PubMed Health⌕ Search

Biomedical subjects

B Maes

Publications and source records attributed to B Maes.

At least 109 records · Page 6Linked to original sources
PubMed1988

Multivariate analysis in solitary cold thyroid nodules for the diagnosis of malignancy.

A stepwise logistic regression (SLR) was performed on 162 patients with a solitary and cold thyroid nodule in order to discriminate between malignant and benign lesions. Sixteen variables were recorded for each patient. The predictions of the logistic regression model were compared to the histological diagnoses in order to evaluate the accuracy of the classification. The value of the logistic function (LF) was calculated for each patient. Using the ROC curve approach, an optimum threshold value (OTV) corresponding to a 100% sensitivity was defined. The classification obtained with the OTV was validated using a cross-validation procedure (CVP). The significant variables selected by the SLR are (from the most significant to the least significant): cytologic result, sex, irregular margin on the Tc scintigraphy and homogeneity on the ultrasound examination. The OTV corresponds to a specificity of 73% for a sensitivity of 100%. The specificity and the sensitivity obtained with the CVP are 73% and 96% respectively. In conclusion, the classification of the patients according to the value of the LF is a highly accurate diagnostic procedure.

Adult↗
PubMed1986

[Thyroid cancer in Champagne-Ardenne: 1967-1984. Epidemiologic findings in a regional register].

Between 1967 and 1984, 600 cases of clinically diagnosed thyroid carcinoma were collected in an area (Champagne-Ardenne) of about 1,500,000 inhabitants. During this period, the complete collection of the cases was progressively ensured by involving all the general practitioners and by creating a cooperative multidisciplinary group. The collected data were sex, age at diagnosis, histological classification and clinical extension in TNM system. We found 19 patients with previous neck irradiation. Thyroid cancer was diagnosed in association with thyrotoxicosis in 36 patients: 13 Graves disease and 23 nodular hyperthyroidism. Incidence rates were estimated on a well defined population of two districts (850,000 inhabitants) and limited to the last four years. The following results were obtained: incidence 4.3/100,000/year, age-specific incidence progressively increasing up to a value of 10/000,000/year in the course of the fifth decade. Sex-ratio was 0.26.

Adolescent↗
PubMed1981

[Is age a prognostic factor in differentiated carcinoma of the thyroid gland? (author's transl)].

Reviewing the outcome of 82 patients with differentiated carcinoma of the thyroid gland operated upon and followed up for more than 5 years, the authors were unable to find any difference between "younger" *under 45) and "older" (above 45) patients. They wonder whether the poorer prognosis of differentiated thyroid gland carcinoma in older patients could be due to to the tumour being usually more advanced in such patients at the time of diagnosis rather than to age itself. II this were the case, there would be no need to tailor the operative procedure to the patient's age.

Adenocarcinoma↗
PubMedDate not supplied

Immunosuppressive drugs after simultaneous pancreas-kidney transplantation.

INTRODUCTION: We report the early and late secondary effects of tacrolimus or cyclosporine-microemulsion (ME), in combination with mycophenolate mofetil (MMF), and rATG. PATIENTS AND METHODS: One hundred three patients were randomly assigned to tacrolimus (initial oral dose 0.2 mg/kg) and 102 to cyclosporine-ME (initial daily oral dose 7 mg/kg). All patients received 4 days of concomitant rATG induction therapy [ATG-Fresenius Biotech GmbH (ATG-F) daily dose of 4 mg/kg or Thymoglobulin-Genzyme/Sangstat (Thymo-S) 1.25 mg/kg], MMF (2 to 3 g per day), and short-term corticosteroids. RESULTS: Thymo-S was associated with a transiently lower white cell count in the first 3 months compared with ATG-F, while ATG-F caused a lower albeit transient early nadir in platelet count. Both polyclonal preparations were well tolerated; they did not differ with respect to clinically relevant side effects such as infections and malignancies. Higher cyclosporine-ME trough levels were associated with pancreas graft thrombosis. Study withdrawal was more frequent among patients on cyclosporine-ME therapy, because of toxicities, graft loss, and lack of efficacy, the last being the cause of subsequent switch to tacrolimus. Tacrolimus-treated patients were mainly withdrawn from the study due to MMF discontinuation. CONCLUSION: Short-term induction therapy in combined kidney-pancreas transplantation is effective and well tolerated. Tacrolimus causes fewer pancreas graft losses and fewer drug discontinuations due to side effects. When MMF is combined with tacrolimus, dose reductions and discontinuations are common.

Antilymphocyte Serum↗
PubMedDate not supplied

beta 2 M-amyloidosis and gastrointestinal bleeding after renal transplantation.

Dialysis-related amyloidosis is a disorder that commonly develops in long-term dialysis with an incidence that is linked to the duration of hemodialysis. The amyloid deposits are composed of the amyloid precursor beta 2 microglobulin, mainly affecting the osteoarticular system, but also involving extra-osteoarticular tissues. We present a patient with repeated rectal bleeding caused by a circumferential atone ulcer in the immediate posttransplantation period due to the use of a rectal canula after 27 years of treatment with hemodialysis. Histopathological examination of the rectal ulcer biopsy specimens revealed positive Congo red stain and additional immunohistochemical investigation showed the presence of beta 2-microglobulin in a blood vessel wall of the rectum. Although dialysis related amyloidosis may be partially prevented, it is important to remain alert for dialysis related amyloidosis complications after renal transplantation in patients with a longstanding history of dialysis.

Amyloidosis↗
PubMedDate not supplied

The podocyte: from bench to bedside.

The understanding of the molecular structure of the podocyte has increased considerabely in recent 5 years by genetic research in inherited glomerulopathies. Injury to the podocyte often leads to a reorganisation of the slit diaphragm and to foot process effacement, which can be noted in all forms of the nephrotic syndrome. Since the recent progress in our understanding of the molecular biology of the podocyte, it has become obvious that the podocyte is crucial in the pathogenesis of not only genetic but also of many acquired glomerulopathies such as focal segmental glomerulosclerosis, membranous glomerulopathy and diabetic nephropathy. In this review we provide a summary of the recent physiological and molecular insights into the podocyte and of its significance in different glomerulopathies.

Angiotensin II↗
PubMedDate not supplied

Alkaline encrusted pyelitis.

Alkaline encrusted pyelitis is an infectious disease characterised by encrustations in the wall of the upper urinary tract, surrounded by severe inflammation. Destruction of native kidneys and kidney grafts may occur, resulting in end stage renal failure. Corynebacterium group D2, an urea splitting microorganism, is nearly exclusively associated with this disease. The most important predisposing factors are previous urological procedures and an immunosuppressed state. In a suggestive clinical context, diagnosis should be made with unenhanced computed tomography findings and bacteriologic isolation of the responsible microorganism. The treatment is threefold: appropriate antibiotic therapy, by preference with glycopeptides, acidification of urine and chemolysis, and if needed, surgical removal of encrustations. We report the case of a patient who was diagnosed with this rare condition and could escape maintenance dialysis after correct diagnosis was made and conservative treatment was started using antibiotics and combined oral and local acidification.

Aged↗
PubMedDate not supplied

Self-expanding metal stents in the palliation of neoplasms of the cervical esophagus.

BACKGROUND/AIMS: Self-expanding metal stents (SEMS) represent a major advancement in the palliative treatment of dysphagia caused by neoplasms of the esophagus. Malignant cervical stenoses are a challenge for palliative techniques, due to their close relationship with the cricopharynx. METHODOLOGY: Six patients with a malignant stricture of the upper esophagus, within 2 cm of the cricopharyngeal muscle, were treated with a self-expanding metal stent. All patients had a circumferential squamous cell carcinoma histologically proven. Patients were intubated under general anesthesia, and the procedure was carried out under simultaneous endoscopic and fluoroscopic control. RESULTS: All patients had a remarkable improvement of dysphagia and none of them reported a foreign body sensation. In 3 patients, an insufficient expansion of the stent, detected 24 hours later, required a balloon dilation in two of them, whereas, for the third patient, it was necessary to introduce a second stent. Neoplastic in- and overgrowth occurred in 4 (67%) patients after 1, 2, 4 and 8 months, respectively. These complications were managed by placing a second stent in 3 patients; in the fourth patient, a neoplastic involvement of the cricopharynx did not allow for an endoscopic examination. Improvement of dysphagia was observed only in the patient who received a covered Cook-Z stent. In the other 2 patients, a percutaneous endoscopic gastrostomy was performed. The only major complication occurred in the patient who received three metal stents, as he complained of severe cervical pain. CONCLUSIONS: Our experience shows that uncovered self-expanding metal stents provide a good palliation in this subgroup of patients. Tumour ingrowth, overgrowth, and the progressive impairment of the swallowing mechanism due to a proximal submucosal infiltration remain complications difficult to solve.

Aged↗
PubMedDate not supplied

[Cerebral gigantism. Review of the literature apropos of one case].

The authors report a case of cerebral gigantism and review 83 cases found in the world literature. The diagnosis depends on the association of several factors, none of which alone are specific but which, on the whole, form a fairly characteristic picture. Large size at birth, leading only rarely to gigantism at adult age. Facial dysmorphia of acromegaloid type. Ecephalopathy with mental deficiency without any neuroradiological abnormality. Finally, endocrine investigations and somatotropic function were normal. No etiology has been found up to now. The most satisfactory theory is that of a hypothalamopituitary disturbance. Treatment may simple avoid excess height at adult age and is based on sex hormone therapy to accelerate bony maturation.

Acromegaly↗
PubMedDate not supplied

[Treatment of hyperthyroidism by radioactive iodine. Development of methods and difficulties in the surveillance].

The experience of treatment of hyperthyroidism with radioactive iodine in the Nuclear Medicine department of the J. Godinot Institute, Rheims, from 1967 till 1987, is described. One thousand one hundred and fifty patients (723 with diffuse and 427 with nodular hyperthyroidism) received a total of 1,565 doses. The dosage calculation method was considerably simplified, enabling a patient to be treated in 24 hours. Thyroid gland mass evaluation, initially based on the scintigraphic projection area, is now performed by ultrasonography. The mean total radioactivity administered is 370 +/- 320 MBq per patient. All patients are seen on the 8th post-treatment week for clinical examination and hormone control. Seven out of 10 patients are cured with a single dose. Long-term follow-up, based on a computer file, is effected by means of an annual letter sent to the patient and to his family doctor, but in spite of sustained efforts 36 per cent of the patients are lost sight of. The diagnosis of iodine 131-induced hypothyroidism is based on plasma levels of TSH which, since 1984, are measured by the ultrasensitive method. The overall incidence of hypothyroidism is 6.6 per cent in the first year and 3 per cent thereafter. Despite a simplified procedure, the results obtained by the authors are similar to those found in the literature, and the cost-efficiency ratio is excellent.

Aged↗
PubMedDate not supplied

[Immunohistochemical study of plasmocytes and T-lymphocyte subpopulations in Hashimoto's thyroiditis].

In Hashimoto's thyroiditis, there is a diffuse interfollicular infiltration of lymphocytes and plasmocytes and lymphoid collections with germinal centers. Eleven cases of Hashimoto's disease were studied with immunocytochemical methods for characterization of intracytoplasmic immunoglobulins (IgA, IgG, IgM, Kappa and lambda light chains). Most of the cells are plasmocytes stained positively for intracytoplasmic IgG; IgA positive cells were less frequent and IgM positive cells are rare. Kappa positive plasma cells are more numerous than lambda positive cells in the germinal centers and the interfollicular infiltration. By an indirect immunofluorescence technique in frozen tissue, we have studied with four monoclonal antibodies (OKT3, OKT4, OKT8, B1) the T cells subsets populations in two cases.

Female↗
PubMedDate not supplied

[Parathyroid risk in thyroid surgery. Reality and prevention. 502 bilateral thyroidectomies].

Prospective study of parathyroid risk in a bulk of 502 consecutive bilateral thyroidectomies. Early post-operative hypocalcemia has been documented in 8,8% of the patients, but persisted in only 1,6% one year later. Late parathyroid risk of total thyroidectomy is 3,3% but increases twofold if neck dissection is simultaneously performed. Methods of this study probably misdiagnose a number of mild hypoparathyroidism. Lack of early hyperphosphoremia seems to be an optimizing criteria for aftermath. In Grave's disease, early post-operative hypocalcemia is more common (6,9%) but often subsides (definitive risk: 0,4%). This acceptable morbidity is compared to the data of literature. To prevent post-operative hypoparathyroidism a painstaking dissection of parathyroid blood supply seems more promising and effective than routine autotransplantation of the glands.

Graves Disease↗