[Mucocele of the maxillary sinus].
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Biomedical subjects
Publications and source records attributed to S Merran.
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BACKGROUND: This multicenter phase II trial was conducted in order to evaluate the efficacy and toxicity of the subcutaneous route of administration of rIL-2 in the treatment of patients with metastatic renal cell carcinoma and to check whether an increased cumulative dose of rIL-2 increases efficacy. PATIENTS AND METHODS: Thirty-nine patients with metastatic renal cell carcinoma were included in this study. During the induction period, rIL-2 was administered subcutaneously 5 days a week for 8 weeks. The weekly dosages were 90 MIU during weeks 1 and 6;63 MIU during weeks 2 to 4 and 7 to 9. After evaluation, responders and patients with stable disease received maintenance treatment which was discontinued upon the appearance of disease progression or unacceptable toxicity. During the maintenance period, rIL-2 was administered 5 days a week for 4 weeks followed by a 2-week rest period. The weekly dosages were 90 MIU in week 1 and 63 MIU in weeks 2 to 4. RESULTS: After completion of induction treatment, 7 of 39 evaluable patients (18%) had objective responses (95% CI: 9% to 37%) with one complete response. Treatment was interrupted or reduced due to toxicity for seven patients: Neuropsychiatric symptoms (3 patients), joint pain (1 patient), major asthenia and anorexia (1 patient), stroke (1 patient), and septicemia (1 patient). Other systemic side effects in the remaining patients were acceptable. Seventeen patients received maintenance treatment. In none of the patients did the response status improve during this maintenance period. The median follow-up of all of the patients included was 19 months. The one- and two-year survivals were 65% and 33%, respectively, ad the median duration of response was 11 months (5 to 16+). CONCLUSIONS: This multicentric study confirms the efficacy of subcutaneously-administered rIL-2 in patients with metastatic renal cell carcinoma in terms of both response rate and survival. The role of a maintenance therapy needs further evaluation.
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The authors report about a rare site of craniopharyngioma, purely extracerebral and located in the sphenoid sinus and the rhinopharynx. No CT or MRI sign is pathognomonic for the lesion, but the presence of a fleshy process containing calcifications and cystic formations must lead to evoking this diagnosis. MRI assesses the extent of the lesions perfectly, but fails to detect small calcifications or ossifications accurately.
Twenty patients with clinical acute pyelonephritis were investigated by routine CT scan. This examination was positive in 19 cases, demonstrating either a hypodense triangular image reflecting a disorder of blood supply or a mass syndrome. The CT scan can therefore confirm the diagnosis of acute pyelonephritis. It also defines the severity of the lesions and helps to guide treatment.
We describe a patient in whom a pseudocyst of the pancreatic tail ruptured into the wall of the stomach. Because of the intramural location of this lesion, its sonographic and computed tomographic features were those of a gastric tumor. The correct diagnosis was made only by endoscopic retrograde cholangiopancreatography, which showed extravasation of contrast material from the pancreatic duct into a nonhomogeneous cystic cavity.
A total of 20 macroscopically normal or hypertropic prostates were taken from cadavers of men older than fifty, who died of causes other than urologic ones. The samples were studied in vitro by nonscreen x-ray films, ultrasonography, computed tomography, and then by a pathologist. There were 4 normal prostates, 12 with benign prostatic hypertrophy, 3 with carcinoma, and 1 with prostatitis. Conventional radiography which showed only prostatic calcifications was of no pathologic interest. Computed tomography is by no means of diagnostic use in distinguishing between benign prostatic hypertrophy and carcinoma, and should be used only as an alternative in the evaluation of regional extension of prostatic carcinoma. On the other hand, ultrasonography appears to be sensitive to detection of very small nonpalpable nodules. However, its specificity is poor and its use should be restricted as a guide in obtaining biopsy specimens or as a means of evaluating tumor volume.
Clinical and ultrasonographic findings in five patients with cardiac echinococcosis are presented. In each case chest film showed abnormal shape or enlargement of the heart shadow, with calcifications in three patients. In four cases, echocardiography was suggestive of a cystic lesion. Echocardiography associated with plain chest film seems to be a reliable technique for positive diagnosis and follow up after treatment. However, it is insufficient for preoperative work up in which selective coronary arteriography remains the cardinal procedure.
Experimental and intraoperative experiences in ultrasonographic localization of calculi are reported. With a small high-resolution real-time probe, we localized 1-mm calculi introduced in ex situ cadaver kidneys. During 13 operations all calculi of various sizes and nature were localized 11 times. This method seems to have many advantages: it is easy to use, it localizes calcific and noncalcific small calculi bidimensionally, and it shortens operative time.
Intraoperative ultrasound examination of the liver, biliary tree, pancreas, and kidney is described. Twenty-three patients were included in the study. In the authors' view the three important indications for operating room sonography of the abdomen are (a) locating biliary, pancreatic, or renal calculi, (b) defining the echostructure and precise location of tumors, and (c) evaluating the spread of tumor. It is concluded that intraoperative ultrasound shortens the length of an operation and increases the safety of the surgical procedure since it is more precise than palpation by the surgeon.
Based on a study of 165 cases of renal carcinoma, we compare the relative diagnosis efficiency of different methods: intravenous urography (IVU), ultrasound (U.S.), arteriography and computed tomography (C.T.). Our evidence enables us to assert the excellent diagnostic accuracy of ultrasound and the superiority of computed tomography for good staging of renal carcinoma. The cost efficient methods for the evaluation of this tumour are intravenous urography (to show and localize the renal mass), ultrasound (to assert the echogenic structure) and computed tomography (to establish the diagnosis of carcinoma and judge its spread).
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