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Biomedical subjects

B Cochand-Priollet

Publications and source records attributed to B Cochand-Priollet.

At least 19 recordsLinked to original sources
PubMed1997

Transjugular liver biopsy with an automated device.

PURPOSE: To determine the potential for use of an automated device for transjugular liver biopsy. MATERIALS AND METHODS: In 29 consecutive patients with liver dysfunction in whom percutaneous transperitoneal biopsy was contraindicated because of thrombocytopenia, severe coagulopathy, or marked ascites, transjugular liver biopsy was performed with an 18-gauge automated device. Histopathologic specimens were quantitatively and qualitatively analyzed. Complications related to the biopsy procedure were noted. RESULTS: In all patients, an adequate biopsy specimen (mean length, 12.0 mm +/- 5.5; range, 5.0-20.0 mm) was obtained during a single pass. In all tissue samples, a confident histopathologic diagnosis was made. Additional information was obtained in 15 patients with cirrhosis who had coexisting diffuse hepatic disease. No complications related to the procedure were noted. CONCLUSION: Use of an automated biopsy device is recommended for transjugular liver biopsy, as it enables safe acquisition of high-quality hepatic tissue samples.

Biopsy, Needle↗
PubMed1997

Microscopic study of the pig ureteral urothelium.

PURPOSE: To characterize the structure of normal pig ureteral urothelium. MATERIALS AND METHODS: Normal ureters of adult pigs [Large White] were studied by light microscopy. Cells were stained histochemically for glycogen and mucin with Periodic Acid Shiff and Alcian Blue. RESULTS: Pig urothelium has a comparable structure to that of man: transitional epithelium comprising 4 to 5 cell layers. However, several mucinous cells are seen between the urothelial cells. CONCLUSIONS: The pig ureter differs from human ureter due to the presence of mucinous cells in the ureteral urothelium under normal conditions. This feature must be taken into account in the interpretation of experimental results obtained with this model.

Animals↗
PubMed1996

[Portal hypertension caused by intra-hepatic block in chronic lymphoid leukemia].

A 83-year-old woman with chronic lymphoid leukemia--well controlled for 14 years with chemotherapy--was admitted for ascitis due to portal hypertension. Liver biopsy showed major portal infiltration with monomorphic little lymphocytes. Portal hypertension during chronic lymphoid leukemia might be caused by this periportal lymphoid infiltration or by intraportal venous thrombosis due to thrombophilia or by increasing of hepatic blood flow. Our observation showed that hepatic localizations of the disease may induce acute symptoms even when the lymphoid leukemia seems to be under control both in terms of blood parameters and lymphadenopathy.

Aged↗
PubMed1996

Laparoscopic fibrin glue ureteral anastomosis: experimental study in the porcine model.

Laparoscopic suturing is still difficult and time-consuming. The aim of this study, using the porcine model, was to evaluate the feasibility, safety, and efficacy of laparoscopic fibrin glue ureteral anastomosis without stay sutures for approximating the ureteral ends. In five pigs, after bilateral cystoscopic insertion of a 7F ureteral catheter, each upper ureter was laparoscopically dissected free and transected with scissors. The ureteral ends were then approximated with two atraumatic grasping forceps, and the fibrin glue was applied over the anastomotic site using a specially designed catheter (Duplocath). After waiting 5 minutes for the sealant to adhere, the forceps were removed, and the anastomotic site was examined for any early disruption. The ureteral stents were then pulled back to the distal ureter, and retrograde ureteropyelography was accomplished bilaterally in order to assess the immediate patency of the anastomoses. The animals were sacrificed and the ureteral anastomoses surgically removed for histologic examination. The operative time after insertion of the trocars averaged 15 minutes for each anastomosis, and no early disruption was observed after withdrawal of the grasping forceps. Immediate ureteral fluoroscopic patency was achieved in all 10 ureteral anastomoses, without leakage in 8 and with minimal leakage in 2. Histologic examination revealed a mild inflammatory reaction in the serosa with no modifications of the mucosa or the muscularis. Subsequently, two pigs were subjected to the same procedure bilaterally and not sacrificed. These two animals died with enormous urinomas on postoperative days 6 and 8. In each case, the anastomotic site was completely disrupted on one side, while the other side remained grossly patent. However, histologic examination of these latter anastomoses revealed no real coaptation of the ureteral ends, while demonstrating complete eversion of the mucosa. In conclusion, fibrin glue ureteroureterostomies, although easy to accomplish, are not safe enough to be used without stay sutures in laparoscopic surgery.

Anastomosis, Surgical↗
PubMed1996

[Embryonal carcinoma and anaplastic seminoma of the testis: diagnostic difficulties].

In this case report concerning a testicular tumor, the difficulty of discriminating between embryonic carcinoma with granulomatous reaction and anaplastic seminoma is described. According to the literature and the findings of the present case, the value of immunohistochemical investigations is emphasized, especially the use of anti cytokeratin antibody in the diagnosis of embryonic carcinoma. Therapeutic issues stress the importance of such a diagnosis. Furthermore the immunohistochemical identification of embryonic carcinoma in every case should lead to a new classification of the so-called anaplastic seminoma's entity.

Adult↗
PubMed1996

Potential of the back propagation neural network in the morphologic examination of thyroid lesions.

OBJECTIVE: To investigate the potential of back propagation (BP) neural networks (NNs) in the discrimination of benign from malignant thyroid lesions. STUDY DESIGN: The study was performed on May-Grünwald-Giemsa-stained smears obtained by fine needle aspiration (FNA). Using a custom image analysis system, 26 features that describe the size, shape and texture of the nucleus were measured from each cell. The cases were distributed according to categories, as follows: 25 cases of goiter and follicular adenomas, 1 case of follicular carcinoma, 12 cases of papillary carcinoma, 6 cases of oncocytic adenoma, 3 cases of oncocytic carcinoma and 4 cases of Hashimoto thyroiditis. From each case about 100 nuclei were measured; they formed a pool of 13,850 feature vectors. Out of this pool, 2,770 vectors were randomly selected to form the training set, and the remaining 11,080 vectors formed the test set. RESULTS: The application of a BP NN on the nuclear measurements permitted correct classification of 90.61% nuclei. Classification at the patient level was performed using a hypothesis test for proportion and two different hypothesis values, one equal to the overall accuracy of the NN and one equal to 50%. The second method permitted correct classification of 98% of patients. CONCLUSION: These results indicate that the use of NNs combined with image morphometry and statistical techniques may offer useful information on the potential malignancy of thyroid cells and may improve the diagnostic accuracy of FNA of the thyroid gland, especially in cases classified as suspicious for malignancy.

Humans↗
PubMed1995

Experimental study of Wallstent self-expandable metal stent in ureteral implantation.

In regard to the risk of stent obstruction, there are persistent controversies concerning the use of the Wallstent self-expandable metal stents in the ureter. Only a few clinical trials have been published to date, and, from a technical point of view, no success predictors have been identified. In an experimental study using a pig model, we have shown that neither the length of the stent (5 or 10 cm) nor an initial 1-month intubation had any influence on the outcome of the stents. Among the eight implantations studied (four 5-cm and four 10-cm stents), only one 5-cm stent was perfectly patent at 35 days. In all the remaining stents, after 35 or 90 days, constant failure was related to distal narrowing at the edge of the stent, with no difference between the 5- and 10-cm stents or between the intubated and the nonintubated stents. This distal narrowing, probably attributable to a functional discrepancy between an adynamic stented ureter and a normal underlying ureter, demands extreme caution in human applications when the ureter is normally peristaltic.

Animals↗
PubMed1995

Methotrexate related B lymphoproliferative disease in a patient with rheumatoid arthritis. Role of Epstein-Barr virus infection.

A 57-year-old woman receiving low dose methotrexate (MTX) for rheumatoid arthritis (RA) developed a B lymphoproliferative disease (LPD) that was initially considered as large cell non-Hodgkin's lymphoma of B cell phenotype. Epstein-Barr virus (EBV) cytotoxic latent membrane protein-1 (LMP-1) expression was found in some large cells. The lymphoproliferative disease reversed with MTX discontinuation and without chemotherapy. These EBV-associated LPD in patients with RA receiving MTX or other immunosuppressive agents seem to be similar to those triggered by EBV in transplant patients receiving cyclosporine A. MTX withdrawal and short followup should be considered before chemotherapy since spontaneous regression is possible.

Arthritis, Rheumatoid↗
PubMed1994

Immunocytochemical comparison of cultured normal epithelial prostatic cells with prostatic tissue sections.

By analyzing a culture system of human prostatic epithelial cells (HPEC) and human prostatic fibroblasts (HPF) for expression of several determinants by immunocytochemistry, we have shown that long-term cultures are able to preserve the phenotypic characteristics of the normal tissue from which they are derived. The cytoskeletal elements, prostate-specific proteins, and steroid receptor profiles were compared to those of prostatic epithelium and stroma in situ. When cultured in low serum and low calcium medium, the adult HPEC grew as two layers of cells, the upper one of which retained the differentiation characteristics observed in the luminal fraction of normal prostatic epithelium. This cell type is the likely origin of prostatic neoplasia, with expression of CK8, 18, and 19 but not CK14. Androgen receptors, prostatic-specific antigen, and prostatic acid phosphatase are also expressed in vitro but at lower level than in situ. The lower cell layer expressed most of the same determinants but at a much lower level, suggestive of a stem-cell type. The HPF cultured in RPMI serum supplemented media retained the stromal pattern of the cells observed in situ. Culture systems which conserve the characteristics of their normal counterparts in vivo should provide useful models for studying in vitro genetic and epigenetic factors associated with differentiation and proliferation, but also with tumorigenic progression in the prostatic gland.

Biomarkers↗
PubMed1994

The diagnostic value of fine-needle aspiration biopsy under ultrasonography in nonfunctional thyroid nodules: a prospective study comparing cytologic and histologic findings.

Fine-needle aspiration biopsy (FNAB) of thyroid nodules has been proposed as a preoperative screening method to reduce the number of patients with benign nodules referred for surgery. Only a few previously published studies have compared cytologic results with a systematic surgical control; furthermore, the role of ultrasound guidance for FNAB in obtaining representative material has been poorly evaluated. The authors tried to assess the diagnostic value of FNAB performed under ultrasonography in a series of patients with a cold nodule and a systematic surgical control. This prospective study included 132 consecutive patients, 19 men and 113 women, aged from 18 to 82 years. The rate of carcinomas was 13.8%. A very high rate of adequate material was obtained (96.2%). Sensitivity, specificity, and global accuracy were 95%, 87.7%, and 89%, respectively. These results, which are equivalent to those previously published but associated with a low level of insufficient material, emphasize the diagnostic value of thyroid FNAB.

Adult↗
PubMed1994

Ureteral and bladder lesions after ballistic, ultrasonic, electrohydraulic, or laser lithotripsy.

Four techniques of intracorporeal lithotripsy are now available: ballistic, ultrasonic, electrohydraulic, and laser. Their therapeutic efficacies have generally been evaluated and compared, but very few data have been available on their relative risks of iatrogenic trauma to the urothelial wall. We conducted a comparative analysis of this risk by testing the pig ureteral and bladder wall with the EMS Lithoclast, Olympus ultrasonic lithotripter, Walz Lithotron EL 23, and Versa Pulse Ho:YAG Coherent Laser. We measured the number of shockwaves or the energy required to perforate the ureter and bladder by delivering shocks perpendicular to the walls. Ureteral perforation was impossible with the 1.0-mm Lithoclast transducer and the 1.5-mm ultrasound transducer. Perforation was induced after 250 shocks with the 0.8-mm Lithoclast transducer, after 110 shocks with the 3F electrohydraulic electrode, and after 0.02 kJ with the laser. Bladder perforation was impossible with the 2.0-mm Lithoclast device and the 3.4-mm ultrasound transducer but was induced after 0.04 kJ had been delivered with the laser. We evaluated the iatrogenic risk under normal conditions of use by delivering the shocks tangentially to the ureteral wall and perpendicular to the bladder wall. We sacrificed animals on days 0, 1, and 6. The immediate histologic lesions induced by the Lithoclast and the ultrasound lithotripter were similar, consisting of a moderate reduction of the epithelial layers or intraepithelial detachments. Electrohydraulic shocks induced almost complete abrasion of the urothelium, and the laser induced extensive lesions of partial or complete necrosis of the urothelial wall.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

[Tuberculosis. Role of fine needle puncture in the current diagnostic approach].

Twenty-one fine needle aspiration biopsies were performed with a diagnosis of tuberculosis or granulomatous inflammation. The ages of the patients ranged from 26 to 66 years (mean, 36 years); 16 were men and 5 women. Two of them were positive for the human immunodeficiency virus. In twenty cases, the cytological diagnosis was confirmed by culture and/or by recovery under a specific anti-tuberculous treatment. In one case, the necrosis observed cytologically was a tumoral necrosis after histological control. According to these results with a global accuracy of 95.2%, fine needle aspiration biopsy which offers the possibility of a thorough diagnosis in a short time (24 hours or less) is a useful method for the diagnosis of tuberculosis.

Adult↗
PubMed1993

[Interstitial cystitis].

Interstitial cystitis, described for many years, remains a mystery for several reasons. Although the clinical and therapeutic understanding of this disease have improved, the histological features are non-specific and the pathogenesis is still unclear. The aim of this article is to briefly review the current state of knowledge and to remind the reader that this disease must not be underestimated or ignored.

Cystitis↗