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Biomedical subjects

M Carsin

Publications and source records attributed to M Carsin.

At least 55 records · Page 3Linked to original sources

[Carcinoma of the left colic angle presenting as an intrasplenic gas collection (author's transl)].

A 65-year-old man was hospitalised for a subocclusive state, fever, 15 kg weight loss and left abdominal pain. The plain abdominal film revealed gas in the left hypochondrium. Barium enema showed a stenosis of the left colic angle. On evacuation, a little barium entered the gas-filled cavity. Left colectomy with splenectomy was carried out. The pathologist found histological evidence of a small carcinoma of the colon invading the hilum of the spleen. An intrasplenic cavity had been formed at the site of contact. Thus an intrasplenic gas collection was the presenting sign of a carcinoma of the colon. Two colosplenic fistulae of similar origin have been reported in the literature; neither associated with similar radiological findings.

Aged↗

Superparamagnetic iron oxide: clinical time-response study.

Superparamagnetic iron oxide (AMI 25) is a promising new contrast agent for imaging the reticuloendothelial-system. Iron oxide crystals possess a large magnetic susceptibility and enhance proton relaxation rates, especially transverse relaxation (T2). In order to guide the clinical utilization of this contrast media we analyzed 4 patients with malignant lesions of the liver before and after slow intravenous administration (20 mumol Fe/kg) of AMI 25. We performed two magnetic resonance (MR) sequences at different times using a 0.35 T magnet. MR signal-to-noise ratio (SNR) of the reticuloendothelial system (particularly the liver SNR) decrease promptly. The maximum decrease in SNR (67-72% for the liver, 46-65% for the spleen, 23-41% for the bone marrow) is observed 3 h after injection (P less than 0.01). However, except the peak of contrast enhancement in T1-weighted sequences of splenic tissue, the curve describes a plateau within 30 min and 6 h, allowing a delay between injection and imaging. T2-weighted sequences give a greater contrast-to-noise ratio (CNR) by adding the spontaneous tumor contrast to the effect yielded by AMI 25. These results suggest that images must be acquired between 1 and 6 h after intravenous administration of superparamagnetic iron oxide.

Aged↗

Influence of the teleradiology technology (N-ISDN and ATM) on the inter-hospital management of neurosurgical patients.

We set out to assess the influence of a teleradiology network on the relations between a general hospital and a 100 km distant university hospital in the context of neurosurgical emergencies, and compared a commercially available technology, N-ISDN (Narrowband Integrated Service/Digital Network), to an emerging technology, ATM (Asynchronous Transfer Mode). The evaluation was conducted using records of advice request calls and patient transfers. Three phases were considered: without teleradiology, with transfer of digitized images over N-ISDN at 64 kbps, and with an experimental ATM network at 10.5 Mbps with DICOM image transfers and videoconferencing. Additionally, staff meetings over ATM videoconferencing were set up. To assess the ATM service, we used log files and questionnaires, 108 advice requests were studied over a 18 month period. The average transmission time for one examination was 38 s with full DICOM image resolution over ATM, versus 150 s with 10:1 JPEG (Joint Photographic Expert Group) compression over N-ISDN. Up to 50% unnecessary patient transfers were avoided. Advice requests increased fourfold, and non-urgent advice requests increased from 0 to 21%. Despite the experimental configuration of the ATM network, the service gave satisfaction to all the physicians. Videoconferencing was unanimously regarded as a prominent tool to improve the quality of interaction. It was particularly useful for non-urgent cases and distant staff meetings. Teleradiology can improve the relations between hospitals through an increase of urgent and non-urgent advice requests. Asynchronous transfer mode is an efficient way for fast transfer of radiological examinations in DICOM format and for discussing them through high-quality videoconferencing.

Brain Neoplasms↗

[The value of computerized tomography in the assessment of hepatic iron overload in genetic hemochromatosis].

The aim of the present study was to evaluate the effectiveness of single-energy computed tomography in determining iron overload in idiopathic hemochromatosis, with special reference to slightly overloaded cases. Liver attenuation was determined in 100 patients (46 cases of idiopathic hemochromatosis, 32 cases of chronic liver disease, and 22 normal controls). The iron load was determined for the first two groups by biochemical determination of liver iron concentration (performed in all but 12 subjects in the chronic liver disease group) and hepatic histologic grading. The main results for liver attenuation (upper normal limit, 72 Hounsfield units) showed that despite a high specificity (0.96), this parameter was of low sensitivity (0.63). Although mean liver attenuation in idiopathic hemochromatosis (77 +/- 14) was significantly higher than in chronic liver diseases (53 +/- 17; p less than 10(-4], and normal controls (66 +/- 3; p less than 10(-3], and despite an overall good correlation between liver attenuation and liver iron concentration (r = 0.72; p less than 10(-3], liver attenuation was unable to detect moderate iron overload. Fourteen of 18 patients with a liver iron concentration of less than 150 mumol/g dry liver wt had liver attenuation values of less than 72. Moreover, 3 of 18 subjects with a liver iron concentration of greater than 150 had a liver attenuation of less than 72. Of these 17 false-negatives, only 7 could be attributed to associated steatosis. On the whole, single-energy computed tomography, when used on a routine basis for diagnosing iron overload, is of limited clinical value in idiopathic hemochromatosis due to its poor sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Traps in hepatobiliary echotomography caused by technical artifacts and the method of evading them].

Errors encountered during evaluation of hepatobiliary ultrasonography explorations due to various artefacts are described. These are mainly due to the problem of the lateral resolution of ultrasonographic recordings leading to false negatives and positives during diagnosis of the pathological process, lithiasis and cholecystitis. These are also the cause of errors during ultrasound guiding of needle punctures and thus the precision of the explorations. The major problem of echogenetic resolution is raised as this is also a cause of numerous artefacts, though it is much more difficult to evaluate their importance. Suggestions are made concerning the use of equipment for conducting explorations with the minimum of error, and the techniques to be employed.

Biliary Tract↗