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Biomedical subjects

R Erny

Publications and source records attributed to R Erny.

At least 19 recordsLinked to original sources
PubMed1992

[Current role of laparoscopy in the diagnosis and treatment of ovarian cysts].

Between October 1986 and March 1990, 220 patients underwent surgical treatment for ovarian cysts. 156 of these patients underwent an initial celioscopy and could potentially benefit from celiosciopic treatment. The group mean age was 33.3 years. The circumstances under which the cysts were discovered usually consisted of pelvic pain or diagnosis during a routine examination. Twenty-four patients underwent laparotomy immediately after coelioscopy either due to a suspect macroscopic diagnosis either due to technical difficulties. 84.6 percent of the patients in the group were able to undergo celioscopic treatment only, essentially consisting of intraperitoneal cystectomy. The main advantages were the reduction in adherent sequelae in these women of a sexually active age, but also some financial savings related to the reduced duration of hospitalization and of sick leave. The theoretical reservations consist of the risk of malignancy and macroscopic diagnosis following coelioscopic exploration must be very restricted, with laparotomy whenever there is any doubt. No malignant tumor was escaped detection in this group.

Adult↗
PubMed1992

[Complications of gynecologic laparoscopy. Multicentric study of 7,604 laparoscopies].

In a series of 7,604 laparoscopic procedures, the authors report one death and a rate of 2.76 per thousand (21 cases) for complications requiring laparotomy. When exclusively diagnostic laparoscopic procedures are considered (1,191 cases) this rate drops to 1.67 per thousand. The likelihood of laparotomy being required is directly related to the degree of importance of the laparoscopic surgical procedure. For major laparoscopic surgery the rate of laparotomy is 4.46 per thousand (18 cases), whereas it is only 0.42 per thousand (1 case) for minor laparoscopic surgery (p less than 0.01). Intestinal injuries represent 52.4% (11 out of 21) of cases requiring laparotomy. The main problem with this type of accident is to recognize them, because in almost half the cases (42.8%; 3 out of 7) the intestinal injury went unseen during the laparoscopic procedure and gave rise to peritonitis. Vascular complications are less frequent and required laparotomy in only 8 cases (38%; 8 out of 21). This low level of complications is yet further proof that laparoscopic surgery is a reliable technique and does not involve a high risk of laparotomy, provided that the surgeon has received specific training.

Female↗
PubMed1991

[Venous insufficiency of the lower limbs in pregnancy].

Pregnancy is a circumstance which may trigger, reveal or aggravate venous insufficiency of the legs. This association (venous insufficiency and pregnancy) is characterized by the rapidity of the onset and aggravation of the signs and by the spectacular nature of the regression which can occur after childbirth. The treatments administered during pregnancy are intended to control the symptoms and prevent complications. After childbirth, a phlebological assessment is carried out to evaluate the sequelae and the therapeutic possibilities.

Clinical Protocols↗
PubMed1991

Epididymal sperm aspiration in conjunction with in-vitro fertilization and embryo transfer in cases of obstructive azoospermia.

Epididymal sperm aspiration is a new treatment for vasal agenesis. In previous reports, epididymal spermatozoa resulted in pregnancy by utilizing in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT). We sought to investigate the efficacy of epididymal sperm aspiration in conjunction with IVF in patients with congenital absence of the vas deferens or with secondary extended obstruction of spermatic ducts. Fifty-eight attempts were performed in 23 patients (25-50 years). Eight patients (34.7%) had vasal agenesis and 14 (60.8%) presented with vasal secondary extended obstruction. The sperm count was adequate (greater than or equal 20 x 10(6)/ml) in 13.8% of sperm retrievals and sperm motility of 20% was obtained in 15.5% of sperm retrievals. Fourteen attempts at IVF were performed with epididymal sperm counts of 2-44 x 10(6)/ml and motilities of 0-45%. A mean of six mature oocytes (0-13) were inseminated in each case. Five embryo transfers were performed in five patients' wives (35.7%) and two couples had an early pregnancy loss (14.2%). Epididymal sperm aspiration is an advance in treating such patients, as an adequate number of mature spermatozoa can be obtained and used for IVF. However, spermatozoa directly aspirated from the proximal epididymis and with fertilizing capacity in vitro, gave a high rate of embryo degeneration (greater than 50%) after embryo transfer.

Adult↗
PubMed1990

[Treatment of uterine fibroma using LH-RH analogs and gestrinone. Limits and indications].

Medical treatment of fibroma has changed radically in recent years with the introduction of analogs of LH-RH (luteinizing hormone releasing hormone). These agents, which are active only via parenteral administration, have proved remarkably effective, and are devoid of metabolic effects. They do engender some disagreeable adverse reactions, and unfortunately their efficacy is transitory and their cost high. Compared with these analogs, gestrinone, a progestogen as yet unused in treatment of luteal insufficiency, seems very interesting in the treatment of fibromas, due to its prolonged antigonadotropic effect and its antiprogesterone effect. Further studies are required to confirm the first results published by Coutinho.

Administration, Intranasal↗
PubMed1989

[Economic advantages of celioscopic treatment of extra-uterine pregnancy].

Laparoscopic surgery has numerous advantages over laparotomy in the treatment of some benign gynaecological conditions and in particular those connected with reproduction. Laparoscopic surgery in ectopic pregnancy seems to be a good example of a condition in which the cost/efficiency ratio can be improved. In 109 cases the mean length of hospital stay was reduced by 4.23 days per case. This led to a saving of 8,954 francs. The mean time off work after operation was reduced by 22 days per patient. This is a considerable economic saving for the population because the numbers ectopic pregnancies have risen considerably.

Female↗
PubMed1989

[Intraperitoneal insemination].

Intra-perineal insemination is a technique used in assisted reproduction. The principle is to stimulate the ovaries, to obtain the partner's sperm and to prepare it by similar techniques to those used in in-vitro fertilization so that the sperm can be placed near the ovaries in the Pouch of Douglas by a direct puncture of the posterior vaginal fornix without using anaesthesia. The woman's pelvis has to be absolutely normal. This technique is useful in cases of unexplained sterility, cervical sterility and inadequate sperm function.

Adult↗
PubMed1989

[Variation in plasma progesterone induced by the vaginal administration of Utrogestan].

The authors of this article have been trying to find out how natural progesterone contained in Utrogestan tablets are absorbed by the body when these tablets are placed in the vagina. To do this they conducted their studies on genitally active young women who had volunteered, who were not pregnant and who were not taking hormones. Several therapeutic protocols were tested. Vaginal administration of 100 mg of progesterone (1 Utrogestan tablet) resulted in an increase in blood progesterone levels within an hour. It reached its maximum level after 2 to 6 hours and lasted for 24 hours on an average. The average level was 3.7 ng/ml with a dose of 100 mg/day and 9.7 ng/ml with a dose of 200 mg/day. One capsule every 12 hours ensures that the least variation between individuals occurs. It is the most worth-while dosage and the one recommended by the authors of this article.

Administration, Intravaginal↗
PubMed1988

[Current therapeutic approach to adnexal cysts].

From a 5-year study of 481 ovarian tumors, the authors discuss their therapeutic management and try to answer two basic questions: what is the proportion of cystic tumors, that actually are carcinomas? To what extent the tapping of a cancerous "cyst" may cause the spreading of the tumor?

Biopsy, Needle↗
PubMed1988

[Lutenyl and menstrual disorders. A hospital study].

The efficacy of nomegestrol acetate in the treatment of menstrual cycle disorders and dysfunctional uterine bleedings was confirmed on 66 cases in this study conducted by three hospital departments. The study also confirmed the perfect clinical tolerance of nomegestrol acetate. One knows that the same is not true with Nortestosterone derivatives which were used up to now in these indications.

Adult↗
PubMed1986

The effects of oral administration of progesterone for premature labor.

The potential tocolytic effect of natural progesterone administration on premature labor was investigated in a double-blind study. An oral progesterone formulation was used because its ability to increase both plasma and myometrial concentration of progesterone in pregnant women had been previously demonstrated. Furthermore, no commercial intravenous or intramuscular natural progesterone formulation is currently available in France. Fifty-seven patients in two obstetric clinics, admitted because of the risk of premature delivery, were included in the study, and uterine contractility and fetal cardiac rhythm were monitored in all of them. At random and after 30 minutes' rest, 29 women absorbed four capsules of 100 mg of progesterone each and 28 women absorbed four capsules of a placebo. Plasma progesterone levels were evaluated in all cases after 30 minutes' rest and 1 hour after absorption of the capsules. The results showed that bed rest and placebo administration decrease uterine activity in 42% of the cases and oral progesterone decreases activity in 75% to 88% of cases, depending on the initial severity of the menace of premature delivery. The difference between the effects of progesterone and of placebo is significant. The tocolytic effect of oral progesterone is not as intense or as rapid as the effect of intravenous beta-mimetics but is sufficient in 80% of cases, on the average, to stop the premature labor without any detectable side effects. This tocolytic effect of oral progesterone is related not just to an increase in plasma progesterone levels but probably to an increase in myometrial progesterone concentration.

Administration, Oral↗
PubMed1986

[Progestogen tests after the menopause].

There is virtually no screening for endometrial cancer after the menopause. The methods so-far available (cervico-vaginal smear or endouterine specimens) are either unreliable or else difficult to perform. The progestogen tests are, in contrast, easy for any doctor to carry out, acceptable to patients, fairly reliable and low cost, which should make their widespread use possible. The administration of a progestogen to a post-menopausal woman should not produce bleeding unless the endometrium is hyperplasic or proliferative. 1 366 tests of this type were carried out and resulted, amongst other discoveries, in the detection of 5 cases of asymptomatic cancers of the endometrium and 2 cases of ovarian cancer.

Endometrial Hyperplasia↗
PubMed1984

Adenosine-dependent activation of tyrosine hydroxylase is defective in adenosine kinase-deficient PC12 cells.

(R)-N6-Phenylisopropyladenosine (PIA) stimulates dopa production 3- to 5-fold in PC12 cells, with a half-maximal effective concentration (EC50) of 50 nM. This increase can be explained by a stable activation of tyrosine hydroxylase [TyrOHase; L-tyrosine, tetrahydropteridine:oxygen oxidoreductase (3-hydroxylating), EC 1.14.16.2] when it is phosphorylated by a cAMP-dependent protein kinase. The activation of TyrOHase is mediated by the adenosine-dependent activation of adenylate cyclase (EC50 = 600 nM). PIA (10 microM) is as effective as cholera toxin or dibutyryl cAMP in activating TyrOHase in wild-type cells. Adenosine kinase-deficient mutants of PC12 were found to be resistant to PIA-dependent activation of TyrOHase (EC50 = 100-1000 nM). This phenomenon was explored in detail in one adenosine kinase-deficient mutant and was shown to occur because the mutant was resistant to the adenosine-dependent activation of adenylate cyclase. In this mutant, TyrOHase was activated 14-fold by cholera toxin, suggesting that activated TyrOHase is about 14 times as active as unactivated TyrOHase. These studies with kinase-deficient PC12 cells provide genetic evidence that adenosine-dependent activation of TyrOHase is mediated by acute increases in cAMP. When the adenosine receptor found on PC12 cells is expressed in vivo, it might function as either a presynaptic (i.e., localized on the nerve terminal) or a postsynaptic (i.e., localized on the cell body or dendrite) receptor that regulates rates of transmitter synthesis in response to cell activity.

Adenosine↗