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J Peltier

Publications and source records attributed to J Peltier.

At least 19 recordsLinked to original sources
PubMed2006

The persistent left superior vena cava: anatomical study, pathogenesis and clinical considerations.

The persistence of a left superior vena cava (LSVC) is an intrinsically cardiac anomaly, which can lead to serious complications during catheterization via the subclavian or internal jugular vein. We found this anomaly during dissection associated with an abnormal origin of the vertebral artery originating from the aortic arch between the left common carotid and subclavian arteries. The LSVC coursed towards the right atrium through a very dilated coronary sinus ostium. No abnormality of the azygos system was found. A thorough anatomic description was then made with external and internal morphology. The embryonic development and variations are described. Radiological and clinical implications are discussed.

Aged↗
PubMed2006

[Terminovertebral aneurysm arising from basilar artery fenestration].

A case of ruptured middle saccular aneurysm arising from basilar artery fenestration is reported. Defects of the medial wall at the junctures of the fenestrated segments explain the association between vertebrobasilar aneurysms and basilar artery fenestration. A 47 year-old woman had a perimesencephalic subarachnoid hemorrhage. Immediate angiography revealed a ventral vertebrobasilar aneurysm and an endovascular coil occlusion was performed. Embryological development, pathogenesis and therapeutic difficulties are discussed.

Adult↗
PubMed2006

Lhermitte-Duclos disease and Cowden's syndrome. Report of two cases.

OBJECTIVE AND IMPORTANCE: Lhermitte-Duclos disease, or dysplastic cerebellar gangliocytoma is a rare entity characterized by a hamartomatous lesion in the posterior fossa. Cowden's syndrome, or hamartoma-neoplasia syndrome is a rare underdiagnosed autosomal dominant genodermatosis with high incidence of malignant tumors. Several recent reports suggest that Lhermitte-Duclos disease may be a component of Cowden's syndrome. CLINICAL PRESENTATION: We report two cases of Lhermitte-Duclos and Cowden disease occurring in adult patients. A 40-year-old woman had symptoms of raised intracranial pressure and macrocephaly. She displayed the stigmata of fibrocystic breast disease, thyroid goitre. Clinical examination showed mucocutaneous lesions. Her mother, brother and uncle had manifestations of Cowden's disease. An asymptomatic 38-year-old male had bilateral optic nerve drusen related to a cerebellar neoplasm. He exhibited manifestations of Cowden's syndrome and his familial history confirmed this hypothesis. INTERVENTION: The first patient was operated on for Lhermitte-Duclos disease. A conservative strategy was performed for the second patient and the clinical and imaging follow-ups were uneventful over 5 years. CONCLUSION: We stress the possibility that Lhermitte-Duclos and Cowden disease might be a peculiar form of phakomatosis. A conservative strategy can be chosen without neurological signs because of slow tumor growth. However, these patients should be carefully examined and followed up because of the risk of future malignancy.

Adult↗
PubMed2005

[Anatomical basis of the extraspinal cord compression].

Knowledge of anatomical landmarks of the spinal cord within the vertebral foramen is essential to understand the pathogenesis of spinal cord compression by tumor growth. The spinal cord can spread in the intervertebral foramen, the epidural space, the vertebral body, and the posterior neural arch. The morphology of the spinal cord, the relations of the spinal roots with the vertebrae, the principal fiber tracts, the spinal membranes, and the arterial and venous distribution are described in order to explain and analyze signs and disorders caused by the most frequent tumors involved in spinal cord compression.

Humans↗
PubMed2005

[Duplication of the inferior vena cava: anatomical dissection and clinical implications].

The duplication of the inferior vena cava is often incidentally discovered during radiological studies. The presence of this anomaly can be mistaken for retroperitoneal adenopathy. Its knowledge allows to avoid hemorrhagic complications during retroperitoneal surgery. An anatomical dissection of a duplication of the inferior vena cava is presented. Embryogenesis and variations are described. Radiological and clinical implications are discussed.

Aorta, Abdominal↗
PubMed2005

Melanocytic schwannomas. Report of three cases.

OBJECTIVE AND IMPORTANCE: Melanocytic tumors are rare. The literature reports less than 40 cases and suggests that they behave aggressively, can recur and progress to malignancy. CLINICAL PRESENTATION: We report three patients with melanocytic schwannomas located in the cervical spine, in the thoracic spine and in the lumbar spine. In the two first cases, these symptoms were a spinal cord compression whereas the last patient presented symptoms of cruralgy. IMAGING: MRI always showed an extramedullary intradural tumor arising from the root destroying the intervertebral foramen. INTERVENTION: The patients underwent laminectomy and the excision was complete. Immunohistochemical stains were positive to S100 and HMB45 antibodies. The evolution was unfavourable for two patients with local recurrence and leptomeningeal metastasis. CONCLUSION: These three cases demonstrate that melanocytic schwannomas have a guarded prognosis because of their metastatic potential, especially for young people.

Adult↗
PubMed2004

[Anatomy of the external laryngeal nerve: surgical implications. Report of 30 dissections].

OBJECTIVES: This anatomic study aimed to detail the anatomy of the external laryngeal nerve and to determine the possible variations of nerves at risk. MATERIAL AND METHOD: Fifteen cadavers (30 nerves) were dissected. The peri pharyngo laryngeal route, the anatomic rapports, the branches of division and the distal penetration point of the external laryngeal nerve were noted. RESULTS: The external laryngeal nerve gave branches to the inferior pharyngeal constrictor muscle in 90% of cases and to the thyroid gland in 70% of cases. There was an adherence between the nerve and the trunk of the superior thyroid artery in 13.33% of cases. The nerve had a distal superficial route even on the cricothyroid muscle in 6.67% of cases. In one case the nerve was situated close to the medial face of the superior thyroid lobe. DISCUSSION/CONCLUSION: The external laryngeal nerve has numerous anatomic variations. The anatomic variations at risk during thyroid surgery are: an adherence between the nerve and the thyroid artery (or a course of the nerve between the branches of the superior thyroid artery); a superficial distal route; a distal situation close to the medial face of the thyroid lobe. In this study, 7 nerves were considered at risk (23.33% of cases).

Humans↗
PubMed2004

[Spontaneous otorrhea involving defects of the tegmentum tympani].

OBJECTIVE: We report two cases and a review of the literature concerning spontaneous otoliquorrhea involving congenital bone defects of the tegmen tympani. CASE REPORTS: Both patients were managed by a cooperative otological and neurosurgical team. Otological symptoms predominated. The bilateral bone defects of the tegmen tympani were highlighted by high-resolution computed tomography. Surgery was undertaken via the middle fossa approach. DISCUSSION: Spontaneous cerebrospinal fluid otorrhea related to tegmen tympani defects is rare. It occurs in adults with no previous otological history. The anomaly is congenital. Otological symptoms (differential diagnosis with serous media otitis) are usually predominant. Infectious meningitis may occur. The diagnosis is based on high resolution computed tomography and surgical treatment is required. Numerous technical approaches are possible (transmastoid and/or middle fossa approach) depending on the extent of the defect. Complete recovery is usual after adapted surgical treatment.

Aged↗
PubMed2004

[Aneurysmal rupture during embolization with Guglielmi detachable coils].

OBJECTIVE: The purpose of this study is to determinate the frequency, causes, management and outcome of aneurysmal rupture occurring during embolization. We present our experience with this severe and feared complication. METHODS: We retrospectively reviewed 314 acute cerebral aneurysms that were treated with endovascular coiling. These patients were identified and the management and outcomes were recorded. The literature was reviewed. RESULTS: Six patients had an intraprocedural aneurysmal rupture. This complication occurred sporadically. Prevalence was 1.9%. Of these six, four were women and two were men. The mean age was 68 years (range: 43-74 years). Four aneurysms were located in the anterior circulation and two in the posterior circulation. Perforation occurred during microcatheterization of the aneurysm in one case and during coil deposition in five cases. In these five patients, aneurysmal rupture resulted from detachment of the first coil in three patients and detachment of the third and last coil in two patients. Hemodynamic changes were noted for one patient. The Glasgow Outcome Scale score at last follow-up examination was 1 in three patients and 3 in one patient (fair recovery). Mortality was 33% and morbidity was 16.7%. CONCLUSION: Aneurysmal perforation during embolization is a rare event (1.8 to 4.4%). When perforation is recognized, embolization can be completed immediately with further coil deposition and reversal of anticoagulation therapy.

Adult↗
PubMed2004

[Contribution of percutaneous acrylic vertebroplasty for tumor-related spinal cord compression].

We report two cases of spinal cord compression due to vertebral hemangioma in the first patient and myeloma in the other. Vertebroplasty was performed in both patients, combined with surgery for the first and radiotherapy for the second. Postprocedural pain decreased within 24 hours. Indications for percutaneous vertebroplasty are limited to aggressive vertebral hemangiomas, malignant spinal tumors including metastasis, multiple myeloma and solitary bone plasmocytoma. Vertebroplasty consolidates the vertebral body and reduces the risk of hemorrhage. It allows provides a rapid analgesic effect, radicullomedullary decompression associated with neurosurgery, spinal stabilization and can restrict progression of vascular malformations or tumors. Incidents and complications appear to be rare.

Aged↗
PubMed2004

[Sarcoidosis revealed by a spinal cord lesion].

Spinal neurosarcoidosis is rarely a presenting symptom. This case deals with a 45-year-old african woman who presented with a regressive spinal cord compression treated by parenteral corticosteroid. Different relapses allowed to diagnose multiple sclerosis. Spinal MRI scan showed diffuse enlargement of the cord with intense intramedullary enhancement from C3 to T1 and an aspect of large spinal cord from C7 to D1. Cranial MRI scan was normal. Radiographs and CT scan of the chest revealed an interstital syndrome without mediastinal lymphadenopathy (subgroup III). The serum angiotensin converting enzyme level was elevated in the blood as the cerebrospinal fluid. CSF fluid showed a lymphocytic meningitis. The bronchio-alveolar lavage found an hyperlymphocytosis with a high CD4/CD8 ratio. The neurological status and biological parameters were improved with oral corticotherapy treatment. This case report that a spinal cord involvement can reveal a sarcoidosis especially in the African race. Finally, in spite of lack of biopsy, the diagnosis is supported by clinical, biological and neuroradiological arguments.

Female↗
PubMed2003

The dural crossing of the vertebral artery.

The aim of this study was to present the anatomic and macroscopic aspects of the vertebral artery at the level of the dural crossing. Twenty vertebral arteries in 10 cadavers were dissected. The preparations were photographed and all the samples at the level of the dural crossing were submitted to a histologic study. Macroscopic results allow specification of the relationships between the dural crossing of the vertebral artery and the nervous elements (C1 and C2 nerves, mixed nerves), the vascular elements (postero-inferior cerebellar artery), the dural sheath and the first two dentate ligament tips. Microscopic results show the intricate relationship of the different layers of the vertebral artery with the dura at its crossing. Dural fibers reinforce the adventitial fibers not only by continuing them in their contact, much as the pages of a book, but also by being encrusted into the adventitia up to the tunica media, thus creating a very efficient mooring system. This work provides some information for an understanding of the symptoms induced by foramen magnum meningiomas and the onset of clinical signs after the surgical excision of these tumors. It also explains why dissections of the suboccipital segment of the vertebral artery stop at the level of the dural crossing, and never spread towards the intracranial segment.

Dura Mater↗
PubMed2003

[Transarticular atlanto-axial screw fixation for treatment of C1-C2 instability].

Posterior transarticular screw fixation of the C1-C2 complex has become an accepted method of arthrodesis for patients requiring posterior C1-C2 fusion. Since 2000, four patients (2 males and 2 females) were treated with this surgical approach for management of atlantoaxial instability, including odontoid fracture with unilateral C1-C2 luxation, odontoid pseudarthrosis, complex congenital malformation of the craniovertebral junction and rheumatoid arthritis. All patients underwent stabilization with 2 transarticular C1-C2 screws, without any posterior interspinous graft. Patients were maintained in a rigid cervical orthesis 3 months postoperatively. Results were good, without any complication, after a short mean follow-up (8 months). Technical aspects of the technique are reported, The risk of screw malpositioning and vertebral artery or neural injury is minimal and can be lowered by using preoperative CT scan and MRI, and by using intraoperative fluoroscopy. Transarticular C1-C2 screw fixation proves to be a major surgical approach for treatment of atlantoaxial instability.

Aged↗
PubMed1999

[Interactions between glucocorticoids and anti-inflammatory peptides].

Both pro- and anti-inflammatory mediators regulate the anti-inflammatory actions of glucocorticoids, in part by modifying the binding of glucocorticoids to specific receptors. For instance, somatostatin has been shown to increase glucocorticoid binding and signaling in macrophages. The mechanism of this regulation does not require an increased expression of glucocorticoid receptors but, rather, a stabilization of glucocorticoid receptor-associated heat shock protein 90. This is related to a decrease in calpain activity. Thus calpain inhibition may offer a new and exciting possibility for enhancing the anti-inflammatory efficiency of glucocorticoids.

Animals↗
PubMed1998

Sandwich-type deoxyribonucleic acid hybridization assays based on enzyme amplified time-resolved fluorometry.

We report microtiter well-based sandwich-type DNA hybridization assays using enzyme amplified time-resolved fluorometry of Tb3+ chelates. The target DNA was hybridized with two adjacent and non-overlapping oligonucleotide probes, one oligonucleotide serving as the capture probe and the other as the detection probe. Two ligand-specific binding protein pairs were used alternately for capture of the hybrids to the solid phase and detection; the biotin-streptavidin and the digoxigenin-anti-digoxigenin interaction. In both cases, alkaline phosphatase was used as a reporter molecule and diflunisal phosphate as a substrate. The catalytic hydrolysis of the substrate produces diflunisal which forms ternary fluorescent complex with Tb(3+)-EDTA. Furthermore, we studied the effect of the probe labeling method and the position of the label on the sensitivity of the assays. The data suggest that capture of the hybrids through biotin-streptavidin and detection via digoxigenin-anti-digoxigenin offer 2-3 times higher sensitivity than the reverse configuration. The highest sensitivity was achieved with enzymatic labeling of capture and detection probes at the 3' end. A signal-to-background ratio of 4 was achieved for 0.2 fmol of target DNA. The RSD were better than 4%.

Cell Line↗
PubMed1985

Patterns of practice with the TAT in juvenile forensic settings.

Psychologists in juvenile forensic psychological clinics were surveyed about usage of the TAT. A clear majority uses the TAT as part of their assessment battery, the majority using between six and ten cards. Administration and scoring methods were examined. Selection of cards was harmonious with prior research on theme productivity. Many respondents were found not to use the TAT because of time constraints, a finding discussed in terms of appropriate standards of care. Additional research needs to establish representative as well as expected standards of ethical practice for the TAT among general clinical groups, both adult and adolescent.

Adolescent↗