Biomedical subjects
Publications and source records attributed to O Renouard.
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Twenty-seven infertile patients presenting with clomiphene citrate- (CC) resistant polycystic ovary syndrome (PCOS) were treated with purified urinary follicle-stimulating hormone (pFSH). We compared the conventional stepwise protocol with a slow protocol starting with 75 IU/d, not increased until 14 days, supplemented by human chorionic gonadotropins (hCG). The slow protocol was characterized by a slightly longer duration of stimulation but a more physiological ovarian response (mono- or biovulatory cycles in 70% versus 19% with the conventional protocol, less follicles, and a lower plasma estradiol [E2] resulting in significantly less discontinuation of treatment for risk of hyperstimulation or multiple birth). The pregnancy rate per cycle was higher with the slow protocol (23% versus 15%). The slow protocol could thus be the treatment of choice for CC-resistant PCOS, as it appeared safer and more effective.
Computed tomography findings appear to be very useful for the diagnosis of exogastric tumors on the basis of six cases: 4 leiomyosarcomas, 1 leiomyoblastoma and 1 schwannoma. The diagnosis of these usually large tumors arising within the gastric wall is often difficult through baryum opacification of the stomach (U.G.I.) owing to their exogastric growth. In the same way, endoscopy usually fails to evidence these tumors. Computed tomography permits to rule out an extrinsic tumor such as a hepatic or pancreatic one for instance and then to demonstrate the tumor originates within the gastric wall. The hypervascular pattern associated in most cases with central necrosis is demonstrated through contrast medium injection, what is a very typical and relatively constant-finding in these tumors.
Investigations in a patient with a multilocular cyst of kidney included urography, ultrasonography and computed tomography. Urography images showed a mass occupying the lower half of the left kidney with a lacunar image of pelvis, the association of these two elements suggesting a possible cancer of kidney. Ultrasound and computed tomography imaging demonstrated the fluid nature of the mass with absent partitioning. Findings were compared with data from the pathologic specimen which showed a main unilocular cyst with multiple satellite smaller cysts and a thick intrapyelic formation composed of microcystic aggregates. Pre-operative diagnosis of multilocular cyst was assisted by the use of modern imaging techniques: ultrasound and CT scan, which demonstrated a partitioned renal cystic lesion. Diagnosis is still difficult in atypical forms, however, and the relative frequency of an intrapyelic cyst protrusion is emphasized.
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Results and diagnostic value of computed tomography and ultrasound imaging in subcapsular hematoma of the kidney are discussed in relation to data from 9 cases. A positive diagnosis could be made in each case from CT scan images, but results of ultrasonography were less evident. An etiological diagnosis is difficult to establish and extreme caution is recommended before excluding a tumoral lesion, even in patients developing hematomas during anticoagulant treatment. Arteriography remains a valid examination since analysis of a large subcapsular hematoma by a CT scan is often risky, and a small cortical tumor may remain undetected.
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