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P Poitout

Publications and source records attributed to P Poitout.

At least 19 recordsLinked to original sources
PubMed2002

[Great elongation of uterine cervix: retrospective study of 20 cases].

BACKGROUND: The aim of the study was to evaluate the safety and efficacy of the Musset Poitout surgical procedure consisting in an anterior uterosacral ligament transposition and a cervix amputation. The main indication is an uterovaginal prolapse with an isolated elongation of the cervix. METHODS: A retrospective consecutive series of 20 women with an elongation of uterine cervix undergoing Musset Poitout procedure over a 10 year period between 1990 and 2001 with analysis of per and post operative complications and success. Four Kelly urethral plications were performed in the same time. The patient's ages, time under anesthesia, change in hemoglobin, days of hospitalization, medical illnesses, complications and follow-up were assessed. Failure was defined as a symptomatic elongation of the cervix or a third degree hysterocele on examination. RESULTS: and discussion. The median age of Musset Poitout procedure was 43.9 years (range 23-83). General anaesthesia could be performed in all patients. Mean operation time was 67 minutes (range 40-130). No major per or post operative complications occurred. The average of post-operative bladder cathetherisation was 3.65 days, the average hospital stay was 6.3 days. Complications were insignificant: urinary tract infection in 2, voiding dysfunction in 2. All the patients but 2 were followed for a mean 59 months (range 6-127). There was one recurence (5.5%). CONCLUSION: In this preliminary assessment the Musset Poitout procedure offered significant avantages in a genital prolapse with elongation of the cervix.

Adult↗
PubMed2001

Results of recto-vaginal fistula repair: retrospective analysis of 48 cases.

OBJECTIVE: To evaluate the long-term outcome of the Musset technique of recto-vaginal fistula (RVF) repair. STUDY DESIGN: During the years 1992-1998, 48 women underwent recto-vaginal fistula repair. A retrospective study in a university tertiary referral center was conducted. RESULTS: The main etiologies were obstetrical trauma (25), local infection (11), inflammatory disease (7), and post surgery (3). Thirty women (63%) had a previous fistula repair failure. The mean+/-S.D. fistula diameter was 1.4+/-1.0, and in 40% of the patients the fistula diameter was >2.5cm. In 19 cases (39.6%) there was a complete opening of the perineum and anal sphincter. Gas and stool incontinence before the operation were noted in 85 and 75% of the patients, respectively. Successful anatomic results were achieved in all patients. Five patients were re-operated due to gas and stool incontinence, and all but one had satisfactory anatomic and functional satisfactory results. The success rates in women with Crohn's disease and with a previous RVF repair failure were 100 and 98%, respectively. No major intra or postoperative complications were noted. CONCLUSION: The Musset procedure provide excellent anatomic and functional results and women with Crohn's disease or previous RVF repair have comparable long-term results.

Adult↗
PubMed2000

[Hormone replacement therapy after endometrial or ovarian cancer].

Use of hormonal replacement therapy after treatment of ovarian or endometrial cancer remains a matter of debate. Novel adjuvant therapies tend to increase the survival of these patients, who are exposed to risk factors of hormonal deficiency subsequent to primary therapy. Therefore, the aims of the present review of literature was to analyse epidemiologic and clinical parameters on behalf on hormonal replacement therapy in this population.

Endometrial Neoplasms↗
PubMed2000

[Bladder endometriosis. Apropos of 4 cases and review of the literature].

The aim of our study is to evaluate the diagnostic and therapeutic attitude toward endometriosis of the bladder. We have analysed four observations treated in the gynecologic service of Hotel-Dieu in Paris between January 1989 and January 1998, which represents 1.3% of all endometriosis operated during this period. Every patient underwent echography, RMN, UIV and cystoscopy. In all for cases a surgical treatment by laparotomy was realised. The choice of this way is explained by the multiple localisations of endometriosis in three cases and the impossibility of a coelioscopic treatment in the forth. The anatomopathologic exam found endometriosis in all of the cases.

Adult↗
PubMed1999

[Action of SERM and SAS (tibolone) on breast tissue].

SERMs are developed in HRT in order to provide the beneficial effects of estradiol on bone and the cardiovascular system. SERMs are antiestrogens and their properties depend upon the pharmacological class they belong to. Tibolone is a progestin with mixed properties. Our studies on breast cells in vitro demonstrated that it behaves as a progestin in these cells. The clinical data obtained with these various therapies on breast are presented.

Antineoplastic Agents, Hormonal↗
PubMed1997

Longitudinal vaginal septum: a retrospective study of 202 cases.

OBJECTIVE: To assess issues and management of longitudinal vaginal septum. STUDY DESIGN: The charts of 202 patients referred for a longitudinal vaginal septum over a 24 year period were reviewed. RESULTS: The most common septa were complete and high partial. Associated uterine malformations were frequent (87.8% of the cases), especially in complete or partial high septum (99.4%). The septum was asymptomatic in 56.4% of the cases. Obstetrical concerns are mainly related to a uterine malformation, but a thick septum may be responsible for dystocia. CONCLUSION: Less than half of the vaginal septa are symptomatic enough to require surgical treatment. However, for obstetrical issues management should include a thorough evaluation of uterine anatomy and preventive section of the septum even when asymptomatic.

Adolescent↗
PubMed1996

Epidermal growth factor receptor and c-erbB-2 expression in normal breast tissue during the menstrual cycle.

EGF receptor (EGF-R) and c-erbB-2 are homologous tyrosine kinase transmembrane receptors. They are involved in controlling proliferation, and probably differentiation, of normal breast epithelial cells, and their expression has been linked to the prognosis of breast cancer. Their physiological roles in normal breast tissue remain to be elucidated, as most studies to date have involved breast cancer cell lines. We studied the location of EGF-R and c-erbB-2 in 100 samples of normal breast with standard immunohistochemical methods and double-labelling techniques. EGF-R was mainly expressed on the stroma and myoepithelial cells, whereas c-erbB-2 expression was exclusively epithelial. An image analyser was used to quantitate variations in their expression during the menstrual cycle. EGF-R and c-erbB-2 expression on epithelial cells was stronger during the luteal phase than the follicular phase (p < 0.01 for EGF-R). The pattern of expression was also compared with that in 28 breast cancers and 7 fibroadenomas.

Breast↗
PubMed1996

Characterization of adnexal masses: combination of color Doppler and conventional sonography compared with spectral Doppler analysis alone and conventional sonography alone.

OBJECTIVE: To evaluate the importance of color Doppler combined with conventional sonography in characterizing adnexal masses and to compare the results with those of spectral Doppler analysis alone and conventional sonography alone. MATERIALS AND METHODS: One hundred and fifteen women with 132 adnexal masses (98 benign, three borderline, and 31 malignant) were prospectively studied with conventional and Doppler sonography (transabdominal in all patients and transvaginal in 111). Three methods differentiated benign from borderline and malignant masses. In the first, conventional sonography was used. In the second, conventional sonography was combined with color Doppler. In this method, the presence of color flow in an echogenic portion classified as indeterminate or malignant by conventional sonography indicated malignancy; the absence of color flow in an echogenic portion classified as indeterminant or malignant at conventional sonography indicated benignancy; the presence or absence of color flow in a regular wall or septum indicated benignancy. The third method used spectral Doppler analysis. Malignancy was indicated by a resistive index (RI) less than or equal to 0.4, a pulsatility index (PI) less than or equal to 1, or a peak systolic velocity (PSV) greater than or equal to 15 cm/sec. RESULTS: Using conventional sonography alone, accuracy was 83%, sensitivity was 88%, and specificity was 82%. Using conventional sonography and color Doppler, accuracy was 95%, sensitivity was 88%, and specificity was 97%. Using spectral Doppler analysis and an RI less than or equal to 0.4, accuracy was 77%, sensitivity was 18%, and specificity was 98%. For a PI less than or equal to 1, accuracy was 68%, sensitivity was 71%, and specificity was 67%. For a PSV greater than or equal to 15 cm/sec, accuracy was 72%, sensitivity was 47%, and and specificity was 81%. CONCLUSION: Adding color Doppler to conventional sonography produced a specificity and positive predictive value higher than those of conventional sonography alone. Specificity increased from 82% to 97% (p < .001), and positive predictive value increased from 63% to 91%. RI, PI, and PSV were of limited value.

Adnexal Diseases↗
PubMed1996

[Adenomatoid tumors of the uterus. Study of 5 cases with immunohistochemical and ultrastructural confirmation of the mesothelial origin].

Five cases of adenomatoid tumors of the uterus (ATU) are reported. These benign lesions are discovered in 1% of the hysterectomy specimens, performed on 20- to 85-years-old women. Their frequency is certainly underestimated, since ATU have the same macroscopic appearance as leiomyomas. Histologically, ATU are formed by gland-like and pseudovascular lumens, lined by regular, cuboidal or flattened cells, and surrounded by hyperplastic smooth muscle bundles. Immunohistochemical coexpression of cytokeratin and vimentin confirms with a mesothelial histogenesis. The ultrastructural study, showing luminal microvilli and desmosomes supports the hamartomatous development of ATU, corresponding to mesothelial inclusions from the peritoneum into the myometrium. Some giant or diffuse ATU, which are clinically disturbing, are differentiated from carcinomatous or vascular proliferations by frozen section examination. The treatment is made by surgical excision.

Adenomatoid Tumor↗
PubMed1994

bcl-2 expression in normal breast tissue during the menstrual cycle.

bcl-2 is a proto-oncogene discovered through the t(14;18) translocation occurring in most human follicular lymphomas. The function so far attributed to bcl-2 is to counteract the occurrence of apoptosis and to prolong cell survival without affecting the cycling cells. Apoptosis has been described in normal breast tissue epithelial cells, and it peaks at the end of the luteal phase. We have studied bcl-2 expression by an immunohistochemical method in 50 samples of normal breast tissue distributed throughout the menstrual cycle. bcl-2 staining predominated in the lobular epithelial cells. It displayed a striking cyclic variation, with maximal expression at the mid-cycle period and a sharp decrease at the end of the cycle. These results strongly suggest that the regulation of bcl-2 expression in breast tissue is hormone-dependent. This could be of significance in tumorigenesis.

Adolescent↗
PubMed1994

Bcl-2 expression in normal endometrium during the menstrual cycle.

Bcl-2 is a proto-oncogene initially described in the (14;18) translocation in follicular lymphoma. It has been shown to prolong cell survival by preventing apoptosis. Endometrium undergoes rapid proliferation and differentiation under hormone control and is thus an excellent model to study the hormone dependency of Bcl-2 expression. We studied Bcl-2 expression by an immunohistochemical method in 53 samples of normal endometrium randomly distributed throughout the menstrual cycle, as well as five samples of hyperplastic endometrium. Bcl-2 staining predominated in glandular cells and peaked at the end of the follicular phase. Bcl-2 expression disappeared at the onset of secretory activity. The stroma, surface lining epithelium and arterial vessels also displayed cyclic variations in Bcl-2 expression. These results strongly suggest hormone-dependent regulation of Bcl-2 expression, which could play an important role in tumorigenesis.

Adult↗
PubMed1993

[The role of calcium at different ages in women's life].

The present long life of women raises the problem of prevention against osteoporosis. Bone mass formation during adolescence is the first critical period, and it might condition the future bone mineral content. Eighty percent of the bone mass is of genetic origin, whereas 20 percent depends on the environment (diet, hormones, etc.). Menstrual disorders may be responsible for bone mineral loss. Pregnancy and breast-feeding are periods in which calcium requirements increase, yet in all but high risk women there are seldom responsible for osteopoenia. The first 10 years of menopause constitute a period of exponential bone mineral loss, and this is when oestrogen therapy is most effective against bone loss. The usefulness of calcium is still a matter of debate, with conflicting results concerning its preventive action on osteoporosis. There seems to be a threshold phenomenon: when normal diet provides a small amount of calcium, calcium supplementation is effective, but beyond a certain level supplementation is thought to be useless. The results found in the literature are presented, and the amounts of calcium intakes recommended at different ages are given.

Adolescent↗
PubMed1993

Fat suppression techniques in MR imaging of mature ovarian teratomas: comparison with CT.

OBJECTIVE: The aim of this study is to analyze the ability of MR fat suppression techniques to characterize fat components of ovarian mature cystic teratomas (MCT) shown by CT. SUBJECTS AND METHODS: MR images of eight MCTs of the ovary were obtained using standard sequences followed by a SPIR (spectral presaturation with inversion recovery) sequence in six cases and by Dixon sequences in two cases. In all cases correlation with CT and pathologic findings was achieved. RESULTS: MR fat suppression sequences showed to be as accurate as CT in detecting fat inside the cystic part of the teratomas (8/8). CONCLUSION: MR fat suppression sequences should be performed when presence of fat is suspected on images of ovarian tumors produced by standard MR sequences.

Adult↗
PubMed1993

[Botryoid rhabdomyosarcoma of the cervix. Clinico-pathologic study of a case].

The botryoid rhabdomyosarcoma of the cervix is a rare tumour occurring in young woman or during genital activity. It mainly causes vaginal bleeding or appears as a polypoid grape-like mass with a gelatinous cut-surface. The diagnosis is based on the presence of a submucosal cambium layer and a rhabdomyoblastic differentiation, corresponding to an intracytoplasmic double cross-striation. Metaplastic cartilaginous islands are sometimes observed. The immunostaining ensures the muscular origin of the tumour, characterized by the expression of actin and desmin. Apart from mullerian adenosarcomas, the main differential diagnosis is represented by the benign polypoid formations of the cervix: the genital rhabdomyoma and the fibroblastic lesion, called fibro-epithelial polyp with atypical stroma. The treatment actually includes both chemotherapy and surgery which is often limited to a conization.

Adolescent↗
PubMed1992

Primary non Hodgkin's malignant lymphoma of the vagina. Report of 3 cases with review of the literature.

Twenty cases of primary non-Hodgkin's malignant lymphoma (ML) of the vagina were studied: the 17 cases reported in the literature, and 3 further cases observed at the Hôtel-Dieu Hospital in Paris over the last 10 years. The mean age of the women was 49 years. The most frequent complaint was vaginal bleeding, only a few patients presented an ulcerated mass. No evidence of ML was seen on any of the cervico-vaginal cytologic smears. Diagnosis was made on the vaginal biopsy. According to the Kiel classification, 8 of these ML were of low malignancy and 12 of high malignancy. Apart from one of our cases, which was an angiocentric pleomorphic T ML with predominance of medium-sized cells, they were all B ML. According to the Ann Arbor staging system for extra-nodal ML, 12 of these ML were stage IE, 2 were stage IIE and 2 other stage IVE. Eight patients died, 6 of ML less than 17 months after diagnosis, 2 much later of diseases unrelated to ML. The mean follow-up period of patients who survived, free of disease, was 75 months. The surgical treatment has to be limited, associated with polychemotherapy and completed by local radiotherapy.

Adult↗
PubMed1992

Focal hyperdense areas in endometriomas: a characteristic finding on CT.

OBJECTIVE: To assess the value of a hyperdense focus seen on CT scans of endometrial cysts in the differential diagnosis of a lesion. MATERIALS AND METHODS: The preoperative CT scans of 328 patients with 410 ovarian masses (54 patients with 62 pathologically proved endometriomas and 274 patients with 348 pathologically proved other ovarian masses) were retrospectively reviewed in a random fashion without knowledge of the pathologic findings to determine whether a hyperdense focus was visible inside a cyst. RESULTS: In nine of 62 endometrial cysts (sensitivity, 15%), CT scans showed a hyperdense round or crescent-shaped focus, measuring 2 to 15 mm. This focus was located close to the inner border of the cyst in eight cases and in the central part of the cyst in one case. A hyperdense focus was not seen on CT scans of 348 other ovarian masses (specificity, 100%). An in vitro CT study of two specimens showed that this hyperdense area corresponded to a blood clot next to the inner wall of the cyst. This hyperdense area appeared as a nonspecific hyperechogenic focus on sonograms in five of nine cases and as a hypointense signal on T1- and/or T2-weighted MR images in four of five cases. CONCLUSION: The finding on CT scans of a hyperdense focus inside an ovarian cyst is suggestive of endometrioma and should help distinguish endometrioma from other pelvic masses.

Carcinoma↗