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Biomedical subjects

R Roger

Publications and source records attributed to R Roger.

At least 19 recordsLinked to original sources
PubMed2005

[Adhesive capsulitis: evaluation of a treatment coupling capsular distension and intensive rehabilitation].

INTRODUCTION: Adhesive capsulitis is a clinical entity characterized by a loss of motion and a decrease of the joint volume capacity. Results of clinical trials have shown that distensions can help to decrease pain and increase the range of motion. OBJECTIVE: The purpose of the study was to measure the effect of repeated distension arthrography combined with an intensive program of rehabilitation on pain, range of motion, and occupational outcome in patients with adhesive capsulitis. DESIGN: 39 cases of idiopathic capsulitis (7 cases) or secondary capsulitis (19 post-traumatic, 13 post-surgery of the rotator cuff) were included in the study. Intervention consisted of an intensive program of passive and active physiotherapy during one? Week and then distension arthrography, performed 3 times at 1- week intervals, with steroid injections in the glenohumeral joint and 1 in the subacromial space. RESULTS: Lateral elevation improved substantially after the first week of physiotherapy and medial rotation after the first distension. Pain intensity decreased after the first distension. After the third distension, very small changes were noted. Results did not differ by etiology of capsulitis. At the end of the program, 9 of 17 patients could return to their previous job. CONCLUSIONS: Two repeated arthrographic distensions with steroid injection and an intensive program of physiotherapy improves the range of motion and the painful condition associated with capsulitis and allows for a rapid return to employment. A third distension does not seem to provide a further benefit, as has been found by other studies.

Bursitis↗
PubMed2004

[MR imaging in the evaluation of blunt pancreatic trauma].

Pancreatic injuries caused by blunt trauma are unusual but associated with a high morbidity and a high mortality because of a delay in diagnosis. Clinical and laboratory findings are non-specific. Accurate grading of blunt pancreatic injury with identification of pancreatic duct disruption helps to define practical treatment guidelines. Computed tomography does not allow direct visualization of the pancreatic duct and may result in low accuracy for the detection of ductal injury. Endoscopic retrograde pancreatography is the "gold standard" but invasive (3-5% complication rate, mainly pancreatitis) and may not be possible in up to 30% of patients, or requested after surgery. Endoscopic retrograde pancreatography may be used as a therapeutic modality (stenting of the main pancreatic duct). Magnetic resonance cholangiopancreatography is non invasive and preliminary results are promising. Magnetic resonance cholangiopancreatography detects pseudocysts, has multiplanar capability and complemented with conventional MR imaging allows evaluation of the pancreatic parenchyma.

Humans↗
PubMed2004

[Gastric necrosis from acute dilatation without underlying psychiatric disorder].

Acute gastric dilatation with necrosis is a rare and severe complication associated with anorexia nervosa, bulimia, and psychogenic polyphagia. The Authors report an unusual case without underlying psychiatric context. Gastric necrosis was suspected based on imaging findings (plain radiograph and computed tomography). The detection of these imaging signs in an appropriate clinical setting, even without underlying psychiatric context, is important to avoid any delay in diagnosis and reduce mortality.

Abdominal Pain↗
PubMed2004

Partial thrombosis of an idiopathic azygos vein aneurysm.

Aneurysms of the azygos vein are often asymptomatic, detected on a chest radiograph simulating paratracheal mass. When the aneurysm is totally thrombosed, it is impossible to distinguish it from another cause of mediastinal mass. A case is presented in which partial thrombosis of the aneurysm and communication with the superior vena cava led to a diagnosis on angiography and CT.

Adult↗
PubMed2003

[Characterization of adrenal incidentaloma discovered with tomography. General review].

The detection of an incidentaloma at abdominal Computed Tomography (CT), except CT features that permit a specific diagnosis (hemorrhage, myelolipoma or cyst), become a problem to differentiate adenomas from "non adenomas" (primary or secondary malignancy) incidentalomas. A density of ten Hounsfield units or less with a nonenhanced CT is a feature of benign incidentaloma (essentially lipid-rich adrenal adenomas). There are two limitations of this characterization: incidentalomas initially detected at enhanced CT and lipid-poor adrenal adenomas. The relative enhancement washout on enhanced CT, by using a threshold of 50% washout, permit then to characterized as adenomas or "non adenomas" incidentalomas on a 10-minute-delayed enhanced CT. Limitations of this characterization are only for benign pheochromocytomas and atypical adrenal cortical carcinomas.

Adrenal Gland Neoplasms↗
PubMed2003

[Enterolith ileus: a rare complication of small bowel diverticulosis].

An elderly patient with subacute small bowel obstruction due to an enterolith that evolved within a small bowel diverticulum is reported. Presence of small bowel diverticulum is not rare. But small bowel obstruction secondary to an enterolith formed within a small bowel diverticulum is a rare complication. Enterolith ileus closely resembles gallstone ileus in its clinical presentation. Diagnosis can be established only by documenting the absence of aerobilia and the presence of small bowel abnormality causing stasis, like small bowel diverticulosis.

Aged↗
PubMed2003

[Isolated dissection of the superior mesenteric artery].

Isolated spontaneous dissection of the superior mesenteric artery is uncommon. We report a case complicated by arterial rupture and discuss diagnostic imaging work-up. Diagnosis is usually made by conventional arteriography. But, dissection can also be diagnosed noninvasively by computed tomography angiography and ultrasound.

Aortic Dissection↗
PubMed2003

[Iatrogenic renal perforation during percutaneous angioplasty].

Percutaneous transluminal angioplasty is recommended as the first choice of therapy for renal artery stenosis. However, morbidity and mortality are significant. Among hemorrhagic complications, renal perforation is unusual. A case is reported, caused by the use of an angled hydrophilic guidewire, in which the diagnosis has been made by computed tomography angiography with typically perirenal hematoma and extravasation of contrast material corresponding to the perforation. This complication has been successfully treated with conservative measures.

Angioplasty, Balloon↗
PubMed2003

[Congenital absence of a cervical spine pedicle: misdiagnosis in a context of trauma].

Absence of a cervical spine pedicle is an exceptional congenital anomaly with a characteristic radiographic triad: i) absence of pedicle producing a pseudo-enlargement of the homolateral foramen, ii) dysplastic aspect with posterior displacement of the homolateral facets and lamina, and iii) defect or absence of the homolateral transverse process. It is particularly important to recognize this radiographic picture in order to avoid misdiagnosis, e.g. unilateral fracture-displacement of the facet joints in a context of acute trauma, as occurred in our case, or pathological enlargement of the foramen (neurofibroma) without trauma. We describe the radiographic presentation of this congenital anomaly, stressing the importance of a homolateral oblique view and the usefulness of computed tomography for correct diagnosis.

Adult↗
PubMed2003

[Radiologic appearance of epiploic appendages and their complications].

A wide spectrum of pathologic processes can involve epiploic appendages, and primary epiploic appendagitis is the most frequent. Pathologic processes are today more frequently identified with the increased use of radiological assessment (ultrasound and computed tomography) of patients presenting with acute abdominal pain. Recognition of specific imaging abnormalities of complications enables the radiologist to make the diagnosis, thus allowing appropriate treatment.

Colon↗
PubMed2002

[Ischemic cholangitis after ligation of the hepatic artery: a case report].

We report a case of ischemic cholangitis that occurred after ligation of the hepatic artery performed to remove a celiac neurofibroma. At seven weeks in a septic setting, the patient developed ischemic cholangitis. Ligation of the hepatic artery and dissection of the hepatic hilum to remove a neurofibroma have played a role in the development of ischemic cholangitis. Our case demonstrates that supplying peribiliary arteries are important for the biliary vascularization of the epithelium.

Abdominal Pain↗
PubMed1997

Bcl-2 expression in target cells leads to functional inhibition of caspase-3 protease family in human NK and lymphokine-activated killer cell granule-mediated apoptosis.

In the granule exocytosis pathway of cell-mediated cytotoxicity, rapid apoptotic nuclear damage in target cells has been unequivocally linked to granzyme B activity. Direct cleavage and activation of caspase-3 and related proteases by granzyme B have been identified as a central event in apoptosis induction by cytotoxic granules. The Bcl-2 oncoprotein has been recently shown to act at the level or upstream of caspase-3 family activation to inhibit apoptosis induced by various stimuli including Fas ligation, an alternative cell-mediated lytic pathway. In this study, we have investigated whether activation of this caspase family by granzyme B, during human NK and lymphokine-activated killer cell granule-mediated apoptosis, could be influenced by Bcl-2 expression. Bcl-2-overexpressing clones were generated from parental K562 and U937 cell lines (K6 and U4 clones, respectively). Bcl-2 expression abrogated early 125I-DNA release and DNA fragmentation, these defects being compensated for by extended incubation times. Cleavage of poly(ADP-ribose) polymerase, a specific caspase-3 family substrate, was detected in parental K562 cells exposed to lymphokine-activated killer effectors but not in K6 targets, indicating that caspase-3 and related proteases function was inhibited by Bcl-2. Functional inhibition of caspase-3 family with benzyloxycarbonyl-Asp-Glu-Val-Asp(OMe) fluoromethylketone led to similar consequences on apoptotic nuclear events as for Bcl-2 expression. Thus, Bcl-2 antagonizes granzyme B-mediated apoptosis by a mechanism that interferes with caspase-3 activity. Finally, Bcl-2 expression or the Asp-Glu-Val-Asp peptide was much less efficient in preventing phosphatidylserine externalization, suggesting that despite impaired nuclear apoptosis, immediate recognition and elimination of Bcl-2-expressing cells by tissue phagocytes should remain partly unaffected.

Apoptosis↗
PubMed1997

[MRI aspect of disk tumor infiltration].

We report a case of tumor infiltration into an intervertebral disk imaged at MR. The MRI appearance of a tumor infiltration into an intervertebral disk is the same as a spondylodiscitis: loss of the internuclear cleft, increased signal intensity of the disk on T2 weighted imaging. Other metastatic infiltration in vertebrae and a primitive tumor suggest the diagnosis. It is confirmed by percutaneous biopsy.

Aged↗
PubMed1996

CD28-mediated cytotoxicity of YT natural killer cells on B7-positive targets induces rapid necrotic death independent of granule exocytosis.

The mechanisms leading to target cell killing by the human NK-like cell line YT2C2 have been studied. YT2C2 cells express CD28 antigen and kill B7-expressing targets by a CD28-mediated mechanism which is inhibited by anti-CD28 mAb (CD28.2). The lysis of B7-negative targets, which are also killed by YT2C2, is insensitive to CD28.2, but can be inhibited by cyclosporin A (CsA). CsA reduces degranulation in YT2C2 as measured by BLT-esterase release assays. A total suppression of B7-negative cell lysis was observed in the presence of EGTA, which blocks both degranulation and perforin polymerization, confirming that lysis of this type of target depends solely upon granule exocytosis. In contrast, an additional extracellular EGTA-resistant component in B7-positive target killing was evidenced. These results were consistently obtained with a panel of B7-positive and B7-negative targets, including a Jurkat subclone transfected to express B7 and its parental cell line. Ca2+-independent killing was completed during the first hour of the cytotoxicity assay, whereas EGTA-sensitive lysis increased throughout the whole incubation time. These two lytic mechanisms used by YT2C2 were found to induce two different modes of cell death. Extracellular Ca2+-dependent killing caused apoptotic death in both B7-positive and B7-negative targets, whereas the EGTA-resistant cytolytic pathway, observed exclusively with B7-positive targets, led to necrosis. CD28 triggering in YT2C2 induces, therefore, an additional mechanism of cell killing, independent of granule exocytosis, the nature of which remains to be identified.

Antibodies, Monoclonal↗
PubMed1996

BCR-ABL does not prevent apoptotic death induced by human natural killer or lymphokine-activated killer cells.

The erythromyeloid cell line, K562, the most sensitive target in human natural killer (NK) cell mediated cytotoxicity, is derived from a chronic myeloid leukemia (CML) patient and expresses the characteristic reciprocal translocation t(9;22). The resulting BCR-ABL fusion protein has been shown to mediate the unusual resistance of K562, and other BCR-ABL expressing lines, to apoptosis induced by a variety of agents (irradiation, UV light, cytotoxic drugs). Here we show that human NK and lymphokine-activated killer (LAK) cells, when tested at low effector to target ratio, can readily induce apoptotic death in K562 cells. This was accompanied with classical DNA oligonucleosomal fragmentation, an unexpected finding given the reported lack of such fragmentation when apoptosis is induced in K562 by chemical agents, after downregulation of BCR-ABL. Apoptosis was assessed by several means: morphological studies, 125I-DNA versus 51Cr release, DNA agarose gel electrophoresis, and results were always concordant, with a delayed kinetics for DNA oligonucleosomal fragmentation. Similar data were obtained with a pluripotent human hematopoietic cell line, UT-7, infected with a defective amphotropic p210 BCR-ABL retrovirus. The BCR-ABL expressing subclone UT-7/9, while being no longer sensitive to cytotoxic drugs or to tumor necrosis factor, a lytic mediator to which UT-7 cells are sensitive, underwent apoptotic death when exposed to LAK effector cells to the same degree as the parental UT-7 line. With these targets, DNA oligonucleosomal fragmentation occurred concomitantly with isotope release. Results obtained with several inhibitors of exocytosis strongly suggest that cytotoxic granules mediate NK and LAK cell-induced apoptotic death. In conclusion, NK and LAK cell-induced apoptotic signals, unlike those activated by chemotherapeutic agents, are unaffected by the antiapoptotic action of BCR-ABL. This unique property may support the observed curative effect of allogeneic bone marrow transplantation in CML.

Apoptosis↗