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Biomedical subjects

B Dupas

Publications and source records attributed to B Dupas.

At least 73 records · Page 4Linked to original sources

[Value of echography in the diagnosis of post traumatic pathology of the ulnar artery, in manual workers].

Three cases of hypothenar hammer syndrome are reported in manual workers who experienced repeated traumatism of the palm of the hand either because of personal habit or the use of professional tools. Hemodynamic examination of the upper limb was performed by plethysmography (Perivein Etna) and Doppler ultrasound (8 MHz) complemented by angiography by direct puncture of the humeral artery. Ultrasonography was performed using a 7.5 MHz probe (Sononranger) for exploration of the ulnar artery at the wrist and in its course through the palm. The 3 patients presented aneurysmal dilatation of the ulnar artery in the palm, complicated by postembolic thrombosis of the collateral arteries of the fingers. The ulnar artery lesion was permeable 1 time, already thrombosed 1 time and thrombosed secondarily 1 time. Ultrasonography of the palm showed suspected aneurysm of the ulnar artery in 2 patients: one case was confirmed by angiography, whereas the other remained only suspect since the thrombosed ulnar artery was not opacified. The third patient presented an ulnar artery thrombosis without true aneurysmal dilatation. It may be concluded that ultrasonography can show suspected aneurysmal dilatation of the ulnar artery and be complementary to arteriography when the ulnar artery is thrombosed.

Adult↗

Evaluation of indium-111-labeled antifibrin monoclonal antibody for the diagnosis of venous thrombotic disease.

The potential advantage of using 111In-antifibrin (111In-AF) monoclonal antibody for the diagnosis of deep venous thrombosis (DVT) was studied in 44 patients with suspected DVT (27 underwent heparin therapy before 111In-AF injection). All patients had contrast venography (considered as the gold standard) and 111In-AF scintigraphy within 24 hr. Two to 3 mCi of 111In-AF were injected intravenously, and planar scintigraphy of the limbs was recorded within 10 min (17 times), 3 hr (44 times), and 18 hr (39 times). Indium-111-AF images were then interpreted without knowledge of the results of the other examinations. The DVT diagnostic accuracy of 111In-AF was greater when interpretation was based on images recorded at different time periods after injection. Indium-111-AF sensitivity for diagnosis of DVT was 85% (29/34) and was not apparently decreased by heparin therapy. None of the 10 patients with negative contrast venography had a positive 111In-AF scan. The results demonstrate the importance of recording serial images and the excellent accuracy of 111In-AF for diagnosing DVT.

Antibodies, Monoclonal↗

[Therapeutic problems caused by rupture of large hepatic adenoma with central location. Apropos of 3 cases].

We report three cases of young female patients (26, 30, 36 years) with intraperitoneal hemorrhage associated with a rupture of a liver cell adenoma. Their topography was central or with central extension. Three patients had taken oral contraceptives, for a period of 10 years, before diagnosis in two cases and for only three weeks in the remaining patient. The diagnosis of hemoperitoneum from a liver tumor was established on initial symptoms and ultra sonographic examination. Angiography and CT were the most valuable investigations. The control of hemorrhage was obtained by hepatic artery ligation (2 cases) and angiographic embolization (1 case). We observed one patient with liver adenomatosis, uncommon lesion consisting of numerous adenomas in an otherwise normal hepatic parenchyma. In emergency major hepatic resection for an adenoma, in central localization, is too a high risk procedure for a benign tumor. Control of hemorrhage should be the aim of treatment, best achieved by alternative treatment, such as hepatic artery ligation of angiographic embolization, highly effective in our experience. Resection may be delayed for a residual tumor.

Adenoma↗

[Non-invasive diagnosis of phlebothrombosis of the limbs. Prospective evaluation of mercury gauge plethysmography associated with ultrasonic Doppler].

Associated ultrasonic Doppler study (D) and plethysmography (P) were evaluated as compared to phlebography in diagnosis of venous thrombosis of the lower limbs (TVP). Probes (5 and 7.5 MHz respectively) were used in D for examination of proximal and calf veins. Plethysmography using a mercury ring gauge (Perivein, ETNA) was considered pathologic if filling volume was less than 1.5 vol% and/or emptying volume less than 40 ml/min/100 ml. One hundred and four patients hospitalized in an internal medicine department for suspected deep venous thrombosis were studied, including 97 for whom phlebography interpretation was unmistakable: 11 calf vein, 28 collector trunk and 42 total limb involvement TVP. In these localizations, D sensitivity was respectively 55, 72 and 100% (mean 85.5%) and that of P 63.5, 68 and 88% (mean 77.7%); association of D or P improved sensitivity: 82, 82 and 100% (mean 91.5%). Specificity was 86.6% for D, a poor 62.5% for P and 93.5% for associated D and P. The results are comparable to those in the literature but disappointing for diagnosis of isolated calf vein TVP. False-negatives in both D and P were due to strong collateral circulation or limited thrombus extension.

Adolescent↗

[Pancreatic cancer with acinar cells. Apropos of 1 case with immunocytochemical study].

A case of acinar cell carcinoma of the pancreas in a 65 years old man is presented. The tumor occupies the area between spleen and porta hepatis. This observation is characterized by remarkable elevation of serum alpha foeto protein and C.T. scan and angiographic findings. In spite of complete resection and post operative immunotherapy (monoclonal antibodies) the patient developed with spread metastatic disease and died 6 months after surgery. The distinctive histological and immunocytochemical features of these tumors and the means of differentiating them from anaplastic duct cell carcinoma and islet cell carcinoma an discussed. Review of 26 well documented cases led to determine clinical, biological and pathologic aspects of these tumors. Histogenesis and differentiation with the others non duct type pancreatic tumors are discussed.

Aged↗

[Value of digital plethysmography in the positive diagnosis and prognostic evaluation of digital arteriopathies].

Maximal digital pulse (M.D.P.) is measured by digital plethysmographic technic with strain gauge. Our normal values are: 0.19 +/- 0.06% delta V. Diagnostic and prognostic significance of this parameter were studied on ten patients with digital necrosis. An arteriography of the hand was performed in each case. We have demonstrated that any value of P.D.M. below 0.10% delta V was always correlated with digital arteriopathy and with high risk of trophic complications. A normal value didn't exclude an arteriopathy. However, in these cases, the risk of trophic complications was get off.

Adult↗

[Superior vena cava syndrome disclosing Behçet's disease].

While venous manifestations are common in Behçet disease and often occur as a presenting feature, thromboses of the vena cava are less frequent and usually occur several years after onset. We report the unusual case of a patient whose Behçet disease was revealed by vena cava thrombosis. Most authors underscore the difficulties encountered in ascribing vena cava thrombosis to Behçet disease and the frequent latency of inferior vena cava involvement. Pathological changes in these venous thromboses are identical to those found in other organs involved in Behçet disease: they consist in inflammation of the venous wall with perivascularitis and secondary thrombosis. Lastly, there is a general agreement as to the adverse prognostic significance of the venous involvement.

Adult↗

[Reliability of pulmonary perfusion and ventilation scintigraphy compared with angiopneumography for the diagnosis of pulmonary embolism].

Fourty-six patients suspected clinically of having a pulmonary embolism (PE) were investigated by angiopneumography (AGP) and perfusion (99m-Tc aggregates) and ventilation (99m-Tc colloid) scintigraphy (SPV Tc). Findings were assessed under blind conditions. A positive diagnosis of pulmonary embolism was made in 19 patients. The SPV Tc was considered as positive if perfusional deficiencies were greater than ventilatory defects, and this was evaluated as such in 23 cases (19 true and 4 false positives). False negatives were not observed. The 4 false positive results corresponded to scintigraphic anomalies suggestive of pulmonary emboli subsegmental in size; true positives were either subsegmental (8), segmental (6) or lobar (5). Sensitivity of the SPV Tc wis therefore 100%; its specificity, all results considered was 76%, but was 100% if only images of lobar or segmental lesions are considered.

Aerosols↗

[Diagnosis of hematomas in the Retzius space during anticoagulant therapy. Prospective study (11 cases)].

During a three-year, prospective study carried out at the Saint Jacques Hospital, Nantes, France, in a group of 33 patients with echographically identified intra-abdominal hematoma, 11 cases of Retzius' space hematoma were detected in patients under anticoagulant treatment (heparin or antivitamin K). This suggests that the frequency of this complication is greater than supposed. The authors emphasize two aspects of Retzius' space hematoma: on one hand, clinical symptomatology, especially involving the urinary system (transient oliguria or oligoanuria in 7 of the 11 cases), on the other, ultrasonic diagnosis (slip-page of the intraperitoneal contents along the posterior surface of the hematoma, rupture sign, denoting diffusion of the hematoma immediately below the Douglas' arch). Ordinarily, the clinical course of this complication of rectus sheath hematoma is spontaneously favorable.

Abdomen↗