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Biomedical subjects

F Barret

Publications and source records attributed to F Barret.

At least 19 recordsLinked to original sources

[Tuberculous meningitis in an immunocompetent adult: contribution of cerebral imaging techniques to the diagnosis and follow-up].

We have studied 5 men, mean age 47 years, affected by tuberculous meningitis (TM) without documented immunodepression. The diagnosis of TM was supported by clinical and biological investigations and confirmed by the cultures of CSF. All the patients received a four-drug combination therapy and steroids. No drug resistance of the bacilli was observed. Cerebral imaging by CT and MRI was rarely diagnostic but most useful during the follow-up. All the patients developed complications including tuberculomas (5), hydrocephalus (4), ischemic lesions (2), arachnoiditis (1) and abscess of spinal cord (1). Four patients recovered and one died. The mean duration of the follow-up was 16 months. MRI was more sensitive than CT scan to identify inflammatory lesions such as granulomas, angeitis or arachnoiditis and to follow their outcome. Tuberculomas and hydrocephalus were easily diagnosed by CT scan with contrast enhancement. Recommendations of sequential imaging are suggested to identify unexpected or asymptomatic complications of TM during therapy and evaluate the outcome.

Adult↗

[Primary epiploic appendicitis].

Primary epiploic appendicitis include torsion and primary inflammation of appendices epiploicae. These uncommon pathologies have been until present exceptionally diagnosed before surgery. Clinical and biological features have a small specificity. However, US and CT findings suggest the diagnosis. Our study reports 6 cases.

Abdomen, Acute↗

[An angiographic study of spinal vascularization at the thoracic-lumbar level].

In this retrospective work based on a series of spinal angiograms performed in the Neuroradiology Department of the Salpêtrière Hospital, Paris, we studied the number of examinations that showed one or several anterior radiculospinal arteries at the thoracolumbar level, as well as their origin at different levels from T6 to L3. Analysis of the whole group of 552 patients showed some deviation from the previously published radio-anatomical papers. This was confirmed and illustrated more clearly by the analysis of a series of 174 cases selected among these 552 patients. This second series was particular in that it featured bilateral catheterization of every artery likely to give off a radiculospinal artery at all levels from T6 to L3, thus providing more reliable statistical data. We found that 48% of the patients had their thoracolumbar blood supply based on two anterior radiculospinal arteries the lowest of which was located at, or lower than, T12, and the second and higher one between T6 and T10. Only 45% of the studies showed a blood supply relying on a single anterior radiculospinal artery which most frequently had its origin at T9. In 7% of the cases the thoracolumbar spinal cord was supplied by 3 anterior radiculospinal arteries. Our results demonstrate the presence of at least two different patterns of spinal cord blood supply at the thoracolumbar level, with a variation in the origin of the anterior radiculospinal arteries. These recent findings may increase the reliability and improve the technique of spinal angiography, especially in difficult cases.

Angiography↗

[Lipoma of the parotid gland. Apropos of a case].

Lipoma of the parotid gland is a rather rare tumor (2-3% of all tumors of the gland). Comparative imaging of a case of parotid lipoma by computed tomography, sonography and magnetic resonance is presented.

Adult↗

[Hemangioma of the adrenal gland. Apropos of a case].

A case of adrenal hemangioma is reported, displayed by computed tomography and confirmed by pathologic investigation. This rare tumor poses a difficult diagnostic challenge and rejoins the problem of incidentally discovered adrenal masses.

Adrenal Gland Neoplasms↗

[Emergency treatment of severe hemoptysis by embolization of systemic arteries].

Over a 6-year period 23 patients with massive haemoptysis were treated at the Hôpital Tenon, Paris. Eighteen of these, usually considered "non-surgical" cases, underwent emergency embolization of the bronchial artery (B.A.E.). The immediate outcome was favourable in 14 patients; 4 died of early recurrence. B.A.E. therefore appears to be a valuable treatment of massive haemoptysis in "non-surgical" patients or in patients awaiting transfer to a thoracic surgery unit. However, because of the failure rate, B.A.E. cannot compete with thoracic surgery in its classical indications, and its effectiveness and safety should be compared with those of balloon catheter endobronchial tamponade in "non-surgical" patients.

Bronchial Arteries↗

[Distal mesenteric arteritis: a rare complication of D. methylsergide treatment (author's transl)].

A patient developed typical abdominal angina due to mesenteric arteritis secondary to D. methylsergide (Desernil) treatment. Multiple regular distal stenoses were revealed by arteriography, but these had completely disappeared 5 months after discontinuing treatment. Histology demonstrated fibrosis of the three tunicae with hyperelastosis. Six analogous cases due to D. methylsergide or ergotamine tartrate have been reported in the published literature, rapid regression occurring in all of them after interruption of treatment.

Arteritis↗

[Vascular investigation of impotence (author's transl)].

Approximately 25% of patients with impotence have erectile dysfunction of vascular origin, which requires systematic investigation in patients under 60 years of age because of the possibility of surgical treatment. Diagnosis is based on clinical findings, confirmed by two tests that are simple to conduct in ambulatory patients, doppler and plethymography. Arteriography of the sexual organs enables precise definition of the lesions, and surgery is indicated when there is strong clinical evidence, no other cause for the lesions can be found, and operative correction appears possible. Many unknown factors still exist in relation to the physiopathology of impotence of valvular origin. Current-research is directed towards detection and possible treatment of disorders of venous origin.

Angiography↗

[The collateral circulations of the spermatic veins (author's transl)].

The frequency and appearance of anastomoses between the spermatic veins and the inferior vena cava and portal vein, are analyzed in a series of 171 patients examined by retrograde spermatic phlebography. Spermatocaval anastomoses are divided into those that occur above the scrotum: direct (spermatocaval and iliospermatic) and indirect (perivertebral and ureteric); and those seen at the level of the scrotum (with the scrotal veins, veins of the vas deferens, and those from the contralateral scrotal area). Spermatoportal anastomoses are frequent but difficult to confirm because of the existence of proximal valves. Three cases are also reported which give examples where the spermatic vein played an important part in the collateral circulation (inferior vena cava thrombosis, left renal vein thrombosis, portal hypertension).

Collateral Circulation↗