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Biomedical subjects

Y Gandon

Publications and source records attributed to Y Gandon.

52 records · Page 3Linked to original sources
PubMed1985

[Renal cancers and caval thrombus, prognostic study. Apropos of 25 cases].

Of the 235 renal cancers treated between 1975 and 1984, twenty five cases were complicated by thrombus of the vena cava. Analysis by Kaplan-Meier's method shows a satisfactory survival rate for isolated thrombus of the vena cava (80 per cent at two years, and 45 per cent at five years). But associated lesions to the perirenal fat or lymph nodes considerably diminishes the survival rate, so that the overall survival rate in this series was only 37 per cent at two years and 20 per cent at five years. 57 per cent of the patients who seemed free of distant metastases during the preoperative investigations, nonetheless died within two years postoperatively, from a lung, liver or bone metastasis. CT scan at present allows diagnosis of renal cancer and assessment of the extension to the fatty capsule and the vena cava. It is to be hoped that nuclear spin electronic resonance will provide a better assessment of the prognostic factors, and, in particular, the lymph node extension.

Adult↗
PubMed1983

[Efficacy of scanography in convulsions and epilepsy in children].

CT scan examinations done in 356 children for epilepsy or occasional seizures showed normal results in over 50% of cases and abnormal results in 40%. The remaining 10% reflect the difficulties in ascertaining that a CT scan examination is normal, particularly regarding pericerebral spaces or ventricular size. The anomalies disclosed on CT scan are of little practical significance. Many of the abnormal results are not specific. An incidence on management was recorded in 5 cases. Other problems which may arise are the connexion between some CT scan findings and epilepsy, or the nature (tumoral or not) of abnormal images. In a few cases, diagnostic investigations or biopsies, which were negative in some instances, were carried out after demonstration of localized decreased density without signs of a space-occupying lesion. The differences in results between the various groups of epileptic patients underscore the necessity of a clinical selection of cases in which a CT scan is required.

Brain Diseases↗
PubMed1983

[Case of early hydrocephalus in mucopolysaccharidosis type 1].

One mucopolysaccharidosis I-H (Hurler's Syndrome) found in 3 months infant, was complicated with an hydrocephalus at the age of 5 months. If macrocephaly is known in several genetic inborn errors of metabolism, specially in the different mucopolysaccharidosis, hydrocephalus is quite more rare. It is probably communicating and due to accumulation of storage material in the piaarachnoid causing an impairment in CSF absorption. It occurs in the evolution of the disease and the reported cases concern only older children; our case is special by the early beginning of hydrocephalus.

Humans↗
PubMed1982

[Anatomic and tomodensitometric study of the levator ani muscle in infants].

A double anatomic and computed tomographic study of the muscle levator ani has been performed in pediatric patients. In or study, we have used frozen anatomical specimens. The anatomic and computed tomographic sections have been made strictly comparable, every 3 millimeters. These actions provide the normal computed tomographic aspect of the muscle levator ani. This anatomic study may have a direct application in the evaluation of imperforate anus, which is often difficult to diagnose : it allows a more precise determination of the level of the terminal rectal pouch compared to the level of the levator ani.

Anal Canal↗
PubMedDate not supplied

Superparamagnetic iron oxide: clinical time-response study.

Superparamagnetic iron oxide (AMI 25) is a promising new contrast agent for imaging the reticuloendothelial-system. Iron oxide crystals possess a large magnetic susceptibility and enhance proton relaxation rates, especially transverse relaxation (T2). In order to guide the clinical utilization of this contrast media we analyzed 4 patients with malignant lesions of the liver before and after slow intravenous administration (20 mumol Fe/kg) of AMI 25. We performed two magnetic resonance (MR) sequences at different times using a 0.35 T magnet. MR signal-to-noise ratio (SNR) of the reticuloendothelial system (particularly the liver SNR) decrease promptly. The maximum decrease in SNR (67-72% for the liver, 46-65% for the spleen, 23-41% for the bone marrow) is observed 3 h after injection (P less than 0.01). However, except the peak of contrast enhancement in T1-weighted sequences of splenic tissue, the curve describes a plateau within 30 min and 6 h, allowing a delay between injection and imaging. T2-weighted sequences give a greater contrast-to-noise ratio (CNR) by adding the spontaneous tumor contrast to the effect yielded by AMI 25. These results suggest that images must be acquired between 1 and 6 h after intravenous administration of superparamagnetic iron oxide.

Aged↗
PubMedDate not supplied

Influence of the teleradiology technology (N-ISDN and ATM) on the inter-hospital management of neurosurgical patients.

We set out to assess the influence of a teleradiology network on the relations between a general hospital and a 100 km distant university hospital in the context of neurosurgical emergencies, and compared a commercially available technology, N-ISDN (Narrowband Integrated Service/Digital Network), to an emerging technology, ATM (Asynchronous Transfer Mode). The evaluation was conducted using records of advice request calls and patient transfers. Three phases were considered: without teleradiology, with transfer of digitized images over N-ISDN at 64 kbps, and with an experimental ATM network at 10.5 Mbps with DICOM image transfers and videoconferencing. Additionally, staff meetings over ATM videoconferencing were set up. To assess the ATM service, we used log files and questionnaires, 108 advice requests were studied over a 18 month period. The average transmission time for one examination was 38 s with full DICOM image resolution over ATM, versus 150 s with 10:1 JPEG (Joint Photographic Expert Group) compression over N-ISDN. Up to 50% unnecessary patient transfers were avoided. Advice requests increased fourfold, and non-urgent advice requests increased from 0 to 21%. Despite the experimental configuration of the ATM network, the service gave satisfaction to all the physicians. Videoconferencing was unanimously regarded as a prominent tool to improve the quality of interaction. It was particularly useful for non-urgent cases and distant staff meetings. Teleradiology can improve the relations between hospitals through an increase of urgent and non-urgent advice requests. Asynchronous transfer mode is an efficient way for fast transfer of radiological examinations in DICOM format and for discussing them through high-quality videoconferencing.

Brain Neoplasms↗
PubMedDate not supplied

[The value of computerized tomography in the assessment of hepatic iron overload in genetic hemochromatosis].

The aim of the present study was to evaluate the effectiveness of single-energy computed tomography in determining iron overload in idiopathic hemochromatosis, with special reference to slightly overloaded cases. Liver attenuation was determined in 100 patients (46 cases of idiopathic hemochromatosis, 32 cases of chronic liver disease, and 22 normal controls). The iron load was determined for the first two groups by biochemical determination of liver iron concentration (performed in all but 12 subjects in the chronic liver disease group) and hepatic histologic grading. The main results for liver attenuation (upper normal limit, 72 Hounsfield units) showed that despite a high specificity (0.96), this parameter was of low sensitivity (0.63). Although mean liver attenuation in idiopathic hemochromatosis (77 +/- 14) was significantly higher than in chronic liver diseases (53 +/- 17; p less than 10(-4], and normal controls (66 +/- 3; p less than 10(-3], and despite an overall good correlation between liver attenuation and liver iron concentration (r = 0.72; p less than 10(-3], liver attenuation was unable to detect moderate iron overload. Fourteen of 18 patients with a liver iron concentration of less than 150 mumol/g dry liver wt had liver attenuation values of less than 72. Moreover, 3 of 18 subjects with a liver iron concentration of greater than 150 had a liver attenuation of less than 72. Of these 17 false-negatives, only 7 could be attributed to associated steatosis. On the whole, single-energy computed tomography, when used on a routine basis for diagnosing iron overload, is of limited clinical value in idiopathic hemochromatosis due to its poor sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Splenogastrorenal shunt in portal hypertension: a little known entity. Study of 6 cases and review of the literature].

The authors report 6 cases of portal hypertension with gastrorenal shunt. This shunt did not arise from the left gastric vein, but from the splenic vein. Portal hypertension was related to alcoholic cirrhosis in 3 cases, to extensive portal thrombosis in 2 cases, and to nodular regenerative hyperplasia of the liver in one case. A gastrointestinal hemorrhage revealed portal hypertension and the liver disease in the 3 cases of alcoholic cirrhosis and complicated the course of the disease in the other cases. Hemorrhage was either massive and life-threatening or often recurred. It was related to a rupture of fundic varices in all cases. The fundic varices were not associated with esophageal varices in the 3 cases of cirrhosis. The degree of portal hypertension was above 20 mm Hg, as assessed by the portohepatic gradient (one case), or the pressure gradient between a tributary portal system vein and the inferior vena cava during laparotomy (5 cases). Definitive control of hemorrhage could not be achieved by endoscopic variceal sclerotherapy (2 cases) or percutaneous transhepatic embolization (one case). Portacaval shunt or splenectomy was performed in 5 cases. These findings suggest that spontaneous splenogastrorenal shunt is a clinical and hemodynamic entity which requires specific treatment when associated with gastric variceal bleeding.

Adolescent↗
PubMedDate not supplied

[Not-always-apparent abuse: the shaken baby syndrome].

The authors report 3 cases of infants presenting with cerebral lesions related to violent head shaking. They emphasize the diagnostic difficulties when the classical signs of the battered child (marks of blows, fractures) are lacking. The traumatism is rarely recognized: only the negativity of the usual medical causes of subdural hematoma, meningeal or retinal hemorrhage and a peculiar familial history lead to the possible diagnosis of shaken baby syndrome. The value of skull CT-scan is major, showing intracranial lesions which could not be found before. Because of the observed lesions, evolution is often severe.

Brain Injuries↗