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Biomedical subjects

A Grignon

Publications and source records attributed to A Grignon.

71 records · Page 4Linked to original sources
PubMed1985

A pseudo-choledocal cyst.

A four-year-old boy presented with a history of intermittent obstructive jaundice. Investigation and surgical exploration revealed an abnormal configuration of the biliary tree which, to our knowledge, has never been otherwise reported.

Bile Ducts↗
PubMed1984

Urinary tract infection in children. A reappraisal of its radiologic investigation.

In a prospective study, 100 children with either an acute or a previous history of urinary tract infection were investigated by intravenous urography, micturition cystourethrography, and ultrasonography. The results from the three diagnostic modalities were compared: The urinary tracts in 59 patients were normal, and revealed some abnormality in 41. Ultrasonography proved to be superior to intravenous urography in outlining renal contours and in detecting subtle cortical changes secondary to urinary tract infection (such as slight increases in cortical thickness and edema or cortical scarring). The mucosa of the renal pelvis and bladder was more easily assessed by ultrasound than by intravenous urography. Both modalities were "equally" accurate in detecting important congenital malformations of the urinary tract. Ultrasound failed to detect 24 of 28 ureters demonstrating reflux on voiding cystourethrography. We propose that carefully performed abdominal ultrasonography can replace intravenous urography in the initial investigation of urinary tract infection in children. It should be done in association with a radiographic or radionuclide voiding cystogram. Intravenous urography would then become a complementary examination for abnormal or problematic patients.

Adolescent↗
PubMed1984

[Echography of pyloric stenosis].

In order to assess the accuracy of ultrasonographic (US) criteria for the diagnosis of pyloric stenosis (PS), the record of 78 infants admitted to Hôpital Sainte-Justine with the clinical diagnosis of PS during the past year was reviewed. Fifty-eight patients had PS at laparatomy. Thirty-four of these had US with 30 true positives and four "doubtful" findings. Twenty-two had normal US. Two of these had PS, nine gastroesophageal reflux and five normal barium studies of the upper gastrointestinal tract (the last six were followed clinically and remained well). The following were criteria for US diagnosis of PS: pyloric anteroposterior diameter greater than or equal to 1.5 cm, length greater than or equal to 2 cm or a muscle thickness greater than or equal to 4 mm. This series contains no false positive US studies and two false negatives, for a positive predictive accuracy of 94% and a negative predictive accuracy of 100% when we measure the length greater than or equal to 2 cm or combine a length of less than or equal to 2 cm with a muscle thickness greater than or equal to 4 mm.

Female↗
PubMed1984

[Compulsory internship in diagnostic radiology in the 5th year of medicine at the University of Montreal].

Problems of methodology, organization, and evaluation confronting the radiology departments of the university hospitals affiliated with the University of Montreal, the medical students, and the University itself in connection with an elective internship in radiology offered in the fifth year of medicine, resulted in the formation of a committee to reorganize the course of study. In this concise article the authors describe this and other measures taken by the University to solve these problems. The committees' main purpose was to restructure the internship which was made compulsory so that future physicians would be prepared to draw on the resources of diagnostic radiology and nuclear medicine. To this end, the committee formulated the objectives, content, evaluation system, and pedagogical methods to be used in those courses. The 25 self-teaching modules, together with the observation and practical interpretation of radiology sessions, proved highly useful in solving the initial problems, and were of particular interest to the students.

Curriculum↗
PubMed1984

[The role of echography in splenic injuries in children].

We have reviewed 39 cases of ruptured spleen in children from 1979 to march 1983 at Ste-Justine Hospital in Montreal. We were mainly interested in the role of ultrasonography, its value and limitations. The practical management is exposed. To the best of our knowledge, it is the first report of this kind in pediatrics.

Child↗
PubMed1983

The importance of an antenatal ultrasonographic diagnosis of correctable fetal malformations.

This study describes the importance of an early echographic examination during pregnancy for the antenatal diagnosis of fetal anomalies potentially correctable after birth. During a period of 18 months there were 28 cases. In seven fetuses a gastrointestinal malformation was diagnosed between 20 and 36 weeks of gestation; there were 16 cases of urogenital anomalies detected between 19 and 38 weeks of gestation, and five other various malformations were detected between 17 and 33 weeks of gestation (two diaphragmatic hernias, one congenital heart malformation, and two cases of benign tumors). This study suggests that ultrasonic antenatal diagnosis could result in a decrease in the morbidity of congenital malformations that are correctable if the delivery is carried out in a high-risk perinatal center.

Congenital Abnormalities↗
PubMed1983

Ultrasonic demonstration of appendicolith.

We report three patients with appendicitis in whom the diagnosis was difficult to establish. Ultrasonography helped in the management of these patients. To the best of our knowledge, this is the first report of the detection of appendicolith by ultrasonography.

Appendectomy↗
PubMed1981

Prosthetic valve infections.

Over a 10-year period, 25 patients were treated for prosthetic valve infections: 13 infections were of early onset (within 2 months of valve insertion) and 12 of late onset. Of the latter group 11 patients survived, 6 without reoperation. By contrast, 6 of the 13 with early infections died, 5 of them being among the group of 9 patients who did not undergo reoperation. Vegetations were found on most valves at autopsy or reoperation; they are a major threat to these patients. The authors believe that the mortality for early prosthetic valve infections can be reduced only by earlier prosthetic valve removal and replacement.

Anti-Bacterial Agents↗
PubMed1977

Early and late results in pulmonary atresia.

The early and long-term results following surgical treatment of 24 infants with pulmonary atresia with an intact ventricular septum were reviewed. Pulmonary valvotomy was the operation most often performed, and we came to realize that this was effective when the preoperative right ventricular angiogram had shown an open conus up to the atretic valve. By contrast, no infant without a patent conus survived pulmonary valvotomy. We suggest that this subgroup of patients (8 of the 24 in this series) should have a systemic-pulmonary shunt followed later by reconstruction of the right ventricular outflow tract. Diminutive right ventricles will grow and dilate if a reasonable passageway is formed from right ventricle to pulmonary artery. Thus the long-term results have been excellent when this has been carried out, with normal right ventricular pressures and appearance on angiography in 7 patients followed up to 13 years.

Cardiac Catheterization↗
PubMedDate not supplied

US of the pediatric female pelvis: a clinical perspective.

When investigating pelvic pathologic conditions in female pediatric patients, one needs to be aware of the developmental changes that take place around puberty. The prepubertal uterus is thin, with a fundus equal in size to the cervix. Owing to the hormonal stimulation of puberty, the uterus enlarges and the fundus becomes prominent. The ovaries are demonstrated with ultrasonography (US) at all ages. Ovarian volume increases after 6 years of age. Microcystic follicles are normally seen throughout childhood. US is the modality of choice for imaging the pediatric female pelvis. The main indications for pelvic US in the pediatric age group are pubertal precocity or pubertal delay, pelvic pain or pelvic masses, and ambiguous genitalia. Vaginal bleeding in the prepubertal child can be due to a vaginal foreign body, vaginal rhabdomyosarcoma, or precocious puberty. Common causes of primary amenorrhea in teenagers include gonadal dysgenesis (Turner syndrome) and müllerian (uterovaginal) anomalies. Pelvic pain or pelvic masses in pediatric patients can be due to ovarian torsion, hemorrhagic ovarian cyst, pelvic inflammatory disease, or ectopic pregnancy.

Adolescent↗
PubMedDate not supplied

Hemopump support for the failing heart.

Under fluoroscopy, the hemopump is passed through the aortic valve into the left ventricle through a Gortex (WF Gore, Denver, CO) chimney sewn to a surgically exposed femoral artery. The system aspirates the left ventricular blood and actively pumps it into the aorta. Five patients (four men, one woman), aged 47-71 years (mean, 62 years), were candidates for hemopump support because of refractory cardiogenic shock. Three were recovering from repeated coronary artery bypass graft (CABG) surgery, and two required postoperative emergency CABG for failed percutaneous transluminal coronary angioplasty (PTCA). One patient died during insertion, and four had the hemo-pump successfully placed. All patients had low cardiac out-put and had intraaortic balloons in place. Average insertion time took 20 min, with maintenance on the hemopump for an average of 13 hr. One patient was maintained on the hemopump for 12 hr, but because of continued deterioration, was placed on a total artificial heart (Harvik 7-70). Patients 3 (hemopump inserted transthoracically) and 4 had the hemopump discontinued because of brain death, and the fifth survived. This patient is alive and working 1 yr later. The hemopump is an effective left ventricular support system that is less invasive than conventional transthoracic systems.

Aged↗
PubMedDate not supplied

Bridging circulatory support before heart transplant without invasion of the mediastinum.

Heart transplantation is becoming a useful tool in the clinical treatment of patients with end-stage cardiac decompensation. Donor organs are not always available at a critical time for a patient waiting for a transplant. Bridging techniques have been described that use mechanical support systems. This article describes the use of femoral-venous to femoral-arterial bypass over a period of 50 hours in a 38-year-old woman waiting for a donor heart. Because the patient sustained cardiopulmonary arrest before organ availability, mechanical circulatory support that used femoral-venous to femoral-arterial bypass was instituted. The patient's own lungs were used as an oxygenator. Pump flow levels were determined by the level of central aortic oxygen saturation. Successful transplant was performed, and bridging, therefore, was done without invasion of the mediastinum.

Adult↗