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Biomedical subjects

H Sevestre

Publications and source records attributed to H Sevestre.

90 records · Page 5Linked to original sources
PubMed1986

[Ocular bobbing. A new hypothesis].

Three of 4 patients with ocular bobbing were typical cases while in the last case the ocular disorder was asymmetric. A neuropathologic study was conducted in 2 cases. In both use, findings included variable degrees of pontine destruction without lesion of the medulla, with extension of the lesion into the mesencephalon in 1 case. The various physiopathogenic hypotheses put forward are reviewed but none appears satisfactory. A new hypothesis is proposed, based on available clinico-pathologic data (35 published and 2 personal cases) and recent experimental studies. Two centers, one mesencephalic, the other in the medulla, could exist that would generate saccadic movements downwards, and in the pons a center would provoke inhibition of saccadic movements. Destruction of the latter could activate spontaneous saccadic movements downwards (the only possible ones remaining) with the condition that the mesencephalic generating center and its pathways are intact.

Aged↗
PubMed1985

[Neuropathy and cerebellar syndrome induced by amiodarone].

A 62 year old man developed a neuropathy after several months of treatment with amiodarone. The clinical picture was atypical in that it associated a polyradiculoneuritis with cell-protein dissociation and an axial and peripheral cerebellar syndrome. Pathology of muscle and nerve showed dense inclusions in Schwann cell cytoplasm and in pericytes, highly suggestive of fat inclusions. Discontinuation of amiodarone therapy resulted in a slow regression of disorders. Diabetes mellitus developed. Several pathogenic hypotheses are proposed.

Amiodarone↗
PubMed1983

[Painful sciatic rubbing caused by benign synovioma of the spinal joints. Apropos of 4 cases].

Synovioma, a benign neoplasm arising from pigmented villonodular synovium or synovitis, is uncommon. It involves the tendons and joints of the finger, ankle and foot. In this study four cases of villonodular synovioma of spinal joints are reported. The authors studied 555 cases of patients operated for sciatica due to herniated disk. Histopathology showed that in four out of 555 cases sciatica was found to be due to synoviomas of the spinal joints. The patients, three women and one man, were between 54 and 70 years of age and each had had a long history of low back pain with episodes of sciatica. Clinical evaluation at the time of surgery showed moderate severity of signs and symptoms. Roentgenographic studies of all four cases revealed osteoarthritic changes of vertebral apophyses, with two cases of spondylolisthesis. The pathogenesis of synovioma remains controversial and its histopathological characterization -hyperplasia VS/true tumours- has not yet been determined. It is possible that the number of recorded cases of sciatica due to synoviomas is small because surgical and pathological studies in patients with sciatica associated with osteoarthritic changes have not been adequately performed. Surgery consists of a large resection of the capsule and ligament including resection of intraspinal extension. Because this study involves only four cases, the first of which occurred in 1977, the possibility of recurrence cannot be evaluated.

Aged↗
PubMedDate not supplied

[Genital sites of giant-cell arteritis].

Temporal arteritis is one of the localisation of the giant cell arteritis. The involvement of the female genital tract had been rarely reported with only 16 cases in the literature. We report 3 cases revealed by a tumor of the genital tract. Histologic features are found in the vessels of ovaries, fallopian tubes and myometrium. Only one patient had symptoms suggestive of temporal arteritis.

Aged↗
PubMedDate not supplied

[Pulmonary metastasis of meningioma of the falx cerebri].

We report the case of a woman who had been operated upon for a recurrent meningioma of the falx cerebri which, 22 years after it was discovered, produced pulmonary metastases. Metastases from meningiomas are extremely rare; they affect the lungs in 60% of the cases or, less frequently, the liver or lymph nodes. The factors predictive of secondary dissemination are the site of the tumour, the quality of excision, the histological type (haemangiopericytic meningioma) and the presence of cell necrosis, hypercellularity and strong mitotic activity.

Adult↗
PubMedDate not supplied

Formation and reactivity of alternative quinone methides from butylated hydroxytoluene: possible explanation for species-specific pneumotoxicity.

Previous work has shown that butylated hydroxytoluene [2,6-di-tert-butyl-4-methylphenol (BHT)] undergoes pi-oxidation in liver microsomes to form the quinone methide 2,6-di-tert-butyl-4-methylene-2,5-cyclohexadienone (QM). This electrophilic species binds covalently to glutathione and protein thiols and is believed to initiate pulmonary toxicity in mice. In the present investigation, we identified another quinone methide metabolite of BHT, 6-tert-butyl-2-(hydroxy-tert-butyl)-4-methylene-2,5-cyclohexadienone (QM-OH), formed subsequent to the microsomal hydroxylation of BHT at a tert-butyl group. Mouse liver and lung microsomes generate the two quinone methides, and evidence was obtained that both metabolites also are formed in vivo. In contrast, rat microsomes produce QM almost exclusively, with only traces of QM-OH formed in liver and none in lung. Studies of the chemical reactivities of the two quinone methides with GSH demonstrated that QM-OH reacts about 6-fold faster than QM. Infrared spectra, 1H NMR spectra, and electrochemical measurements all support the proposal that the enhanced electrophilicity of QM-OH is due to intramolecular hydrogen bonding of the ring oxygen with the side-chain hydroxyl. The results provide evidence, therefore, that the previous metabolic scheme for bioactivation of BHT to a pulmonary toxin should be amended to include tert-butyl hydroxylation and subsequent pi-oxidation to the activated electrophile QM-OH. This scheme is consistent with published data concerning BHT-induced pulmonary toxicity and provides an explanation for the species specificity of this effect.

Animals↗
PubMedDate not supplied

MR imaging of CNS relapse of Whipple disease.

We report a case of late CNS relapse of Whipple disease without articular or digestive signs. Magnetic resonance (MR) imaging of the brain clearly showed the disappearance of the normal low intensity signal of the aqueduct of Sylvius and the presence of high intensity signals in the frontal white matter and in the caudate nucleus. This case suggests that MR imaging of the brain is the procedure of choice for identifying cerebral involvement in Whipple disease.

Adult↗
PubMedDate not supplied

Hepatic oil embolism following lymphography: CT diagnosis.

Hepatic oil embolism following lymphography is reported in a 68-year-old man admitted for chylous ascites associated with recurrent prostatic carcinoma. Abdominal plain radiography, CT, and ultimately liver biopsy strongly support a direct lymphatic pathway and are against the role of lymphaticovenous anastomoses generally advocated to explain this phenomenon.

Aged↗
PubMedDate not supplied

[Heart volume overload in the rabbit during growth via chronic arteriovenous fistula. Evaluation of an original model].

A heart volume overload model was developed in male New Zealand rabbit nine weeks old, using femorofemoral or jugulo-carotid fistulae, producing 50% increase of the mean cardiac output. An evaluation was performed after 2 and 11 weeks. It was evaluated by dimensional echocardiogram and doppler system flow measurement at the aorta ring, angiography and right cardiac pressure recording. This hemodynamic analysis was completed by a heart and fistulae histopathological study. In some volume overload cases, an increasing volume index parameter was described. Two weeks later an increase of the cardiac frequency and a dilatation of the aorta ring were observed but the stroke volume remained unchanged. 11 old weeks fistula animals presented similar frequency and stroke volume. So, the heart compensatory mechanisms varied with the age of the rabbit. The right catheter and cardiac angiography were not useful for ventricular volume overload estimation. Histopathological study showed parenchymal changes and alveolo capillary congestion. An increase of the heart weight/body weight ratio was described. When analysed by ultrasound and blood flow measurement, data were similar to those obtained by invasive pressure recordings or by dilution system. An experimental model of overload volume in rabbit with non invasive recording methods (bidimensional ultrasound and doppler system) can be proposed.

Aging↗
PubMedDate not supplied

[Non-discal sciatica secondary to a cystic lesion of the posterior longitudinal ligament. 10 cases].

Cyst of the longitudinal posterior ligament of the spine is a new entity described here on the basis of 10 cases. This is a lesion, perhaps of traumatic origin, which occurs in young, athletic subjects suffering from classical lumbosciatica. Computerized tomography showed an image resembling nucleus pulposus herniation. In one of our cases magnetic resonance imaging provided the preoperative diagnosis. Following surgery the outcome was favourable, with less postoperative complications than with discal herniation. The macroscopic and histological findings were the same in all cases, making the anatomico-pathological diagnosis easy.

Adult↗
PubMedDate not supplied

[Puncture of solid tumors of the liver with large caliber needle guided by ultrasonography. Study of 70 punctures].

Seventy specimens of solid hepatic tumors were obtained for histologic examination with a 18 G (1.2 mm) diameter needle under real-time ultrasound control. Overall sensitivity was 95.6 p. 100 while specificity was 100 p. 100. Distinction between primitive and secondary malignant tumor was possible in 91 p. 100 of cases. Transient hemorrhage at the puncture site occurred in one patient. These results attest to the superiority of guided puncture with a needle of sufficient caliber, thus allowing for correct histologic study. Side effects did not occur more frequently than with fine caliber needles.

Adult↗
PubMedDate not supplied

[Portal thrombosis and liver cirrhosis. Value of ultrasound-guided puncture-biopsy of the thrombus].

OBJECTIVES AND METHODS: Portal vein thrombosis which occurs in the course of cirrhosis, associated or not with hepatocellular carcinoma, can be either cruoric or neoplastic. The aim of this study was to assess the feasibility and the results of ultrasound guided biopsy of portal vein thrombosis in 21 patients with cirrhosis (20 men and 1 woman; mean age 66 +/- 9 years), who were hospitalized between May 1989 and November 1993. Ultrasound guided biopsies of the cirrhotic liver, of the portal vein thrombosis and, when present, of a hepatic nodular lesion were performed. The diagnosis of hepatocellular carcinoma was made if the histological examination of the hepatic and portal biopsy samples were positive or if serum concentrations of alpha-fetoprotein were higher than 500 IU/mL. RESULTS: All portal vein thrombosis biopsies were successfully performed. No side-effects were observed. Before ultrasound guided biopsy of the portal thrombosis, diagnosis of hepatocellular carcinoma was made in 15 cases, and diagnosis of cirrhosis in 6 cases. After histological examination of the portal sample, hepatocellular carcinoma was diagnosed in 19 cases and cirrhosis in 2 cases. Thus, in 19% of cases, ultrasound guided biopsy of the portal thrombus provided a definitive diagnosis. CONCLUSION: Ultrasound guided biopsy of the portal vein thrombosis must be performed before liver transplantation for cirrhosis or hepatocellular carcinoma to exclude the presence of a vascular neoplastic extension.

Adult↗
PubMedDate not supplied

[Respective roles of thecal and granulosa cells in the morphogenesis of the corpus luteum].

Studies on human ovary embryogenesis and adult post-ovulatory surgically resected ovaries allowed the authors to propose a new conception on the genesis of corpus luteum: large luteal cells would be derived from theca interna cells and small luteal cells would come from externa theca cells. So there would be a structural unity of luteal tissue which might explain steroidogenesis potential of these two types of cells, derived both from the same ovarian stroma. On the other hand if granulosa cells played an important function in bio-conversion of androgens to oestradiol by aromatase activity before ovulation, their role is over after the expulsion of the oocyte out of the follicle; derived from primitive sex cords of coelomic mesothelium origin, granulosa cells act to support and surround the oocyte; they disappeared at the disappearance of the oocyte from the follicle.

Corpus Luteum↗
PubMedDate not supplied

[Ultrasound-guided puncture-biopsy of the liver could replace blind puncture-biopsy in diffuse hepatopathies. Retrospective study of 1293 patients].

OBJECTIVES: The aim of this retrospective study was to compare the efficiency and complications of percutaneous hepatic biopsy either guided by ultrasonography in the left lobe, or blindly by the intercostal route in the right lobe, in the diagnosis of diffuse liver diseases. PATIENTS AND METHODS: Liver biopsy was performed in 1,293 patients for 5 years. In group 1 (289 patients, including 140 out-patients), liver biopsy was guided by ultrasound. In group 2, blind intercostal liver biopsy was performed in 1,004 patients. Patients were observed for 6 hours after biopsy in both groups. RESULTS: The failure rate of liver biopsy was significantly lower in group 1 (1.7%) than in group 2 (9.25%, P < 0.01). The prevalence of the histological lesions was similar in both groups. No related-biopsy death occurred. Complications were more serious after blind biopsy (1 acute pancreatitis with a hematoma of the liver, 1 bile leakage around the gallbladder, 1 hemoperitonitis, 1 large intrahepatic hematoma), than after guided biopsy (1 small hematoma of the liver, 1 acute biliary pain on the 10th day). CONCLUSION: Hepatic biopsy guided by ultrasonography could replace blind biopsy in the diagnosis of diffuse liver diseases.

Biopsy, Needle↗