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C Chagnaud

Publications and source records attributed to C Chagnaud.

At least 19 recordsLinked to original sources
PubMed2006

Placement of intra-articular injection verified by the backflow technique.

OBJECTIVE: To develop and to assess a simple, inexpensive method for ascertaining, without any imaging procedure, the intra-articular placement of the needle in the knee for intra-articular injections. METHODS: Outpatients referred for intra-articular treatment with "dry" symptomatic knee osteoarthritis were included in this prospective study. "Dry" knee disease was defined as a knee without any clinically detectable effusion. Once intra-articular positioning of the needle considered adequate using the backflow technique, contrast solution was injected using the same needle without changing its position and immediately afterwards lateral and anterior-posterior X-rays were taken to assess the needle position. RESULTS: Of the 32 of 33 cases with obtained backflow, the needle was correctly placed in all cases. In the remaining case, the needle was extra-articularly positioned. The concordance between the two techniques using the Cohen's Kappa was 1 [CI 95%: 0.22-1]. CONCLUSION: The backflow technique allows to accurate the intra-articular placement of the needle for "dry" knee joints injection. This technique can be proposed as a learning tool as well as a daily practice technique to ascertaining intra-articular knee injections without using fluoroscopy with injection of contrast material. Further studies are needed to assess the technique for other joint injections.

Female↗
PubMed2001

Normocalcemia with elevated parathyroid hormone levels after surgical treatment of primary hyperparathyroidism.

BACKGROUND: Thirty percent of patients who undergo successful parathyroidectomy for primary hyperparathyroidism show unexplained elevated postoperative serum parathyroid hormone (PTH) levels despite normocalcemia. METHODS: PTH levels were measured monthly in 97 patients for 6 months after parathyroidectomy. Renal function, 25-OH-vitamin D levels, serum alkaline phosphatase levels, osteocalcin, and bone densitometry were evaluated before and 6 months after surgery. PTH reactivity to calcium loading was tested at the sixth month. RESULTS: Thirty patients had elevated PTH levels despite normocalcemia after parathyroidectomy. Before surgery, these 30 patients had higher PTH and creatinine levels, lower vitamin D levels, and more extensive bone involvement than those with normal postoperative PTH levels. In patients with normal renal function and normal vitamin D levels, postoperative PTH values correlated with preoperative PTH levels but not with bone disease. CONCLUSION: In most cases, elevated PTH levels after surgery is an adaptive reaction to renal dysfunction or vitamin D deficiency. If no adaptive cause can be found, persistent hyperparathyroidism must be suspected.

Calcium↗
PubMed2000

Serial anatomy of the larynx in MRI: MRI-histologic correlations.

The larynx is an organ with a complex anatomic structure. MRI allows the performance of sections in the three planes of space, so that this study of the soft parts of the larynx yields results superior to those of other imaging techniques. Together with laryngoscopy, MRI is most often used in assessing the extension of malignant laryngeal tumors. This assessment is fundamental in choosing the indications for surgery, but the published reports of MRI of the larynx are sometimes discordant. The visualization of certain important anatomic structures such as the conus elasticus is uncertain. Our aim was to study the MRI radio-anatomy of the larynx based on correlations between MRI and histologic sections. Eight anatomic specimens were studied: four in the transverse plane, two in the sagittal plane, and two in the frontal plane. The MRI and histologic sections made at the same levels were compared. These comparisons allowed a description of the sectional radio-anatomy of the larynx and an assessment of the reliability and limitations of MRI. All the major anatomic structures could be identified. It was possible to demonstrate the conus elasticus. We were able to visualize the vocal process of the arytenoid cartilage, which has not to our knowledge been previously described in the literature.

Aged↗
PubMed2000

Iatrogenic dissection of the portal vein during TIPS procedure.

Dissection of the portal vein is a rare entity which has been rarely described during transjugular intrahepatic portosystemic shunt (TIPS) procedure. We report three cases of dissection during this procedure and their complications. One dissection was immediately treated with coaxial stents. The two others were complicated either by a thrombus or by a false aneurysm. In the first case a second parallel stent was used to treat this complication. The patient with the portal vein false aneurysm was transplanted 4 days after this diagnosis. Portal vein dissection in TIPS procedure appeared to be less rare than has been reported and must be considered as a potential cause of TIPS dysfunction.

Adult↗
PubMed2000

Radiological follow-up of inverted papilloma.

The aim of this study was to describe cross-sectional imaging features of recurrent papilloma of the nasal fossa and paranasal sinuses and to evaluate the role of MR and CT in the postoperative follow-up of this lesion. Magnetic resonance imaging and CT of ten patients who presented recurrence of inverted papilloma were reviewed and correlated to initial imaging, endoscopy, and surgical reports. Imaging patterns of recurrent inverted papilloma are identical to those of initial tumors and recurrence location is closely related to the site of the former lesion. Magnetic resonance is more efficient than CT for the diagnosis and evaluation of extensions. Magnetic resonance supplies the deficiencies of endoscopy in case of extensions to the frontal sinus or the lateral recess of the antrum, especially if mucosal hyperplasia or sinusitis is associated. Magnetic resonance imaging is the first imaging modality to perform in the follow-up after removal of inverted papilloma.

Adult↗
PubMed2000

[Differential diagnosis of infective spondylodiscitis and erosive degenerative disk disease].

PURPOSE: To assess the value of imaging in the differential diagnosis of erosive intervertebral osteochondrosis (EIVO) versus infectious discitis (ID). MATERIALS AND METHODS: Twelve cases of EIVO and 30 cases of ID were reviewed to define the usefull signs for differential diagnosis on plain films, CT, and MR. RESULTS: No single sign is sufficient, but the association of several signs is suggestive of EIVO: discal vacuum phenomenom, well-defined sclerosis and erosions of vertebral endplates, high signal strip surrounding low signal of vertebral endplates on T1-weighted images. CONCLUSION: Imaging is helpful in difficult differential diagnosis of EIVO versus ID.

Adult↗
PubMed2000

[Accessory retrograde aneurysmal aortic lumen supplying the inferior mesenteric artery].

We report the case of a patient with infrarenal abdominal aortic aneurysm with mural thrombus covering the ostium of a patent inferior mesenteric artery (IMA). The IMA was supplied via flow from an accessory aneurysmal lumen within the mural thrombus that filled retrogradely from the aorta. This unusual pattern, associated with calcifications within the thrombus, raised the possibility of chronic aortic dissection.

Aged↗
PubMed1999

Anteroposterior atlantoaxial subluxation in cervical spine osteoarthritis: case reports and review of the literature.

Nontraumatic anteroposterior atlantoaxial subluxation (AAS) has been described in several rheumatic or inherited disorders, especially rheumatoid arthritis and to a lesser extent the inflammatory spondyloarthropathies. We describe AAS secondary to osteoarthritis (OA) of the cervical spine in a 76-year-old man and a 73-year-old woman with severe cervical OA, symptomatic C1-C2 facet joints, and signs of generalized OA. Only 6 similar cases exist in the literature. OA should be added to the causes of AAS, and conversely AAS should be assessed in cases with severe OA of the upper cervical spine.

Aged↗
PubMed1999

[Intralesional injection of vinblastine in treatment of laryngeal Kaposi sarcoma associated with AIDS].

Kaposi's sarcoma (KS), is the most frequent malignant neoplasm associated with acquired immunodeficiency syndrome (AIDS). Classically arising in the skin, mucosal lesions are seen in 50 percent in oral cavity. KS rarely involves the larynx (37 cases have been reported in the world literature), when KS occurs in the larynx airway compromise can be a serious threat and immediate treatment is necessary. We report one case of KS of the supraglottic larynx, and intralesional injections were performed. A complete response was noted eleven months later. Although several modes of treatment are available (radiation therapy, systemic chemotherapy) to manage KS, intralesional injections with vinblastine sulfate may after an effective therapeutic alternative.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Vanishing osteosclerotic lesion of the humeral head.

We report on the spontaneous disappearance of a dense round lesion from within the greater tuberosity of the humerus. The patient was treated with oral non-steroidal anti-inflammatory agents for symptoms of subacromial bursitis. Symptoms resolved in 10 days and the lesion had vanished when radiographed 3 months later. We surmise the lesion to represent intraosseous crystal deposition.

Calcinosis↗
PubMed1998

Postoperative follow-up of juvenile nasopharyngeal angiofibromas: assessment by CT scan and MR imaging.

The purpose of this study was to assess the radiological findings after surgical removal of juvenile nasopharyngeal angiofibromas (JNA). The postoperative CT and MRI scans of ten patients were reviewed. The cured group included six patients. The non-controlled group included six patients with eight recurrences. Two patients belonged to both groups as they were also followed and cured after surgery for relapse. Four recurrences were asymptomatic and diagnosed by imaging. The imaging patterns were matched to the patients clinical status and endoscopic findings. In the cured group, non-enhanced residual soft tissue masses were seen in all cases. In the non-controlled group, recurrence was always demonstrated on early postoperative CT or MR as a dramatically enhanced mass. The recurrence was located in the lateral or superior aspect of the nasopharynx (n = 3), deep to the fossa of Rosenmuller (n = 4) or out of the nasopharynx (n = 1). In two cases a remaining enhanced mass disappeared spontaneously on iterated examinations. Because of numerous asymptomatic relapses, a radiological workup is recommended four months after surgery, even in patients with normal endoscopy, to rule out posterolateral or extranasopharyngeal recurrences. Spontaneous evolution of residual masses must be appreciated on iterated imaging examinations.

Adolescent↗
PubMed1998

Visceral fat as a main determinant of plasminogen activator inhibitor 1 level in women.

OBJECTIVE: To substantiate in a premenopausal population of women, the link between visceral adipose tissue and circulating plasminogen activator inhibitor 1 (PAI-1) levels. DESIGN: Study of correlations between anthropometric parameters and PAI-1 and evaluation of the changes induced by weight loss. SUBJECTS: Forty-two healthy pre-menopausal women (aged 18-51 y, with a wide range of body mass index (BMI, 21-48.8 kg/m2). Thirteen women were evaluated after weight loss (6.6+/-3.3 kg). MEASUREMENTS: BMI, waist and hip circumferences. Total, subcutaneous and visceral adipose tissue areas at the L3-L4 level by computed tomography. Insulin, cholesterol, triglyceride, HDL cholesterol, PAI-1 activity, PAI-1 antigen and tissue plasminogen activator (tPA) antigen. RESULTS: PAI-1 activity, PAI antigen and tPA antigen were positively correlated with visceral adipose tissue, but not with subcutaneous adipose tissue. This correlation was independent of insulin or triglyceride levels. The amount of visceral adipose tissue explained 28% of the PAI-1 activity variance. Weight loss confirmed this link, PAI-1 diminution being correlated only with visceral adipose tissue loss and not with total fat, insulin or triglyceride decrease. CONCLUSION: This study suggests, like in vitro studies, that visceral fat may be an important contributor to the circulating PAI-1.

Adipose Tissue↗
PubMed1998

Young woman's digestive arterial occlusion--a case report and literature review.

The authors report the observation of a 31-year-old woman who presented with total occlusion of digestive arteries and was successfully treated pharmacologically. A review of the literature shows that digestive arteries thrombosis is a rare condition in young women. Only 15 cases have been previously reported. Prognosis was poor with a mortality rate of 71%; 93% used oral contraception and more than 50% were smokers. All these cases were curiously similar. The authors accentuate the role of iloprost in the recovery of the patient. Digestive artery occlusion should be taken into consideration in the differential diagnosis of abdominal pain, especially in young women who smoke and take estrogen-containing birth control pills.

Adult↗
PubMed1998

[Peritoneal splenosis simulating a right retroperitoneal mass].

We report a case of an incidentally diagnosed apparently isolated splenosis nodule located in the hepatorenal peritoneal recess. According to imaging features, this mass was a non-renal retroperitoneal tumor. In spite of the isolated location, the history of splenic rupture should have led to a heat-damaged red blood cell scintiscan and would thus have avoided percutaneous biopsy.

Adult↗
PubMed1997

The intravertebral vacuum phenomenon ("vertebral osteonecrosis"). Migration of intradiscal gas in a fractured vertebral body?

STUDY DESIGN: Retrospective cohort. OBJECTIVES: To compare the prevalence of the association between contiguous intervertebral disc and vertebral collapses with or without an intravertebral vacuum phenomenon. SUMMARY OF BACKGROUND DATA: The mechanism of occasional gas accumulation within some vertebral collapses is poorly known. The current hypothesis is that this phenomenon is indicative of bone ischemia. In fact, avascular necrosis as the main pathologic event remains speculative, and should not explain per se the presence of gas within a vertebral body. METHODS: Comparison of the prevalence of intervertebral disc vacuum phenomenon adjacent to the affected vertebral body in 23 cases of intravertebral vacuum phenomenon in 19 patients (intravertebral vacuum phenomenon group) and in 708 osteoporotic collapses without intravertebral vacuum phenomenon in 199 patients (control group). RESULTS: There were no differences in sex and age between the two groups, and all the patients in the intravertebral vacuum phenomenon group had signs of underlying osteoporosis. A vacuum phenomenon in at least one intervertebral disc adjacent to the collapses on radiographs, conventional tomography, computed tomography, or magnetic resonance imaging was found in 19 cases (83%) in the intravertebral vacuum phenomenon group, compared with 13% in the control group (P < 0.0001). Considering plain radiographs only, this association was found in 50% of the intravertebral vacuum phenomenon group and in 9.7% of the control group (P < 0.0001). The intervertebral and intravertebral gaseous collections were connected through a fractured endplate in six cases. CONCLUSIONS: The high prevalence of the association of contiguous intervertebral and intravertebral vacuum phenomenon could have implications in the pathogenesis of the intravertebral vacuum phenomenon. We hypothesize that the intravertebral vacuum phenomenon could simply be the result of migration of an intradiscal-gaseous collection through the fractured endplate of some osteoporotic collapses.

Aged↗