion was performed in a collagenase solution for 90 min at 37 degrees C. The follicles were recovered using a discontinuous Ficoll density gradient method. MAIN OUTCOME MEASURE(S): The number of follicles present in the interface layers of Ficoll gradient was quantified. Follicular viability of these recovered follicles was assessed with live-dead stains, using calcein-AM and ethidium homodimer-I. RESULT(S): Out of a total of 6,811 recovered follicles, we found 63% (n = 4,201) at the medium-1.06 Ficoll interface and 36.9% (n = 2,590) at the 1.06-1.09 Ficoll interface, which represents 99.9% of total recovered follicles. Analysis by vital fluorescent staining showed that 95.8% of the follicles treated with Ficoll were totally viable. CONCLUSION(S): The Ficoll density gradient method allows us to maximize the recovery of isolated human ovarian follicles and minimize the manipulation time while maintaining high follicular viability.

Adult↗
PubMed2004

Freeze-thawing intact human ovary with its vascular pedicle with a passive cooling device.

OBJECTIVE: To test the feasibility of freezing intact human ovary using a passive cooling device. DESIGN: Prospective experimental study. SETTING: Academic research unit of the department of gynecology in a university hospital. PATIENT(S): Ovaries were obtained from three women who were between 29 and 36 years of age. INTERVENTION(S): Ovarian perfusion with cryoprotective solution and slow freezing with a cryofreezing container (5100 Cryo 1 degrees C Freezing Container; Nalgene, VWR, Belgium). Rapid thawing of ovaries by perfusion and bathing with decreased sucrose gradient. MAIN OUTCOME MEASURE(S): Viability of follicles, stromal cells, and vascular components was assessed with live-dead stains in freshly removed ovary, after cryoprotectant exposure before freezing, and after thawing. Histological morphology was assessed at these three different times. RESULT(S): The percentage of live follicles was 99.4% in fresh tissue, 98.1% after cryoprotectant exposure, and 75.1% after thawing. Viability assessment showed live stromal cells and small vessels after thawing. On histological evaluation, the morphology of follicles and cortical and medullar tissue was similar in all three groups. CONCLUSION(S): We described the cryopreservation, using an accessible protocol, of intact human ovary with its vascular pedicle and proved high survival rates of follicles, small vessels, and stromal cells and a normal histological structure in all the ovarian components after thawing using our protocol.

Adult↗
PubMed2004

Laparoscopic excision of deep endometriosis.

Deep endometriosis is essentially characterized by the presence of a rectovaginal or retrocervical nodule, which is a circumscribed, nodular aggregate of smooth muscle, endometrial glands, and, usually, endometrial stroma. The authors suggest that the retroperitoneal space should definitely be considered as the origin of this retroperitoneal adenomyotic disease. This article reviews the classification, the diagnosis, and the surgical treatment of deep endometriosis (adenomyotic disease).

Endometriosis↗
PubMed2004

Gynecologic laparoscopic surgery with a palm-controlled laparoscope holder.

During laparoscopic surgery, the operator relies on the skills of an assistant, particularly during laparoscope manipulation. If possible, the surgeon would prefer to hold the scope while at the same time operating with both hands similar to open surgery conditions. A palm electronic interface (Lapman) was developed to allow remote control of a laparoscope manipulator and to make laparoscope displacement and instrument manipulation synchronous for the surgeon. It was tested in gynecologic surgery, where it restored vision and instrument manipulation and allowed laparoscopic surgery to be performed with fewer personnel.

Equipment Design↗
PubMed2004

Typical and subtle atypical presentations of endometriosis.

PURPOSE OF REVIEW: To review the concept of typical, subtle and invisible endometriosis and analyze the evolution and progression of the disease, as well as some factors possibly involved in the pathogenesis. RECENT FINDINGS: Although rejected by Redwine, the concept of non-visible endometriosis has been proven to exist. Some new ideas on the implication of reactive oxygen species in the development of endometriosis and its early stages are described here. SUMMARY: The increased diagnosis of endometriosis can be explained not only by the increased experience and ability of the surgeon to detect typical and non-typical endometriotic lesions, but also by a better understanding of the pathogenesis.

Endometriosis↗
PubMed2003

Safety of conservative management and fertility outcome in women with borderline tumors of the ovary.

OBJECTIVE: To assess the safety of fertility-sparing treatment and the remaining chance of childbearing after surgery. DESIGN: Retrospective clinical study. DESIGN: Gynecology department of a university teaching hospital. PATIENT(S): Seventy-five women underwent surgical management in our institution between 1986 and 2001 for borderline tumors of the ovary. INTERVENTION(S): Fifty-nine patients were treated by radical, fertility-compromising surgery. The remaining 16 patients underwent conservative surgery, preserving the uterus and at least some functional ovarian tissue. Seven unilateral adnexectomies, one simple cystectomy, and two adnexectomies associated with contralateral cystectomy were performed. MAIN OUTCOME MEASURE(S): Recurrence, survival, and pregnancy rates. RESULT(S): The observed recurrence rates after radical and conservative surgery were 0.0% and 18.7%, respectively. No disease-related deaths occurred in any group; there is no significant difference in survival rates. We can report 12 pregnancies in 7 of 11 women who underwent fertility-sparing management and who wished to become pregnant. CONCLUSION(S): In certain circumstances, conservative management offers a safe solution for borderline tumors of the ovary. Recurrence is noted significantly more often after this type of treatment, but all cases of recurrent disease can be detected with close follow-up and can be treated accordingly. No significant change in survival rates was found. Moreover, the pregnancy rate in women desiring pregnancy, those treated conservatively, was as high as 63.6%.

Adult↗
PubMed2003

A randomized, placebo-controlled, dose-ranging trial comparing fulvestrant with goserelin in premenopausal patients with uterine fibroids awaiting hysterectomy.

OBJECTIVE: To compare the use of a new antiestrogen fulvestrant with goserelin in reducing uterine fibroid growth before hysterectomy. DESIGN: An international, multicenter, randomized, placebo-controlled study. SETTING: Departments of obstetrics and gynecology. PATIENT(S): Premenopausal women (n = 307) diagnosed with uterine fibroids requiring hysterectomy. INTERVENTION(S): Over a 12-week period, patients received fulvestrant (50 mg, 125 mg, or 250 mg) as an i.m. injection, goserelin (3.6 mg) as a s.c. injection, or an injection-matched placebo once every 4 weeks. Patients underwent a hysterectomy at week 13. MAIN OUTCOME MEASURES: Efficacy endpoints included changes in fibroid growth, endometrial thickness, and uterine volume. The excretion of urinary markers of bone resorption was also examined. RESULT(S): Goserelin significantly reduced fibroid growth and endometrial thickness compared with placebos. Fulvestrant did not significantly alter fibroid volume or endometrial thickness or change endpoints such as endometrial histology or vaginal bleeding. Fulvestrant was associated with fewer postmenopause-related adverse events than goserelin. Goserelin, but not fulvestrant, significantly increased markers of bone resorption. CONCLUSION(S): At doses equivalent to those used for the treatment of breast cancer in postmenopausal women, fulvestrant did not significantly inhibit fibroid growth and, of particular note, did not lead to bone resorption.

Adult↗