PubMed Health⌕ Search

Biomedical subjects

J J Monsuez

Publications and source records attributed to J J Monsuez.

At least 37 records · Page 2Linked to original sources

Catheter fragments embolization.

Although the use of central venous silicone catheters is widespread, little is known about the incidence of catheter rupture and embolization. Over a three-year period, 3916 silicone catheters were inserted in 3672 patients in the authors' hospital. Catheter or catheter fragments embolism occurred in 4 patients (1.2 embolizations per 1000 patients treated). Inappropriate mechanical deobstruction attempts resulted in 2 embolizations, and hence, these should be avoided. Chest roentgenography failed to detect the small fragments within the heart silhouette in 2 cases. Two-dimensional echocardiography showed the separated catheter fragment in all 4 cases. All four catheter fragments were subsequently removed from the right-heart chambers.

Adult↗

Non-Hodgkin's lymphoma related eosinophilic endomyocardial disease.

Two patients with eosinophilic endomyocardial disease related to peripheral T-cell lymphomas are reported. Both patients were free of cardiac symptoms at presentation and during follow-up. Routine two dimensional echocardiography revealed bi-apical ventricular obliteration, which was also seen on MR imaging. On the T1-weighted sequence, the thickened endocardium appeared with an isointense signal. Gadolinium DOTA provided an enhanced contrast of the internal part of the left ventricular wall. On T2-weighted sequence, a thin hypointense curvilinear structure drew a dividing line between the internal, endocardial, and the external, myocardial area. Left-ventricular systolic and diastolic functions remained unaltered during subsequent follow-up.

Adult↗

Absence of enhancement of spontaneous echocardiographic contrast by thrombocytosis in a patient with left ventricular aneurysm, primary thrombocythemia, and von Recklinghausen neurofibromatosis: a case report.

A thirty-eight-year-old man with primary thrombocythemia, von Recklinghausen neurofibromatosis, and myocardial-infarction-related left ventricular aneurysm with spontaneous echocardiographic contrast was followed up, suggesting that: 1. Neurofibromatosis may promote silent myocardial infarction or ischemia. Whether involvement of cardiac sensory nerves is a possible underlying mechanism remains nevertheless uncertain. 2. Platelets, whose role in the genesis of spontaneous echocardiographic contrast has been advocated, are probably not involved in this phenomenon, even in large numbers.

Adult↗

Cardiopulmonary toxicity after three courses of ABVD and mediastinal irradiation in favorable Hodgkin's disease.

The combination of chemotherapy and radiotherapy in Hodgkin's disease has been associated with iatrogenic effects. Forty adult patients were studied to evaluate the early toxicity following three courses of ABVD (cumulative dose of doxorubicin [Adriamycin] 150 mg/m2, and bleomycin 60 mg) and mediastinal irradiation at 40 Gy. Cardiopulmonary toxicity was assessed from six months to three years after completion of irradiation. Of the 40 patients, all of whom were in complete remission from Hodgkin's disease, 6 experienced dyspnea on exertion. In studies related to Cardiac toxicity, the left ventricular ejection fraction ranged from 50 to 77% (mean 63%); 8 patients had a minor pericardial effusion, 4 had valvular calcification, and 6 had minimal cardiac abnormalities. With regard to pulmonary toxicity, CT scan showed a small pleural effusion with pleural thickening in 19 patients and mediastinal or apical fibrosis in 15 patients. The total pulmonary capacity value was low (less than 80%), in 19 patients, and decreased carbon monoxide diffusion capacity (less than 70%) was found in 10 patients. We conclude that early cardiac toxicity was absent despite the use of Adriamycin and mediastinal irradiation. Pulmonary toxicity was present but minor, and it may decrease with the use of smaller fraction sizes for mantle field irradiation.

Adolescent↗

Non-Hodgkin's lymphoma with cardiac presentation: evaluation and follow-up with echocardiography and MR imaging.

Cardiac presentation of non-Hodgkin's lymphoma is rare and usually associated with a short survival. Two cases were documented and followed-up with echocardiography and magnetic resonance imaging (MRI). The tumoral masses were accurately delineated by MRI. A non-delayed diagnosis ensued and, in association with a multiple drug antimitotic therapy, an improved prognosis obtained.

Adult↗

Prognosis of ruptured intracranial mycotic aneurysms: a review of 12 cases.

Intracranial mycotic aneurysms (IMA) occur in 1-3% of all infective endocarditis. Although spontaneous resolution was evidenced on serial angiograms in many asymptomatic cases, the prognosis, if they rupture, is reported to be worse and partly contingent on the therapeutic approach. Among 12 patients (six acute and six subacute endocarditis) with ruptured IMA, six were treated surgically and four were treated medically. Two patients died during rupture before any treatment could be started. Six patients had a sudden rupture manifested by coma, less clear consciousness seizures, hemiparesis unilateral mydriasis. CT-Scan showed intracerebral, intraventricular and subarachnoid haemorrhage. Ten angiograms showed 11 IMA. For patients with ruptured IMA, the decision for surgical treatment was made in the presence of deepening coma and extensive mass-lesion on CT-scan (one of six died in the postoperative period). Others received medical treatment (four cases: all survived) and were followed-up with serial angiographies. Of the nine patients who survived, five remained free of any disability 1-4 years later. We suggest that the prognosis of ruptured IMA (25% mortality rate) is not as bad as previously reported if surgery following angiography is performed early in the presence of deepening coma and extensive lesion.

Adolescent↗