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Biomedical subjects

M Smets

Publications and source records attributed to M Smets.

12 recordsLinked to original sources
PubMed1997

Rectovaginal septum adenomyotic nodules: a series of 500 cases.

OBJECTIVE: Laparoscopic procedure with excision of deep fibrotic endometriotic nodules of the rectovaginal septum and histological study of the lesions. SETTING: An academic teaching hospital. PARTICIPANTS: A series of 500 women undergoing laparoscopy for pelvic pain or infertility. RESULTS: Laparoscopic (n = 497) and laparotomic (n = 3) excision of endometriotic nodules resulted in considerable pain relief. Histologically the rectovaginal nodule was similar to an adenomyoma as it was a circumscribed nodular aggregate of smooth muscle and endometrial glands and stroma. The variations in oestrogen receptor and progesterone receptor content suggested a regulatory mechanism different from that of eutopic endometrium. CONCLUSION: This form of disease should be considered as an entity distinct from peritoneal and ovarian endometriosis, and originating from the Müllerian rests present in the rectovaginal septum.

Endometriosis↗
PubMed1996

Expansive benign lesions: treatment by laser.

Submucous fibroids, polyps and dysfunctional bleeding are responsible for meno-metrorrhagia in women over 40 years of age. The authors describe the technique of hysteroscopic myomectomy and endometrial ablation using the Nd-YAG laser and the advantages of the preoperative use of GnRH agonist therapy. They report their results in a series of 746 patients treated for meno-metrorrhagia (366 cases of myomectomy and 380 cases of endometrial ablation).

Adult↗
PubMed1996

Morphometric, immunohistological and three-dimensional evaluation of the endometrium of menopausal women treated by oestrogen and Crinone, a new slow-release vaginal progesterone.

Recently advanced computerized technology was applied to the investigation of morphometric, immunohistological and three-dimensional changes of the endometrial mucosa in order to evaluate quantitatively the effects of three doses of a new slow-release vaginal progesterone on the endometrium in post-menopausal women. A total of 20 menopausal women, deprived of ovarian function, were given oestrogen for 12 days and a combined therapy of oestrogen (administered orally) and progesterone for another 12 day period. Progesterone was administered vaginally through a new gel (Crinone) utilizing a bioadhesive, biocompatible polymer as a base to achieve a sustained release effect. An endometrial biopsy was taken before treatment, after oestrogen-only treatment and after the oestro-progestogen therapy. Before treatment, all the patients exhibited an atrophic endometrium. After oestrogen-only treatment, typical proliferative changes occurred: an increase in the endometrium thickness, an increase in the mitotic index, numerous cylinder-like glands and no coiled glands, and high concentrations of oestrogen receptors (ER) and progesterone receptors (PR). After the oestro-progestogen therapy, whatever the dose of progesterone given, a secretory transformation of the endometrial mucosa occurred, mitotic activity decreased significantly, more ramified and coiled glands were observed, and a decrease in PR content was noted in epithelial and stromal nuclei, and a decrease in PR content was also observed in epithelial nuclei but not in stromal nuclei. Accurate new techniques of image analysis have shown that crinone therapy could eliminate the proliferative effects of oestrogen treatment in post-menopausal women, despite doses as low as 45 mg of progesterone administered vaginally every other day. The results suggest that the sustained release effects of Crinone are clinically relevant.

Capillaries↗
PubMed1996

Large ovarian endometriomas.

The management of large endometriomas was described in a series of 814 patients. Combined therapy using gonadotrophin-releasing hormone agonist (GnRHa) and carbon dioxide laser laparoscopy was proposed. Drainage and GnRHa for 12 weeks provoked a reduction of the endometrioma size up to 50% of the initial value. After vaporization of the internal wall, a cumulative pregnancy of 51% after 1 year was achieved. A recurrence rate of 8% was observed for a follow-up of 2-11 years. Histological data demonstrated that the epithelium covering the ovary which is the mesothelium can invaginate in the ovarian cortex. Some of the invaginations were seen to be continuous with endometrial tissue, strongly suggesting the metaplasia theory in the pathogenesis of ovarian endometrioma.

Combined Modality Therapy↗
PubMed1995

Hysteroscopic myomectomy.

Transhysteroscopic myomectomy has proved to be safe and effective with experienced operators. The use of the continuous flow hysteroscope and preoperative monitoring of intrauterine pressure has contributed to the prevention of fluid intravasion accidents. Effectiveness has been demonstrated in a number of recently published long-term studies.

Female↗
PubMed1995

LASH: laparoscopic supracervical (subtotal) hysterectomy.

From July 1990 to December 1993, 156 laparoscopic supracervical hysterectomies (LASH) were performed. No complications occurred. The technique and the advantages are described. Because of the easy feasibility of this technique, the quick recovery of the patients and the absence of complications this strictly laparoscopic approach must be widely proposed when an hysterectomy is indicated and no risk of remaining cervix cancer is assumed.

Adult↗
PubMed1993

Laparoscopic myolysis with the Nd:YAG laser.

Laparoscopic myomectomy can be carried out in cases of subserosal and intramural fibroids. Laparoscopic myolysis can be proposed as an alternative to laparoscopic myomectomy in cases of large or multiple intramural fibroids in women aged over 40 or not desiring to bear more children but wishing to avoid a future hysterectomy. The authors report the technique and the long-term results in a series of 48 women with fibroids treated by myolysis. Because of the risk of bowel adhesions, further studies with another type of laser fiber are required.

Adult↗
PubMed1991

Regional increase in isolated myocyte volume in chronic myocardial infarction in cats.

Healing of myocardial infarction is associated with hypertrophy of a region surrounding the scar. In order to characterize the pattern of regional hypertrophy after healing of small myocardial infarctions, we used a Coulter Channelyzer to measure directly regional cell volume and light microscopy to measure cell length of isolated myocytes. Acute left ventricular myocardial infarctions were surgically created in adult cat hearts. After healing for 10.4 +/- 5.0 months, cells were dissociated by collagenase perfusion. Myocardial cells were isolated from three regions of the infarcted ventricle and the same three anatomical regions of unoperated control hearts: (1) remote from the infarct, (2) non-scarred tissues adjacent to the infarct, and (3) from the infarct. The volume of cells from control hearts was correlated significantly with individual body weight resulting in large inter-animal variations, but small intra-animal variations. Inter-animal comparisons were made by normalizing adjacent and infarct regions to percent change from its remote region. Myocyte volumes from hearts with healed infarcts were increased by 31% in the infarct region and by 20% in the adjacent region, relative to the corresponding regions from control hearts (P less than 0.05). Cell lengths were not different from control in any region. Calculated cross-sectional areas followed the same pattern as was observed for cell volumes. We conclude that there is a region of hypertrophy surrounding a small, transmural healed myocardial infarction that is characterized by increased myocyte cross sectional area with no change in cell length. This pattern is typical of the concentric hypertrophy observed with pressure overload rather than eccentric hypertrophy observed with volume overload.

Analysis of Variance↗
PubMedDate not supplied

[Correlations between delayed auditory evoked potentials and clinical evaluation of schizophrenic symptoms].

Late auditory evoked potentials (AEPs) were recorded by the "odd-ball" method in 20 schizophrenic patients according to DSM III R diagnosis criteria compared with 30 control subjects matched for sex and age. Patients were on antipsychotic medications; mean duration of illness was 3, 55 years. We have also proceeded to a clinical quantitative assessment of negative and positive symptoms of schizophrenia with Andreasen's rating scales. In the group of patients, we have observed a significant lengthening of the latency of N 1, N 2, P 3, N 3 and a decreased amplitude of N 1 and P 3. These results are in favour of an impairment of cerebral information processing probably localized in the subcortical level. Statistically significant correlations have been noticed between the anomalies of the last stages of information processing (P 3, N 3) and negative symptoms, more particularly affective flattening and attentional impairment. The disturbances of the first stages of information processing (P 2) and of automatic information processing (N 2) were related to positive symptoms, hallucinations and delusions especially. The anomalies of N 2 were also related to the sum of the global scores: an attentional impairment could be a main factor in the determinism of schizophrenia.

Adult↗