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Biomedical subjects

G Marchal

Publications and source records attributed to G Marchal.

At least 91 records · Page 5Linked to original sources

Enhanced magnetic resonance imaging for tissue characterization of liver abnormalities with hepatobiliary contrast agents: an overview of preclinical animal experiments.

Because of the demand for an extension of the range of diagnostic uses for currently available extracellular magnetic resonance imaging (MRI) contrast agents, a new generation of tissue-specific (i.e., hepatobiliary) contrast agents have been successfully developed to enhance the performance of hepatic MRI. These agents include mangafodipir trisodium (formerly manganese dipyridoxal diphosphate [Mn-DPDP]), gadoxetic acid (formerly gadolinium ethoxybenzyl diethylenetriaminopentaacetic acid [Gd-EOB-DTPA]), and gadolinium butylbenzyl diethylenetriaminepentaacetic acid (MS-264). In a series of experiments in animals, the potential of these agents for noninvasive characterization of liver lesions was evaluated with the use of a comprehensive methodology. The purpose of this report was to summarize the observed imaging behaviors of these agents toward different types of cholestasis and focal liver lesions, compare the similarities or dissimilarities of these agents in their possible mechanisms of action, and discuss the clinical implications of the results of the experiments. In summary, through intravenous administration of these agents, both global and local obstructive cholestases can be identified on the postcontrast image. With certain reliability, liver tumors of different origins and grades of cellular differentiation can be detected and classified according to their contrast enhancement patterns occurring at certain postcontrast phases. The invasiveness or degree of a malignancy of the liver tumor can also be suggested by the presence or absence of a peritumoral rim sign. Such diagnostic information, otherwise only invasively achievable, may prove to be invaluable in clinical decision making.

Animals↗

Strength training: importance of genetic factors.

PURPOSE: This study focuses on the quantification of genetic and environmental factors in arm strength after high-resistance strength training. METHODS: Male monozygotic (MZ, N = 25) and dizygotic (DZ, N = 16) twins (22.4 +/- 3.7 yr) participated in a 10-wk resistance training program for the elbow flexors. The evidence for genotype*training interaction, or association of interindividual differences in training effects with the genotype, was tested by a two-way ANOVA in the MZ twins and using a bivariate model-fitting approach on pre- and post-training phenotypes in MZ and DZ twins. One repetition maximum (1RM), isometric strength, and concentric and eccentric moments in 110 degree arm flexion at velocities of 30 degrees x s(-1), 60 degrees x s(-1), and 12 degrees x s(-1) were evaluated as well as arm muscle cross-sectional area (MCSA). RESULTS: Results indicated significant positive training effects for all measures except for maximal eccentric moments. Evidence for genotype*training interaction was found for 1RM and isometric strength, with MZ intra-pair correlations of 0.46 and 0.30, respectively. Bivariate model-fitting indicated that about 20% of the variation in post-training 1RM, isometric strength, and concentric moment at 120 degrees x s(-1) was explained by training-specific genetic factors that were independent from genetic factors that explained variation in the pretraining phenotype (30-77%). CONCLUSIONS: Genetic correlations between measures of pre- and post-training strength were indicative for high pleiotropic gene action and minor activation of training-specific genes during training.

Adult↗

An image-guided planning system for endosseous oral implants.

A preoperative planning system for oral implant surgery was developed which takes as input computed tomographies (CT's) of the jaws. Two-dimensional (2-D) reslices of these axial CT slices orthogonal to a curve following the jaw arch are computed and shown together with three-dimensional (3-D) surface rendered models of the bone and computer-aided design (CAD)-like implant models. A technique is developed for scanning and visualizing an eventual existing removable prosthesis together with the bone structures. Evaluation of the planning done with the system shows a difference between 2-D and 3-D planning methods. Validation studies measure the benefits of the 3-D approach by comparing plans made in 2-D mode only with those further adjusted using the full 3-D visualization capabilities of the system. The benefits of a 3-D approach are then evident where a prosthesis is involved in the planning. For the majority of the patients, clinically important adjustments and optimizations to the 2-D plans are made once the 3-D visualization is enabled, effectively resulting in a better plan. The alterations are related to bone quality and quantity (p < 0.05), biomechanics (p < 0.005), and esthetics (p < 0.005), and are so obvious that the 3-D plan stands out clearly (p < 0.005). The improvements often avoid complications such as mandibular nerve damage, sinus perforations, fenestrations, or dehiscences.

Dental Implantation, Endosseous↗

Nonalcoholic duct-destructive chronic pancreatitis: imaging findings.

OBJECTIVE: Nonalcoholic duct-destructive chronic pancreatitis is a new entity that should be distinguished from alcoholic chronic pancreatitis. The purpose of this study was to assess the imaging features of nonalcoholic duct-destructive chronic pancreatitis. CONCLUSION: Nonalcoholic duct-destructive chronic pancreatitis has characteristic CT and MR imaging features that include the presence of a focal or more diffuse mass causing either regular or irregular narrowing of the main pancreatic duct, the absence of parenchymal atrophy and significant ductal dilatation proximal to the site of stenosis, and the absence of extrapancreatic spread.

Adolescent↗

Normal Vaterian sphincter complex: evaluation of morphology and contractility with dynamic single-shot MR cholangiopancreatography.

OBJECTIVE: The objective of this study was to assess the usefulness of dynamic single-shot MR cholangiopancreatography in the evaluation of the morphology and contractility of the normal Vaterian sphincter complex and to assess whether i.v. injection of glucagon can improve visualization. SUBJECTS AND METHODS: Sixty patients without signs of Vaterian sphincter complex dysfunction were studied. A fast single-shot MR imaging sequence was used to obtain 20 consecutive images of the Vaterian sphincter complex during successive episodes of breathholding. In patients of group A (n = 30), 10 images were obtained before and 10 after i.v. administration of a sphincter-relaxing agent (glucagon). In the patients of group B (n = 30), no glucagon was administered. The degree of visualization of the Vaterian sphincter complex was assessed. RESULTS: Overall, the morphology and contractility of the Vaterian sphincter complex was adequately assessed in 57 patients (95%). However, the number of repetitions required to obtain this result varied greatly (mean, seven; range, two to 18). Glucagon had no apparent effect on the visibility of the most distal portion of the common bile duct. CONCLUSION: Nonvisualization of the most distal portion of the common bile duct on MR cholangiopancreatography studies is a normal variant that can simulate disease. Obtaining serial breath-hold images using a single-shot technique is helpful to avoid diagnostic errors.

Adult↗

T2-weighted MR imaging of the uterus: comparison of optimized fast spin-echo and HASTE sequences with conventional fast spin-echo sequences.

OBJECTIVE: Our objective was to compare the value of a half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence with optimized fast spin-echo and conventional fast spin-echo techniques in evaluation of the uterus. SUBJECTS AND METHODS: Optimized fast spin-echo imaging was compared with fast spin-echo and HASTE imaging, for both image quality and ability to assess the zonal anatomy of the uterus, in 40 volunteers. In optimized fast spin-echo imaging, the imaging time was reduced using partial-Fourier reconstruction, reducing the echo spacing, and increasing the echo train length. RESULTS: HASTE imaging offered the least motion artifact of all techniques. On optimized fast spin-echo imaging, motion artifacts were moderate to severe in 10% of patients. On fast spin-echo imaging, motion artifacts were moderate to severe in 40% of patients. Optimized fast spin-echo imaging was superior to the other two techniques in terms of anatomic sharpness and overall image quality. CONCLUSION: Although HASTE imaging offers the unique feature of providing images free of motion artifacts, optimized fast spin-echo imaging appears to be the preferred technique for T2-weighted imaging of the uterus.

Adolescent↗

Lack of direct correlation between CD4 T-lymphocyte counts and induration sizes of the tuberculin skin test in human immunodeficiency virus type 1 seropositive patients.

SETTING: The study was conducted in Bobo-Dioulasso, Burkina Faso, where Mycobacterium tuberculosis infection and human immunodeficiency virus type 1 (HIV-1) infection are prevalent. OBJECTIVE: To identify proportions of representative (test) populations who are reactive to the tuberculin skin test, and to study the relationship between CD4 T-lymphocyte counts and the induration size of the tuberculin skin test in these groups. DESIGN: A group of 435 healthy students was tuberculin skin tested in order to evaluate the intensity of skin testing in a 'normal' population. The study group consisted of 195 subjects with or without tuberculosis, and with or without HIV-1 infection, who received a tuberculin skin test and a CD4 T lymphocyte count on the same day. RESULTS: In total, 90% of the control (nontuberculous, HIV negative) subjects, 32% of the HIV-1 seropositive subjects, 76.5% of the tuberculous patients and 57% of the tuberculous HIV-1 seropositive patients were tuberculin positive. There was no direct correlation between the induration size of reactions to the tuberculin skin test and CD4 T-lymphocyte count in these study groups using linear regression analysis. CONCLUSION: In vivo skin testing using tuberculin yields clinically significant information on the degree of immunodeficiency which is different from that of CD4 T-lymphocyte counts. The tuberculin skin test should therefore be used as an independent marker of the weakened immunological status of HIV-1 seropositive subjects.

AIDS-Related Opportunistic Infections↗

Caroli's syndrome.

We report the case of a two-year-old girl presenting with recurrent episodes of fever and hepatomegaly. High resolution ultrasound (US) and computed tomography (CT) of the liver show dilated intrahepatic bile ducts with bridge formation and intraluminal protrusions. The extrahepatic bile duct is normal. The diagnosis of irregular dilated bile ducts with signs of cholangitis and cholangiolitis is proved by liver biopsy. The histologically associated congenital liver fibrosis in our patient enter into the Caroli's syndrome. We illustrate the high resolution US and the CT findings in this case.

Bile Ducts, Intrahepatic↗

Functional magnetic resonance imaging (fMRI) visualises the brain at work.

Functional Magnetic Resonance Imaging (fMRI) is a recent MRI technique capable of visualising neuronal activity in humans in a non-invase way. The technique visualises the physiological changes in oxy- and deoxyhemoglobin concentration changes in small cortical blood vessels upon neuronal activation without the need for radiation or the administration of contrast media or radioactive tracers. The spatial accuracy of the technique is of the order of millimeters and the temporal resolution of the order of one second. The concept has captured the interest of neuroradiologists as well as neuroscientists, who now have a means to visualise their theories in human volunteers. In the clinical environment the non-invasive studies should aid neurosurgeons in adopting a safe course into the brain and assist neurologists in unraveling neurological hypotheses. This report describes the technical principals of fMRI and presents some of our clinical results on the mapping of several cortical functions, such as motor, auditory and language functions, in a large group of patients.

Brain↗

[Ataxic hemiparesis with cerebellar dysarthria due to an opercular lesion].

A 63 year-old-man, with an opercular infarct had a motor deficit with ataxic hemiparesis and cerebellar dysarthria. The motor deficit disappeared, but the cerebellar signs remained after three months. A voice instrumental analysis confirmed the cerebellar pattern of the dysarthria. CT and MRI showed the opercular lesion and the normality of the cerebellum and the pons. A volumic MRI analysis precised the localisation and the volume of the lesion. The oxygen consumption (CMRO2) was measured with PET and showed no cerebellar diaschisis. We propose that, in this case, the cerebellar dysarthria is the orofacial ataxic component of the hemiparesis. We suggest that it is related to disruption of the cortico-cerebellar tract, connecting the right orofacial frontal area of the primary motor cortex with the paravermal segment of the left cerebellar hemisphere.

Ataxia↗

Arterial bleeding after biliary drainage catheter placement: diagnosis and treatment.

A case of hepatic arterial haemorrhage after percutaneous biliary drainage catheter placement is presented. Temporary control of the haemorrhage was obtained by placement of a larger drainage catheter which tamponaded the bleeding artery. Hepatic angiography followed by transcatheter embolotherapy provided a definitive control of bleeding.

Aged↗

Osler-Rendu-Weber with liver involvement.

Osler-Rendu-Weber disease, or hereditary hemorrhagic telangiectasia, is a vascular disease with autosomal dominant transmission. The liver is involved in 31% of patients with hereditary hemorrhagic telangiectasia (1). It appears that the lesions uncommonly causes serious disease. We report the imaging findings and the therapy in a case with extensive telangiectasis in the liver.

Aged↗

Computed tomography of laryngeal carcinoma: technique, imaging findings and implications for radiation therapy.

Optimal radiological visualisation of laryngeal carcinoma demands for a tailored imaging technique. The technique for computed tomography of the larynx is reviewed, and imaging findings in laryngeal carcinoma are described. The application of CT-findings for selection of patients into the favourable group for radiation therapy is discussed. The use of CT in the follow-up of irradiated laryngeal carcinoma is reviewed.

Carcinoma, Squamous Cell↗

Ex vivo experiment on radiofrequency liver ablation with saline infusion through a screw-tip cannulated electrode.

PURPOSE: To investigate whether radiofrequency (RF) therapy with hypertonic saline infusion through a hollow screw-tip electrode can cause a lesion size suitable for liver tumor ablation. MATERIALS AND METHODS: RF tissue ablation of 180 sites was performed by using a hollow screw-tip electrode in 40 freshly excised swine livers. Under both power and temperature control modes, the ablation effects with and without various regimes of 5% hypertonic saline (1 ml/min) prior to and/or during the procedure were compared by measuring the size of lesions at dissection and confirmed by T1 and T2 weighted magnetic resonance (MR) imaging. RESULTS: The maximal lesion diameter of 5.5 cm was reached at 30 W with saline infusion 1 min prior to and during 12 min of ablation. The smaller sizes (P < 0.01) between 0.3 and 2.5 cm in diameter were met with noninfusion or preinfusion-only groups. The RF ablation lesions appeared as hyper- and hypointense areas on T1 and T2 MR images, respectively. CONCLUSIONS: RF ablation in combination with present hollow screw-tip electrode and saline infusion allows for necrotic development of suitable size for liver tumor ablation. Such ablated lesions can be visualized with MR imaging.

Animals↗

Introduction

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Journal Article↗

High sensitivity of transgenic mice expressing soluble TNFR1 fusion protein to mycobacterial infections: synergistic action of TNF and IFN-gamma in the differentiation of protective granulomas.

To investigate the role of tumor necrosis factor (TNF) in protective immune responses to Mycobacterium tuberculosis and M. bovis Bacillus Calmette Guérin (BCG), we have used transgenic mice unable to use TNF because of the expression of high amounts of a soluble TNF receptor (R) type I (sTNFR1) fusion protein, and studied resistance of these mice to infection by lethality assays, evaluation of bacterial recovery and histologic examination. These mice showed a strongly increased sensitivity to M. tuberculosis and BCG infections, with bacterial overgrowth and marked inhibition of macrophage differentiation within granulomas; after M. tuberculosis infection, this resulted in extensive lesions of caseous necrosis in the lung. To explore the respective roles of TNF and interferon (IFN)-gamma in resistance to BCG and granuloma differentiation, controls and sTNFR1-transgenic mice were compared to IFN-gammaR mutant mice and mice double defective in TNF and IFN-gamma activity (obtained by crossing transgenic and mutant mice). The three groups of deficient mice showed a strongly enhanced susceptibility to BCG infection, with the following decreasing order of sensitivity between groups: TNF + IFN-gamma --> TNF --> IFN-gamma-deficient mice. The hepatic granulomas of IFN-gammaR mutant mice were small and contained eosinophils but few differentiated macrophages; compared to those of sTNFR1-transgenic mice, acid-fast bacilli were less numerous within the macrophages. Granulomas of double-deficient mice were strikingly different by their very large size and cellular content, made up large numbers of polymorphonuclears, eosinophils, and cells undergoing apoptosis, but without detectable differentiated macrophages; acid-fast bacilli were spread in the lesions. These studies show the essential role of both TNF and IFN-gamma in the development, during mycobacterial infections, of protective granulomas containing highly differentiated macrophages capable of destroying ingested bacteria, and emphasize that these two cytokines act synergistically in granuloma formation.

Animals↗

FMRI studies of the supplementary motor area and the premotor cortex.

Brain activation patterns associated with three motor tasks, differing in the mode of movement selection, were studied in seven right-handed subjects, using functional magnetic resonance imaging (fMRI). The tasks consisted of sequences of finger movements in which the next finger was selected (i) according to a fixed sequence (FIX), (ii) in response to an external sensory cue (RAND), or (iii) on the basis of free, internal selection (SELF). Periods of hand relaxation (REST) alternating with the tasks served as a control. Functional maps resulting from comparison of the motor tasks with REST reveal activation in primary sensorimotor cortex, medial and lateral premotor areas, cingulate cortex, and parietal cortex. The task activation level, defined as the percentage MR signal increase for each task relative to REST, and the differential activation, defined as the percentage MR signal increase for RAND and SELF relative to FIX, were calculated in each area. All areas showed a higher activation level for RAND and SELF than for FIX. A significant difference in activation level or differential activation between SELF and RAND was found in the posterior part of the superior frontal sulcus, in a part of the premotor cortex on the lateral brain surface, in the anterior cingulate motor cortex, and in the posterior part of the superior parietal cortex. The high-resolution and single-subject approach, provided by fMRI, allowed the distinguishing of multiple foci in medial frontal areas, premotor cortex, and parietal cortex, reflecting the functional heterogeneity of these areas suggested by previous studies.

Adult↗