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Biomedical subjects

E Dhondt

Publications and source records attributed to E Dhondt.

14 recordsLinked to original sources
PubMed2006

Nora's lesion, a distinct radiological entity?

OBJECTIVE: To describe the radiological findings of "Bizarre parosteal osteochondromatous proliferation"(BPOP)-otherwise known as Nora's lesion, to describe the natural evolution of BPOP and to assess radiologically if BPOP is indeed part of a spectrum of reactive lesions including florid reactive periostitis and turret exostosis. DESIGN: Four experienced musculoskeletal radiologists studied plain radiographs and other imaging documents of histologically-proven Nora's lesions, looking for soft-tissue changes, periosteal reaction/calcification and calcified/ossified pseudotumours, and compared those findings with findings on pathology reviewed by a peer group of pathologists. PATIENTS: Twenty-four Nora's lesions originating from a series of 200 consecutive, histologically-verified bone (pseudo)tumours of the hand, seen by the "Netherlands Committee on Bone Tumours" for review and second opinion. RESULTS: Nora's lesions have a recognised presentation on radiographs without specific MR characteristics. Natural evolution could be assessed retrospectively in four cases. Recurrent lesions were seen in seven cases and are difficult to differentiate from primary lesions. CONCLUSIONS: Nora's lesion, defined as a "well-marginated mass of heterotopic mineralization arising from the periosteal aspect of an intact cortex, without medullary changes" has a distinct radiological presentation and is part of a spectrum of reactive lesions which includes florid reactive periostitis and turret exostosis. As it has a distinct radiological appearance, differential diagnosis of malignant lesions such as osteosarcoma and chondrosarcoma should be clear. It does not require immediate biopsy unless the natural evolution is unspecific.

Adolescent↗
PubMed2005

Accuracy of radiography in grading and tissue-specific diagnosis--a study of 200 consecutive bone tumors of the hand.

OBJECTIVE: To determine the usefulness of radiography and magnetic resonance imaging in differentiating benign from malignant bony tumors of the hand and in making a tissue-specific diagnosis. DESIGN: Two hundred consecutive bony tumors of the hand, the details of which originated from a national databank, were studied in a prospective way by radiography (100%) and by MRI (25%). All tumors were graded on a five-point scale, from certainly benign to certainly malignant, using location and morphology as diagnostic parameters. For all tumors a tissue-specific diagnosis was made, by the proposal of three possibilities in decreasing order of probability. Histological diagnosis was made by peer review, according to the WHO classification. RESULTS: By the combining of "certainly" and "probably" benign (grades I and II) and "certainly" and "probably" malignant (grades IV and V), a correct grading was obtained in 165 (82.5%) of the cases (154 of the 173 benign and 11 of the 27 malignant tumors). A correct tissue-specific diagnosis was included in the three proposed differentials in 87.5%. MRI confirmed a correct diagnosis made on radiography in 72% and improved the grading capability by correctly upgrading malignant tumors and downgrading benign tumors in, respectively, 8% and 12%. The capability to obtain a tissue-specific diagnosis improved with change of an incorrect diagnosis on radiography to a correct one on MRI in 12 cases (24%). CONCLUSION: Subjective (semiquantitative) grading on radiography by an expert group proved to be excellent when compared with the results of a quantitative analysis of individual grading parameters. Multiple logistic regression analysis of these parameters resulted in a grading formula containing only six variables. The additional value of MRI in grading was amply demonstrated. Already high accuracy of radiography, in making a tissue-specific diagnosis, improved substantially after the performance of MRI.

Adult↗
PubMed1995

Superior vena cava syndrome after implantation of a transvenous cardioverter defibrillator.

Superior vena cava syndrome is a rare, but nevertheless well known complication of permanent pacemaker implantation. Nowadays cardioverter defibrillators are also routinely implanted transvenously. A superior vena cava syndrome occurred in a 48-year-old female 2 years after implantation of cardioverter defibrillator. The clinical problem, in the presence of a predisposing thrombophilic condition (circulating lupus anticoagulant), resolved only partially after treatment with thrombolytics and oral anticoagulation. This syndrome should be recognized as a possible important complication of defibrillator therapy and requires lifelong anticoagulation.

Defibrillators, Implantable↗
PubMed1994

Upper airway obstruction due to inoperable intrathoracic goitre treated by tracheal endoprosthesis.

Thyroidectomy is the treatment of choice in patients with thyroid enlargement complicated by compression or displacement of the trachea because of the risk of complete airway obstruction due to sudden enlargement of the goitre by, for example, haemorrhage. In patients who are medically inoperable an endoscopically inserted tracheal endoprosthesis may provide longstanding airway patency, as reported here.

Aged↗
PubMed1994

Successful management of recurrent pneumothorax in cystic fibrosis by localized apical thoracoscopic talc poudrage.

Thoracoscopic talc poudrage of the entire pleural surface constitutes successful treatment of recurrent pneumothorax in cystic fibrosis (CF); however, subsequent lung transplantation is seriously jeopardized due to the development of extensive pleural adhesions. We describe a 27-year-old patient with CF with recurrent right-sided pneumothorax, refractory to chest tube drainage and to chemical (tetracycline) pleurodesis, who was successfully treated with a localized, apical thoracoscopic talc poudrage, thereby preserving the possibility of subsequent lung transplantation.

Adult↗
PubMed1994

A simplified insertion technique for tracheobronchial silicone stents.

In many patients with central airway obstruction due to extrinsic compression or malacia, insertion of tracheobronchial stents can provide effective and permanent relief. Of the various types of prostheses described, the silicone Dumon-Artemis stents (Medicore, Brussels, Belgium) are probably the most efficient. The use of an elegant and safe specially designed stent introducer system combined with a special bronchoscope is proposed for insertion by Dumon. This combined stent insertion system, however, is relatively expensive and cumbersome, especially for centers where relatively limited numbers of patients are treated. We propose an alternative, simplified insertion technique of silicone Dumon-Artemis stents, which was proven safe and efficient in our series of patients.

Aged↗
PubMed1982

Long-term functional results of the non-surgical treatment of common bacterial infections of joints.

Thirty patients with acute bacterial infection of a peripheral joint were treated with intravenous antibiotics, daily closed needle aspiration and early mobilization therapy. Joint mobility, expressed as a percentage of normal mobility, was evaluated at the end of the reconvalescence period and again after 42 to 65 months (mean: 50 months). The functional outcome was excellent and joint mobility normal in 2/3 of the cases as revealed by the short- and long-term evaluation results. Factors that affected joint mobility were: delayed treatment, joint disorders prior to treatment, and ease of access to the joint for needle aspiration. Poor results were found in the presence of hip infections. In the long term, deterioration of joint mobility can occur in the same aggravating conditions. Treatment of septic arthritis with daily needle aspiration and early mobilization gave very good functional results.

Anti-Bacterial Agents↗
PubMedDate not supplied

Impaired microcirculation in heart failure.

The aim of the present study was to examine the nailfold capillary morphology and dynamics in treated chronic heart failure (CHF) in relation to parameters of left ventricular structure and function. Twenty patients with CHF class II according to the New York Heart Association underwent a capillaroscopic examination at the finger nailfold using a computerized videophotometric system (Capiflow) at rest and after 1 min arterial occlusion. Study parameters ere number, length and diameter of the capillaries as well as capillary blood velocity (CBV). Further experiments included echocardiography and determination of left ventricular ejection fraction by Tc scintigraphy. Nailfold capillaries in established CHF are enlarged and the CBV is dramatically decreased. The reactive hyperemic response to 1 min arterial occlusion is attenuated. CBV correlates positively with left ventricular ejection fraction (r = 0.61, p = 0.01) and inversely with left ventricular end-diastolic (r = -0.56, p = 0.04) and end-systolic (r = -0.69, p = 0.01) diameters. The time-to-peak flow after 1 min arterial occlusion is positively related (r = 0.68, p < 0.05) to the duration of CHF. Our data indicate that finger microcirculation in CHF deteriorates as a function of the severity and duration of heart failure.

Aged↗
PubMedDate not supplied

Levamisole as basic treatment of rheumatoid arthritis: longterm evaluation.

We evaluated longterm levamisole treatment of 201 rheumatoid patients. Fifty-nine patients in their 1st yr of treatment were not analyzed; of the remaining 142, 69 (49%) still took levamisole with benefit. Levamisole was stopped in 32 patients (22%) for inefficacy and for reversible adverse reactions in 37 (26%). Leukotoxic side-effects were the commonest cause of withdrawal (23 patients = 16%). Since June 1977, we administer levamisole on a 1 d/wk schedule (150 mg), with determination of white blood cells 10 h after intake to detect high-risk patients for agranulocytosis. With disease exacerbation during treatment or lack of response after 6 months, the drug is given on a 2nd non-consecutive day. Since June 1977, cases of agranulocytosis have not been observed. Allergic vasculitis did not occur with a 1 d/wk schedule. The absence of nephrotoxicity and hepatotoxicity is stressed. Only 4 patients (3%) were lost to follow-up. Comparison is made with longterm use of gold and D-penicillamine. We conclude that levamisole is a useful slow acting antirheumatic drug.

Agranulocytosis↗