[Radiodiagnosis at the University of California].
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Academic Medical Centers↗
Biomedical subjects
J F Moreau
Publications and source records attributed to J F Moreau.
Macrophage colony-stimulating factor (CSF-1) gene expression in human T-lymphocyte clones.
Macrophage colony stimulating factor (CSF-1) is one of several cytokines that control the differentiation, survival, and proliferation of monocytes and macrophages. A set of 11 human T-cell clones, chosen for their phenotypic diversity, were tested for their ability to express CSF-1 mRNA. After 5 hours of stimulation with phorbol myristate acetate (PMA) + calcium ionophore (Cal), all T-cell clones expressed a major 4-kb transcript, a less abundant 2-kb transcript, and several other minor species. This pattern of expression is typical for CSF-1 mRNAs. Furthermore, of the two alloreactive T-cell clones analyzed, only one showed a definitive message for CSF-1 on specific antigenic stimulation, but with delayed kinetics and less efficiency. Both conditions of stimulation induced the release of CSF-1 protein by T cells in the culture medium. Together, these findings demonstrate for the first time that normal T cells are able to produce CSF-1, previous reports being limited to two cases of tumoral cells of the T-cell lineage.
Antigens↗
Selective venous catheterization in the evaluation of hyperandrogenism.
Retrograde bilateral ovarian-adrenal vein catheterization was carried out in 16 patients with plasma testosterone levels exceeding 1.4 ng/ml (4.85 nmol/l). While pelvic ultrasonography and computerized axial tomographic scan failed to locate the androgen-producing ovarian tumors, catheterization led to a diagnosis of occult ovarian tumor in 5 patients, based on the observation of an abnormally-high and unilateral ovarian-peripheral vein testosterone gradient, which was subsequently confirmed histopathologically. In one case, unilateral elevation of the adrenal-peripheral vein testosterone gradient was found, complementing the ultrasonographic finding of an adrenal mass and confirming the diagnosis of a virilizing adrenal tumor. In the other 10 patients, gradient analysis ruled out an androgen-producing tumor, leading to the identification of nontumoral hyperandrogeny, such as a severe form of the polycystic ovary syndrome in the 6 premenopausal patients and of ovarian stromal and hilus cell hyperplasia in the 4 menopausal patients. In conclusion, appropriate indication of selective catheterization may considerably reduce the need for exploratory surgery and may help in selecting the adequate surgical approach.
Adrenal Gland Neoplasms↗
Iodinated contrast media. Renal pharmacokinetic study by factor analysis dynamic computed tomography in the rabbit.
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Animals↗
Impassable ureteral strictures: management with percutaneous ureteroneocystostomy.
Sixteen of 227 patients referred for percutaneous placement of a ureteral stent had impassable stenoses. Stenoses were benign (n = 8) or attributed to malignant retroperitoneal neoplasm (n = 8). Electrocautery was used to create a neotract between the stenosed ureter and the bladder or ileal loop. A double-J stent was placed after dilation of the tract by use of angioplasty. Neotracts were established and stents were placed in all patients. Complications (digestive tract fistulas) developed in two patients. This technique is safe if the electrode is placed close to the bladder or ileal loop. The procedure can be used as an alternative to surgery or permanent nephrostomy or in initial treatment of benign anastomotic stenosis.
Aged↗
[Color and pulsed Doppler of renal masses. Angiographic and anatomo-pathological correlation].
We report the results of a prospective study about the detection of tumoral neovascularization, the renal vein involvement and the characterization of renal tumors by color and pulsed doppler. Twenty-six renal tumors including 19 renal carcinomas and 7 benign tumors (2 angiomyolipomas, 2 oncocytomas, 2 complex cysts and one adenoma) were prospectively explored. Benign cysts were excluded from the study. The results were correlated to pathologic (24/26) and angiographic datas (24/26). Doppler ultrasonography seems to be an accurate method for the detection of a neovascularization (19 true-positives/19 vascularised tumors, no false-positive) but pulsed doppler (no false-negative) is more sensitive than color doppler imaging (3 false-negatives), the results of color doppler were improved by using a new software for the color detection of very low flow. Spectral analysis found 3 different types of doppler curves inside the masses, but all of them were observed in benign and malignant tumors. We did not find any correlation between the size of the tumor and the peak systolic velocity. The specificity of Doppler regarding the renal vein and inferior vena cava involvement seems to be good (no false-positive). But as, in our series, we do not have any case of main renal vein involvement, the sensitivity of this technique cannot be assessed.
Adult↗
[Spontaneous urine extravasation during intravenous urography. Apropos of 21 cases. Review of the literature].
Twenty one cases of spontaneous urine extravasation during an intravenous urography have been analysed in order to determinate the radiological signs and the causes of this rare phenomenon. Related to the increased pressure of the excretory tract, these extravasations usually disappear without complications. No specific treatment is required except the treatment of the obstacle due generally to calculi. No infection nor development of retroperitoneal fibrosis nor sinusal lipomatosis were observed in the patients we studied.
Adult↗
[Conservative surgery of kidney cancer. Ex vivo surgery with immediate magnetic resonance imaging].
In addition to the technical difficulties arising when the tumor is located in the centre of the kidney, one of the stumbling blocks of conservative partial surgery of the parenchyma is the risk of leaving a second tumoral focus in place. In these cases, we propose an ex vivo operation associated with an intraoperative examination of the isolated kidney with nuclear magnetic resonance.
Anastomosis, Surgical↗
[Spontaneous urine extravasation during intravenous urography. Apropos of 21 cases. Review of the literature].
Twenty one cases of spontaneous urine extravasation during an intravenous urography have been analysed in order to determinate the radiological signs and the causes of this rare phenomenon. Related to the increased pressure of the excretory tract, these extravasations usually disappear without complications. No specific treatment is required except the treatment of the obstacle due generally to calculi. No infection nor development of retroperitoneal fibrosis nor sinusal lipomatosis were observed in the patients we studied.
Adult↗
[Long-term results of angioplasty balloon dilatation of stenosed uretero-digestive anastomoses. Effect of prolonged pattern with large caliber prosthesis].
UNLABELLED: 16 strictured uretero enteric anastomoses were dilated and stented for 4 months with a large size stent (18F in fifteen cases and 14F in one case). All the patients had undergone a radical cystoprostactectomy, had received radiotherapy prior to surgery. The length of the stenosis did not exceed 3 cm in all cases. All the stenoses occurred within 2 years following the removal all of the stent. RESULTS: 6 cases (37%), have a patent anastomosis, 18 to 36 months following removal of the stent. Most of the recurrences occurred within six months following removal of the stent. We recommend a long term stenting with a large size stent to obtain long term patency of dilated anastomotic strictures.
Anastomosis, Surgical↗
[Radioclinical dialogues at the Necker Hospital. Renal tumor syndrome and Bardet-Bield syndrome].
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Adolescent↗
MR imaging of renal transplant rejection.
The results of 62 consecutive MR examinations were correlated with the subsequent clinical course and histologic results. Twenty-six cases of rejection showed a marked diminution of cortico-medullary differentiation (CMD). The renal parenchymal vascular pattern and visibility of renal sinus fat were not markedly altered in rejection and there was no difference between normal and rejected allograft shape. The ability of MR imaging to diagnose renal transplant rejection is only based on CMD, which, however, is non-specific. In 2 cases of severe acute rejection, T2 weighted images showed an abnormal signal intensity of the cortex due to renal infarction. Our preliminary results in 8 patients with Gd-DOTA injection showed 2 cases with necrosis seen as areas with absent contrast enhancement. This technique seems to be promising in the detection of perfusion defects.
Adult↗
[Magnetic resonance imaging and preoperative evaluation of cancer of the kidney. The results apropos of 60 cases].
Sixty renal carcinomas confirmed at surgery or autopsy were studied. Capsular effraction, present in 17 cases, was well assessed in 8 cases, under staged in 8 cases and over staged in 5 cases (sensitivity 47%, specificity 88%). Renal vein involvement was present in 11 cases. In 8 of these 11 cases, a thrombus was present in the inferior vena cava. MRI detected a thrombus in the renal veins in 10/11 cases and in 7/8 cases of caval invasion. The false negative case was due to a huge right upper pole tumor laminating the inferior vena cava. The false positive case was due to an enlarged lymph node compressing the inferior vena cava. Cranial extension of the thrombus was well assessed in 6 of the 7 cases. One thrombus in the right atrium was missed. Lymph node involvement was present in 10 cases and correctly diagnosed by MRI in 7 cases. Three false negative cases were noted, because of microscopic invasion in non enlarged lymph nodes. Adjacent organ invasion, present in 2 cases, was detected in 1 case of liver invasion. Initial results of MRI seem very promising and at present, the best indications of MRI in pre-operative evaluation of a renal carcinoma are assessment of caval extension and spread to adjacent organs in patients with large tumors.
Adult↗
[Use of papillotome for antegrade treatment of ureteral stenoses and uretero-ileal anastomotic strictures under radioscopic control. Experimental study in dogs and clinical application].
A new technique of electro-incision of ureteral stenoses and strictured uretero-enteric anastomoses is presented. Incision is performed with a papillotome, routinely used to achieve endoscopic retrograde sphincterotomy of the duodenal papilla. Group I: 7 ureteral stenoses were performed, on a dog model after surgical ligation of the lumbar ureter. Ten days later, through a percutaneous approach, the papillotome was placed through the stenosis, deflected, and cutting current was applied to incise the stenosis. The IVP performed one month later showed disappearance of the stenosis in 4 cases, a residual stenosis without obstacle in 2 cases and a residual stenosis with obstacle in one case. Group II: 7 strictured uretero-enteric anastomoses on 6 patients. After placement of a percutaneous nephrostomy, a wire guided papillotome was placed into the stenosis. Cutting current was then applied to cut the stenosis. A 18 F ureteral stent was subsequently placed for 8 weeks. Two patients have a patent anastomosis, 7 and 10 months after removal of the stent. One patient died from metastases of bladder tumor. The three remaining patients are still stented. An urinoma occurred in one patient the day following removal of the stent, and was surgically drained. This new technique which combines electro-incision and stenting with a large caliber stent may be proposed as an alternative to surgery or balloon dilatation for the treatment of strictured uretero-digestive anastomoses.
Anastomosis, Surgical↗
Production of human interleukin for DA cells (HILDA)/leukemia inhibitory factor (LIF) by activated monocytes.
We demonstrate mRNA accumulation and production of HILDA/LIF by human activated Mo, monocyte-derived macrophages and myelomonocytic cell lines. Among the various stimuli tested, the synergistic combination of phorbol diester and VD3 was the most potent inducer of HILDA/LIF gene expression. The kinetics of mRNA accumulation on activated Mo showed a stimulation peak at 24 hr which declined thereafter. HILDA/LIF activity in culture supernatants was detected at 24 hr and reached a plateau at 72 hr of culture. In contrast to Mo, PBL did not accumulate HILDA/LIF mRNA upon culture with PDBu and VD3, whereas PHA and the combination of PDBu and A23187 induced HILDA/LIF mRNA accumulation and secretion in the culture supernatant. To exclude the possibility that HILDA/LIF was produced by contaminating PBL, highly enriched Mo preparations were used, which were devoid of T cells as assessed by the absence of TCR-beta chain mRNA transcripts. HILDA/LIF production by monocytic cells was further documented by the capacity of stimulated U937 cell conditioned medium to compete with 125I-labeled nHILDA/LIF for binding to its receptor on murine M1 cells. Under the synergistic effect of PDBu and VD3 stimulation, Mo-derived macrophages as well as HL-60 and U937 cell lines accumulated HILDA/LIF mRNA and produced this cytokine with identical kinetics as for Mo. Finally, we show that HILDA/LIF mRNA accumulation in U937 cells upon stimulation with PDBu, or the combination of PDBu and VD3, was inhibited in the presence of the protein synthesis inhibitor CHX. These results document for the first time that human Mo, when stimulated appropriately in vitro, can express the HILDA/LIF gene and its product, and that intermediate proteins must be newly synthesized in this process.
Cell Differentiation↗
Pseudotumor of the craniocervical junction during long-term hemodialysis.
A systematic study of the upper cervical spine was performed using magnetic resonance imaging in 25 patients (15 men and 10 women) who had been undergoing hemodialysis for more than 10 years. Seven pseudotumors of the periodontoid soft tissue were disclosed, which were similar to the pannus recently described in rheumatoid arthritis. Bone cystic radiolucencies were observed in association with these pseudotumors in 5 patients. The radiolucencies were located in the atlas (1 in the lateral mass and 1 in the anterior branch) and in the axis (3 in the odontoid process and 1 in the vertebral body). No horizontal or vertical atlantoaxial subluxation was demonstrated. These features were observed only in patients who had amyloid arthropathy. They could be a frequent, yet thus far little-recognized, feature of beta 2-microglobulin amyloidosis.
Adolescent↗
Immune repertoire of graft-invading T cells.
The immune repertoire of T lymphocytes invading human allografts is of fundamental importance both at the operational level, in order to achieve relevant matching, and at the functional level, since the unique capacity of T and B cells to specifically recognize allogeneic components restricts the origin of the signals leading to rejection by these cells. In this paper, the authors review their own work, as well as other contributions in this domain, with special reference to the frequency and function of donor-committed cells among the infiltrate and the relationship between T-cell receptor gene rearrangements and repertoire.
Clone Cells↗
Characterization of skin-infiltrating T lymphocytes during acute graft-versus-host disease.
A panel of 34 clones was established from a cell line derived from the skin biopsy of a patient (genotype: A1, A2, B7, B8, DR3, DR6) undergoing acute graft-versus-host disease after semiallogeneic bone marrow transplantation with his mother's bone marrow (genotype: A1, A1, B7, B8, DR3, DR6). The T-cell line obtained presented the following phenotype: CD3+, CD4+, CD8-, CD16-, WT31+, T-cell receptor delta 1-, 4B4+, 2H4-, CD25+, DR+. This CD4+ T-cell line was poorly cytotoxic against the target cells tested, including the mother's phytohemagglutinin blasts as a negative control (autologous T cells), the father's phytohemagglutinin blasts bearing the mismatch haplotype, K562, U937, SVK14 (a keratinocyte cell line), and a panel of B-lymphoblastoid cell lines bearing HLA-A2, the known mismatch antigen. All but 1 of the 34 clones obtained were of CD4+ phenotype, and none was CD16+. Only the sole CD8+ clone showed significant cytotoxicity against the father's phytohemagglutinin blast; however, this cytotoxic activity was associated with the highest score for nonspecific killing against both K562 and U937. This work demonstrates the feasibility of obtaining a large panel of clones from a graft-versus-host disease target organ to constitute the basic cellular material for in vitro study of the graft-versus-host process.
Acute Disease↗