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Biomedical subjects

S Chagnon

Publications and source records attributed to S Chagnon.

At least 19 recordsLinked to original sources

[Angiographic identification of spinal cord arteries before bronchial artery embolization].

Ischemic spinal cord injury is the major risk of bronchial artery embolization. The spinal artery may be overlooked on initial intercostobronchial trunk arteriography, as a result of reverse flow within the intercostal branch. Its identification, conversely, is easier on postembolization angiography. An illustrative case is presented, with angiographic correlation. The pathophysiology of the reverse flow is discussed. Technical recommendations are proposed for its detection.

Adult

[Failures and complications of bronchial artery embolization].

Bronchial artery embolization (BAE) is well accepted and widely used for management of massive and recurrent hemoptysis. Recurrent hemoptysis occurs in 20% of cases. It may be due to partial embolization, recruitment of other systemic collaterals, recanalization of an embolized artery, or progression of primary disease. Severe complications of BAE are limited to spinal cord injury, oesophageal necrosis, and bronchial ischemia. The proper application of bronchial arteriography and embolization techniques depends on a thorough knowledge of the arterial anatomy, a meticulous catheterization technique, the use of nonionic or lowosmolarity contrast materials, and adequate positioning of the catheter. In these optical conditions of safety, BAE is the treatment of choice for severe and recurrent hemoptysis.

Bronchi

Reliability of three methods of radiologic assessment in patients with rheumatoid arthritis.

RATIONALE AND OBJECTIVES: To assess the intraobserver reliability of three methods used frequently to evaluate joint destruction in rheumatoid arthritis: the Sharp method, the Larsen method, and the carpo:metacarpal ratio. METHODS: One observer analyzed twice within a 6-week interval 71 radiographs from patients with rheumatoid arthritis. Reliability was estimated by intraclass correlation coefficient (R) and by Altman-Bland graphical method. Correlations were examined by the Spearman's coefficient (r). RESULTS: The intraobserver reliability of each method appeared satisfactory with a good result for the Sharp method (R = 0.97). The correlation was strong (r > 0.80) between the results obtained by Sharp's and Larsen's methods and weaker between the results of the two former methods and the carpo: metacarpal ratio. CONCLUSIONS: Sharp's method should be used preferentially in studies evaluating the radiologic changes in rheumatoid arthritis over time, especially in clinical trials. The carpo:metacarpal ratio may be considered as a complementary method, when wrist destruction is of conceptual importance.

Adult

[Dysphagia with fever revealing mediastinal lymph node tuberculosis. Apropos of 2 cases].

The oesophagus is a rare localization of extrapulmonary tuberculosis. We report 2 cases of tuberculous mediastinal lymph nodes revealed by dysphagia and fever in immunocompetent subjects. With the actual outbreak of tuberculosis, this localization is worth mentioning, as the precocity of the diagnosis and the therapeutic handling is an important prognostic factor.

Adult

The diagnostic value of fine-needle aspiration biopsy under ultrasonography in nonfunctional thyroid nodules: a prospective study comparing cytologic and histologic findings.

Fine-needle aspiration biopsy (FNAB) of thyroid nodules has been proposed as a preoperative screening method to reduce the number of patients with benign nodules referred for surgery. Only a few previously published studies have compared cytologic results with a systematic surgical control; furthermore, the role of ultrasound guidance for FNAB in obtaining representative material has been poorly evaluated. The authors tried to assess the diagnostic value of FNAB performed under ultrasonography in a series of patients with a cold nodule and a systematic surgical control. This prospective study included 132 consecutive patients, 19 men and 113 women, aged from 18 to 82 years. The rate of carcinomas was 13.8%. A very high rate of adequate material was obtained (96.2%). Sensitivity, specificity, and global accuracy were 95%, 87.7%, and 89%, respectively. These results, which are equivalent to those previously published but associated with a low level of insufficient material, emphasize the diagnostic value of thyroid FNAB.

Adult

[Tuberculosis. Role of fine needle puncture in the current diagnostic approach].

Twenty-one fine needle aspiration biopsies were performed with a diagnosis of tuberculosis or granulomatous inflammation. The ages of the patients ranged from 26 to 66 years (mean, 36 years); 16 were men and 5 women. Two of them were positive for the human immunodeficiency virus. In twenty cases, the cytological diagnosis was confirmed by culture and/or by recovery under a specific anti-tuberculous treatment. In one case, the necrosis observed cytologically was a tumoral necrosis after histological control. According to these results with a global accuracy of 95.2%, fine needle aspiration biopsy which offers the possibility of a thorough diagnosis in a short time (24 hours or less) is a useful method for the diagnosis of tuberculosis.

Adult

Simultaneous noninvasive evaluation of gastric emptying and orocaecal transit times. Use in studying the actions of cisapride in diabetic patients.

The aim of the study was to use a novel combination of two methods for the simultaneous evaluation of two effects of oral cisapride in 10 diabetic patients with autonomic neuropathy; gastric empyting time was measured by following radio-opaque markers and orocaecal transit time by the sulphasalazine-sulphapridine method. The study was of double-blind, randomized, placebo-controlled, cross-over design. It was possible to evaluate the effect of a prokinetic drug on gastric emptying and orocaecal transit times using these two noninvasive techniques at the same time. Cisapride significantly reduced both the gastric empyting (1.2 h versus 2.1 h) and orocaecal tansit (5.9 h versus 7.7 h) times.

Adult

Percutaneous recanalization of a renal artery in aortic dissection.

Chronic renal failure acutely worsened in a patient with a type B aortic dissection. Aortography revealed an occlusion of the left renal artery without renal intimal tear. Percutaneous recanalization, performed with a self-expandable stent, resulted in improvement in the renal function. This technique offers a new therapeutic choice in patients with visceral complications of aortic dissection.

Aortic Dissection

[X-ray computed tomographic aspects of mesenteric panniculitis].

Mesenteric panniculitis also known as lipodystrophy is an inflammatory condition of adipose tissue. A case of a 55 year old, female who presented a weight loss and a tender palpable mass located in the left flank is reported. CT patterns were not specific but might suggest the diagnosis: fatty mass, with a higher density than subcutaneous fat, located in the root of the mesentery and surrounding mesenteric vessels without distoting them. Intestinal loops were only pulled in periphery. This signs are not always present and even in this typical pattern mesenteric panniculitis could not be differentiated from liposarcoma. Thus an histological proof was needed. The evolution was good, with resolution of the abdominal pain. The knowledge of this rare Radioclinical syndrome should prevent any aggressive therapy.

Abdominal Neoplasms

Pelvic cancers: staging of 139 cases with lymphography and fine-needle aspiration biopsy.

One hundred thirty-nine patients with pelvic cancers (101 bladder carcinomas, 27 prostatic carcinomas, and 11 testicular tumors) considered for radical surgery were studied with lymphography and percutaneous fine-needle aspiration (FNA) biopsy, and the results were correlated with lymphadenectomy. Adequate material for FNA was obtained in 97%, 88%, and 100% of the bladder, prostatic, and testicular tumors, respectively. For bladder carcinoma, the global accuracy was 58% for lymphography and 93% for FNA; the high false-negative rate for lymphography (48%) was lowered to 25% with FNA, providing that the obturator nodes were punctured. For prostatic carcinomas, it was not possible to evaluate the true-positive rate because the patients with positive FNA results did not under-go surgery. For testicular tumors, lymphography and FNA had almost the same global accuracy (73% and 75%), but FNA had a better specificity (100%) than lymphography (86%). FNA had no false-positive results, which means that positive biopsy results obviate radical surgery; when FNA results are negative a lymphadenectomy should be performed. With its mild morbidity, FNA has a role in the preoperative staging of pelvic carcinomas.

Aged

[Rectal malacoplakia. Contribution of x-ray computed tomography and endorectal echography].

The authors report about the observation of a case of malacoplakia with rectal involvement. They lay stress on the usefulness of computed tomography and of rectal echography, which allow assessing extension within the rectal wall and, as the case may be, into the lymph nodes. These examinations also allowed following up the disease, the signs of which abated with antibiotic treatment.

Adolescent

[Contribution of imaging in complications of colo-anal anastomoses. Apropos of 61 cases].

The authors studied the complications occurring in 61 cases of colo-anal anastomosis carried out for cancer in 55 cases. Fistula formation occurred in 14 cases i.e. approximately 23%. This was symptomatic in 11 cases i.e. 18%. Their clinical course was favourable. One case of necrosis of the reservoir was seen. The recurrence rate for neoplasms was 14.3% and was no higher than after abdomino-perineal resection. The procedure is justified in terms of tumour recurrence.

Adult

[Xanthogranulomatous pyelonephritis with fatty proliferation of the renal space. Aspects in x-ray computed tomography and MRI].

The authors report one case of one case of xanthogranulomatous pyelonephritis associated with very extensive fatty proliferation in the renal space. This mass surrounded a small, pyelonephritic kidney with a considerable xanthomatous component containing a coral calculus. It was associated with a streaming abscess in the lumbar fossa. The computed tomography (CT) and magnetic resonance imaging (MRI) features are described in this article.

Adipose Tissue

[Abdominal and retroperitoneal masses. Diagnostic value of fine needle cytopunctures. 121 consecutive controlled cases].

A series of 121 consecutive patients with abdominal (96 cases) and retroperitoneal (25 cases) masses was studied in order to evaluate the contribution of cytology in establishing a definite diagnosis of the tumors. The cytologic results on aspirates were obtained with 22 or 23 gauge Chiba needles. At the same time, percutaneous fine needle aspiration biopsy was performed with 19 or 21 gauge fine needles having circumferentially bevelled tips that produced tiny tissue cores suitable for histologic study in 88 cases. These diagnoses were controlled with larger pathological specimens in 78 cases and appeared to be consistent with the clinical and biological course in 43 cases. The sensitivity of the cytologic diagnosis was 83 per cent, and its overall accuracy 87.6 per cent. There were no false-positive results. Furthermore, the method proved to be safe and well-tolerated, with low morbidity (0.8 per cent) and no mortality.

Abdominal Neoplasms