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D Mathieu

Publications and source records attributed to D Mathieu.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Gradient echo sequences in the diagnosis of inferior vena cava thrombosis].

The capability for studying noninvasively vessels has been dramatically improved with the use of gradient echo sequences. Twenty-one patients presenting a suspected inferior vena cava obstruction on cavography underwent MR examination with axial, sagittal and coronal gradient echo images. Eighteen patients were also imaged with ultrasound and/or CT. Gradient echo sequences visualized a thrombus in 19 cases and a normal vein in the remaining 2 cases. The potential MR pitfalls are illustrated and the two cases of false positive on cavography are discussed. Gradient echo sequences allow a fast and performant examination of the vessels.

Adolescent↗
PubMed1991

Usefulness of influenza vaccination in the elderly.

Since influenza morbidity and mortality are high in the elderly, the usefulness of vaccination has been evaluated. One hundred and twenty-six older persons aged 60-90 yr were given a vaccine consisting of the 3 antigens Singapore, Shanghaï and Yamagata, the latter 2 being new antigens. Antibody levels for each of the antigens were determined by ELISA calibrated in HA units prior to and 1 month after vaccination. Before vaccination, antibodies to Shanghaï and Singapore antigens were found in practically all sera tested, and antibodies to Yamagata antigen in only 66% of sera. After vaccination, significant levels of antibodies to all 3 antigens were found in sera tested. Thus, it was observed that influenza vaccination proved to be effective in the elderly. The elderly should be immunized against influenza, since this is a safe and efficacious preventive measure. In addition, vaccination should limit the spreading of influenza in nursing homes.

Aged↗
PubMed1991

[Diagnostic and therapeutic strategy in acute pancreatitis].

The diagnostic and therapeutic management of acute pancreatitis (AP) is directly related to the severity of the initial attack. Mild AP usually subsides spontaneously. On the other hand, severe AP requires admission to an intensive care unit and supportive care for multiple organ failure. During the second phase of the disease, repeated CT scans with the routine use of percutaneous fine needle aspiration and drainage allows both diagnosis and treatment of pancreatic abscesses. However, infected necrosis usually requires surgical drainage. The treatment of acute biliary pancreatitis must be performed during the same admission for mild AP. In contrast, it seems better to postpone any kind of surgical treatment in the severe forms of gallstone pancreatitis. The efficacy of endoscopic sphincterotomy has not yet been demonstrated.

Acute Disease↗
PubMed1990

Cystic dilatation of intrahepatic bile ducts in primary sclerosing cholangitis.

A case of primary sclerosing cholangitis associated with cystic dilatations of intrahepatic bile ducts simulating Caroli's disease is described. The diagnosis of primary sclerosing cholangitis was based upon cholangiogram features, liver histologic examination and the association with chronic ulcerative colitis. It may be suggested that the cystic dilatation of intrahepatic bile duct represents an extreme form of the usual mild dilatations (cholangiectases) described in primary sclerosing cholangitis. We suggest that cystic dilatation of intrahepatic bile ducts could be included among the radiologic features of this disease.

Bile Duct Diseases↗
PubMed1990

Effect of urogenital infections on sperm parameters and hypofertility in man.

Urogenital infections can notably reduce the sperm's capacity of fecundation by affecting the spermatozoa directly. The aim of this study was to compare the main parameters of the spermogram of 2 groups of hypofertile subjects, the first group presenting negative semen cultures, the second one positive semen cultures. The only significantly different parameter between these 2 groups of hypofertile patients studied was motility. This anomaly alone could explain some states of hypofertility.

Adult↗
PubMed1990

Post-traumatic limb ischemia: prediction of final outcome by transcutaneous oxygen measurements in hyperbaric oxygen.

In limb injuries (amputation, laceration injuries, or compartment syndrome), a circulatory insufficiency with a total or subtotal ischemia may occur and jeopardize the result of reconstructive surgery. Transcutaneous oxygen monitoring has been shown to reflect tissue perfusion and has been advocated to predict the final outcome of major vascular trauma of the limb. Unfortunately, in normal atmospheric conditions, this test is not sufficiently discriminative; we evaluate the effect of hyperbaric oxygen on the efficiency of this test. 23 patients with major vascular trauma of the limbs were evaluated by clinical examination and transcutaneous oxygen pressure (PTCO2) measurements. Sixteen had arterial repair and seven had clinical evidence of peripheral ischemia without an arterial lesion. In normal air, the transcutaneous oxygen values in the traumatized limb, of these 23 patients, were significantly lower than in the nontraumatized limb. But neither the absolute PTCO2 value nor the ratio between the traumatized limb's PTCO2 and that of the nontraumatized one can predict the final outcome (amputation). In hyperbaric oxygen (2.5 ATA), this ratio is significantly higher in the group where the surgery will succeed than in the group where final amputation will be needed (81.2 +/- 26.0 vs. 15.2 +/- 13.1; p less than 0.01). The overall sensitivity and specificity of prediction of the limb's final outcome when the bilateral PTCO2 ratio in 2.5 ATA pure oxygen is less than 0.40, are 100% and 94%, respectively. But what is perhaps more interesting is that, when considering a ratio value of less than 0.20, amputation can be predicted with a 100% true predictive value.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1990

Hyperbaric oxygen therapy in chronic vascular wound management.

Many nonhealing tissues are hypoxic, with oxygen tensions frequently ranging from 5 to 15 mmHg. In such an environment, the normal wound healing sequence is disrupted or halted and phagocytic killing activity depressed. So the adjunctive use of hyperbaric oxygen (HBO), based on physiologic data and clinical observations, can provide the substrate necessary to initiate and sustain the healing process. During a twelve-month period, 20 patients with a nonhealing wound were referred to the hyperbaric center: chronic arterial insufficiency ulcers in 9 cases, diabetic wounds (foot lesions) in 11 cases. Adjunctive HBO therapy, initiated twice a day, consisted of pure oxygen, 2.5 ATA, 90 min. The average length of sessions was 46 (15-108). Complete healing was observed in 15 of 20 cases. The wound management can be helped with the transcutaneous oxygen measurements under hyperbaric oxygen. The distal TCPO2 at 2.5 ATA pure oxygen is a reliable test to predict final outcome (healing or no change), when these values were not different in normal air and in normobaric oxygen: (table; see text) In hyperbaric oxygen therapy, when the distal TCPO2 value was inferior to 100 mmHg, all patients showed either no improvement or aggravation, and when the value was higher than 100 mmHg, wound healing was achieved with all patients.

Blood Gas Monitoring, Transcutaneous↗
PubMed1990

[Hyperbaric oxygen therapy in the treatment of wounds, in plastic and reconstructive surgery].

After recalling the mechanism of action of hyperbaric oxygen (HBO) on healing processes, the authors review the principal indications for this technique in plastic and reconstructive surgery, such as crush injuries and acute post-traumatic ischemia of the limbs, skin flaps and skin grafts, when there is a risk of their not taking, and burns. They stress the importance of strict, stratified therapeutic protocols with control of the hyperoxygenation induced by HBO. In the authors' experience, transcutaneous measurements of the partial pressure of oxygen under the hyperbaric atmosphere is a very useful method with a predictive value to determine the indications for treatment with HBO and to monitor its effects.

Blood Gas Monitoring, Transcutaneous↗
PubMed1990

[Gastric duplication. Apropos of 3 cases].

Duplication of the stomach is a rare congenital malformation. Most reported cases involve infants or young children. On the basis of 3 cases identified at a later age, we describe the CT appearance of this malformation. Those 3 cases were demonstrated by the histological study of the surgical specimen.

Adenocarcinoma↗
PubMed1990

[Hepatic infarction of arterial origin. X-ray computed tomographic aspects].

Unlike other major abdominal organs, infarctions affecting the liver is extremely rare. In humans, the rarity of hepatic infarction is explained commonly on the basis of the double blood supply via the hepatic artery and portal vein. The imaging studies and clinical records of seven patients with hepatic infarcts were reviewed. These infarctions were essentially observed during post-operative periods: after aortoceliac graft and after accidental ligation of the hepatic artery (4 cases). The other etiologies included: acute hypovolemic shock in patients with atherosclerosis (2 cases) and finally one case of acute thrombocytosis. Dynamic CT was performed initially in all the cases and during the evolution, demonstrating peripheral low attenuation areas without enhancement. Associated splenic infarcts were present in 4 patients and renal infarcts in two. While the clinical and laboratory findings in hepatic infarction can be completely mimicked by hepatic abscess, CT-guided aspirations were performed in 6 patients demonstrating in only one case the presence of infection.

Aged↗
PubMed1989

[Diagnosis of disorders affecting the solid organs of the supra-mesocolic compartment].

Sonographic and computed tomographic (CT) examinations have modified the investigation of hepatic, splenic and pancreatic tumors. Because of advances in non-invasive diagnostic procedures, these different benign or malignant tumors are now more frequently detected and surgically treated. However, for these different lesions sonography is the gold standard imaging technique. The different indications for CT and magnetic resonance imaging are discussed for each tumor. For the diagnostic imaging of an acutely injured patient, sonography remains the useful examination in emergencies. The indications for CT scans are limited to the difficulties of sonographic diagnosis in stable trauma patients.

Humans↗
PubMed1989

Association of focal nodular hyperplasia and hepatic hemangioma.

The association between hepatic hemangioma and focal nodular hyperplasia has been occasionally reported. To evaluate the reality of this association, the prevalence of hemangioma was studied in 26 patients with focal nodular hyperplasia by comparison with 27 patients with hepatocellular adenoma. All of these patients underwent surgery, which provided the histologic confirmation of the type of tumor. The presence of hemangioma was assessed by preoperative ultrasonography, dynamic computed tomography, and pathological examination of resected liver specimens. No hemangioma was found in patients with hepatocellular adenoma, but 6 of the 26 patients with focal nodular hyperplasia (23%) had one or two associated hemangiomas that varied in size from 1.5 to 4 cm. All 6 patients having focal nodular hyperplasia and hemangioma were women who had previously used oral contraceptives. None of the patients who had not used oral contraceptives had this association. Moreover, oral contraceptives were taken for a significantly longer period by the women with focal nodular hyperplasia and hemangioma than by those without this association. It is concluded that (a) the association of hemangioma with focal nodular hyperplasia is frequent (23%) and not fortuitous, and (b) prolonged administration of oral contraceptives may facilitate the recognition of this association, possibly by affecting the growth of these tumors.

Adult↗
PubMed1989

Acute Budd-Chiari syndrome secondary to leiomyosarcoma of the inferior vena cava.

The authors report a case of leiomyosarcoma of the inferior vena cava, responsible for an acute Budd-Chiari syndrome. The diagnosis, suggested by lower limb edema, ascites, and renal failure, was confirmed by sonography, CT scan, and pathological examination. A mesoatrial shunt and right atrial thrombectomy were performed under extracorporeal circulation. The inferior vena cava was ligated because the tumor was considered to be unresectable.

Acute Disease↗