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Biomedical subjects

P Chevallier

Publications and source records attributed to P Chevallier.

139 records · Page 8Linked to original sources
PubMedDate not supplied

Hepatic abscess caused by Brucella US, CT and MRI findings: case report and review of the literature.

The authors describe the findings detected by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) in a 42-year-old patient with a hepatic abscess due to brucellosis. This localization by Brucella (hepatic brucelloma) is quite rare and very often is asymptomatic. A review of the medical literature shows only 40 cases of an hepatic abscess due to brucellosis. The findings demonstrated by US, CT and MRI can offer important diagnostic elements, albeit not specific, which should, together with a positive serologic test, confirm the diagnosis.

Adult↗
PubMedDate not supplied

Kaposi's sarcoma confined to the colorectum: a case report.

Reported is a new case of a Kaposi's sarcoma involving only the colorectal area in an HIV-negative patient presenting with hemorrhagic rectocolitis. The colonoscopic examination and the radiological imaging showed the presence of multiple nodular pseudopolypoid formations in the rectum, which suggested, in the differential diagnosis, primarily a malignant non-Hodgkin lymphoma.

Adult↗
PubMedDate not supplied

Rare localization of a portal cavernoma in the wall of the common bile duct.

The first communication on biliary complications secondary to a portal cavernoma was published in 1965 [Br. J. Surg. 52 (1965) 636.], and since then several cases have been reported in the medical literature. These biliary complications, studied initially by anterograde or retrograde cholangiography, and later MR cholangiography [Van Hoe L, Van Beckevoort D, Van Steenbergen W. Atlas of across-sectional and projective MR cholangiography. Berlin: Springer; 1999. p. 166-7.], appear to be secondary to a double mechanism which produces a compression of the common bile duct (CBD) and ischemic changes. The biliary abnormalities most frequently found are a dilatation of the intrahepatic biliary ducts associated with extrinsic strictures and segmental dilatation of the CBD [J. Radiol. 83 (2001) 341.]. We report a rare type of portal cavernoma characterized by a thickening of the walls of the CBD and by a dilatation of the intrahepatic biliary ducts. The thickened walls of the CBD were evaluated by ultrasound and by magnetic resonance imaging.

Common Bile Duct Neoplasms↗
PubMedDate not supplied

Etiologic diagnosis of hepatic lesions in cancer patients. Value of ultrasound and liver function tests.

The purpose of this study was to evaluate the value of a combination of ultrasound (US) and liver function tests (LFT) for determination of the benign or malignant nature of one or more hepatic lesions in cancer patients. A total of 1235 patients with hepatic metastases and 832 patients with benign liver lesions investigated by US-LFT over a 12-year period were analyzed retrospectively. Ultrasound patterns considered indicative of a benign process (cyst, calcification without mass, irregular hyperechoic area without mass effect, small hyperechoic focal lesion as less than 3 cm) or malignancy (peritumoral halo, hypoechoic focal lesion, multiple solid nodules) were associated with LFT results. A US pattern of a benign process associated with normal LFT led to a diagnosis of benign disease with a false negative rate for malignancy of 11.6%. The highest figure corresponded to small hyperechoic nodules, for which the positive predictive value of malignancy (PPVM) depended on the type of primary cancer: 2.1% for breast cancer versus 62.5% for colorectal cancer. A US criterion of malignancy associated with abnormal LFT led to a diagnosis of malignancy (PPV 96.2% to 100%). Overall, the combination of US and LFT had a sensitivity of 80.6% and a specificity of 99.4%. The US-LFT combination correctly determined the benign or malignant nature of 74.5% of all hepatic lesions; the PPV was never less than 96.2% (small and solitary hyperechoic focal lesions were excluded because their PPV for malignancy is too high).

Calcinosis↗
PubMedDate not supplied

Hepatic multi-nodular focal fatty metamorphosis in acquired porphyria cutanea tarda. Sonographic, CT, and MRI features.

The authors report the sonographic, computed tomography (CT), and magnetic resonance imaging (MRI) findings in a patient with acquired porphyria cutanea tarda and hepatic multi-nodular focal fatty metamorphosis. There has only been one previous description of an association between these two conditions. The diagnosis was confirmed by histological analysis of a liver biopsy specimen. Symptomatology related to the hepatic abnormality may be due to an inflammatory reaction induced by the presence of uroporphyrin crystals in the liver. Each of the radiological techniques demonstrated unusual hepatic abnormalities and, in particular, MRI showed poorly defined areas in the liver which, on T2-weighted sequences, exhibited a hypersignal with fat saturation. Treatment of porphyria cutanea tarda led to clinical remission and resolution of radiological abnormalities.

Adult↗
PubMedDate not supplied

Inferior vena cava hypoplasia with intrahepatic venous continuation: sonographic, angiographic and MR features including MR angiography.

In cases of inborn or acquired obstacles on the inferior vena cava (IVC), the derived blood flow usually goes through collaterals in the azygos or the hemiazygos venous systems. Exceptionally, a collateral pathway through the portal system or through an anastomosis in between hepatic veins, shunting the IVC interruption, is encountered. In the present paper, the authors describe the fortuitous discovery of a IVC hypoplasia in its retrohepatic segment. MR venography, correlated with fluoroscopic angiography, clearly depicted an intrahepatic collateral circulation consisting of a double aneurysmal communication between an inferior right hepatic vein and the main right hepatic vein.

Aged↗
PubMedDate not supplied

Modification of arterial and portal hemodynamics after injection of iodized oils and different emulsions of iodized oils in the hepatic artery: an experimental study.

PURPOSE: A strong embolic effect of iodized oil/drug mixtures injected in the hepatic artery appeared to be an efficient way of prolonging the contact time between drugs and tumor tissue. Therefore, the authors evaluated arterial and portal embolic effects after hepatic intra-arterial injection of iodized oils and various emulsions of iodized oil. MATERIALS AND METHODS: Twenty-five pigs were monitored for the Doppler resistance index (DRI) in the hepatic artery and wedge hepatic vein pressure (WHVP) during 1 hour after injection of pure iodized oil, ultra-fluid or fluid, and four different emulsions of iodized oil ultra-fluid, into the hepatic artery. RESULTS: Mean area under the curve (AUC) values of DRI increases varied from 20.3 to 24.2 after injection of pure iodized oils or water-in-oil emulsions, and were 13.2 for large-droplet oil-in-water emulsion and 8.2 for small-droplet oil-in-water emulsion. Mean AUC values of WHVP increases varied from 151.6 to 195.6 after injection of pure iodized oils or water-in-oil emulsions, and were 105.5 for large-droplet oil-in-water emulsion and 8.5 for small-droplet oil-in-water emulsion. There was a significant difference in DRI and WHVP modifications between small-droplet oil-in-water emulsions and all other products (P = .001), between the two oil-in-water emulsions and the two water-in-oil emulsions (P = .004), and between the two oil-in-water emulsions and pure iodized oils (P = .002). CONCLUSION: After hepatic intra-arterial injection, water-in-oil emulsions and pure iodized oils provided a stronger embolic effect than oil-in-water emulsion, both in the hepatic artery and in the portal vein.

Animals↗
PubMedDate not supplied

Non invasive prediction of severe fibrosis in patients with alcoholic liver disease.

OBJECTIVES: The aim of this study was to assess the diagnostic accuracy of noninvasive markers of liver fibrosis in alcoholic liver disease. PATIENTS AND METHODS: Fifty-four clinical and biochemical parameters including serum fibrosis markers (hyaluronate and transforming growth factor beta1) were analyzed in 146 consecutive heavy drinkers (106 men, 40 women; mean age 49.2 years). Following liver biopsy, fibrosis was evaluated using a semi-quantitative scoring system (no fibrosis (0) to severe fibrosis (3 + )). Multivariate analysis was performed to determine the markers that were best correlated with the fibrosis score. RESULTS: Fifty-nine patients (40.4 %) had severe fibrosis (3 +) while 87 (59.6 %) had no fibrosis or moderate fibrosis (0 to 2 +). In multivariate analysis, serum hyaluronate and the prothrombin index were the best markers for the prediction of severe fibrosis. Hyaluronate and the prothrombin index had a diagnostic accuracy of 91.1 % and 89.7 %, respectively in the whole population. Finally, a significant negative correlation was found between hyaluronate and the prothrombin index (r =- 0.86, P <0.0001). CONCLUSIONS: Using only hyaluronate and the prothrombin index, 9 out of 10 alcoholic patients can be correctly classified according to the severity of liver fibrosis.

Adult↗
PubMedDate not supplied

[Synchrotron radiation techniques for structural characterisation of biological entities: an example with renal stone analysis].

This paper describes the opportunities given by the synchrotron radiation techniques regarding the structural characterisation of biological entities. After a short recall on the characteristics of the synchrotron radiation, are described the experimental devices based on fluorescence X, wide angle X-ray scattering and X-ray absorption spectroscopy, which may applied for biological samples, especially in the field of stone analysis. Recent progresses in medical research using synchrotron radiation will be also discussed.

Crystallography, X-Ray↗
PubMedDate not supplied

Intracellular accumulation and cytotoxic effect of (8-thiotheophyllinate) (triphenylphosphine) gold(I) in Friend leukemia cells.

Following continuous exposure to tTAuP in medium containing 10% fetal calf serum (FCS), cells resistant to doxorubicin (DOX-RFLC) were 3 fold more resistant to tTAuP than its sensitive counterpart (FLC). Moreover, FLC were 100 fold more sensitive to tTAuP when the cells were grown in the absence of FCS but in the presence of synthetic medium (BMS). When the cytotoxic effect was measured after short-term exposure (60 min) followed by 72 hr incubation in drug-free medium, unexpectedly, DOX-RFLC were 8 fold more sensitive [ID50 = 1.5 microM] than FLC [ID50 = 12 microM] to tTAuP. When FLC were exposed 60 min at different temperatures (4, 25 or 37 degrees C) to tTAuP prior to 72 hr incubation in drug free medium, the ID50 was achieved at 20, 13 and 3 microM respectively). In contrast, when DOX-RFLC were treated in similar conditions, the cytotoxic activity of tTAuP did not vary following exposure at 4, 25 or 37 degrees C. Although the mechanism of action of gold compounds is still unknown we have assumed that tTAuP cytotoxicity is related to the ease with which it is accumulated. This assumption was supported by the analysis of tTAuP incorporation by SXRF. The results reported here show that tTAuP accumulates rapidly in the cell and is distributed in the cytoplasmic and the nuclear fractions. It is suggested that accumulation is mediated by passive diffusion. However, the detection of gold binding to DNA in complexes resistant to solvent treatments suggests that interaction with macromolecules can be mediated by the formation of covalently bound complexes.

Animals↗
PubMedDate not supplied

[Immunosuppression: a case of mucoviscidosis].

Cystic fibrosis is a recessive disease that causes changes in mucus secretions, affecting different systems: respiratory, digestive, pancreatic, hepatic; resulting in obstructions and secondary infections. Transplantation may be used for the most severe forms and is then complicated by the pediatric context, the existence of malabsorption and secondary infections and the type of transplantation (pulmonary and/or hepatic). The follow-up is characterized by pulmonary infections and pulmonary chronic rejection. In our experience, the initiation of the immunosuppressive treatment must avoid corticoids in the early post-transplantation days and have recourse to intravenous cyclosporin (CyA) 2 mg/kg/day, given on average for one month in an oral form. In case of persistent acute rejection, tacrolimus (FK 506) is instituted. Oral CyA (10-12 mg/kg/day) seems more sensitive to malabsorption syndrome than FK 506 (0.2 mg/kg/day). In both cases, the development of an inhibitory metabolic interaction in the presence of itraconazole must be taken into account: used against aspergillosis, itraconazole is metabolized as CyA and FK 506 by Cyt P450 3A4. The intensity of the interaction is twofold for CyA versus fivefold for FK 506. The strategy for the use of other recently available immunosuppressives such as mycophenolate is under evaluation.

Adolescent↗