PubMed HealthSearch

Biomedical subjects

A Ramée

Publications and source records attributed to A Ramée.

12 recordsLinked to original sources

Recurrent postoperative sciatica: evaluation with MR imaging and enhanced CT.

Magnetic resonance (MR) imaging and computed tomography enhanced with intravenous iodine injection (ECT) were prospectively compared in 80 patients in the diagnosis of recurrent postoperative sciatica. Diagnostic accuracy was determined with surgical verification. Isolated fibrosis was considered a contraindication to surgery. A decision to operate was made in 56 of the 80 patients on the basis of MR imaging findings; in 21 of the 56, the decision was also made on the basis of ECT findings. Of the 80 patients, 45 underwent surgery, In all but one of these patients, the diagnosis made on the basis of MR imaging findings was confirmed with surgical analysis. The only surgical finding that did not agree with MR imaging findings was a calcification of the common posterior ligament. The 21 diagnoses of disk herniation based on ECT findings were confirmed surgically, but among the 24 diagnoses of fibrosis made with the help of ECT, there were actually 19 recurrent herniations, four herniations with fibrosis, and one herniation at the level above the previously resected disk. MR imaging seems to be the investigation of choice in diagnosing the cause of recurrent postoperative sciatica.

Adult

Hepatic artery injection of I-131-labeled lipiodol. Part I. Biodistribution study results in patients with hepatocellular carcinoma and liver metastases.

Biodistribution of iodine-131-labeled Lipiodol Ultra-Fluide (I-131 LUF) injected into the hepatic artery was studied scintigraphically in 47 patients with hepatocellular carcinoma (n = 23), hepatic metastases (n = 14), or normal livers (n = 10). The investigation was extremely well tolerated. I-131 LUF concentrated mainly in the liver (L) and the lungs (l), with L/L + l activity ratios greater than 75% for all three groups of patients. I-131 LUF distribution was homogeneous in normal livers and heterogeneous in cirrhotic livers. I-131 LUF concentrated in the tumor with a tumorous (T) to nontumorous (NT) activity ratio (T/NT) of 4.3 +/- 3.6 for hepatocellular carcinoma and 2.4 +/- 0.7 for hepatic metastases. The effective half-life of I-131 LUF is more than 4.5 days for the three groups. It was eliminated mainly through the urine. Clearance from tumor is slower than from normal liver, as shown by the increase in T/NT at day 18. Biodistribution did not change in patients who had a second injection, which indicates that there is no saturation phenomenon. The results of this study suggest that LUF may be considered as a potential carrier vehicle for therapeutic agents.

Carcinoma, Hepatocellular

Hepatic artery injection of I-131-labeled lipiodol. Part II. Preliminary results of therapeutic use in patients with hepatocellular carcinoma and liver metastases.

Internal radiation therapy with transarterial injection of iodine-131-labeled iodized oil (Lipiodol Ultra-Fluide [LUF]) was evaluated in 15 patients with hepatocellular carcinoma and eight with hepatic metastases. Five patients with hepatocellular carcinoma received more than one injection. Treatment tolerance was excellent, as assessed clinically and by means of liver function tests. An analgesic effect was noted in the two patients with painful hepatocellular carcinomas. Serum alpha 1-fetoprotein levels dropped rapidly in 11 of the 12 patients with elevated basal values. An average reduction in tumor size of 50% was observed in the nine cases followed up with computed tomography. After 5-12 months of follow-up, six of the 15 patients with hepatocellular carcinoma were alive. Two of them had undergone liver transplantation. Histologic examination of one of the livers, removed 3 months after a third injection, revealed microscopic features highly suggestive of radiation effect in LUF-containing areas. In the group with widespread hepatic metastases, no objective response was noted, except for an analgesic effect in three cases.

Adult

[Comparison of MRI and scanning coupled with myelography in the diagnosis of cervicobrachial neuralgia].

A prospective study was undertaken to compare the accuracy of surface coil magnetic resonance imaging (MRI) and computed tomography with myelography (CTM) in the determination of cervical radiculopathy with or without myelopathy. Twenty five patients underwent both imaging studies. The separately imaging diagnosis and the surgical findings were the basis of this study. The based-MRI and based-CTM predictions were not significant. MRI predicted two disc herniations that CTM did not predict. CTM predicted a combination of disk herniation and stenosis and one more lateral stenosis that MRI did not predict. Among the fourteen patients who underwent surgery, one underwent surgery only on based-MRI prediction, it was a disc herniation; one patient was operated on only on based-CTM prediction, it was a stenosis. In these operated patients, the predictive value of the both imaging modalities was not significant. In this report the diagnostic assessment of MRI and CTM was overall the same. The major advantages of MRI were its ability to display all the cervical spine, to study the disk pathology and to delineate a signal alteration within cord substance but the disadvantage was the difficulty to characterize the osteophytes made of cortical bone which did not give signal.

Adult

[Value of magnetic resonance imaging in the diagnosis of recurrent postoperative lumbosciatica].

Twelve patients who had a subsequent lumbar sciatica after surgery were evaluated with computerized tomography (C.T.) and magnetic resonance imaging (M.R.I.). The M.R.I. was performed with a 0.35 T whole body superconducting unit using spin echo technique. Two pulse sequences were realized varying the repetition time (TR) from 500 to 2,000 ms and the echo time (TE) from 28 to 60 ms. For the longer pulse, the twice echo were interpreted. The slide obtained with a surface-coil were performed in sagittal plane for the twice pulse sequences and in transaxial plane for the shorter pulse sequence. In seven cases, the results obtained with C.T. and M.R.I. were correlated. In two cases, the C.T. showed a scar formation, the M.R.I. showed a recurrent disk herniation. In three times, C.T. was unable to differentiate clearly between recurrent disk herniation and scar formation, the M.R.I. showed unequivocally on one case a scar formation and on two cases a recurrent disk herniation.

Adult

[A new diagnostic method of spondylodiscitis. Magnetic resonance imaging].

Twenty four patients who were hospitalized for a suspicion of spondylodiscitis were prospectively evaluated with magnetic resonance imaging (MRI), radiology and radionuclide studies. Fifteen patients had an infectious spondylodiscitis, four had a vertebral degenerative disease, four had a rheumaticus spondylodiscitis, one had a chemical spondylodiscitis. The microbiological examinations and the clinical development bore the diagnosis out. Seven patients underwent Indium 111 scanning. The results of this scanning were correlated with MRI results. The MRI was performed with a 0.35 T whole body superconducting unit using spin echo technique. All patients were studied in the sagittal plane with two pulse sequences and more often with a surface-coil: TR 500 msec./TE 28 msec. and TR 2,000 msec./TE 60 msec. In all cases of true infectious spondylodiscitis the MRI results finding were characteristics. On the image obtained with the TR 500 msec./TE 28 msec., there was a confluent decreased signal intensity from the vertebral bodies and the intervertebral disk space. On the image obtained with TR 2,000 msec./TE 60 msec. there was an increased signal intensity from the vertebral bodies and the intervertebral disk space. The other spondylodiscitis have given a different MRI imaging, it was a confluent decreased signal intensity from the vertebral bodies and the intervertebral disk space on the twice pulse sequences. different images were obtained during the evolution of the infectious: first we observed a modification of the vertebral signal then the typical image that we described then a normal signal of the vertebral bodies with a pathological signal from the intervertebral disk space at last a degenerative intervertebral disk.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

[Angioplasty in primary Budd-Chiari syndrome. Apropos of 3 cases].

Three patients with the primary Budd-Chiari syndrome were treated by percutaneous transluminal angioplasty. Results showed an apparent poor response to angioplasty of irregular stenoses of the suprahepatic vessels and a good response when stenosis was due to membrane, but recurrence of the latter lesion after several months. The transient efficacy of this procedure in cases with a suprahepatic or caval membrane suggests that it be used pre-operatively for this indication.

Adult

[Acute exacerbation of prolactin-secreting adenomas during pregnancy following the treatment of sterility. 2 cases (author's transl)].

These 2 cases were similar in terms of the time of onset of problems at the 8th month, the clinical and radiological signs of the tumour, and the existence of an amenorrhoea-galactorrhoea syndrome with hyperprolactinaemia. They differed with regard to the mode in which the pregnancy was obtained: one was induced by anti-prolactins in the presence of a normal sella turcica whilst the other began during the cycle following the administration of clomiphene with no prior radiological study of the sella turcica. They also differed in terms of the course: intra-tumoural haematoma requiring early surgery in one, hyperplasia and oedema regressing after delivery in the other making it possible to avoid immediate treatment.

Adenoma

[Revascularization of arteries of the leg by bypass in chronic arteriopathies of the lower limbs. Apropos of 50 cases].

The authors report 50 by-pass operations followed up for from 6 months to 4 years, which were designed to restore the blood supply via the leg arteries in peripheral arterial disease of the lower limbs. 40 patients were at stages III and IV; acute ischemia required emergency operation in 6 cases. 2 Patients died immediately after operation. 30 by-passes remained permeable. A cure of the trophic disorder and a functional improvement were obtained in 39 patients with only 8 subsequent amputations. In the light of the world literature and their personal experience they discuss the main pronostic factors and the indications for this method which has proved to be a remarkable progress in the treatment of severe arterial disease of the lower limbs.

Adult