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Le Touquet – Paris-Plage, France

Radu A.,Mount Sinai School of Medicine | Pichon C.,French Institute of Health and Medical Research | Camparo P.,Val de Grace Hospital | Antoine M.,Tenon Hospital | And 5 more authors.
New England Journal of Medicine | Year: 2010

BACKGROUND: In adult humans, the follicle-stimulating hormone (FSH) receptor is expressed only in the granulosa cells of the ovary and the Sertoli cells of the testis. It is minimally expressed by the endothelial cells of gonadal blood vessels. METHODS: We used immunohistochemical and immunoblotting techniques involving four separate FSH-receptor-specific monoclonal antibodies that recognize different FSH receptor epitopes and in situ hybridization to detect FSH receptor in tissue samples from patients with a wide range of tumors. Immunoelectron microscopy was used to detect FSH receptor in mouse tumors. RESULTS: In all 1336 patients examined, FSH receptor was expressed by endothelial cells in tumors of all grades, including early T1 tumors. The tumors were located in the prostate, breast, colon, pancreas, urinary bladder, kidney, lung, liver, stomach, testis, and ovary. In specimens obtained during surgery performed to remove tumors, the FSH receptor was not expressed in the normal tissues located more than 10 mm from the tumors. The tumor lymphatic vessels did not express FSH receptor. The endothelial cells that expressed FSH receptor were located at the periphery of the tumors in a layer that was approximately 10 mm thick; this layer extended both into and outside of the tumor. Immunoelectron microscopy in mice with xenograft tumors, after perfusion with anti-FSH-receptor antibodies coupled to colloidal gold, showed that the FSH receptor is exposed on the luminal endothelial surface and can bind and internalize circulating ligands. CONCLUSIONS: FSH receptor is selectively expressed on the surface of the blood vessels of a wide range of tumors. (Funded by INSERM.) Copyright © 2010 Massachusetts Medical Society.

Berkane N.,University Pierre and Marie Curie | Moutafoff-Borie C.,Tenon Hospital
Current Opinion in Obstetrics and Gynecology | Year: 2010

Purpose of review To describe data on the effects of uterine artery embolization (UAE) on fertility. Recent findings UAE is used to treat postpartum hemorrhage (PPH) and fibroids. This effective therapy is replacing surgery in many cases. One of the main goals of UAE is to preserve the uterus and therefore fertility (pregnancies, menses and ovarian reserve). Pregnancies after this technique have been described. The main complications encountered during these pregnancies are not only PPH but also miscarriages and cesarean deliveries after UAE for fibroids. Conflicting results varying from completely well tolerated to serious complications such as definitive negative effect on endometrium and ovary function have been reported. Nevertheless, the series differ in that they included women of different ages and used different material for vessel occlusion (definitive microparticles of varying sizes, temporary pledgets of gelatine sponge, etc.). We discuss the impact of these differences on uterus vascularization and fertility. Summary UAE is an effective treatment for PPH and fibroids. Pregnancy is possible after UAE. Recurrent PPH is a serious and frequent complication. Synechia is also a potential complication. Desire of childbearing should be considered when choosing embolization or surgery and, in case of embolization, the choice of material used. Further studies on future fertility after UAE are needed as well as information on fertility after surgery. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Chabbert-Buffet N.,Tenon Hospital | Esber N.,French Institute of Health and Medical Research | Bouchard P.,University Paris - Sud | Bouchard P.,University Pierre and Marie Curie
Fertility and Sterility | Year: 2014

Although fibroids are common benign tumors, their impact on women's quality of life can be considerable. The most frequent symptoms are uterine bleeding, resulting in anemia, and pelvic pain. Fibroids can be of genetic or hormonal origin or arise from intrauterine events. Current options for medical treatment include control of estradiol and progesterone production or action and are discussed in this review. Although curative treatment of fibroids relies on surgical strategies, the current trend is for uterine-sparing treatment to preserve fertility and avoid unnecessary surgery. Currently approved medical treatments include intrauterine progestin delivery to reduce uterine bleeding, GnRH analogues, and, more recently, selective progesterone receptor modulators to control uterine bleeding and reduce fibroid volume. © 2014 by the American Congress of Rehabilitation Medicine.

Fabrizi F.,Maggiore Policlinico Hospital | Plaisier E.,Tenon Hospital | Saadoun D.,University Pierre and Marie Curie | Martin P.,University of Miami | And 2 more authors.
American Journal of Kidney Diseases | Year: 2013

Hepatitis C virus (HCV) may instigate mixed cryoglobulinemia; the most significant accompanying kidney lesion is type I membranoproliferative glomerulonephritis, usually occurring in the context of type II mixed cryoglobulinemia. Additionally, recent data support a link between HCV infection and proteinuria in population-based studies, raising the possibility that kidney diseases associated with HCV may be more common than previously thought. A number of strategies have been used to treat HCV-related glomerulonephritis, including antiviral agents, immunosuppressive therapies such as corticosteroids and cytotoxic agents, and plasma exchange. Limited but encouraging data about the utility of antiviral treatment in the setting of HCV-associated glomerulonephritis exist, with one pooled analysis noting a sustained viral response of 42%, albeit with significant heterogeneity. Immunosuppressive therapy may be most useful for cryoglobulinemic kidney disease, with individualized approaches considered for the treatment of HCV-associated cryoglobulinemic glomerulonephritis based on the level of proteinuria and kidney failure. Of note, rituximab, a chimeric monoclonal antibody that blocks CD20 receptors on B cells, has been reported to be effective for the treatment of mixed cryoglobulinemia symptoms, including glomerulonephritis. © 2013 National Kidney Foundation, Inc.

Pecquet C.,Tenon Hospital
European Journal of Dermatology | Year: 2013

Some products derived from insects can induce allergic reactions. The main characteristics of some products from honeybees, cochineal and silkworms are summarised here. We review allergic reactions from honey-derived products (propolis, wax, royal jelly), from cochineal products (shellac and carmine) and from silk: clinical features, allergological investigations and allergens if they are known.

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