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Biomedical subjects

F Joffre

Publications and source records attributed to F Joffre.

At least 109 records · Page 6Linked to original sources
PubMed1988

[Segmental renal hypoplasia of an adult originating from pseudo-tumor hyperreninism].

A 38 year-old man was admitted for severe hypertension with hypokalemia. Blood pressure was 180-120 mmHg, funduscopic examination revealed grade II retinopathy and left ventricular hypertrophy was present. Laboratory data disclosed: natremia = 140 mmol/ml, kalemia = 2.8 mmol/l, chloride = 105 mmol/l, bicarbonate = 30 mmol/l, creatinine clearance = 100 ml/mn, natriuresis = 140 mmol/day, kaliuresis = 80 mmol/day. Intravenous pyelography was normal. Angiography revealed a defect in the mid third of the right kidney without arterial abnormalities. Study of renin angiotensin aldosterone system showed: plasma renin activity: peripheric blood = 36 ng/ml/h (normal range I to 2), right renal vein = 30 ng/ml/h. Left renal vein = 18 ng/ml/h, inferior cava vein = 19 ng/ml/h. Plasma aldosterone level = 86 ng/100 ml (normal range 10 to 15). Captopril acute administration was followed by a fall of BP to 70-50 mmHg at 2 hours. Right nephrectomy was performed and revealed an ischemic retracted cortical area without necrosis nor tumoral aspect. The day after BP was 140/80 mmHg. Eight days after, kaliemia was 4.2 mmol/l, PRA was 0.5 ng/ml/h. Light microscopy showed that affected area was sharply delimited from surrounding normal tissue. In this area, glomeruli were present and seemed more numerous as usual; interstitial fibrosis and infiltrates of inflammatory cells were also noted. The main fact was tortuosities of intralobular arteries, thickened, with intimal proliferation. There was a pelvic recess near this cortical tissue. Immunofluorescence findings: antirenin serum fixed on JGA but also on interlobular arterial walls and on peritubular interstitium.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Lateralization of renin secretion in renovascular hypertension with bilateral arterial stenosis].

A retrospective analysis of peripheral and renal vein plasma renin activity has been performed in 9 patients with bilateral renal artery stenosis (3 fibromuscular dysplasia and 7 atherosclerosis). In all cases angiography showed a reduction of the arterial diameter of more than 70 p. 100. The renal artery was occluded in 3 cases. All patients received a constant sodium diet (100 mEq/day). Peripheral PRA values were classified as normal or low in 6 cases (less than 2.8 ng/ml/h) and high in one case (greater than 2.8 ng/ml/h): this values concerned 2 cases with renal artery occlusion and 1 case with a narrowing of 90 p. 100. Renal venous renin ratio of 1.5 or more has been found in 8 cases. In one case, the stenosis was quite symmetrical (70 p. 100) and the ratio less than 1.5. The secretion index has been calculated as the ratio between the venoarterial difference of both affected and unaffected side over the arterial value of PRA (V-A/A). On the more stenosed side, was found a V-A/A ratio of 0.5 or more. This ratio is particularly high in case of artery thrombosis, but there is no correlation between the ratio and the degree of stenosis. On the contralateral side, where the lesions were less important, the V-A/A ratio was low, ranging from 0 to 0.2; this estimation of renin secretion was found despite a significant stenosis on the angiography. 7 patients underwent PTA or surgery. 2 kidneys with arterial thrombosis were nephrectomized. In 5 cases the surgical treatment is performed on the 2 sides during the same procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty.

Occlusion and restenosis are the most common reasons that transluminal balloon angioplasty may fail to provide long-term benefit. An intravascular mechanical support was therefore developed with the aim of preventing restenosis and sudden closure of diseased arteries after angioplasty. The endoprosthesis consists of a self-expandable stainless-steel mesh that can be implanted nonsurgically in the coronary or peripheral arteries. Experiments in animals showed complete intimal coverage within weeks and no late thrombosis during a follow-up period of up to one year. We performed 10 implantations in 6 patients for iliac or femoral arterial disease; 24 coronary-artery stents were implanted in 19 patients who presented with coronary-artery restenoses (n = 17) or abrupt closure (n = 4) after transluminal angioplasty or deterioration of coronary-bypass grafts (n = 3). We observed three complications in the group with coronary disease. One thrombotic occlusion of a stent resulted in asymptomatic closure, a second acute thrombosis was managed successfully with thrombolysis, and one patient died after bypass surgery for a suspected but unfound occlusion. Follow-up in the patients has continued for nine months without evidence of any further restenoses within the stented segments. Our preliminary experience suggests that this vascular endoprosthesis may offer a useful way to prevent occlusion and restenosis after transluminal angioplasty. Long-term follow-up will be required to validate the early success of this procedure.

Angioplasty, Balloon↗
PubMed1987

Self-expanding endovascular prosthesis: an experimental study.

A new type of endovascular prosthesis was inserted in 28 animals and evaluated for several factors, including thrombogenicity, tendency to migrate, critical implant zones, and incorporation into the vascular wall. The new prosthesis is a woven, multifilament structure of stainless steel alloy; its inherent elastic, self-expanding characteristics hold it against the vessel walls. Forty-seven endoprostheses (3-5 mm in diameter, 15-50 mm long) were percutaneously implanted with either a 6-F introducer sheath, a coaxial 9-F catheter, or a 0.014-inch (0.036-cm) guide wire into the femoropopliteal, coronary, carotid, and renal arteries and iliac veins. Anticoagulant or platelet antiaggregating agents were not used before or after implantation. Angiographic and histologic analyses showed that the prosthesis had a very low thrombogenicity when it was well adapted to the native vessel diameter and that it was incorporated into the vessel wall by a new intima by the 3d week after implantation. No migration occurred, and branch vessel flow was preserved even in those vessels in which ostia were traversed by the prosthesis. This prosthesis has potential for clinical application in the treatment of postangioplasty restenoses, particularly in the coronary arteries.

Animals↗
PubMed1987

[Subungual glomus tumors. Apropos of 2 cases].

Glomus tumours are uncommon, though not exceptional, benign growths developed from the constituents of the "neuromyoarterial glomus" initially described by Masson. Two cases of subungual glomus tumours of the hand in middle-aged women are reported. In spite of characteristic symptoms, with paroxysmal episodes of pain triggered off by cold and the most minute traumas, and of the finding in both cases of a violine++ tumour under the nail, the condition was belatedly diagnosed (7 and 27 years respectively after the onset of symptoms). Diagnosis rested not so much on standard radiography, which showed erosion of the distal phalanx in both patients, as on arteriography of the hand which displayed a small vascular pool at the arterial stage. Tumoral excision was successful.

Angiography↗
PubMed1987

Ureteral metastases--computed tomographic findings.

CT findings in three cases of ureteral metastases are reported. Metastases to the ureter is an uncommon cause of the upper urinary tract obstruction. The most common primary sites include breast, stomach and neoplasms from pelvic organs. Radiographic studies revealed an ureteral stenosis in all the presenting cases. CT scans demonstrated a thickened regular ureteral wall at the level of the narrowing and no other abnormalities of the retroperitoneum. Such CT features suggest the possibility of ureteral metastases in a patient with the appropriate clinical setting. Histological studies, whenever possible, must confirm these radiographic findings. Early recognition of ureteral metastases and appropriate treatment for relief of urinary tract obstruction may prolong survival time.

Adenocarcinoma↗
PubMed1986

Recurrent pheochromocytoma: intrarenal and pulmonary spread.

A case of intrarenal malignant pheochromocytoma, closely resembling hypernephroma radiologically, is presented. This tumor with 2 other pulmonary masses, recurred 12 years after ablation of an adrenal pheochromocytoma and extended into the inferior vena cava.

Adrenal Gland Neoplasms↗
PubMed1985

[Scanographic diagnosis of a localized form of Caroli's disease].

The authors report a case of Caroli's disease, localized in the left hepatic lobe without any associated abnormality. Preoperative diagnosis of such localized forms is actually possible by the use of non invasive methods, especially computed tomography. This diagnosis is important leading to a curative surgical treatment.

Bile Duct Diseases↗