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Biomedical subjects

P Rouleau

Publications and source records attributed to P Rouleau.

At least 19 recordsLinked to original sources
PubMed1999

Esophageal swallowing phase assessed by audiosignal recording: relationship with manometry in gastroesophageal reflux disease patients.

The acoustic technique has been used for pharyngeal exploration but to date no such technique has been devised to assess esophageal motility. The aim of this study was to demonstrate that displacement through the esophagus can be quantified using this method in healthy subjects and in patients with gastroesophageal reflux. Concurrent manometric and acoustic recordings were also performed in the patients. Fifteen controls (38.5 +/- 13 years old) and 10 patients (34.9 +/- 6 years old) were included. All were recorded during wet and dry swallow sequences with microphones placed below the cricoid cartilage and on the xiphoid appendix. Standard manometry was performed for lower esophageal sphincter (LES) exploration. For the acoustic technique, the frequency of xiphoid signals (FX), esophageal transit time (ETT), duration of xiphoid sound (SD), and for the manometric study, the duration of LES relaxation (RD) were recorded and mean values were calculated (FXm), (ETTm), (SDm), (RDm). FXm for wet (94 vs 81.6%) and dry swallows (86 vs 66.6%) decreased in patients. ETTm was significantly higher (P < 0.01) for wet than for dry swallows (5.6 +/- 0.9 vs 5.2 +/- 1.2 sec) for controls but not for patients. ETTm was significantly higher for patients for wet (7.2 +/- 2.1 sec) and for dry swallows (6.5 +/- 2.3 sec) than for controls and SDm was lower. Xiphoid sound appeared in the second half of LES relaxation. Our noninvasive acoustic technique is simple and reproducible. It is well correlated with manometry, and it allows characterization of the displacement of the bolus through the esophagus and the LES. The technique could be used alone to determine appropriate pharmacological and surgical treatments for esophageal motility disorders.

Acoustics↗
PubMed1998

[MRI diagnosis of sinus cavernous invasion by pituitary adenomas].

PURPOSE: To evaluate the preoperative MRI criteria of a sinus cavernous invasion by a pituitary adenoma. MATERIAL AND METHODS: Study of 102 cavernous sinuses among 51 patients who had had a surgical cure of pituitary adenoma. Thirteen patients had a surgical invasion of the cavernous sinus. RESULTS: A certain number of signs eliminated cavernous sinus invasion. The best means consisted in not crossing the intercarotid line (Sensitivity-Se = 100%, Specificity-Sp = 85% and Negative Predictive Value-NPV = 100%). The others means implied: not going past twelve o'clock on the internal carotid artery-ICA (NPV = 97.1%), symmetrical size of the cavernous sinus (NPV = 92.5%), non-convexity of the lateral wall (NPV = 90.2%), visualization of at least two venous groups of the laterosellar space (NPV = 90.2%) and finally, non-displacement of the ICA (NPV = 89.2%). The best criteria for diagnosis were passing by the intra and supracavernous ICA lateral tangent (Se = 84.6%, Sp = 95%) and the percentage of ICA encasement by the adenoma exceeding 25% (Se = 92.3%, Sp = 85%). CONCLUSION: Except the total encasement of the intracavernous ICA, the cavernous sinus can be invaded when the lateral tangent of the supra and the intracavernous ICA is crossed, and also when the percentage of ICA encasement exceeds 25%.

Adenoma↗
PubMed1997

Exploration of pharyngeal swallowing by audiosignal recording.

The aims of this study were to analyze the following by audiorecording of swallows: (1) the influence on the volume and consistency of ingested substances on the audiosignal recorded during separate swallows; and (2) the characteristics of successive swallows during ingestion of 100 ml of the same substances to define deglutitive behaviors. Volunteers followed two protocols. Protocol (P) 1 comprised ingestion of 100 ml of water or yoghurt in successive swallows and Protocol 2 comprised separate swallows of different volumes of the same substances. Audiosignal recordings were made with a dynamic microphone. The following parameters were measured in P1: total time of ingestion (TT), number of swallows necessary for ingestion (N), and spontaneous swallowing intervals (SI). In P2 the duration (d) of each signal was measured according to consistency and volume. Mean (m) values were then calculated (TTm, Nm, SIm, and dm). During P1, TTm for yoghurt was significantly longer than for water (23.1 vs. 6.5 sec (men) and 21.8 vs. 7.8 sec (women). Nm was also greater for yoghurt (10.1 vs. 4.3 (men) and 10.0 vs. 4.8 (women). Three types of swallowing behavior were defined according to SI: swallowing at regular intervals (Reg) with increasing intervals during ingestion (Prog) and swallowing at variable intervals (Irreg). These patterns did not differ significantly according to sex. In P2 the increase in volume swallowed increased the duration (dm) of the signal for water (600 msec for 5 ml and 960 msec for 15 ml). The dm for yoghurt was significantly less than for water (580 msec for 5 ml and 920 msec for 15 ml). Our technique of recording sounds of pharyngeal swallowing is simple, reproducible, and not expensive. It permitted the analysis of each swallow according to volume and consistency and the determination of three swallowing patterns (Reg, Prog, and Irreg), taking into account the spontaneous swallowing interval. Ingestion by successive swallows could be used to characterize certain pharyngoesophageal motor dysfunctioning in relation to this reference population and to integrate this into a deglutition rehabilitation program.

Acoustics↗
PubMed1997

Erythromycin elicits opposite effects on antro-bulbar and duodenal motility: analysis in diabetics by cineradiography.

We have previously demonstrated by cineradiography analysis that erythromycin (Ery) increases antral contractility and antropyloric coordination in diabetics. The aim of this study was to further characterize antro-bulbar and duodenal motility after Ery i.v. administration. Fourteen diabetic patients (mean age 61.2 years) were randomly allocated to receive either 100 or 500 mg of Ery intravenously 4 hours after a standard solid liquid meal. After ingestion of a barium sulfate suspension, a series of 15 fluorographic plates (one every two seconds) was performed. the same procedure was repeated twice for each subject with a delay of 3 days once before and once after Ery. Antral, bulbar and duodenal areas and evolution diagrams were calculated in baseline conditions and after Ery administration using a graphic table connected to a microcomputer. No differences were found between the two doses of the drug. Ery significantly decreased antral (1284 +/- 268 mm2 vs 704 +/- 181 mm2; P < 0.01) and bulbar areas (127 +/- 26 mm2 vs 73 +/- 21 mm2; P < 0.01). In contrast, duodenal areas were significantly increased after Ery (875 +/- 112 mm2 vs 575 +/- 112 mm2; P < 0.01). This study suggests that the known prokinetic effect of Ery on gastric emptying seen in diabetic patients could be related to an increase of motility in the antrum and in the bulb simultaneously with a relaxation in the duodenum.

Adult↗
PubMed1996

Time course of biodistribution and changes in density following administration of iobitridol in rabbits. A comparative study vs iohexol.

PURPOSE: A new nonionic low-osmolality contrast medium, iobitridol (Xenetix 350) was compared with iohexol (Omnipaque) after i.v. injection in anesthetized rabbits to assess efficacy in CT examinations and biodistribution. MATERIAL AND METHODS: The densities in test tubes and the pharmacogenetics and biodistribution of iobitridol 350 and iohexol were compared in rabbits. CT of the brain, liver, the abdominal aorta and the kidneys was performed before and after injection of the contrast media. RESULTS: In aqueous medium, iobitridol absorbed roentgen rays in a manner exactly identical to that of iohexol. Within 15 min following injection of iohexol and iobitridol at a dose of 300 mg I/kg, both contrast agents resulted in aortic enhancement which decreased with time. An increased attenuation of the liver also occurred, decreasing with time. There was no significant enhancement in the brain but enhancement was found in the renal pelvocalyceal cavities 10 min postinjection. No significant difference was found between the 2 contrast agents under the study conditions. CONCLUSION: As could be expected from its behavior as a tracer of extracellular fluid, iobitridol resulted in significant changes in the signal, corresponding to its vascular, hepatic and renal pharmacokinetics in rabbits.

Animals↗
PubMed1996

[Color Doppler ultrasonography of local recurrent breast cancer].

Local lesions occurring after conservative surgery for breast neoplasms require diagnostic means capable of detecting and assessing the recurrence of such cancers. In the present color-coded Doppler was used in 20 women who had under gone conservative surgery (mean 4 years before) to screen all suspect lesions. Among the 14 malignant lesions assessed histologically, one or more arterial vessels were detected inside or beside the lesion in 13. Among the 6 benign lesions, only of one arterial vessel was detected, in all cases far from the lesion (12.5 to 3.3 mm). No significant difference was observed for systolic velocities and resistance index. These results indicate high accuracy of color coded Doppler examination associated with echotomography and mammography for positive diagnosis of recurrent lesions in post-conservative follow-up of breast cancer.

Adult↗
PubMed1995

Immediate and delayed tolerance of iohexol and ioxaglate in lower limb phlebography: a double-blind comparative study in humans.

RATIONALE AND OBJECTIVES: We compared the tolerance and efficacy of iohexol-300, a nonionic low-osmolar monomer, with those of ioxaglate-320, an ionic low-osmolar dimer, in lower limb phlebography. METHODS: One hundred twenty inpatients were randomly divided into two groups in this double-blind comparative study. Two hundred milliliters of contrast medium (100 ml per leg) was injected intravenously. The immediate tolerance was classified as discomfort (i.e., sensation of warmth, pain, coldness related to the injection) and adverse events occurring up to 1 hr after administration. Delayed tolerance was followed up to 8 days after the examination. The main parameter was immediate adverse events. Image quality was assessed by a radiologist using a visual analog scale. RESULTS: The number of immediate adverse events was significantly higher in the ioxaglate group (p < .02). The more frequent events were digestive disorders and skin rashes; 13 of these events were reported in the ioxaglate group, but none were reported in the iohexol group (p < .001). The other parameters were not significantly different in the two groups. CONCLUSION: We found a similar efficacy and a better tolerance of iohexol-300 than ioxaglate-320 in lower limb phlebography.

Contrast Media↗
PubMed1994

[Minor aplasia of the ear: anatomical findings and results of functional surgery].

We report a retrospective study of 57 cases of minor aplasia of the ear. Each case was analyzed according to the clinical presentation, audiometric results and preoperative radiography. Intra-operative classification of the malformation was obtained in 56 of the 57 cases. The post-operative anatomic and functional results were analyzed. Stapedectomy in type II malformations (stapedo-vestibular ankylosis) gave the best results but this procedure also carries the highest risk for the inner ear. Globally, functional results were good or average in 48% of the patients. These results may appear unsatisfactory but must be appreciated in light of the fact that half of the patients benefited from the operation (particularly in eliminating further use of an external hearing aid). Nevertheless, the long-term stability of these audition results is unknown.

Adolescent↗
PubMed1994

[Simplified measurement of colonic transit time by one radiography of the abdomen and a single type of marker. Normal values in 82 volunteers related to the sexes].

Assessment of total and segmental colonic transit times (CTT) in man using a single type of radiopaque marker and one abdominal X-ray has been validated but not extensively studied. The aims of our prospective study were to establish normal values of this method as a function of age, gender and fiber intake in healthy subjects. Eighty-two healthy volunteers (51 men, 31 women, mean age 38 yr, range 21-61) with normal stool frequency (between 3/day and 3/week) and no history of gastrointestinal disease or medication were enrolled and ingested 10 small (3 mm edge) radiopaque markers every morning for 6 consecutive days. On the 7th day, an abdominal X-ray was performed to calculate total and segmental (right, left, rectosigmoid) CTT according to Arhan's method (CCT = 2.4 N; N = number of markers in the considered zone). During the study the number of stools was recorded and fiber intake estimated on a questionnaire. Stool frequency, total and segmental CTT were evaluated for differences due to age, gender and/or fiber intake. In volunteers, total, left and rectosigmoid CTT were closely related to stool frequency (P = 0.0001) being longer in women than in men (P < 0.02). In contrast, right CTT was independent of gender or stool frequency. Finally, in this group CTT were independent of age and fiber intake. This study confirms the influence of gender on CTT and demonstrate the ability of this simple and non-invasive method (0.08 mrad surface exposure) to assess CTT. Its use as a diagnostic tool in self-defined constipated patients would be of interest in clinical practice.

Adult↗
PubMed1993

[CASTOR-Radiology: software of management in a Unit of Medical Imaging: use in the CHU of Tours].

Despite the large volume of information circulating in radiology departments, very few of them are currently computerised, although computer processing is developing rapidly in hospitals, encouraged by the installation of PMSI. This article illustrates the example of an imaging department management software: CASTOR-Radiologie, Computerisation of part of the Hospital Information System (HIS) must allow an improvement in the efficacy of the service rendered, must reliably reflect the department's activity and must be able to monitor the running costs. CASTOR-Radiologie was developed in conformity with standard national specifications defined by the Public Hospitals Department of the French Ministry of Health. The functions of this software are: unique patient identification, HIS base, management of examination requests, allowing a rapid reply to clinician's requests, "real-time" follow-up of patients in the department, saving time for secretaries and technicians, medical files and file analysis, allowing analysis of diagnostic strategies and quality control, edition of analytical tables of the department's activity compatible with the PMSI procedures catalogue, allowing optimisation of the use of limited resources, aid to the management of human, equipment and consumable resources. Links with other hospital computers raise organisational rather than technical problems, but have been planned for in the CASTOR-Radiologie software. This new tool was very well accepted by the personnel.

France↗
PubMed1993

[Antro-pyloro-bulbar contractibility in diabetics studied by cineradiography. Effect of erythromycin].

We studied antropyloroduodenal contractility in diabetics and the effect of erythromycin IV (100-500 mg) using the non invasive Boiron cineradiographic method analysis. Fourteen diabetics and 22 controls were examined. Four hours after a standard liquid-solid meal, patients drank 250 mL baryum solution. Fluorographic plates (10 x 10 cm) were taken every 2 s during 30 s. Semi-automatic data processing analysis allowed to measure motility parameters including antral (CA) and bulbar (CB) contractility indexes; pyloric opening index (OP), gastric (FG) and bulbar (FB) frequencies. Three types of pylorus behaviour patterns were define: A and B related to antropyloric and antropyloroduodenal coordination respectively and N without coordination. In diabetics, CA, OP and FG were decreased vs controls (P < 0.01) (CA: 65.5 +/- 6.8 vs 83.1 +/- 2.4%; OP: 60.9 +/- 8.7 vs 84.8 +/- 1.9%; FG: 2.42 +/- 0.14 vs 3.08 +/- 0.04 c/min) and antropylorbulbar coordination altered (N was predominant; no bulbar cycles at 3/min). Antral hypocontractility was correlated with autonomic neuropathy. After erythromycin, radiological parameters returned to normal values (CA = 83.0 +/- 2.4%; OP = 86.0 +/- 4.7%; FG = 3.0 +/- 0.16 c/min) and coordination improved type N disappeared and FB = 3 c/min (58%). Cineradiographic analysis is simple, able to show antropylorobulbar contractile abnormalities, to study pharmacological effects, and in diabetics is capable of studying improvement of motility parameters with erythromycin.

Adult↗
PubMed1991

[Motility of antrum, pylorus, and duodenal bulb: importance of radiologic series analysis in man].

The quantification of gastroduodenal motility uses invasive methods. The aim of our study was to further characterize the contractility of antrum, pylorus and duodenal bulb in two states, using a new, non invasive fluorographic method. Healthy volunteers (mean age = 28) were involved in this study under fasting conditions (n = 20) and after a meal (n = 20). In both conditions, the subjects have swallowed 250 ml of a barium sulfate solution for fluoroscopic gastrographies taken every 2 seconds, during 30 s. Spot films were analysed using a graphic table and locally developed microcomputer program to generate space-time diagrams of antral and duodenal areas and of pylorus diameters. For each subject, the antral CA, duodenal CB contractilities (maximal variation of antral, duodenal areas in p 100) and pylorus contractility CP (closure during the observation time in p 100) were calculated. CA values were high in the two situations, but did not differ (81.1 p 100 vs 82.5 p 100 post-prandial). In contrast, CP was higher under fasting (54.0 p 100) than in post-prandial (15.0 p 100; p less than .001). Two pyloric motor patterns were observed in post-prandial: A--pyloric contractions in relation with the end of antral contraction B--augmented pyloric resistances observed during the end of antral contraction and also associated with duodenal contractions. CB was low in post-prandial (27.0 p 100) compared to fasting CB (50.8 p 100; P less than .001). This method is reproducible and simple to use. It allows quantification of contractility and coordination in the antrum, pylorus and duodenal bulb. It may be useful to assess gastroduodenal motility under pathological conditions.

Adult↗
PubMed1991

[Gastric peristalsis and dyspepsia: value of cineradiographic analysis in men].

Gastric peristalsis has not been studied extensively in patients with dyspepsia. The aim of our study was to further characterize gastric peristalsis in such patients using a newly described fluorographic method. Thirty-two patients with dyspepsia and 18 healthy volunteers were included in our study. Four hours after a standard solid-liquid meal, the subject swallowed 250 ml of a baryum sulfate solution and (100 mm x 100 mm) fluoroscopy of the stomach was performed every 2 s during 30 s. Spot films were analyzed using a graphic table and a amateur microcomputer program. For each subject, the instant velocity, vi, and mean velocity, V, of gastric peristalsis were calculated and used to generate a time-space diagram of contractions, a velocity histogram and an index of propagation, Ip. These parameters were compared to normal values (V = 2.2 +/- 0.2 mm/s; Ip = 2.2 +/- 0.4). When compared with normal values, 3 different motility patterns appeared in dyspeptic patients with a high correlation between V and Ip (P less than 0.01): normoperistalsis (n = 8; 1.8 less than V less than 2.6 mm/s); 1.4 less than Ip less than 30); hypoperistalsis (n = 7; V less than 1.8 mm/s; Ip greater than 3.0) and hyperperistalsis (n = 7; V greater than 2.6 mm/s; Ip less than 1.4). In a 4th group (n = 5), a retroperistalsis was effect observed with Ip less than 0. For 5 other patients, Ip or V was abnormal with atypical motor activity detected on the time-space diagram.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Use of peak expiratory flow rate to identify patients with increased risk of contrast medium reaction. Results of preliminary study.

Although the intravenous injection of iodinated contrast media is usually well tolerated by patients, it does cause a significant number of side effects. The current study was designed to determine whether the measurement of peak-expiratory-flow rate before injection of contrast medium can be taken as a predictor of reactions to contrast media. The study covers a population of 100 patients who underwent excretory urography; those with a history of allergy or atopic hypersensitivity were given premedication before contrast injection. Peak-expiratory-flow measurements were made 10 minutes before, and immediately before injection, and at 1 and 15 minutes postinjection by a Wright flow meter. They revealed a subclinical bronchospasm after the intravenous injection of iodinated contrast medium that was more severe for subjects demonstrating an untoward reaction to contrast media. A single measurement of peak expiratory flow 10 minutes before contrast injection is, in itself, a good indicator of increased risk. A patient with a peak expiratory flow of less than 400 L/min 10 minutes before the injection, runs a 3.8 times higher risk of developing an adverse reaction to intravascular radiodiagnostic compounds in this study.

Bronchial Spasm↗