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Biomedical subjects

J L Lamarque

Publications and source records attributed to J L Lamarque.

At least 19 recordsLinked to original sources

[Histological typing of the breast by multifocal biopsies].

The current concept of high risk mastopathy was revolutionised by the work of Dupont and Page (1985), who demonstrated the importance of proliferative mastopathies in the assessment of the risk, particularly when they are associated with epidemiological factors. Based on these data, the Montpellier breast pathology study and research group (GERPAMM) developed on original method designed to define the precise histological profile of women considered to be at risk of breast cancer, despite the absence of any focal mammographic signs. This typing, consisting of a rigorous surgical protocol strictly complying with Page's histological definitions, was performed in women presenting a certain risk defined by clinical, cytological and radiological criteria (density and disseminated microcalcifications). This paper presents a preliminary review of 6 years' experience in 162 cases. The preliminary results confirm than many cases of atypical hyperplasia are not associated with a focal mammographic abnormality. However, in the absence of focal signs, certain types of disseminated microcalcifications with a morphological appearance suggestive of an intraductal origin, are significantly associated with high-risk histological signs. Histological typing is therefore useful to predict the cancer risk, to dedramatise cases without significant hyperplasia and to propose an adapted and justified approach to cases with a high histological risk.

Adult

[Mass screening for breast cancer in Herault county. First results in women between 40 and 70 years old].

A large scale mammography breast cancer screening has begun in Herault county on the first of july 1990. The aim of the project was to determine the impact of two-view mammography upon the size of the tumor and later upon mortality from breast cancer. The women aged 40-70 at entry were invited by mail to the first round of mobile breast screening. Between the start and the 8th of march 1991, 5098 (64%) attended the first round. The cancer detection rate was 5.9/1000, the positive detection rate was 7.75%, the benign malignant surgical biopsy ratio was 1:0.7 and the percentage of surgical biopsies positives for malignancy was 42.6%. Two months after this study, the screening specificity was 96.7% and the sensibility was 92.7%. The rate of tumor size less or equal to 1 cm was 72% (for 30 malignancies) and the rate of mastectomies was 43.3%. These friendly results were compared to those of others breast cancers screenings.

Adult

[Thyroid nodules and non-functional goiters. Diagnostic contribution of nuclear resonance imaging].

The finding of a "cold" thyroid nodular or goiter raises the problem of its potential malignancy, usually resulting in systematic surgery. Ultrasonography and computerized tomography provide accurate information concerning the size, structure and connections of these abnormalities, but they have very little to say about their histological nature. We evaluated the contribution of magnetic resonance imaging (MRI) to the histological diagnosis by attempting tissue characterization before surgery in 97 patients with nonfunctional thyroid nodule or goiter. Comparisons with the pathological study of operative specimens showed a very small percentage (1.05 percent) of false negative results in terms of malignancy, and this was due to reliable arguments for benignity which we were able to collect from MRI signal intensity and structural analysis. Without these criteria, a decisive answer would have been very difficult, as shown by the significant rate of false positive results (14.73 percent) and a specificity of only 81.8 percent if every lesion interpreted as doubtful is considered malignant. Attention is drawn to the difficulties encountered in characterizing lesion with intracystic vegetations and in distinguishing between thyroiditis and lymphoma. The possibility of obtaining frontal and sagittal sections increases the usefulness of MRI. The operator's experience is essential in interpreting the signals and deciding on the therapeutic approach.

Adult

[Proposal for a radiologic classification of disorders of the pelvi-rectal angle based on measurement of the posterior rectal inclination. Value of dynamic digitalized rectography].

The difficulties for evaluation of the perineal descent have always been linked to the choice of references and mostly with the incertitude of the measurement of length on the radiographic film. This present study was carried out to evaluate the perineal descent on the choice of an angular measurement: the posterior rectal inclination. The dynamic digitalized rectography was used to investigate the pelvic floor status of 134 women: 115 patients complaining of idiopathic constipation, and 19 healthy volunteers. Results have shown 3 populations with an increasing graduation of perineal impairment and led to propose a radiologic classification of pelvic floor impairment: stage I, or solid perineum, stage II, or descending perineum and stage III or descended perineum. This study has brought up that the first sign of a pelvic floor abnormality may be increased descent during straining, only later followed by perineal descent at rest. The relationship linking abnormal perineal descent and excessive opening of the ano-rectal angle suggested logically that fecal incontinence may be the end complication of the Descending Perineum Syndrom.

Adult

[Computerized tomography: physiological reheightering of the images by sugars (author's transl)].

During experimental utilization on the dog (per os) of several types of materials capable to be modified by the liver after digestive absorption, sugars appeared naturally opaques in the gastric cavity and so they could substitute in C.T. to the habitual materials of contrast, we also notice some belated modifications on intra hepatic density that might be in relation with the metabolism of intra hepatic glucose.

Animals

The use of iodolipids in hepatosplenic computed tomography.

Iodolipids have been used as a contrast medium for hepatosplenic computed tomography (CT) in 148 patients. In all but two of these cases, the contrast material was injected by the intravenous route. The method appears to be safe due to the marked reduction of dosage in CT compared with conventional radiographic iodolipid hepatography. This decreased dosage is made possible by the improved density and spatial resolution of CT. Pictorial and histographic densitometric analysis of normal and abnormal liver after iodolipid administration yields considerable diagnostic improvement.

Fatty Acids

[An experimental study to evaluate mineralization of vertebral bone by computerized tomography (author's transl)].

Computerized tomography ("tomodensitometry") should, in principle, be able to calculate the linear attenuation coefficient of a compact or spongy bone volume. This coefficient is related to the amount of mineralization, enabling the use of the Scanner X to measure the density of the bone. Thirty vertebrae from the vertebral columns of 14 subjects who died after acute infections were examined by C.T. and by standard methods, and then calcinified. The correlation between ashes weight-Houns-field number was positive but only moderate (r = 0.54), and lower than the result obtained (r = 0.84) with standard methods. Errors occur with presently used apparatuses which are related to: polychromatism, too high an energy of the beam, artefacts, and the effects of "partial volume". Futhermore, the mineral concentration by unit of vertebral volume is very low, and large variations must occur for it to be detectable. Finally, considerable errors arise from the intravertebral bone fat. Suggestions are made with the objective of improving the quality of C.T. as a measuring instrument.

Densitometry

[Therapeutic angiography in hemoptysis (author's transl)].

Clinical results of therapeutic bronchial artery embolization in 100 patients are presented. The most frequent causes were chronic fibroproductive tuberculosis and bronchiectasis. 85 patients were cured, 10 patients showed recurrent bleeding and in 4 patients bleeding could not be stopped. Complete embolization of all supplying vessels is of great importance to achieve successful results. Caution has to be applied not to risk medullary complications.

Adult