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Biomedical subjects

E De Kerviler

Publications and source records attributed to E De Kerviler.

13 recordsLinked to original sources

[Digital thoracic radiology: devices, image processing, limits].

In a first part, the different techniques of digital thoracic radiography are described. Since computed radiography with phosphore plates are the most commercialized it is more emphasized. But the other detectors are also described, as the drum coated with selenium and the direct digital radiography with selenium detectors. The other detectors are also studied in particular indirect flat panels detectors and the system with four high resolution CCD cameras. In a second step the most important image processing are discussed: the gradation curves, the unsharp mask processing, the system MUSICA, the dynamic range compression or reduction, the soustraction with dual energy. In the last part the advantages and the drawbacks of computed thoracic radiography are emphasized. The most important are the almost constant good quality of the pictures and the possibilities of image processing.

Humans↗

Diagnostic imaging of choroid plexus disease.

Disorders of the choroid plexus, a central nervous system structure, are rare, but can pose diagnostic difficulties. The purpose of this review is to illustrate the computed tomography and magnetic resonance imaging findings of a wide spectrum of lesions that affect the choroid plexus. The areas covered include (1) neoplasms (papilloma, leukaemia, meningioma, lymphoma and metastases); (2) infections (bacterial, fungal and viral); (3) cysts; (4) haemorrhage; (5) congenital abnormalities (Sturge-Weber syndrome, Klippel-Trenaunay-Weber syndrome and vascular malformations); and (6) non-infectious inflammatory disorders (xanthogranulomas, inflammatory pseudotumour, neurosarcoidosis, rheumatoid nodule and villous hypertrophy). Few of the patterns of choroid plexus involvement are specific for a particular pathological process. Guermazi, A. (2000) Clinical Radiology 55, 503-516.

Adolescent↗

The clinical and radiological features of Fanconi's anaemia.

Fanconi's anaemia is a severe refractory anaemia, associated with congenital malformations in approximately two-thirds of cases. Although these malformations may involve every organ system, suggestive dysmorphic features include growth retardation, radial ray deformities and urinary malformations. These malformations are not specific for Fanconi's anaemia, but should be recognized during pregnancy, or later in childhood, and suggest the possibility of inherited haematopoiesis disorders.

Abnormalities, Multiple↗

Effects of a single bout of exercise and exercise training on steroid levels in middle-aged type 2 diabetic men: relationship to abdominal adipose tissue distribution and metabolic status.

Lower androgen levels have been suggested to be associated with type 2 diabetes and central obesity and are probably involved into the development of atherosclerosis. The present study investigates the effect of acute and chronic exercise on Dehydroepiandrosterone (DHEA) levels in relation to abdominal fat distribution and metabolic status in type 2 diabetes. Twenty weight-stable, middle-aged males with type 2 diabetes were enrolled in the study and participated in a submaximal (VO(2) peak) and moderate (50% VO(2) peak) exercise bout. The subjects were randomly assigned either to a trained or a control group, respectively. Physical training consisted of an 8 week program of aerobic exercise (75% VO(2) peak, 45 min), twice a week and intermittent exercise, once a week, on a bicycle ergometer. Acute exercise significantly increased DHEA and Testosterone (T) levels. Physical training increased VO(2) peak (42%, p <0.001), insulin sensitivity index (K(ITT) ) (57.5%, p <0.02), and basal DHEA levels (36%, p <0.05), and decreased HbA1c (29%, p <0.001), visceral adipose tissue (VAT) (44%, p <0.01) and subcutaneous adipose tissue (SAT) levels (18%, p <0.01). Body weight, BMI and insulin, T levels were not modified. Changes in DHEA levels were not correlated with changes in insulin sensitivity and abdominal fat distribution. In conclusion, exercise training favourably affects DHEA levels independently of improvements of metabolic status and abdominal fat distribution in patients with type 2 diabetes.

Abdomen↗

Mobilization of visceral adipose tissue related to the improvement in insulin sensitivity in response to physical training in NIDDM. Effects of branched-chain amino acid supplements.

OBJECTIVE: To evaluate the effects of an intense physical training program on abdominal fat distribution, glycemic control, and insulin sensitivity in patients with NIDDM and to determine whether branched-chain amino acid (BCAA) supplements influence these effects. RESEARCH DESIGN AND METHODS: Twenty-four patients (ages 45 +/- 2 [mean +/- SE] years, BMI 30.2 +/- 0.9 kg/m2, HbA1c 7.9 +/- 0.3%) were randomly assigned to four groups: training plus BCAA supplement (n = 6), training plus placebo (n = 6), sedentary plus BCAA supplement (n = 6), and sedentary plus placebo (n = 6). Physical training consisted of a supervised 45-min cycling exercise at 75% of their oxygen uptake peak (VO2 peak) two times per week and an intermittent exercise one time per week for 2 months. RESULTS: Patients who exercised increased their VO2 peak by 41% and their insulin sensitivity by 46%. Physical training significantly decreased abdominal fat evaluated by magnetic resonance imaging (umbilicus), with a greater loss of visceral adipose tissue (VAT) (48%) in comparison with the loss of subcutaneous adipose tissue (18%), but did not significantly affect body weight. The change in visceral abdominal fat was associated with the improvement in insulin sensitivity (r = 0.84, P = 0.001). BCAA supplementation had no effect on abdominal fat and glucose metabolism. CONCLUSIONS: Physical training resulted in an improvement in insulin sensitivity with concomitant loss of VAT and should be included in the treatment program for patients with NIDDM.

Adipose Tissue↗

[Lipoma of the superficial lobe of the parotid gland. A case report].

We report the case of a patient with a lipoma of the superficial lobe of the right parotid gland. Lipomas of the parotid gland are very rare. They are said to constitute one to two percent of all parotid tumours. Only six cases were found in the recent literature. Preoperative diagnosis is difficult when the physical examination reveals a renitent, well-localized and painless mass. However, magnetic resonance imaging is now the imaging modality of choice to facilitate the diagnosis, but the diagnosis can only be confirmed by histological examination of the tumour. We discuss the value of superficial parotidectomy, while some authors suggest an enucleation of lipomas of the superficial lobe of parotid.

Humans↗

MR quantification of muscle fatty replacement in McArdle's disease.

McArdle's disease is an energy-dependent disorder of skeletal muscle caused by the inability to break down glycogen. The aim of this study was to quantify fatty replacement in patients with McArdle's disease. Calf and thigh axial spin echo T1-weighted magnetic resonance (MR) images (repetition time 500 ms, echo time 25 ms) were obtained at 0.5 T in nine patients with McArdle's disease (age 51 +/- 16 years, range 26-74) and nine sex- and age-matched healthy subjects (age 52 +/- 16 years, range 29-78) to quantify intramuscular fat. Regions of interest were drawn manually, encompassing the largest cross section of muscle. A fatty replacement index (IF) was determined from histograms of signal in the regions of interest in calf and thigh muscles. In normal subjects, IF = 3.6 +/- 2.8% in calf and 4.9 +/- 2.3% in thigh. In patients, IF = 11 +/- 9.3% in calf and 13.5 +/- 10.4% in thigh, significantly different from IF values in normal subjects (p = .03). IF correlated well with age in patients (p = .03). In older patients, up to 25% of the muscle volume was replaced by fat. Patients with McArdle's disease, usually weakly disabled, exhibit significant muscle fatty replacement on MR images. These findings suggest a progressive muscle loss over time related to the disease process.

Adipose Tissue↗

Chest high resolution CT in adults with primary humoral immunodeficiency.

The purpose of this study was to assess the findings on chest high resolution computed tomography (HRCT) in patients with primary humoral immunodeficiency. HRCT was prospectively and consecutively performed in 19 patients with primary humoral immunodeficiency, aged 15-64 years (mean 36), and in 15 healthy subjects. HRCT results were correlated with clinical and biological data. Bronchial lesions were observed in 11 patients (58%), consisting either of bronchial wall thickening in eight or bronchiectasis in eight; both were present in five patients. Lobar and/or segmental collapses were found in seven patients (37%), scars in eight patients (42%), interstitial lesions in six patients (32%), and lobular air-trapping in two patients (11%). Parenchymal collapses were correlated with the annual frequency of infections (p = 0.03) and with the IgA level (p = 0.01). Scars were correlated with the annual frequency of infections (p = 0.04). No correlation was found between bronchial wall thickening or bronchiectasis and the data analysed. In conclusion, HRCT is a useful method to demonstrate lung disease in primary humoral immunodeficiencies, with special emphasis on bronchial changes and interstitial lesions.

Adolescent↗

[Radiography of the thorax with phospholuminescent screens].

Image digitalization can be performed in several ways: equalization of the x-ray beam (Scanning Equalization Radiography and Advanced Multiple-Beam Equalization Radiography), digital fluorography, use of linear computed tomography detectors, digitalization of radiographic films and memory screens. Phospholuminescent screens use an x-ray receptor which is able to store the x-ray energy. This latent energy is then extracted and can be processed to obtain images with matrices ranging between 1,760 x 2,140 and 1,770 x 2,370. Several types of image processing systems can be used depending on the pathology investigated. The blurred mask substraction method is the most widely used. The first clinical results demonstrate a reduction in patient irradiation and performances equal to or better than those of standard x-rays.

Humans↗

Treatment of salivary stones by extracorporeal lithotripsy.

PURPOSE: This study was designed to evaluate the efficacy of extracorporeal lithotripsy (ECL) in the treatment of salivary stones. PATIENTS AND METHODS: In a prospective study, an additional 15 patients suffering from sialolithiasis were treated by applying extracorporeally generated shock waves. No patients needed general anaesthesia, sedatives, or analgesics. RESULTS: Treatment was effective in 80% of the 15 patients in this series (5 total efficacy and 7 partial efficacy). Only minor complications were observed. CONCLUSION: Lithotripsy is a promising nonsurgical therapy for the treatment of sialolithiasis.

Adult↗

[Painful bruising syndrome mimicking cellulitis of the leg].

BACKGROUND: Autoerythrocyte sensitization syndrome (painful bruising syndrome) is marked by spontaneous and painful ecchymotic bruising, without any biological abnormality, occurring in women with pathological mental profile. Sometimes, when the inflammation is severe, an infectious cellulitis or muscular compression may be suspected. CASE REPORT: A 21-year-old woman was referred for the rapid occurrence of a diffuse and painful inflammation of the right leg, with fever. The leg was red, warm, with diffuse bruising. The foot was fixed in varus equin. The biological parameters were normal. Magnetic resonance imaging showed normal muscles but modifications in the subcutaneous fat, similar to an acute cellulitis. A cutaneous biopsy showed a moderate oedema of the dermis and erythrocyte extravasation. Antibiotics were inefficient on the pain and the aspect of the lesions. Because of the efficacy of saline serum injections on the symptoms and a pathological psychological profile, an autoerythrocyte sensitization syndrome was suspected. The skin test was negative. Psychiatric evaluation revealed a severe personality disorder associated with depression. The ecchymotic lesions disappeared with adapted psychiatric treatment. DISCUSSION: Painful bruising syndrome occurs most often in young women with various psychiatric problems. The lesions are characterized by recurrent, painful, swollen and bleeding bruises in any part of the body. Fever, abdominal pain and external bleeding are possible. Haematological and immunological findings are usually normal. The histology of early lesions reveals oedema of the dermis and modest perivascular infiltrate, whereas extravasated erythrocytes appear later. The magnetic resonance imaging aspect of the lesions has never been described. Abnormalities of the subcutaneous fat are similar to those of acute cellulitis, expressing the inflammation process secondary to the ecchymoses. The syndrome results from complex somatic and psychological mechanisms. Many drugs were tried for the treatment of the disease, without any significant improvement.

Adult↗

Localization techniques for the thoracoscopic resection of pulmonary nodules.

The recent progress made in endoscopic surgery has increased the number of thoracoscopic procedures, especially in the field of pulmonary nodules resection. The main problem related to these newly developed surgical procedures is the difficulty in locating the target nodule. We describe the techniques we currently use to facilitate the localization of pulmonary nodules. These techniques include preoperative methylene blue injection and insertion of a hookwire into the lung nodule, but also intraoperative palpation (digital and instrumental) and ultrasonography.

Endoscopes↗