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Biomedical subjects

A Janvresse

Publications and source records attributed to A Janvresse.

At least 19 recordsLinked to original sources
PubMed1999

[Pulmonary lymphangioleiomyomatosis: an often fortuitous diagnosis. A case report].

INTRODUCTION: Lymphangioleiomyomatosis is an uncommon disorder of unknown origin, which exclusively occurs in women of reproductive age. The condition is characterized by proliferation of immature smooth muscle cells throughout the lungs, i.e., in the peribronchial, perilymphatic, and perivascular areas. This results in obliteration of the respiratory tract and in the development of cysts. Lymphangioleiomyomatosis has a poor prognosis due to both numerous lung complications and progression of the disease to respiratory failure. EXEGESIS: We report the case of a patient in whom lymphangioleiomyomatosis was fortuitously diagnosed from chest CT scan, itself performed for the diagnosis of pulmonary embolism. This case is therefore of particular interest. CONCLUSION: Our results suggest that the prevalence of lymphangioleiomyomatosis is probably underestimated due to its clinical latency and the absence of specific laboratory tests. Therefore, the development of non-invasive radiological methods should permit early diagnosis of the disease.

Adult↗
PubMed1997

[Thrombophlebitis and cancer: evaluation of the diagnostic value of abdominal ultrasonography in the acute phase of a deep venous thrombosis. Report of 148 consecutive examinations].

If an association between venous thromboembolism and malignancy is now well established, there is no consensus about the investigations which should be performed to detect occult malignancy after deep vein thrombosis episode. We investigated the usefulness of systematic abdomino-pelvic ultrasonography in 148 consecutive patients older than 40 with deep vein thrombosis and or pulmonary embolism. Ultrasonography was abnormal in 8 patients (5.4%) and detected only 6 cancers. In 5 cases, clinical examination and laboratory tests were sufficient to suggest malignancy. Our results suggest that ultrasonography should not be systematically performed in patients with deep vein thrombosis. Decisions to performed additional diagnostic tests can be based on the finding of the initial clinical examination, that includes medical history, physical examination, routine laboratory tests and chest-x-ray.

Abdomen↗
PubMed1996

Computed tomography of the normal sternoclavicular joint.

OBJECTIVE: The objective of this work was to establish a reference population for the study of the sternoclavicular joint (SCJ). DESIGN: A prospective study of the SCJ was carried out by high-resolution computed tomography (CT). CT images were read by two radiologists and two rheumatologists using a pre-established grid (27 elementary signs). PATIENTS: Sixty healthy subjects, homogeneously distributed by sex and decade of life, from 20 to 80 years old, were studied. RESULTS AND CONCLUSIONS: The main results were the following: 98% of healthy subjects presented at least one sign; mean number of signs per subject was 2.4 +/- 1.9; mean number of signs was higher ( P < 0.005) in men (mean = 3.1 +/- 2.1) than in women (mean = 1.7 +/- 1.3); number of signs increased with age (P < 0.001). Some signs were very frequent: "ossification of the first costal cartilage" (88%), "Surrounded subchondral clavicular erosion" (27%). Some signs were significantly more frequent in the elderly: "sternal osteophyte" after the age of 70 (P < 0.01) and "meniscal calcification" (P < 0.01) and "sternal subchondral sclerosis" (P < 0.05) after the age of 60. The number of clavicular signs was greater than that of sternal signs (P < 0.001). These results can be used as references for the study of the SCJ.

Adult↗
PubMed1996

Effects of the low-osmolality contrast medium ioversol (Optiray) on renal function in a geriatric population.

PURPOSE: To assess the incidence of nephrotoxicity following i.v. injection of the iodinated low-osmolality contrast medium ioversol 300 (Optiray) in a geriatric population compared with a control group aged under 60 years, neither group presenting any associated risk factors. MATERIAL AND METHODS: CT with i.v. bolus injection of ioversol 300 mg I/ml was performed at a mean dose of 1.36+/-0.06 ml/kg (range 1-2 ml/kg b.w.) in 47 patients aged over 69 years. Serum creatinine level was measured and creatinine clearance was calculated at 24, 48 and 72 h after the examination, and compared to a reference serum creatinine value taken before CT. The findings were compared with a control group of 44 patients aged under 60 years. RESULTS: No significant increase in serum creatinine (+0.6 mmol/l) or in creatinine clearance (+0.7 ml/min) was found during the course of 3 days after the injection. Only one patient (aged 82) presented an increase of 25% in serum creatinine (109 mmol/l). CONCLUSION: The trial did not demonstrate any significant difference between the 2 groups, although the elderly patients had a subclinical renal impairment revealed by the decrease of the initial creatinine clearance. The use of low-osmolality ioversol makes it possible to perform examination with an iodinated contrast agent without increasing the incidence of nephrotoxicity in elderly subjects.

Age Factors↗
PubMed1996

[Lumbar interapophyseal septic arthritis. Apropos of 3 cases].

Septic arthritis of spinal apophyseal joint, seldom described, mainly concern the lumbar spine. We report three cases. Inflammatory lesions of the paravertebral soft tissues were associated in each case; an epidural abscess was present twice. Our three cases were due to Staphylococcus aureus. The initial clinical features were consistent with a spondylodiscitis. Imaging led to the correct diagnosis in all cases. According to our observations and several others of the literature: facet joint lesions are visible too late on plain films. Bone scintigraphy is sensitive, but not specific. CT scan and MRI are the most contributive investigations. A pathologic aspect of the paravertebral soft tissues is visible less than one week after the beginning of the symptoms on CT scan and MRI. Lesions of the facet joint are detectable as soon as the first week on MRI, and after 15 days of clinical course on CT scan. Epidural abscess, when present, is best shown by MRI as early as the first week. CT scan can guide percutaneous needle biopsies of the paravertebral abscesses or of the concerned facet joint.

Abscess↗
PubMed1995

[Late manifestation of congenital intrahepatic portacaval shunt in a healthy liver].

We report the discovery of a congenital intrahepatic portocaval shunt during heart failure in a 68 year-old woman, without cirrhosis or portal hypertension. She had hepatic encephalopathy. Only 17 such cases have been reported. Their physiopathology remains unclear. Reasons for late revelation are debated. Color doppler imaging is very useful for diagnosis following and treatment of these shunts. Therapeutic options are presented.

Aged↗
PubMed1991

[Indications for angiographic study of renal arteries in elderly hypertensive subjects].

During a 30 months period, 70 patients (60-84 years old) underwent a renal artery angiographic investigation, either by combined intravenous angiography and pyelography, either by intravenous or intra-arterial digital angiography. Thirty-nine were males, 31 were females. All patients were hypertensive. Thirty-three had a normal renal function and 37 had a renal insufficiency arbitrarily definite as creatinine clearance lower than 60 ml/min (m = 33 +/- 15 ml/min). Eight aortic anevrysms were discovered. Thirteen patients (18.6%) had atherosclerotic renovascular disease. Criteria which led to undertake these investigations and results are listed in the following table. [table; see text] Transluminal percutaneous angioplasty and surgical treatment were performed 7 and 3 times respectively. In one case, nephrectomy was done. In all these patients but one, improvement of hypertension and/or renal function occurred. In patients with renal impairment, difference in size between the two kidneys detected by echography or plain abdominal X-rays were noted in 8 among the 9 patients with renovascular disease; six among them had proteinuria less than 0.5 g/day. In conclusion, in hypertensive patients older than 60, criteria for detection of renovascular disease are the same as in younger patients. When renal function is decreased, difference in size between the two kidneys requires an angiographic evaluation. Proteinuria does not exclude renovascular pathology.

Age Factors↗
PubMed1988

The evaluation of CA 19-9 antigen level in the early detection of pancreatic cancer. A prospective study of 866 patients.

To establish if CA 19-9 could detect early pancreatic cancer, we measured its serum concentration in 866 patients admitted for benign diseases and observed for 2 years. All patients with an elevated CA 19-9 level (greater than 40 units (U)/ml) were submitted to a computed tomography (CT) scan of the pancreas. The CA 19-9 level was increased in 117 patients. One hundred fifteen of these 117 patients had false-positive elevations. The CA 19-9 concentration was elevated mostly in benign hepatobiliary diseases. In this group of patients, CA 19-9 was correlated to alkaline phosphatase values. Eleven patients showed an elevated CA 19-9 level for 10 months without any malignancy developing. One patient had a normal CA 19-9 concentration 8 months before clinical signs of pancreatic carcinoma developed. We conclude that CA 19-9 measurement is of no value for the early detection of this malignancy.

Aged↗
PubMed1988

[X-ray computed tomographic aspects of benign mesotheliomas. Apropos of 4 cases].

Localized pleural mesothelioma or benign mesothelioma is a rare tumor and it has a good prognosis. The value of computed tomography (CT) in the evaluation of pleural disease is now well recognized. However, little information has been written regarding the value of CT in localized pleural mesothelioma. We describe four cases. CT findings include sharply delineated, smoothly contoured masses, often with homogeneous soft tissue density. Angles with the chest wall are obtuse or acute. In case of acute angles, a smoothly tapering margin may be encountered.

Adult↗
PubMed1984

[Treatment by arterial embolization of a case of Wirsung's duct hemorrhage].

A 49 years old patient was hospitalized following a eight days episode of gastro intestinal bleeding. Medical history revealed a chronic pancreatitis for more than three years. Physical examination upon admission was unremarkable. Acute oesophago-gastro-duodenoscopy showed red blood issue from the papilla. Echotomographic examination revealed no pancreatic pseudo cyst. A coeliac angiogram showed an extravasation of contrast material. Subselective pancreatico duodenal angiogram revealed the extravasation and the instantaneous opacification of the pancreatic duct with flow into the duodenum. Arterial embolization was chosen for treatment and stopped the bleeding. The patient has now been followed for three years and has had no recurrence of gastro intestinal bleeding.

Celiac Artery↗