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Biomedical subjects

P Lecomte

Publications and source records attributed to P Lecomte.

At least 19 recordsLinked to original sources
PubMed1992

[Tubular gastrostomy using celioscopy].

Surgical feeding gastrostomy is attended by a significant morbidity and mortality. Today, the percutaneous endoscopic route is regarded as the best method, but it is not feasible in case of pharyngo-oesophageal stenosis and has its own drawbacks. A new method using laparoscopy to perform a Depage-Janeway gastrostomy is presented here. The theoretical advantages of this method are clear: the limited parietal damage should avoid cicatricial complications, and the limited ventilatory aggression should reduce the amplitude of respiratory complications. Moreover, in surgical practice this is a simple, rapid and efficient operation.

Aged↗
PubMed1992

[Primary amenorrhea revealing micropolycystic ovary syndrome].

Nine patients with polycystic ovary syndrome revealed by primary amenorrhea were studied clinically, biochemically and ultrasonographically. One of them had excess weight, four had hirsutism and five acne. Testosterone and delta 4-androstenedione levels were high in all patients. Luteinizing hormone (LH) basal levels were increased in five patients. Basal values of follicle-stimulating hormone (FSH) remained within normal range. The LH to FSH ratio was elevated (over 2) in six patients. The LSH response to gonadotropin-releasing hormone (GnRH) was explosive in all patients. Ultrasonography showed that three out of five patients had enlarged ovaries with multiple follicles not exceeding 8 mm. Following treatment, two patients had children after ovulation was induced with clomiphene citrate, one patient became pregnant spontaneously but thereafter opted for voluntary interruption; two patients are still on ovulation-inducing therapy; four patients still have contraception. These results indicate the clinical heterogeneity and the diagnostic problems that surround this uncommon form of a frequently observed disease.

Adolescent↗
PubMed1992

[One hundred and twenty-five consecutive choledochotomies for suspected lithiasis without mortality. Current state of complications from common bile duct surgery].

The postoperative courses of 125 consecutive surgical common bile duct explorations performed between 1983 and 1990 were analysed. All cases of common bile duct lithiasis, but three, were operated on. Intraoperative cholangiography was performed in 98 percent and cholangioscopy in 92 percent of patients; common bile duct stones were found in 95 patients (76 percent); the common bile duct was sutured without drainage in 78 patients (58 percent). There were no deaths. Morbidity was 14 percent, of which 10 percent were serious. Four percent of common bile ducts retained stones. The specific morbidity was 4 percent. These results confirm the reliability of surgical management of common bile duct stones and therefore should be considered for the evaluation of new procedures, such as laparoscopic treatment of common duct stones, or combined laparoscopic cholecystectomy and endoscopic sphincterotomy.

Aged↗
PubMed1990

[Phosphorus-calcium metabolism in hyperthyroidism].

Because of the bone remodelling it induces, hyperthyroidism modifies the parameters of calcium-phosphorus metabolism. For a better determination of the mechanism involved, we studied 13 patients with Graves' disease compared with 13 controls. We measured the various parameters of calcium-phosphorus metabolism, notably the levels of parathormone, 25-hydroxycholecalciferol, 1-25 dihydroxycholecalciferol and ostocalcin; 8 patients were re-examined in euthyroidism. Total and corrected values of calcaemia (P less than 0.05 and P less than 0.01), phosphoreamie (P less than 0.01), alkaline phosphatase (P less than 0.01), calciuria (P less than 0.01) and hydroxyprolinuria (P less than 0.01) were significantly higher in patients with hyperthyroidism. Osteocalcin also was significantly increased (P less than 0.01) and correlated with thyroid hormone levels, thus confirming its usefulness as marker of bone remodelling in hyperthyroidism. Creatininaemia was significantly lowered (P less than 0.01). The intestinal absorption of calcium after injection of 1 g of calcium was reduced. Parathormone and 25-hydroxycholecalciferol levels were not significantly different in patients and in controls. In patients who were re-examined in euthyroidism, there was a significant increase in parathormone and in 1-25 dihydroxycholecalciferol levels (P less than 0.05). Thus, in situations of hyperthyroidism 2 elements contribute to a deficit in calcium balance: (a) a fall in parathormone level, consecutive to a rise in calcaemia, induces hypercalciuria; and (b) a fall in 1-25 dihydroxycholecalciferol level, consecutive to functional hypoparathyroidism and hyperphosphoraemia, results in a decrease of intestinal calcium absorption.

Adolescent↗
PubMed1990

Diagnosis of medullary carcinoma of the thyroid (MCT) by calcitonin assay using monoclonal antibodies: criteria for the pentagastrin stimulation test in hereditary MCT.

A new calcitonin (CT) immunoradiometric assay, using anti-11-7 and anti-24-32 CT fragment monoclonal antibodies was evaluated and compared to classical RIA. The sensitivity was 2.5 ng/L, the normal basal level (n = 83) was lower than 10 ng/L, the response to pentagastrin stimulation in control subjects was absent in nine and between 10-30 ng/L in nine others. (mean, 15.4). In patients with renal failure the basal level was increased between 10-52 ng/L. In patients with medullary thyroid carcinoma (MTC; n = 28), the basal level was between 189-28,900 ng/L. A pentagastrin test was performed as screening for familial MTC in eight patients with confirmed MTC at subsequent surgery; the calcitonin peak was equal or greater than 38 ng/L. Large differences exist between CT levels measured by RIA and immunoradiometric assay. The latter method provides a greater sensitivity to pentagastrin test and allows a better identification of microcarcinoma in hereditary cases of MTC.

Adolescent↗
PubMed1990

[Steroid-sensitive cavitating pulmonary opacity in Horton's disease].

We report the case of a 72 year old woman treated for seven months for Horton's disease presenting with a cavitating pneumonia of the left axillary segment associated with a deterioration of the general state, at the time of which the steroid therapy was in the course of being decreased. The radiological appearance and the clinical context of immune depression had led to a trial of a quadruple anti-tuberculous therapy in spite of the absence of any bacteriological proof. This rapid aggravation of the condition under treatment led to the suggestion of a pulmonary localisation of Horton's disease. The rapid regression of the lesions after increasing the dose of steroids and the negative cultures on Lowenstein medium pleaded in favour of this hypothesis. However the continuation of anti-tuberculous treatment seems justified in such cases in so far as the diagnosis of Horton's disease of the lung often cannot be maintained other than retrospectively in the absence of histological proof.

Aged↗
PubMed1989

Evidence of 11 beta-hydroxylase deficiency in a patient with cortical adrenal adenoma.

We explored a 61 year old woman with mild hirsutism. An adrenal tumor was found in the left adrenal, which was held responsible for the androgen secretion. The in vitro incubation of the tumor tissue showed an impaired 11 beta-hydroxylation of 11-deoxycortisol. This is a rare and unusual case of adrenal pathology showing that a deficiency in 11 beta-hydroxylase activity does not rule out the presence of an adrenocortical adenoma.

Adenoma↗
PubMed1989

Ectopic prolactinoma within the sphenoid sinus.

A case of an ectopic prolactin-producing tumor located within the sphenoid sinus is reported. It was discovered in a girl who experienced secondary amenorrhea without galactorrhea. We discuss the different diagnoses proposed before immunocytochemical staining results were available. This case presented unusual radiological, surgical, and histopathological aspects.

Adolescent↗
PubMed1988

[Thyroid ectopia and Basedow's disease].

Graves' disease was diagnosed in a 35-year old woman with a history of myxoedema in childhood. Clinical data, ultrasonography and radioisotope scanning showed that the disease had developed in an ectopic subhyoid thyroid gland. Although numerous thyroid diseases associated with an ectopic thyroid have been described, Graves' disease does not seem to be frequent since only one case has been published so far.

Adult↗
PubMed1988

Seminal fluid transferrin as an index of gonadal function in men.

Seminal fluid transferrin concentrations of proven fertile donors and normozoospermic patients were significantly higher (P less than 0.001) than those in other groups examined. There were no significant differences in the transferrin values among vasectomized, azoospermic and very severe oligozoospermic subjects. Values were also similar in patients affected by secretory or excretory azoospermia. Regression analysis showed a positive correlation (P less than 0.001, r = 0.72) between seminal fluid transferrin concentrations and sperm density. A negative correlation (P less than 0.02, r = 0.28) existed between circulating FSH and seminal fluid transferrin concentrations. There were no significant differences between seminal fluid transferrin and the percentages of abnormal sperm cells or immature seminal line elements. These results indicate that the nature of seminiferous tubule dysfunction can be precisely defined by examining seminal fluid transferrin in combination with other biological values usually used to explore testicular function.

Follicle Stimulating Hormone↗
PubMed1988

[Experimental Enterobacter cloacae endocarditis treated with gentamicin. Predictive value of the in vitro bactericidal rate].

The predictive value of in vitro time-kill curve was tested on an Enterobacter cloacae endocarditis experimental model. The antibiotic studied was gentamicin. Despite a similar MIC, 2 Enterobacter cloacae strains exhibited very different time-kill curves in vitro. This difference was found being predictive of efficacy on the in vivo model, 24 hours after a single injection of gentamicin.

Animals↗
PubMed1988

[An in vitro study, in the human, of the relation between epididymal spermatozoa and the zona pellucida].

The ability of non capacitated human spermatozoa recovered from the caput, corpus and cauda epididymis, to bind the isologous or heterologous (rat) zona pellucida has been investigated. Experiments were performed with cold immobilized spermatozoa to avoid differences resulting from motility into the epididymis. Comparison with similar investigations in the ram (works and review of Fournier-Delpech and Courot, 1987) lead to conclude that human spermatozoa are: 1) able to bind to the human zona in the proximal epididymis; 2) unable to recognize heterologous zona at any level of the epididymis. From this, a strict species-specificity of the sperm-zona interactions exists in the proximal epididymis, in the human. By contrast, in the ram, sperm-zona binding develops in the epididymis iso- or hetero-specifically. Restricted species specificity appears in the ejaculate only. Data are in agreement with species specificity of gametes interactions in the human (Bedford, 1977). Such results could contribute to explain in vitro or in vivo fertilization with sperm originating from the middle epididymis (Temple-Smith et al., 1985; Soychsman and Bedford, 1986).

Adolescent↗
PubMed1988

[Insulin-resistant diabetes and polycystic ovary].

The observation of one patient with insulin resistance (114 unités of soluble insulin in 3 injections per day + 54 units of medium acting insulin at 8 pm) associated with a polycystic ovarian disease prompted us to discuss the relationship between hyperandrogenism, acanthosis nigricans and endogenous hyperinsulinism. An in vitro study of the insulin binding to patient's erythrocytes allowed to diagnose the rare Type A insulin-resistance syndrome proposed by Kahn.

Adolescent↗
PubMed1987

A method for measuring testosterone-estradiol-binding globulin--new analysis of experimental data and comparison with two commercially available kits.

Some binding assays have been suggested to measure serum testosterone--estradiol-binding globulin (TeBG) concentration. They have led to discrepant results. This study brought to surface the lack of these methods and the interest of a method using an accurate analysis of the binding isotherm. These observations led us to propose an absolute reference method especially suitable for the radioimmunological assays standardization. Our method used Con A Sepharose as a solid phase and DHT as a radioligand. We succeeded in solving the difficulties related to binding methods by evaluating the non-specific binding of the ligand and ligand--albumin binding. A careful analysis of experimental data, by setting equations specific to this DHT-TeBG system permitted the systematic errors to be corrected and allowed a precise determination of the serum TeBG concentration (27.3 +/- 6.0 nmol/l for 30 healthy men; 40 +/- 13 nmol/l for 15 healthy women). Moreover, the affinity constant of the ligand for the protein was accurately evaluated KDHT = (0.7 +/- 0.1)10(9) (mol/l-1) at 20 degrees C, which was not permitted by other methods. Two lines of evidence supported our assumptions and results. On the one hand, using estradiol as a radioligand instead of dihydrotestosterone, we found the same value for serum TeBG concentration; on the other hand, our assay favourably compared with two different kits commercially available. The correlation (r = 0.89) with 3H-SBP kit Merieux was good though this kit was not suitable for correctly assaying serum TeBG concentrations between 30 nmol/l and 60 nmol/l. An excellent correlation (r = 0.97) with SHBG IRMA Kit Farmos was found. This antibody-based assay and our binding assay yielded quite similar values that mutually validated both methods.

Binding, Competitive↗
PubMed1986

Evidence for an intermediate in DNA synthesis involving pyrophosphate exchange. A possible role in fidelity.

The incorporation of exogenous deoxyribonucleotide monophates (dNMP) was measured under conditions of ongoing DNA synthesis, providing arguments for the existence of a [DNAn X dNMP X PPi] intermediate in the nucleotide incorporation step of DNA synthesis: (formula; see text). The existence of such an intermediate is suggested by an apparent exchange of both dNMP and pyrophosphate (PPi) moieties of the deoxyribonucleotide triphosphate (dNTP) substrate with exogenous molecules. Such exchange and the incorporation of exogenous dNMP into DNA, strictly require ongoing DNA synthesis, suggesting that the energy for exchange reactions is provided by the cleavage of dNTP substrate. We propose that nucleotide selection during ongoing DNA synthesis results largely from the different relative rates of forward (beta) and backward (-alpha) reactions involving the [DNAn X dNMP X PPi] intermediate: the forward (incorporation) reaction is expected to predominate for the correct nucleotide, whereas the backward (abortive) reaction is expected to predominate for incorrect nucleotides.

Animals↗