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Barranger E, Fay S, Cortez A, Uzan S, Daraï E. [Value of the sentinel node biopsy in uterine cancers]. Gynecol Obstet Fertil 2004; 32:694-702. [PMID: 15380747 DOI: 10.1016/j.gyobfe.2004.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/10/2004] [Accepted: 07/13/2004] [Indexed: 11/20/2022]
Abstract
In cancer research, regional lymph node status is a major prognostic factor and a decision criterion for adjuvant therapy. The sentinel node procedure, which has emerged to reduce morbidity of extensive lymphadenectomy, remains a major step in the surgical management of various cancers. Sentinel node procedure has become a standard technique for the determination of the nodal stage of the disease in patients with melanoma, vulvar cancer and recently in breast cancer. In cervical and endometrial cancers, the sentinel node biopsy is still at the stage of feasibility. In this article, we review the technical aspects, results and clinical implications of sentinel node procedure in cervical and endometrial cancers.
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Affiliation(s)
- E Barranger
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, Cancer Est, 4, rue de la Chine, 75020 Paris, France.
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52
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Bazot M, Thomassin I, Hourani R, Cortez A, Darai E. Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis. Ultrasound Obstet Gynecol 2004; 24:180-185. [PMID: 15287057 DOI: 10.1002/uog.1108] [Citation(s) in RCA: 164] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To determine the accuracy of transvaginal sonography (TVS) for the diagnosis of deep pelvic endometriosis. METHODS In a prospective study, 142 women with clinical signs of endometriosis underwent TVS followed by surgical and histopathological investigations. The presence and extent of endometriosis involving the uterosacral ligaments, vagina, rectovaginal septum, intestines, bladder and ovaries shown by TVS were compared with surgical and histological findings. The sensitivity, specificity, predictive values and accuracy of TVS for predicting deep pelvic endometriosis were assessed. RESULTS Ovarian and deep pelvic endometriosis were found by surgery and histology in respectively 83 (58.5%) and 79 (55.6%) of the 142 patients. The sensitivity, specificity, and positive and negative predictive values of TVS for the diagnosis of deep pelvic endometriosis were 78.5%, 95.2%, 95.4% and 77.9%, respectively. The sensitivity and specificity of TVS for endometriotic involvement of the uterosacral ligaments, vagina, rectovaginal septum and intestines were 70.6% and 95.9%, 29.4% and 100%, 28.6% and 99.3%, and 87.2% and 96.8%, respectively. The sensitivity and specificity of TVS for bladder involvement were 71.4% and 100%, respectively. CONCLUSION TVS accurately diagnoses intestinal and bladder endometriosis, but is less accurate for uterosacral, vaginal and rectovaginal septum involvement.
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Affiliation(s)
- M Bazot
- Department of Radiology, Hôpital Tenon, Paris, France.
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53
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Castro AMMG, Cortez A, Ruiz VLA, Leomil H, Moreno AM, Doto DS, Richtzenhain LJ. Detection and differentiation of porcine circoviruses in Brazilian pigs. Vet Rec 2004; 154:728-9. [PMID: 15214518 DOI: 10.1136/vr.154.23.728] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A M M G Castro
- Department of Preventive Veterinary Medicine and Animal Health, University of São Paulo, São Paulo, 05508-900, Brazil
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54
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Barranger E, Cortez A, Commo F, Marpeau O, Uzan S, Darai E, Callard P. Histopathological validation of the sentinel node concept in cervical cancer. Ann Oncol 2004; 15:870-4. [PMID: 15151942 DOI: 10.1093/annonc/mdh227] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The sentinel node (SN) is defined as the first node in the lymphatic system that drains a tumor site. If the SN is not metastatic, then all other nodes should also be disease-free. We used serial sections and immunohistochemical (IHC) staining to examine both sentinel and non-sentinel nodes (non-SNs). MATERIALS AND METHODS From July 2001 to March 2003, 18 patients (median age, 48 years) with cervical cancer (stage IA2, one patient; stage IB1, nine patients; stage IB2, three patients; stage IIA, three patients; and stage IIB, two patients) underwent a laparoscopic SN procedure based on a combined detection method, followed by complete laparoscopic pelvic lymphadenectomy. If the SN was free of metastasis by both hematoxylin and eosin (H&E) and IHC staining, all non-SNs were also examined by the combined staining method. RESULTS A mean of 2.4 SNs (range 1-5) and 8 non-SNs (range 4-14) were excised per patient. Eight SNs (18.2%) from five patients (27.8%) were found to be metastatic at the final histological assessment, including two macrometastatic SNs, three micrometastatic SNs and isolated tumor cells in three SNs. In 13 patients, no metastatic SN involvement was detected by H&E and IHC staining. In these 13 patients, 106 non-SNs were examined by serial sectioning and IHC, and none was found to be metastatic. CONCLUSIONS The SN procedure appears to reliably predict the metastatic status of the regional lymphatic basin in patients with cervical cancer.
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Affiliation(s)
- E Barranger
- Department of Gynecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France.
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55
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Salomon LJ, Detchev R, Barranger E, Cortez A, Callard P, Darai E. Treatment of Anterior Vaginal Wall Prolapse with Porcine Skin Collagen Implant by the Transobturator Route: Preliminary Results. Eur Urol 2004; 45:219-25. [PMID: 14734010 DOI: 10.1016/j.eururo.2003.09.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the feasibility and efficacy of porcine skin collagen (Pelvicol) implant by the transobturator route for the treatment of anterior vaginal wall prolapse. PATIENTS AND METHODS Twenty-seven women with stage III or IV prolapse underwent anterior vaginal wall repair with porcine skin collagen implantation by the transobturator route, together with bilateral sacropinofixation; respectively 17 and 16 women underwent hysterectomy and bilateral sapingo-oophorectomy during the same procedure. The feasibility and peri/postoperative complications of the transobturator procedure were assessed, together with anatomical and functional outcome. RESULTS Porcine skin collagen implantation was feasible in every case. The transobturator procedure lasted a median of 25 min (range 20-35). There were no vessel or bladder injuries and no postoperative complications (including infections). Median follow-up was 14 months (range 8 to 24). No rejection of the porcine grafts occurred. Twenty-two women (81%) had optimal anatomic results, while the remaining five women (19%) had persistent asymptomatic stage I or II anterior vaginal wall prolapse (1 and 4 cases, respectively). In one case the collagen implant had to be removed after one year because of persistent pain due to transfixing vaginal stitch. One patient with optimal anatomic results had recurrent stage III Ba prolapse at 18 months. Quality of life and urinary discomfort scores improved significantly after the procedure (p<0.0001 and p<0.005, respectively). CONCLUSION These preliminary results suggest that porcine skin collagen implantation by the transobturator route is a safe and effective treatment for anterior vaginal wall prolapse.
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Affiliation(s)
- L J Salomon
- Department of Gynecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, 4 rue de la Chine, 75020 Cedex 20, Paris, France
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56
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Challier JC, Landi M, Galtier M, Bintein T, Cortez A, Rabreau M. Separation of trophoblastic and vascular cell lineages and vascular maturation in early human placental development. Cell Mol Biol (Noisy-le-grand) 2004; 50 Online Pub:OL527-31. [PMID: 15555417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2004] [Accepted: 03/16/2004] [Indexed: 05/01/2023]
Abstract
The trophoblast and vascular cell lineages have been studied by immunohistochemistry at 6 and 12-14 weeks of pregnancy. Perivillous and extravillous cytotrophoblasts were specifically stained by anti-cytokeratin 7 whereas endothelial cells were labelled by anti-CD34 at these two stages of pregnancy. Perivillous and extravillous cytotrophoblasts together with erythroblasts showed mitotic figures and anti-Ki67 positive nuclei at the 6th week. In the perivillous cytotrophoblast, the number of Ki67 positive nuclei decreased by 12-14 weeks and the staining was limited to the proximal extravillous trophoblast of cell islands. Some endothelial and perivascular cells were labelled with anti-Ki67 at 12-14 weeks. Erythroblasts did not stain at all at this stage. Endothelial cells bound lectin UEA1 and vessels exhibited a fluorescent signal after anti-myosin staining at 12-14 weeks. These data showed that the cytotrophoblast and endothelial cell lineages are not related from 6 to 12-14 weeks of pregnancy. Because mitotic figures or anti-Ki67 staining were not observed in endothelium or perivascular cells at the 6th week, it seems likely that the endothelial cells committed to vasculogenesis derived from stromal cells. By 12-14 weeks, endothelial cells had nearly achieved their maturation by acquiring 1-fucosyl-binding sites revealed by UEA1-lectin binding and insuring their own renewal by mitosis. The maturation of perivascular cells at 12-14 weeks was shown by the anti-sm-myosin staining. We conclude that placental vasculogenesis involves mesenchymal cells rather than trophoblast. The differenciation of vessels organizing from random plexi to a vascular arborescence may involve paracrine regulatory loops with the trophoblast.
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Affiliation(s)
- J C Challier
- Physiopathologie de l'Implantation et du Développement, Upres 2396, Faculté de Médecine St Antoine, Paris 75012, France.
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57
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Barranger E, Cortez A, Grahek D, Callard P, Uzan S, Daraï E. Technique du ganglion sentinelle dans les cancers utérins : revue de la littérature. ACTA ACUST UNITED AC 2003; 128:680-7. [PMID: 14706877 DOI: 10.1016/j.anchir.2003.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In cancer research, regional lymph node status is a major prognostic factor and a decision criterion for adjuvant therapy warranting the lymphadenectomy. The sentinel node procedure, which has emerged to reduce morbidity of extensive lymphadenectomy, remains a major step in the surgical management of various cancers. Sentinel node procedure has become a standard technique for the determination of the nodal stage of the disease in patients with melanoma, vulvar cancer and recently in breast cancer. In cervical and endometrial cancers, the sentinel node biopsy is still at the stage of feasibility. In this article, we review the technical aspects, results and clinical implications of sentinel node procedure in cervical and endometrial cancers.
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Affiliation(s)
- E Barranger
- Service de gynécologie-obstétrique, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
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58
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Salomon LJ, Lefevre M, Cortez A, Antoine JM, Uzan S. [Struma ovarii: a rare tumor that deserves special management. Case report and review of the literature]. J Gynecol Obstet Biol Reprod (Paris) 2003; 32:175-8. [PMID: 12717308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Struma ovarii is a rare benign tumor which represents less than 3% of ovarian teratomas. We report a case of struma ovarii occurring in a 64-year-old woman. This tumor was thought to be a malignant ovarian tumor until surgical exploration. Based on this observation and the review of the literature we describe the main characteristics and propose a diagnostic and therapeutic management scheme for such tumors.
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Affiliation(s)
- L J Salomon
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Tenon, Paris
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59
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Abstract
Alternate mRNA splicing of human leptin receptor generates four membrane isoforms with different C-terminal sequences. They differ by the length of their intracellular domain which include specific motifs crucial for the specificity of leptin signalling. As a step towards functional studies, we have characterized leptin receptors in human placenta from normal pregnancies and pregnancies associated with diabetes and pre-eclampsia. Leptin and leptin receptors were visualized by immunohistochemistry of placentas obtained from first and third trimester pregnancies. Antibodies against N and C-terminal epitopes showed signals in the apical membrane of the syncytiotrophoblast in early and term placental villi as well as in JAr and BeWo derived trophoblast cells. In addition, a distinct isoform recognized by its extracellular juxtamembrane epitope was exclusively localized in cytotrophoblast cells and likely stains the soluble receptor. At contrast with the transmembrane receptors, the expression of this isoform is increased in placentas of pre-eclamptic and diabetic women which synthesize more leptin than placenta from uncomplicated pregnancy. These data demonstrate that short and long transmembrane leptin receptors are expressed in the trophoblast and indicate that leptin synthetized within the placenta can act locally through both receptor isoforms. Being also accessible to leptin from maternal origin, these transmembrane receptors may signal differently in pregnancy with normal and increased leptin production. The co-localization of leptin and the soluble receptor isoform suggests that this isoform serves for modulating maternal free leptin levels through modification of leptin binding capacities.
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Affiliation(s)
- J Challier
- Université P & M Curie, Physiopathologie de I'Implantation et du Développement, 12 rue Cuvier, Paris, France
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60
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Bazot M, Daraï E, Rouger J, Detchev R, Cortez A, Uzan S. Limitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlation. Ultrasound Obstet Gynecol 2002; 20:605-611. [PMID: 12493051 DOI: 10.1046/j.1469-0705.2002.00852.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVES To evaluate the accuracy of transabdominal sonography (TAS) and transvaginal sonography (TVS) for the diagnosis of adenomyosis, and to determine the diagnostic relevance of various sonographic criteria. SUBJECTS AND METHODS A total of 129 women scheduled for hysterectomy were enrolled into this prospective study. Group 1 (n = 23) consisted of patients with menometrorrhagia who were free of myoma and endometrial disorders on TAS. Group 2 consisted of all the other patients (n = 106). TAS and TVS findings were compared to histopathological results. RESULTS The prevalence of adenomyosis in Groups 1 and 2 was 91.3% and 24.5%, respectively. TAS had limited value for the diagnosis of adenomyosis in both groups. The sensitivity, specificity, and positive and negative predictive values of TVS in Groups 1 and 2 were 80.9% and 38.4%, 100% and 97.5%, 100% and 83.3%, and 40% and 82.9%, respectively. The accuracy of combined TAS and TVS in Groups 1 and 2 was 91.3% and 83%, respectively. The presence of myometrial cysts was the most specific ultrasound diagnostic criterion for adenomyosis. Hypoechoic linear myometrial striations related to the presence of myometrial hypertrophy correlated to hormonal status with a sensitivity of 66.6% and a specificity of 100% in Group 1. CONCLUSIONS Our results show that TAS has a limited diagnostic capacity for adenomyosis but also that TVS alone was poor in patients with an enlarged uterus. In these cases a combination of TVS and TAS should be used.
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Affiliation(s)
- M Bazot
- Department of Radiology, Hôpital Tenon, Paris, France.
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61
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Heinemann MB, Fernandes-Matioli FMC, Cortez A, Soares RM, Sakamoto SM, Bernardi F, Ito FH, Madeira AMBN, Richtzenhain LJ. Genealogical analyses of rabies virus strains from Brazil based on N gene alleles. Epidemiol Infect 2002; 128:503-11. [PMID: 12113496 PMCID: PMC2869848 DOI: 10.1017/s095026880200688x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Thirty rabies virus isolates from cows and vampire bats from different regions of São Paulo State, Southeastern Brazil and three rabies vaccines were studied genetically. The analysis was based on direct sequencing of PCR-amplified products of 600 nucleotides coding for the amino terminus of nucleoprotein gene. The sequences were checked to verify their genealogical and evolutionary relationships and possible implication for health programmes. Statistical data indicated that there were no significant genetic differences between samples isolated from distinct hosts, from different geographical regions and between samples collected in the last two decades. According to the HKA test, the variability observed in the sequences is probably due to genetic drift. Since changes in genetic material may produce modifications in the protein responsible for immunogenicity of virus, which may eventually cause vaccine failure in herds, we suggest that continuous efforts in monitoring genetic diversity in rabies virus field strains, in relation to vaccine strains, must be conducted.
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Affiliation(s)
- M B Heinemann
- Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, SP, Brasil
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62
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Bernard J, Le Breton C, Piriou P, Khalil A, Boumenir Z, Cortez A, Carette MF, Bigot JM, Judet T. [Value of MRI to evaluate extra-abdominal desmoid fibromatosis]. J Radiol 2002; 83:711-6. [PMID: 12149587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
PURPOSE To describe the MR appearance of extra-abdominal desmoid fibromatosis, especially using sequences such as MR angiography, STIR and FAT SAT. Materials and methods. We reviewed retrospectively the MRI studies of 8 patients (4 men and 4 women) with histologically proved desmoid fibromatosis. In five patients the lesion corresponded to recurrent disease. Eleven MRI examinations were available (Siemens, Vision, 1.5T) including the following sequences: pre- and postcontrast T1 weighted (11 cases), STIR (9 cases), and MRA (3 cases). All lesions were imaged in at least two orthogonal planes. CT was available for 5 patients. RESULTS The lesions were localized to the girdles in 8 cases and to the upper extremity in 3 cases. Most lesions (10/11) were isointense to muscle on noncontrast T1W images and showed intense enhancement on postcontrast T1W images. All lesions (9/9) were hyperintense on STIR images. CONCLUSION A STIR sequence is useful as a first sequence to identify smaller lesions (usually recurrences) and to better adapt the FOV of following sequences, especially before administration of intravenous contrast. MR angiography may be valuable for surgical planning.
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Affiliation(s)
- J Bernard
- Service de Radiologie, Hôpital Tenon, France
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63
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Soares RM, Bernardi F, Sakamoto SM, Heinemann MB, Cortez A, Alves LM, Meyer AD, Ito FH, Richtzenhain LJ. A heminested polymerase chain reaction for the detection of Brazilian rabies isolates from vampire bats and herbivores. Mem Inst Oswaldo Cruz 2002; 97:109-11. [PMID: 11992159 DOI: 10.1590/s0074-02762002000100019] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A heminested-PCR (hn-PCR) using primers to the nucleoprotein-coding gene in a nested set was evaluated in the detection of Brazilian strains of rabies virus (RV). A representative number of RV nucleoprotein sequences belonging to genotype 1 were aligned. Based on such alignment, primers were directed to highly conserved regions. All 42 clinical samples positive by both fluorescent antibody and mouse inoculation tests were also positive by the hn-PCR. Brain tissue that had been left to decompose, obtained from an experimentally inoculated mouse was tested by hn-PCR and yielded positive results. In conclusion, primers designed here were capable of amplifying Brazilian RV isolates obtained from a rural epidemiological cycle.
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Affiliation(s)
- R M Soares
- Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brasil
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64
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Affiliation(s)
- P P Cortez
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Portugal
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65
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Bazot M, Cortez A, Darai E, Rouger J, Chopier J, Antoine JM, Uzan S. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod 2001; 16:2427-33. [PMID: 11679533 DOI: 10.1093/humrep/16.11.2427] [Citation(s) in RCA: 297] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The objective of this study was to compare the accuracy of transabdominal (TAUS) and transvaginal sonography (TVUS) and magnetic resonance imaging (MRI) for the diagnosis of adenomyosis, and to correlate imaging with histological findings. METHODS In a prospective study, 120 consecutive patients referred for hysterectomy underwent TAUS, TVUS and MRI. Results of these examinations were interpreted blindly to histopathological findings. RESULTS Histological prevalence of adenomyosis and leiomyomas was 33.0 and 47.5% respectively. Adenomyotic uteri were accompanied by additional pelvic disorders in 82.5% of cases. Sensitivity, specificity, and positive and negative predictive values of TAUS and TVUS were 32.5 and 65.0%, 95.0 and 97.5%, 76.4 and 92.8%, and 73.8 and 88.8% respectively. Myometrial cyst was the most sensitive and specific TVUS criterion. In MRI, the presence of a high-signal-intensity myometrial spot was as specific but less sensitive than a maximal junctional zone thickness (JZ(max)) >12 mm and a JZ(max) to myometrial thickness ratio >40%. Sensitivity, specificity, and positive and negative predictive values of MRI were 77.5, 92.5, 83.8 and 89.2% respectively. No difference in accuracy was found between TVUS and MRI, but sensitivity was lower with sonography in women with associated myomas. CONCLUSIONS TVUS is as efficient as MRI for the diagnosis of adenomyosis in women without myoma, while MRI could be recommended for women with associated leiomyoma.
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Affiliation(s)
- M Bazot
- Department of Radiology, Hôpital Tenon, 4 rue de la Chine, 75020, France.
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66
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Cortez A, Scarcelli E, Soares RM, Heinemann MB, Sakamoto SM, Genovez ME, Ferreira F, Richtzenhain LJ. Detection of Brucella DNA from aborted bovine foetuses by polymerase chain reaction. Aust Vet J 2001; 79:500-1. [PMID: 11549051 DOI: 10.1111/j.1751-0813.2001.tb13025.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Cortez
- Faculdade de Medicina Veterinária e Zootecnia, University of São Paulo, Brazil
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67
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Merviel P, Mergui JL, Gaudet R, Sananes S, Cortez A, Uzan S. [Are cervicovaginal smears feasible in women over 65 years under hormone replacement therapy?]. Contracept Fertil Sex 1999; 27:826-32. [PMID: 10676039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- P Merviel
- Service de gynécologie-obstétrique et médecine de la reproduction, Hôpital Tenon, Paris, France
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68
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Affiliation(s)
- M Bazot
- Department of Radiology, Hôpital Tenon, Paris, France
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69
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Heinemann MB, Garcia JF, Nunes CM, Morais ZM, Gregori F, Cortez A, Vasconcellos SA, Visintin JA, Richtzenhain LJ. Detection of leptospires in bovine semen by polymerase chain reaction. Aust Vet J 1999; 77:32-4. [PMID: 10028391 DOI: 10.1111/j.1751-0813.1999.tb12422.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In view of the considerable importance of venereal transmission of bovine leptospirosis, the objective of the present study was to compare the polymerase chain reaction (PCR), culture/isolation and serology to detect leptospire infection in bovine semen. DESIGN Blood for serologic examination and semen for bacterial culture and PCR were collected from 20 bulls at artificial insemination centres in Brazil. Each animal was sampled twice for serology. RESULT Forty-five percent (9/20) of the serum samples collected showed agglutinin titers to serovar hardjo in the first sample and 25% (5/20) had agglutinin titers to serovar hardjo in the second sample. Eighty percent (16/20) of semen samples were positive by PCR. Leptospires could not be isolated from any of the semen samples examined. CONCLUSION Polymerase chain reaction can be a method of great potential for the detection of leptospires at artificial insemination centres.
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Affiliation(s)
- M B Heinemann
- Faculdade de Medicina Veterinária e Zootecnia, University of São Paulo, Brazil
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70
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Gibson KM, Sweetman L, Kozich V, Pijackova A, Tscharre A, Cortez A, Eyskens F, Jakobs C, Duran M, Poll-The BT. Unusual enzyme findings in five patients with metabolic profiles suggestive of succinic semialdehyde dehydrogenase deficiency (4-hydroxybutyric aciduria). J Inherit Metab Dis 1998; 21:255-61. [PMID: 9686370 DOI: 10.1023/a:1005368106563] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- K M Gibson
- Institute of Metabolic Disease, Baylor University Medical Center, Dallas, Texas, USA
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71
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Contencin P, Gumpert LC, Cortez A, Livarek S. Squamous cell carcinoma of the trachea in an infant: a case report. Int J Pediatr Otorhinolaryngol 1998; 43:163-73. [PMID: 9578126 DOI: 10.1016/s0165-5876(97)00171-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Primary malignant tumours of the trachea are extremely rare in infants. This report describes an 11-month-old boy suffering from severe dyspnea with a 5-month history of stridor and 'bronchitis'. A hard mass could be palpated below the right lobe of the thyroid gland. Roentgenograms and endoscopy showed an exophytic tumour filling more than 80% of the tracheal lumen. A tracheal resection and a subtotal thyroidectomy with primary anastomosis was performed. An invasive squamous cell carcinoma of the trachea was diagnosed. This is the first reported case in an infant in the English literature. A local recurrence was found on MRI 19 weeks later. The infant died at 16 months of age.
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Affiliation(s)
- P Contencin
- Service d'ORL, Hôpital Robert-Debré, Faculté de Médecine X., Bichat, Paris, France
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72
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Germain JF, Farnoux C, Pinquier D, Cortez A, Hartmann JF, Sibony O, de Lagausie P, Beaufils F. Can blood gas values predict pulmonary hypoplasia in antenatally diagnosed congenital diaphragmatic hernia? J Pediatr Surg 1996; 31:1634-9. [PMID: 8986975 DOI: 10.1016/s0022-3468(96)90036-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The prognosis of antenatally diagnosed congenital diaphragmatic hernias (CDH) is clearly related to the degree of pulmonary hypoplasia (PH). After birth, controversies remain regarding the implementation of various therapies, especially the use of extracorporeal membrane oxygenation (ECMO). In the literature, the persistence of a Pao2 below 100 mm Hg and of Paco2 above 40 mm Hg despite optimal conventional therapy indicates poor prognosis. Therefore, since 1992, published and personal experiences led the authors to exclude CDH patients from ECMO when conventional therapy (including high-frequency oscillatory ventilation and nitric oxide) did not obtain Pao2 of above 80 mm Hg and Paco2 of below 60 mm Hg. The aim of this retrospective study is to determine whether blood gas results correlate with postmortem findings. Between July 1990 and July 1994, 32 cases of CDH were monitored antenatally and managed postnatally at the authors' institution. Six patients survived; 26 died, including one immediately at birth. Thirteen were treated by ECMO. Seventeen had a best Pao2 of above 80 mm Hg, including the six survivors. Fourteen did not reach this level, and none of them survived. Twenty-three infants underwent postmortem examination. PH was assessed using two criteria: (1) lung weight to body weight ratio (LW/BW) and (2) radial alveolar count (RAC). Two patients did not have hypoplasia (LW/BW > 0.018). Twenty-one patients had PH; 12 of them had an LW/BW ratio of less than .009; for 9, the LW/BW ratio was between .009 and .018, and the RAC (< 3.1) confirmed PH. All infants with a best Pao2 of less than 80 mm Hg had PH. Patients with a best Pao2 of greater than 80 mm Hg included two infants who died from complications without PH, eight infants with demonstrated PH, and the six survivors. In conclusion. (1) No infant with nonhypoplastic lungs has been deprived of ECMO by the authors' criteria. (2) Adequate values of blood gases may not eliminate PH. Therefore, this probably justifies starting ECMO when conventional therapy fails. (3) Conversely, permanent poor values of Pao2 allowed the prediction of PH in all cases. Such patients probably can be excluded from ECMO treatment.
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Affiliation(s)
- J F Germain
- Faculty of Medicine, Hôpital Robert Debré, Paris, France
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73
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Abstract
An atypical case of a first branchial cleft presenting with a cutaneous fistula and an epidermoid cyst of the external auditory canal is reported. The relevant embryology of the branchial apparatus is summarized, and variations of first branchial anomalies are discussed. The relationship with a congenital cholesteatoma is discussed.
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Affiliation(s)
- I de Gaudemar
- Service d'Oto-Rhino-Laryngologie, Hôpital Robert Debré, Paris, France
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74
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Tagari P, Abraham WM, McGolrick J, Charleson S, Soler M, Ahmed A, Cortez A, Ford-Hutchinson AW. Increased leukotriene E4 excretion during antigen-induced bronchoconstriction in allergic sheep. J Appl Physiol (1985) 1990; 68:1321-7. [PMID: 2161409 DOI: 10.1152/jappl.1990.68.4.1321] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The metabolism of leukotrienes (LT) in the sheep was investigated to define markers of 5-lipoxygenase involvement in allergic responses, obtainable by noninvasive techniques. Intravenous administration of 14, 15-[3H]LTC4 (0.5 microCi/kg) revealed a rapid clearance from the circulation (half time = 90 s). Circulatory metabolism was apparent, with early formation (within 1 min) of LTD4 and LTE4 shown by reverse-phase high-pressure liquid chromatography (RP-HPLC). Urinary 3H excretion comprised 10% of the original dose. [3H]LTE4 (characterized by coelution with authentic standards during RP-HPLC analysis) was observed in early urine samples. By use of a sensitive and specific RP-HPLC radioimmunoassay analysis, immunoreactive material coeluting with LTE4 was detected in urine from allergic sheep. Excretion of this material was significantly increased during antigen-induced acute bronchoconstriction in eight conscious allergic sheep [preantigen, 65.70 +/- 24.27 (SE) pg; 0-1 h postantigen, 208.00 +/- 71.10 pg, P less than 0.05], but not during late responses. However, total postantigen LTE4 excretion (37.8 - 956.1 pg/8 h) was highly correlated (r = 0.976, P less than 0.001) with the severity of bronchoconstriction (445.3 - 2,409.1% specific pulmonary resistance per hour) assessed by measurement of the area under the curve of pulmonary function plotted against time. These findings represent an important demonstration of in vivo allergen-induced peptide LT generation in a physiologically characterized animal model of prolonged allergic bronchoconstriction and further substantiate an important role for LT in this model of allergic asthma.
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Affiliation(s)
- P Tagari
- Department of Pharmacology, Merck Frosst Centre for Therapeutic Research, Point-Claire, Quebec, Canada
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75
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Jarry A, Cortez A, René E, Muzeau F, Brousse N. Infected cells and immune cells in the gastrointestinal tract of AIDS patients. An immunohistochemical study of 127 cases. Histopathology 1990; 16:133-40. [PMID: 2323734 DOI: 10.1111/j.1365-2559.1990.tb01081.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Human immunodeficiency virus (HIV) proteins were detected by immunohistochemistry in the duodenal and rectal mucosa of 30% of 127 AIDS patients studied. HIV-infected cells were present in the lamina propria in 95% of the positive biopsies. They were immune cells, either isolated lymphocytes and macrophages (1-4 per positive biopsy) or dendritic reticulum cells forming a network in the germinal centres of mucosal lymphoid follicles. HIV proteins were not found in the duodenal epithelium or in the superficial rectal epithelium. In two cases (5% of the positive biopsies), they were found in rectal glands: the HIV-infected cells could be either epithelial cells or immune cells. This study confirms that the gut can be a target organ for HIV and that HIV is mainly carried by gut immune cells. The phenotypic study of lymphoid populations and macrophages in the gut mucosa of AIDS patients showed an inverse CD4/CD8 ratio in the lamina propria, compared with normal controls. This was independent of the presence of HIV proteins and is probably responsible for the appearance of opportunistic infections in the mucosa. An increase in activated macrophages was also noted in the mucosa of AIDS patients.
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Affiliation(s)
- A Jarry
- INSERM U239, Faculté de Médecine X, Bichat, Paris, France
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76
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Bousquet JC, You K, Cortez A, Grellet J, Vayre P. [Carcinosarcoma of the gallbladder. Echographic and anatomopathological diagnosis. Apropos of a case with review of the literature]. J Radiol 1986; 67:719-23. [PMID: 3540290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Precise diagnosis of carcinosarcoma of gallbladder, a rare tumor, is based on histopathology since clinical and epidemiologic elements fail to differentiate it from other gallbladder cancers. Ultrasound imaging is the most effective radiodiagnostic technique since it allows visualization of the tumor and suggests the presence of a carcinosarcoma when a polypoid or vegetating mass is detected within the gallbladder.
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77
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78
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Langlois P, Bodin L, Bousquet JC, Rouby JJ, Godet G, Davy-Mialou C, Wiart D, Cortez A, Chomette G, Grellet J. [Post-stress nonlithiasic acute cholecystitis. Contribution of ultrasonics to the diagnosis and treatment in 50 cases]. Gastroenterol Clin Biol 1986; 10:238-43. [PMID: 3525307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Fifty cases of post-stress acute acalculous cholecystitis were observed during the past 9 years, mainly after major surgery or trauma. The apparently increasing incidence over the last 4 years (42 cases) could probably be explained by a better diagnostic approach of this condition by routine use of ultrasonography. No specific etiological factor could be found; however total parenteral nutrition and/or sepsis and/or use of narcotics could possibly play a role in the appearance of this complication. Although diagnosis can occasionally be suspected in the basis of abdominal and infectious signs, diagnosis was made primarily on the following ultrasonographic signs: enlarged gallbladder with thickened wall, sludge, and occasionally a double-wall aspect and a pericholecystic collection. In this series, most of the patients were treated by cholecystectomy, but a new therapeutic approach was used in 10 cases: percutaneous transhepatic drainage under sonographic control. Outcome is still poor, with a 50 p. 100 mortality rate.
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79
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Davy C, Riveau E, Bousquet JC, Curet P, Vayre P, Cortez A, Grellet J. [Small intestine transit anomalies in a patient with chronic abdominal pain and treated for Hansen's disease]. J Radiol 1986; 67:213-8. [PMID: 3528476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This new case of enteropathy due to Clofazimine provided demonstration of the diagnostic value of small bowel follow-through examination in this complication. Various small intestine anomalies have been reported: ileal or partial jejunal lesions; variations in caliber; loss of physiologic folds; irregularly outlined surface and border lacunae and persistence of suppleness of pathologic loops. Knowledge of these anomalies should avoid exploratory laparotomy, Clofazimine-induced enteropathy regressing after discontinuation of treatment. Repeat small bowel follow up examinations can be performed to review course of this regression.
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80
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Jost JL, Venencie PY, Cortez A, Orieux G, Debbasch L, Chomette G, Puissant A, Vayre P. [Enteropathy caused by clofazimine]. J Chir (Paris) 1986; 123:7-9. [PMID: 3958073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A case of Clofazimine enteropathy is reported, diagnosed on the demonstration of red brown birefringent crystals in the small bowel mucosa and submucosa as well as in the mesenteric lymph nodes whereas the clinical and radiological signs appear to be non specific. After the withdrawal of the drug, a clear improvement of the symptoms was achieved only under a gluten free diet. The possibility of such accidents, sometimes lethal, suggests the restriction of clofazimine to leprosy.
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81
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Levine JD, Murphy DT, Seidenwurm D, Cortez A, Fields HL. A study of the quantal (all-or-none) change in reflex latency produced by opiate analgesics. Brain Res 1980; 201:129-41. [PMID: 6251949 DOI: 10.1016/0006-8993(80)90780-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The properties of opiate-induced changes of tail-flick latency were studied in the rat. (1) Morphine and pentazocine produced a stepwise increase in latency which rose from near baseline to cut-off (usually greater than 20 sec) in less than 30 sec. Abrupt return to pre-treatment latencies was observed either spontaneously or when the rat was back-titrated with the narcotic antagonist naloxone. (2) The proportion of rats showing this stepwise change increased with increasing dose; however, the step itself was independent of dose. The same step was produced by a slow, constant infusion of morphine but was not produced by ice-water stress or barbiturate administration. (3) Increasing heat intensity to the tail shortened the baseline latency and raised the mean dose of morphine required to produce a step latency increase. (4) A step increase in latency was also observed when paw withdrawal instead of tail-flick was measured. We hypothesize that the analgesic behavior described partly defines the operating characteristics of an intrinsic endorphin-mediated analgesia system which mediates narcotic suppression of withdrawal reflexes.
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82
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Lucas CE, Zito JG, Carter KM, Cortez A, Stebner FC. Questionable value of furosemide in preventing renal failure. Surgery 1977; 82:341-20. [PMID: 888101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The effects of furosemide on renal function and hemodynamics were evaluated in 54 critically ill surgical patients. Standard clearance techniques were used to measure glomerular filtration rate (GFR), renal plasma flow (RPF), osmolar clearance (COsm), sodium clearance (CNa), and renal blood flow (RBF). RBF distribution to outer cortex, inner cortex-outer medulla, and inner medulla was measured by the radioactive xenon disappearance technique. Furosemide produced a marked rise in urine output, COsm, and CNa; it produced no change in GFR, RPF, RBF, and RBF distribution. Twelve of the 54 patients received furosemide for therapy not related to the study; six patients developed renal failure and five became hypotensive 2 to 10 hours after administration of furosemide. These data demonstrate that furosemide does not protect against renal failure by altering or increasing RBF but may cause renal failure by producing hypovolemia.
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83
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Abstract
Inappropriate polyuria leading to hypovolemia and hypotension occurs frequently in severely septic patients. It's etiology was studied in three patients with polyuria and systolic hypotension. Glomerular filtration rate and renal blood flow were measured by the standard renal clearance techniques. Renal blood flow distribution to the outer cortex, inner cortex-outer medulla, and the inner medulla were measured by radioactive xenon. The glomerular filtration rate, renal blood flow, and renal blood flow distribution were normal. Polyuria does not result from a maldistribution of renal blood flow. Antidiuretic hormone did not alter the polyuric syndrome. These data suggest that sepsis produces a blockade at either the distal tubule or the collecting duct, thereby preventing salt and water conservation. This blockade may be due to either a toxin or a toxic metabolic breakdown product of sepsis.
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84
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Walt AJ, Singhakowinta A, Brooks SC, Cortez A. The surgical implications of estrophile protein estimations in carcinoma of the breast. Surgery 1976; 80:506-12. [PMID: 184556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Assays of estrophile protein (ER) in 161 patients with no previous additive or ablative hormonal therapy have been analyzed; 47.2 percent were ER positive; 52.8 percent ER negative. A total of 37.5 percent of premenopausal and 50.8 percent of postmenopausal patients had ER-positive tumors. The effects of additive and ablaive hormonal therapy were observed in 75 patients; 63.5 percent of the ER-positive group and 8.6 percent of the ER-negative group responded, but the incidence in the ER-negative group is thought to be spuriously high. The level of the ER content in the ER-positive group did not influence the degree of response. The ER-negative group had a shorter life span after discovery of the tumor and was more likely to develop dominant visceral metastases. Of 15 patients followed with sequential ER assays after hormonal therapy (additive and/or ablative), 14 demonstrated substantial falls in ER levels but these did not correlate with the clinical response. Tumor assayed in nine patients after irradiation of the lesion contained no demonstrable ER. ER assays of breast cancer tissue proved to be a useful but imperfect tool in predicting clinical progress following hormonal maneuvers but some readings may be spuriously low due to imperfect techniques of measurement, prior exogenous hormonal administration or hormonal ablation, and previous irradiation of the tumor.
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85
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Cortez A, Mendoza M, Muniz G. The utilization of nurses in expanded roles to deliver pediatric cardiology health care. Pediatr Nurs 1975; 1:22-9, 32. [PMID: 1040771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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86
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Pacheco CR, Cortez A, Ramírez C. [Radiological image of the pulmonary lymphatic vessels in living animals]. GAC MED MEX 1972; 103:505-10. [PMID: 5080804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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87
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Lafenêtre H, Carrère L, Cortez A, Vollhardt Y, Quatrefages H. Les limites de la protection vaccinale antibrucellique chez la Brebis. ACTA ACUST UNITED AC 1964. [DOI: 10.4267/2042/67000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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88
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Lafenêtre H, Carrère L, Cortez A, Vollhardt Y, Quatrefages H. Évolution de quelques agglutinines vaccinales brucelliques chez la Brebis. ACTA ACUST UNITED AC 1962. [DOI: 10.4267/2042/67235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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89
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Lafenêtre H, Carrère L, Cortez A, Vollhardt Y, Quatrefages H. Efficacité comparée de cinq vaccins antibrucelliques chez la brebis. ACTA ACUST UNITED AC 1962. [DOI: 10.4267/2042/67303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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90
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Lafenêtre H, Carrère L, Cortez A, Vollhardt Y, Quatrefages H. Vaccinations des ovins contre la Brucellose avec la souche vivante B. 112 (Culture en bouillon). ACTA ACUST UNITED AC 1961. [DOI: 10.4267/2042/67523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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