Search PubMed⌕ Search

Biomedical subjects

G Breton

Publications and source records attributed to G Breton.

At least 55 records · Page 3Linked to original sources
PubMed1988

The radiological report: what is useful for the referring physician?

To assess what constitutes a useful radiological report for referring physicians, we sent a questionnaire to 200 doctors (general practitioners, internists, and surgeons). Questions testing style, length of the report, and several points of content, including mention of clinical correlation, negative findings, and sequence of further investigations, were included. The principal qualities useful to the clinician were clarity, brevity, and clinical correlation. Advice on planning of future investigations was especially valued by general practitioners.

Communication↗
PubMed1987

Hemodynamic changes in portal circulation after portosystemic shunts: use of duplex sonography in 43 patients.

Forty-five patients with 46 surgical portosystemic shunts were examined by duplex Doppler sonography, and the results were compared with those of esophageal endoscopy, angiography, surgery, and clinical follow-up. Thirty-eight shunts were patent, and in 33 of these, the shunt was directly visualized and flow was observed with Doppler sonography. Eight shunts were obstructed. After a successful portosystemic shunt procedure, flow in the shunted splanchnic vein was directed toward the shunt and the systemic vein. We studied the intrahepatic portal venous circulation in all of the patients; we found that in the presence of patent portosystemic shunt, portal flow is hepatofugal. This reversal of blood flow occurred in all but four patients. In the end-to-side portacaval shunt, where the portal vein is ligated, blood in intrahepatic portal branches presumably reaches the shunt through perihepatic collaterals. In the presence of a thrombosed shunt, intrahepatic portal venous flow was hepatopetal. To our knowledge, this is the first noninvasive in vivo study of intrahepatic portal circulation after portosystemic shunt surgery. The duplex Doppler evaluation of portosystemic shunts appears to be reliable and should be the method of choice for shunt patency assessment in patients with recurrent signs of portal hypertension. In addition to demonstrating flow at the site of the anastomosis, the Doppler study may yield an easy and reliable sign of shunt patency: reversed flow (hepatofugal flow) in the intrahepatic portal veins probably signals a patent shunt, even if the site of the anastomosis cannot be visualized directly by sonography.

Adolescent↗
PubMed1986

Ascites: ultrasound guidance or blind paracentesis?

The classic site for paracentesis in generalized ascites is in the left lower quadrant of the abdomen at a position equivalent to McBurney's point. Its use has an average success rate of 58%, depending on the amount of liquid. To assess the efficacy of paracentesis at this site and to establish the ideal site for blind puncture, we studied 27 consecutive patients with ascites detected by abdominal ultrasonography. The amount of ascites was graded from 1 to 4. Free fluid had accumulated mostly in the perihepatic region, then around the bladder and in the right paracolic gutter, and finally in the left flank. In six of the eight patients in whom fluid was found in the left or right flank, air-filled bowel loops were observed between the abdominal wall and the fluid, in the expected path of a blind puncture. These findings suggest that the safety and efficacy of paracentesis would be greatly improved by ultrasonographic guidance.

Adult↗
PubMed1986

Sonography of the hypertrophied column of Bertin.

A prospective sonographic analysis of kidneys in 136 adults without clinical or radiologic evidence of renal disease revealed 22 cases of large columns of Bertin. Most were located in the middle third of the kidney, more frequently on the left side. They were bilateral in 18%. Water bath sonograms of normal cadaver kidneys and subsequent anatomic correlation revealed hypertrophied columns and confirmed the sonographic findings seen in vivo. The following are characteristic of a hypertrophied column of Bertin: It is a projection of cortex into the renal sinus (and therefore is isoechogenic with it). The sinus may engulf it in a clawlike fashion. The renal contour is smooth. Sonography is characteristic and obviates further investigation.

Adolescent↗
PubMed1986

The V-shaped artifact of the gallbladder wall.

Among 20,000 patients who had undergone abdominal or gallbladder sonographic examinations, 36 had a short V-shaped artifact originating from an hyperechoic focus in the gallbladder wall. Associated symptoms were varied and nonspecific. The 10 gallbladders excised because of associated cholelithiasis showed a thickened wall, and seven patients had diverticulosis of the wall with impacted stones. In vitro sonographic examination of five gallbladders reproduced the "V" artifact and showed that it originated from a small intramural cholesterol stone. The V artifact should be distinguished from the larger comet-tail and ring-down artifacts, which arise from metal or gas.

Adult↗
PubMed1985

The recanalized umbilical vein in portal hypertension: a myth.

The demonstration of a vessel in the falciform ligament, traditionally presumed to be a reopened umbilical vein, is an important sonographic sign of portal hypertension. This vessel was sought in 200 umbilicoportographies (all portal hypertensive) and in 41 autopsy-dissected falciform ligaments (34 normal and seven cirrhotic). The normal falciform ligament contained one to three tiny collapsed paraumbilical veins. In cirrhotics, the number and caliber of paraumbilical veins increased. A reopened umbilical vein was never found. The authors conclude that the umbilical vein does not recanalize in portal hypertension. The vessel involved is actually an enlarged paraumbilical vein.

Adult↗
PubMed1984

Portal venous system measurements in portal hypertension.

The diameters of the portal, splenic, superior mesenteric, and coronary veins were measured during umbilicoportal venography in 64 cirrhotic patients with or without portal hypertension. The diameter of the portal vein did not increase along with the portohepatic gradient and even tended to decrease depending on the severity of hypertension and the opening of spontaneous portosystemic shunts. While there was no relationship between portohepatic gradient and splenic or superior mesenteric vein diameter, a coronary vein larger than 0.7 cm was associated with a portohepatic gradient greater than 10 mm Hg. This could be a useful sign of severe portal hypertension.

Anthropometry↗
PubMed1983

Hepatic abscess complicating ulceroglandular tularemia.

In a patient with the clinical features of classic ulceroglandular tularemia a solitary hepatic abscess was found during an ultrasound examination. Hepatic tularemia has rarely been reported since the advent of specific therapy, which prevents the disease from reaching the disseminated state. This case, however, shows that the liver can be involved early in the course of tularemia. Increased serum levels of hepatic enzymes may be the only sign of such a complication.

Aged↗
PubMed1983

Echographic demonstration of an oncocytoma.

Renal oncocytomas are rare and apparently benign tumors. Diagnosis other than by angiography has not been reported. We report the echographic demonstration of an oncocytoma.

Adenoma↗
PubMed1976

Clinical description and roentgenologic evaluation of patients with Friedreich's ataxia.

The 50 patients in this survey were classified by a panel of neurologists into 4 clinical sub-groups: Group Ia ("typical" Friedreich's ataxia, complete picture), Group Ib ("typical" Friedreich's ataxia, incomplete picture), Group IIa ("atypical" Frriedreich's ataxia, possible recessive Roussy-Levy syndrome), Group IIb (heterogeneous ataxias). The clinical symptoms and signs were analyzed for each of these groups. A constellation of signs constantly present in Friedreich's ataxia and obligatory for diagnosis was described. Other important symptoms, such as the Babinski sign, kyphoscoliosis and pes cavus were found to be progressive, but not essential for the diagnosis at any given time. Finally, a host of other symptoms can only be called accessory. The progression of scoliosis was found to be an important tool in the differential diagnosis of ataxias. Our study also indicates, in contrast to the opinion of some authors, that absent deep tendon reflexes in the lower limbs and early dysarthria are essential in "typical" Friedreich's ataxia.

Adolescent↗
PubMed1976

Friedreich's ataxia: preliminary results of some genealogical research.

A preliminary genealogical investigation of all the known ancestors from the year 1608 of 4 apparently unrelated French Canadian kindreds with Friedreich's ataxia reveals that the original ataxia gene in the province of Quebec was present within a core of no more than 10 families living in Quebec City in the mid-1600's.

Consanguinity↗