Biomedical subjects

H Caillet

Publications and source records attributed to H Caillet.

9 recordsLinked to original sources

PubMed2002

Histological findings in surgical specimens after core biopsy of the breast.

Pathological changes induced by needling procedures found in breast surgical specimens are rare but can induce misinterpretation or compromise the definitive histological analysis. These abnormal findings depend on the interval between the core biopsy and excision. Early findings are local haemorrhage, disrupted tissue and epithelial cell displacement, whereas, fibrosis, fat necrosis and inflammatory reaction are observed later in time. The radiologists must be aware of these histological pitfalls and must consider the benefits of their core biopsies (indications, surgeon's question, number of samples).

Biopsy↗

PubMed1996

Single agent activity of oxaliplatin in heavily pretreated advanced epithelial ovarian cancer.

BACKGROUND: Platinum-containing chemotherapy combinations achieve high response rates in women with advanced ovarian cancer. Unfortunately, most patients need further therapeutic options. Oxaliplatin (L-OHP) is a diaminocyclohexane (DACH) platinum analog active against human and murine cells in vitro and in vivo, including ovarian cells lines, with non-cross resistance characteristics with first (CDDP) and second (CBDCA) generation platinum compounds. The single agent activity of oxaliplatin in 34 consecutive platinum-pretreated ovarian cancer patients, not eligible for other phase II trials, was explored in a compassionate use program framework in a single institution. MATERIALS AND METHODS: Thirty-five patients (34 of them eligible) were treated by L-OHP at the median initial dose of 100 mg/sqm q 3 weeks (5 patients: 58-89 mg/m2; 24 patients: 90-100 mg/m2; 6 patients: 120-130 mg/m2) by short (30'-2 hours) i.v. infusion; the treatment was repeated every three weeks until treatment limiting toxicity or disease progression. RESULTS: Thirty-one patients (median previous chemotherapy lines: 3) were evaluable for antitumoral activity, with a 29% objective response rate. According to Markman's criteria, objective partial responses were seen in six out of 13 evaluable potentially platinum-sensitive patients (46%) and three responses in the 18 evaluable platinum-resistant patients (17%). The tolerance was excellent, with no grade 3-4 (WHO) leukoneutropenia despite previous ABMT and abdominopelvic radiotherapy in six and eight cases, respectively. There was no renal or ototoxicity, and nausea/vomiting were moderate. The only grade 3 (WHO) peripheral neuropathy recorded concerned a patient with a neurotoxicity status grade 2 at baseline. CONCLUSION: The 29% ORR single agent activity of oxaliplatin at hematological subtoxic doses in heavily pretreated ovarian cancer patients, with objective responses in platinum refractory patients, supports experimental data on non cross-resistance and a differential clinical toxicity profile to other available platinum compounds. The 12 month median overall survival of this poor prognosis patients cohort (62% platinum-refractory patients, median number of three previous chemotherapy lines) gives a strong empirical basis for the further exploration of oxaliplatin's role in confirmatory phase II and combination chemotherapy studies.

Adult↗

PubMed1994

[Liver transplantation, vascular complications, role of imaging, percutaneous therapeutic possibilities].

Duplex Doppler ultrasound should be the first investigation when a vascular complication is suspected. Serial examinations may increase sensitivity. Color imaging enhances identification of small vessels and increases specificity. Angiography is not necessary unless an pseudoaneurysm is suspected. When duplex Doppler ultrasound is abnormal, angiography is performed to evaluate the possibility of treatment. Endovascular therapeutic procedures appear to have a limited field of application in comparison to percutaneous biliary procedures. Hemostatic embolization or dilatation of vascular strictures can be used either as definitive treatment or while waiting for a new graft to be performed under better conditions.

Angiography↗

PubMed1992

Value of CT and sonography in the conservative management of acute splenoportal and superior mesenteric venous thrombosis.

Acute splenoportal and superior mesenteric venous thrombosis were diagnosed on sonography and computed tomography (CT) in six patients. Sonography demonstrated the presence of echoic material filling the involved vessels in all patients. Precontrast CT scans demonstrated an increased, intra luminal density of the clots in four patients with splenoportal thrombosis. However, in two cases of superior mesenteric venous thrombosis, no hyperdensity was observed within the lumens. Nevertheless, the clots were always visualized as low-density regions in the vessel lumens after bolus injection. Intravenous anticoagulant therapy was started immediately after the diagnosis. All patients were evaluated twice a week with sonography and/or CT until recanalization occurred. The patency of the previously involved vessels was assessed from 6 days to 4 weeks after the acute episode (average time of recanalization: 17 days) without development of collateral pathways. It is concluded that, in the absence of clinical signs of a life-threatening process, a conservative management of acute splanchnic thrombosis can be successfully achieved by (1) early diagnosis, (2) efficacious intravenous anticoagulant therapy, (3) careful imaging follow-up of these patients by sonography and/or CT during the acute phase and, finally, (4) by an extensive search for a hypercoagulable state.

Acenocoumarol↗

PubMed1992

[Use of a constant-flow 2-phase injector for abdominal scanners in 60 patients].

The intravenous injection of a contrast medium is carried out in more than 80% of all the patients undergoing abdominal CT. The use of a constant-flow two-phase injector has several advantages in practice: possibility to vary the injections, safety, easy use, reproducibility, overall quality of the results and possibility to reduce the dose of contrast medium. The routine use of such equipment seems to be indispensable at present.

Contrast Media↗

PubMed1991

[The normal cranial nerves in MRI. Description and visualization frequency].

In order to assess the value of MR in the depiction of intracranial nerves, we retrospectively reviewed 60 patients investigated over a period of 2 years. The aim of this study was: 1) to assess the score of MR in the detection of cranial nerves III to XII; 2) to determine accurate landmarks allowing for easy detection of those cranial nerves. Cranial nerves III, V, VII, VIII are well seen (70 to 100%), very often in both axial, sagittal and coronal sections. Nerves IX to XII are correctly studied only on axial planes [81 and 83%), but it is difficult to distinguish between the vagal nerve and the glossopharyngeal and spinal nerves. Due to their oblique direction and small size, fourth and sixth nerves are rarely visualized. The more important landmarks are the chiasma, the colliculi, the Meckel's cave, the internal auditory canal, the jugular foramen, the hypoglossal canal and the different brainstem structures. We suggest the following scanning protocol: short spin echo sequences (TR = 600 ms, TE = 20 msec), 3 to 5 continuous sections, 16 to 20 cm field of vue with respectively 4 or 2 excitations, 256 x 256 matrix, with at least one acquisition plane (axial), but preferably two or three planes. Thus MR is sensitive exam in the recognition of cranial nerves, and it must be the first step exam in patients presenting with cranial nerve disease.

Adult↗

PubMed1990

Visibility of cranial nerves at MRI.

In order to assess the value of MRI in the depiction of intracranial nerves, we retrospectively reviewed 60 patients investigated over a 2-year period. The purposes of this study were: 1) to determine the score of MRI in detecting cranial nerves III to XII, and 2) to establish accurate landmarks for easy detection of these nerves. Cranial nerves III, V, VII and VIII are well seen (70 to 100%), very often on axial, sagittal and coronal sections. Nerves IX to XII are correctly studied only on axial planes (81 and 83%), but it is difficult to distinguish between the vagus nerve and the glossopharyngeal and spinal nerves. Due to their oblique direction and small size, nerves IV and VI are seldom visualized. The most important landmarks are the chiasma, the colliculi, Meckel's cavity, the internal auditory canal, the jugular foramen, the hypoglossal canal and the brainstem structures. We suggest the following scanning technique: short spin-echo sequences (TR 600 ms, TE 20 ms), 3 to 5 mm thick contiguous sections, 16 to 20 cm field of view with 4 or 2 excitations respectively, 256 x 256 matrix, and at least one acquisition plane (axial plane), but preferably two or three planes. MRI is a sensitive examination in the recognition of cranial nerves. It should be the first-step exploratory procedure in patients with cranial nerve pathology.

Adolescent↗

PubMedDate not supplied

Specificity of temporal amygdala atrophy in Alzheimer's disease: quantitative assessment with magnetic resonance imaging.

The aim of the study was to assess the specificity of temporal amygdala (TA) atrophy with magnetic resonance imaging (MRI) by comparing a group of early impaired patients with Alzheimer's disease (AD) with 'other types of dementia' and controls. In this prospective case-control study, 41 patients were selected: 12 with probable AD according to NINCDS-ADRDA and CERAD inclusion and exclusion criteria, 14 with other types of dementia and 15 age-matched control subjects. Two radiologists blindly measured the TA volumes on coronal oblique contiguous slices with a 1.5-tesla MRI scanner. TA volume measurements obtained by the 2 observers and right-left TA values were not significantly different. A significant TA atrophy was found in the AD group as compared to the other groups, with 39.7% (p < 0.001) difference in TA volumes between AD and other types of dementia groups and 41.4% (p < 0.0005) difference between AD and control groups. There was no significant difference between other types of dementia and control groups. There was an overlap between the three groups for 4 patients. TA atrophy assessed with MRI could be of diagnostic value in AD, especially in the early stage of the disease.

Aged↗

PubMedDate not supplied

[Imaging in the diagnosis of vascular complications after hepatic transplantation].

Twenty-nine vascular complications which occurred after 388 hepatic transplantations performed over a 5 year period (14 arterial thromboses, 4 aneurysms and ruptures of the hepatic artery, 8 portal thromboses and 3 peri-anastomosis portal stenoses) were investigated retrospectively in order to determine the role of imagery in diagnosing these vascular complications. The best screening examination for the diagnosis of hepatic artery thrombosis appeared to be pulsed Doppler coupled with echography. It provides a means of selecting candidates for arteriography, the only investigation allowing certain diagnosis of thrombosis. False aneurysms, suspected in cases of severe post-operative sepsis should be investigated with arteriography even if CAT scans and echo-pulsed Doppler imagery is normal. The diagnosis of portal thrombosis and stenosis relies on echo-pulsed Doppler imagery. In these cases, arteriography is carried out before treatment to evaluate the extent of vascular involvement. Thus echography coupled with pulsed Doppler is the best first intention screening examination to be performed whenever a vascular complication is suspected after hepatic transplantation. Nevertheless, arteriography remains the key examination for the diagnosis and evaluation of these complications.

Cholangiography↗