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Biomedical subjects

A Remond

Publications and source records attributed to A Remond.

At least 19 recordsLinked to original sources
PubMed1991

Destructive spondyloarthropathy with beta 2-microglobulin amyloid deposits in a uremic patient before chronic hemodialysis.

We report a case of erosive arthropathies discovered radiologically before dialysis in a uremic patient with Alport syndrome. This patient had no hereditary amyloidosis or causes of acquired generalized amyloidosis (no chronic infections or inflammatory disease, neoplasia, lymphoma or monoclonal gammapathy). Erosive spondyloarthropathies of the cervical spine at the C5-C6 and C6-C7 levels, erosive arthropathy of the right acromioclavicular joint, metacarpal lacuna of the right hand, and lacuna of the left femoral neck were discovered 24 months before starting dialysis in this patient with chronic renal insufficiency of 17 years duration. Puncture of the vertebral disc before starting dialysis took a fragment showing amyloid deposits with permanganate-sensitive Congo red staining and positive staining with anti-beta 2-microglobulin antibodies. This observation suggests that beta 2-microglobulin amyloidosis in uremia may not be exclusively related to chronic kidney replacement therapy, but to uremia per se, especially when the latter is of long duration.

Amyloid↗
PubMed1991

[Portal venous system calcifications. Study of 3 cases and review of the literature].

Three cases of calcifications of the portal system are reported in men aged 42, 53 and 40 years old. Two patients had alcoholic cirrhosis, and one had familial congenital hepatic fibrosis, respectively. Calcifications were discovered fortuitously on plain abdominal films. Ultrasound and computed tomography studies, and in two cases, angiography, confirmed that calcifications were located within the vein walls. The veins involved were the portal vein in 3 cases, the splenic vein in 2 cases, and the superior mesenteric and left gastric veins in one case each. Investigations demonstrated splenoportal and splenic thrombosis in 2 cases, whereas the portal vein system was patent in the other. In two cases, the splenic artery was aneurysmal, associated with several intrasplenic arterial aneurysms in one. Based on these three cases, combined with a review of the literature of 123 previous reports, the features of this rare entity are described with emphasis placed on the value of computed tomography studies.

Adult↗
PubMed1990

Arterioportal fistulas: twelve cases.

During the last 20 years, we encountered 14 arterioportal fistulas in 12 patients. Gastrointestinal hemorrhage or mesenteric artery insufficiency were the most frequent conditions found after the diagnosis. Arterioportal arterial fistulas were congenital in two cases and acquired in 10; seven of these 10 were iatrogenic. One patient had three successive and different sites of arterioportal fistula. The fistula originated from a branch of the celiac axis in nine cases, the superior mesenteric artery in three, and the inferior mesenteric artery in two. One patient died of massive anal bleeding before any treatment was possible. Eight fistulas were treated surgically and five by arterial embolization. After treatment there was no early mortality, while hemorrhagic and ischemic complications regressed in all cases. Three hemorrhagic recurrences were observed in patients with preexisting cirrhosis (two cases) or by recurrence of a congenital arteriovenous fistula (one case). Closure of symptomatic arterioportal fistula is justified. The choice of the most appropriate method for each patient should be discussed between the surgeon and interventional radiologist on a case by case basis.

Adult↗
PubMed1990

[Mid-term results of 50 percutaneous aortic valvuloplasties. Follow-up studies using Doppler echocardiography].

The aim of this study was to assess the results of percutaneous aortic valvuloplasty in 50 patients (29 men and 21 women, mean age 74 years) at 6 months by Doppler echocardiography performed 24 hours before, 24 hours, 3 and 6 months after the procedure. The following parameters were compared: maximum instantaneous transaortic pressure gradient; mean gradient; aortic valve area and index of valve patency. The initial results of catheterisation and valvuloplasty were very satisfactory as the peak-to-peak and mean pressure gradients decreased by 50 per cent and the aortic valve area increased from 0.55 +/- 0.2 to 0.83 +/- 0.30 cm2 and the success rate defined as a final surface area greater than 0.75 cm2 was 84 per cent. Unfortunately, these favourable results were not sustained in most cases: restenosis, defined as a valve area of less than 0.7 cm2, was observed in 18 per cent of patients at Day 1 and 71 per cent of patients at the 6th month; the natural history of disease was little affected with a global mortality rate at 6 months of 18 per cent through cardiac failure and sudden death; only 18 per cent of patients maintained an aortic valve area of over 0.75 cm2 at 6 months. These results suggest that percutaneous aortic valvuloplasty should be reserved for patients in whom surgery is formally contra-indicated.

Aged↗
PubMed1990

[Iatrogenic coronary stenosis after angioplasty].

Restenosis is the usual mechanism of recurrent myocardial ischaemia in the months following successful percutaneous transluminal coronary angioplasty (PTCA). Control coronary arteriography may occasionally show another cause: the constitution of a new stenosis near the dilated segment or in the left main coronary stem after angioplasty in a branch of this artery. The authors report 4 cases of patients who developed new coronary stenoses within a few weeks of PTCA, interpreted as traumatic complications of the initial procedure due to a lesion of the intima with a secondary fibrotic reaction and luminal narrowing. The guiding catheter was probably responsible for the trauma to the left main coronary stem whereas the tips of either the balloon catheter or the guide wire were thought to have been responsible for the endothelial effraction of the dilated vessels.

Angioplasty, Balloon, Coronary↗
PubMed1990

[For a better diagnostic strategy in idiopathic diaphragmatic paralysis].

The authors report a case of right-sided paralysis of the diaphragm which revealed a lung cancer extending to the mediastinum and involving the right phrenic nerve. This case underlines the limitations of thoracic imaging in case of phrenic nerve paralysis. It also demonstrates the value of early exploratory thoracotomy in all patients with allegedly "idiopathic" unilateral phrenic nerve paralysis.

Echocardiography↗
PubMed1989

[Hydatid cyst of the thymus. Apropos of a indigenous case].

Hydatid cysts located in the thymus are extremely rare. Only 8 cases were reported in a recent publication, and all concerned patients from endemic areas. The case presented here is original in that it concerns a patient living in Picardy.

Adult↗
PubMed1988

[Memory, attention and evoked potentials during aging and in Alzheimer type senile dementia].

A study of event-related brain potentials (ERPs) in Alzheimer type dementia has been performed on 6 elderly subjects (mean age: 67.5). Patients were included if they met DSM-III criteria for primary degenerative dementia. They presented important loss of memory function (in short-term memory-STM and long-term memory-LTM) and impairment of attention. They were compared to two groups: normal elderly subjects with no memory trouble and no attention dysfunction (12 subjects, mean age: 66) and elderly subjects with minor trouble in STM and little attention disturbance (6 subjects, mean age: 68.5). The chosen procedure is a dichotic listening and selective attention paradigm. Three series of tone bursts occurred in counterbalanced order (frequent tones: 1,000 Hz, 2,000 Hz; rare tones: 1,450 Hz). Rare/frequent ratio was 10/90. Subjects were asked to press a key to the rare tones. During the task, ERPs are recorded with 16 electrodes (cross montage), using 2 different reference electrodes sites: nasion and 7th vertebra. Results are displayed with the use of chronograms, spatio-temporal maps, reaction time histograms. In Alzheimer's group compared to the 2 others: N100, N200, P300 are significantly delayed in latency. P300 has a smaller amplitude. In Alzheimer's, P300 distribution on the scalp is more frequently founded of greater amplitude on the frontal region than on the centro-parietal region while the opposite is found in normal subjects. These results suggest that memory trouble or attention dysfunction are well correlated with the abnormalities of the ERPs.

Aged↗
PubMed1988

[The captopril test in nonselected hypertensive patients: absence of value for screening of renovascular patients and for unilateral small kidneys].

UNLABELLED: The decrease of blood pressure and the increase of plasma renin activity (PRA) after oral administration of captopril was evaluated in 104 consecutive hypertensive out-patients in whom the morphology of the renal arteries and parenchyma was assessed thanks to an intravenous digitalized angiography. Twenty five of these patients were excluded because of a natriuresis less than 50 mmol/24 h or non discontinuation of their treatment; 50 of these patients were classified as essential hypertension, 12 had renovascular disease (10 unilateral stenosis 2 of which significant; 2 bilateral significant stenosis); 9 had unilateral small kidneys (4 significant). The significance was ascertained on the PRA in the renal veins and/or the decrease of hypertension after surgery. The decrease of blood pressure after captopril was not different between the various groups. The increase after captopril of PRA was higher in unilateral significant lesions. However the highest post captopril PRA value was found in the essential hypertension group so that renovascular diseases could not be screened by higher post captopril PRA values. However taking into account that these latter were decreasing with age, a better discrimination of significant unilateral disease was possible in the hypertensive patients above 40 years of age. Furthermore once the diagnosis of unilateral kidney disease is established by radiological investigation, the captopril test allows to predict unilateral hypersecretion of renin with a sensitivity of 100% and a specificity of 78%. IN CONCLUSION: the captopril test does not allow to screen the non selected hypertensive patients for an efficient radiological investigation by intravenous digitalized angiography but may help to select the patients with unilateral renal disease for the renal venous PRA evaluation.

Adolescent↗
PubMed1987

[Hepatocellular carcinoma invading the right atrium: clinical, echographic and angiographic study].

The authors report the case of a 54 year old woman suffering from hepatocellular carcinoma with tumor growth into right hepatic vein, inferior vena cava and right atrium. On cardiac examination, a pansystolic bruit and a diastolic rumble were audible at the tricuspid focus. Diagnosis was confirmed by inferior vena cavography and two-dimensional echocardiography, which demonstrated a large mobile mass in the right atrium moving to and fro through the tricuspid valve. This case report emphasizes the value of routine cardiac examination during the course of hepatocellular carcinoma.

Carcinoma, Hepatocellular↗
PubMed1986

Hepatic siderosis in extrahepatic portal vein obstruction. Role of spontaneous portosystemic shunting?

We report on the observation of a 26-year-old woman with portal vein obstruction, diagnosed at the age of 3, and liver iron overload. Celiac and superior mesenteric angiography showed large and multiple venous collaterals between the portal and caval systems. Liver biopsy demonstrated, on Perl's staining, an important hemosiderin deposition, confirmed by an increased hepatic iron concentration (15.6 mumol/100 mg dry weight). No other histologic abnormality was found. This report suggests that large spontaneous portosystemic shunting may stimulate hepatic iron deposition in an otherwise normal liver. This mechanism could, at least in part, explain the significant hepatic siderosis observed in some cirrhotic patients.

Adult↗
PubMed1985

[Insulinoma: critical study of methods of localization and strategy].

In patients with proven hyperinsulinism, localization of the underlying insulinoma may be difficult. The localization diagnosis may be performed preoperatively using different procedures, such as ultrasonography, computed tomography, selective arteriography of the pancreatic vessels and percutaneous transhepatic blood sampling in the portal venous system. At operation, insulinomas may be detected by inspection and bidigital palpation, pancreatico-sonography and rapid determination of insulin concentration after sampling of blood in pancreatic veins. By discussing the advantages and disadvantages of each localization procedure, the authors propose a strategy fort the detection of pancreatic insulinomas.

Adenoma, Islet Cell↗
PubMed1979

Gastrointestinal bleeding due to chronic portal vein thrombosis in ulcerative colitis.

The authors report the case of a patient suffering from ulcerative colitis, who had several episodes of digestive hemorrhage due to portal hypertension. Portal hypertension was secondary to chronic portal vein thrombosis. This diagnosis was made on the venous phase of celiac and mesenteric angiography. The authors review the published cases of ulcerative colitis with portal vein thrombosis and discuss the possible etiologic factors: hypercoagulability, thrombocytosis, and intraabdominal sepsis.

Angiography↗