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Biomedical subjects

D Larde

Publications and source records attributed to D Larde.

At least 19 recordsLinked to original sources

[Erdheim-Chester disease. The multiviceral form presenting as exophthalmos].

Erdheim-Chester disease is a rare visceral xantho-granulomatosis, the 17th case of which is reported here. The initial symptom, bilateral exophthalmos, was uncommon. The picture was completed by a retroperitoneal xanthogranuloma and by bilateral and symmetrical osteosclerosis of the long bones. The lack of X-bodies at electron microscopy differentiated the disease from Hand-Schüller-Christian disease. The patient's condition improved with chemotherapy (vinblastine and doxorubicin) combined with corticosteroid therapy. After a 5-month remission period, he died of an intercurrent infection. No autopsy was performed.

Diagnosis, Differential↗

[Digital angiography of bone sarcoma in the child].

The authors analyze the results of 50 computed angiographies made for osteosarcoma and Ewing's sarcoma. Better tolerated than conventional angiography computed angiography is also more sensitive in preoperative evaluation of effectiveness of neoadjuvant chemotherapy. Automatic subtraction, direct measuring of tumor size and vascularization density give to angiographic changes after chemotherapy the most predictive value. After conservative surgery or radiotherapy digital angiography provides most reliable local follow up.

Angiography↗

[Diagnostic contribution of computer tomography in muscular pathology].

CT analysis in 26 patients with well-identified muscle diseases, and 4 normal controls was performed to evaluate its diagnostic interest. Scans were obtained through pelvis, thigh and calves at comparable levels in all subjects. Results showed that elementary changes were devoid of specificity and density measurements did not significantly increase the diagnostic significance of images. A good correlation was found between the degrees of CT changes and clinical evaluation of the muscles. However, CT allowed a more precise study of abnormalities in muscles difficult to assess clinically and, in all pathological cases, led to a clear analysis of the topography and the selectivity of the pathological process. If safety criteria are fulfilled, CT would allow a precise follow-up study of muscle atrophies.

Charcot-Marie-Tooth Disease↗

[Leg aneurysm complicating bacterial endocarditis. 2 cases].

Arterial aneurysms constitute a classical, albeit rare (1.1%) complication of bacterial endocarditis; they uncommonly involve the arteries of the legs (6.6%). Two cases successfully treated are reported. In both cases the initial diagnosis was phlebitis, which emphasizes the difficulty of diagnosing the disease at an early stage and the need for additional investigations, notably computerized tomography. Surgery is usually required.

Adult↗

[Suppurating splenic infarction originating from endocarditis].

Three cases of splenic infarction complicated by abscess formation during bacterial endocarditis are reported. In all three cases there were associated clinical abdominal signs and, in one case, there was persistently positive hemocultures. The diagnosis was made by CAT scanning. The three patients underwent splenectomy and one patient also underwent valve replacement the same day. The methods of early diagnosis of splenic complications during endocarditis and the indications of splenectomy are discussed. Ultrasonography and abdominal CAT scanning are the most sensitive diagnostic methods for splenic lesions. As splenic rupture is associated with a high mortality and this complication may occur at any time during infarction complicated by abscess formation, early splenectomy is justified when abdominal clinical signs are elicited associated with a persistent, infectious syndrome with or without positive blood cultures, under appropriate antibiotic therapy. Splenectomy should also be considered if valve replacement is carried out in the same circumstances to avoid infection of the prosthesis.

Abscess↗

[Irregular hepatic steatosis. Ultrasonic and computed x-ray tomographic aspects].

A 39-year-old moderately obese and alcoholic man complained of abdominal pain and nausea. An ultrasound examination of the liver showed large hyperechoic areas surrounding a limited pseudotumorous zone of relatively decreased echogenicity. CT scan showed a decreased density (35 UH) in the hyperechoic areas, suggesting fatty liver which was confirmed histologically; conversely, the hypoechoic area appeared normal on CT scan. Six months later, after reduction of caloric intake and cessation of alcohol ingestion, ultrasound examination and CT scan of the liver were normal.

Adult↗

Unilobar small hepatic vein obstruction: possible role of progestogen given as oral contraceptive.

The case of a 33-yr-old woman with an obstruction of small hepatic veins limited to the right lobe of the liver is reported. Abdominal pain, fever, absence of ascites, and normality of liver biochemical tests were the most striking features. Abnormalities characteristic of lesions were observed on surgical wedge liver biopsy, hepatic phlebography, and computerized tomography. None of the usual causes of small hepatic vein obstruction were found. This patient had been taking an oral progestative compound as contraceptive therapy for 7 mo before evaluation. Because progestogens have recently been incriminated in the occurrence of vascular alterations, the possible role of this drug in our case is discussed.

Adult↗

Computed tomography and post-laparotomy intra-abdominal abscesses.

Thirty-one patients were prospectively studied and had abdominal computed tomography for post laparotomy sepsis. Computed tomography is of particular interest in seriously ill post-operative patients, 15 of our patients were on ventilators, and it enabled diagnosis and localization of abscesses in 15 patients. Drainage could therefore be achieved via a limited surgical approach, and extensive laparotomy was avoided. Of 16 patients without abscess, the abdominal computed tomogram was negative in 14 cases and there were two false positives. The overall accuracy was 0.94 with a sensitivity of 1 and a specificity of 0.88. The ability to screen the whole abdomen and exactly localize the lesion are the advantages of this non-invasive method.

Abdomen↗

[Value of tomodensitometry in the diagnosis of lumbar disk hernias].

The authors relate their experiences concerning tomodensitometric examination to evaluate the herniation of a disk. 45 patients and 50 herniations of a disk have been studied. 39 herniations have sustained surgical procedures. The tomodensitometric examination and the radiculosaccography have been performed among these patients in order to compare the findings. The fact that there has only been 3 failures prove the reliability of tomodensitometric examination; among these failure there is 2 post-operative recurrences and one L4 L5 herniation. The radiculosaccography fails 5 times (1 L4 L5 herniation and 4 L5 S1 herniations). There is not any common negative in the two methods. Because of its total innocuity (no injection of any kind) the tomodensitometric examination seems to be the first exploration to prescribe when an herniation of a disk is resistant to clinical treatment and when a surgery is planned.

Diagnosis, Differential↗

Lumbar phlebography in the diagnosis of disc herniations.

The authors report their experience with 240 cases with lumbar phlebography in the diagnosis of lumbar disc herniations. The normal radiological anatomy and the radiological signs of disc herniations are described. Indications for phlebography are given, and the reliability of this test is compared with that of myelography performed with water-soluble agents.

Humans↗