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Biomedical subjects

J F Viallet

Publications and source records attributed to J F Viallet.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Ultrasonography and tomodensitometry staging of kidney tumors: anatomo-radiologic correlations in 46 patients].

OBJECTIVE: To comparatively evaluate CT scan and MRI in the preoperative staging of renal tumours. METHODS: 46 patients with a solid renal tumour were investigated preoperatively by CT scan (n = 43) and MRI (n = 46), the results of which were compared with pathological data. RESULTS: MRI assessed capsular effraction with a sensitivity of 95.6% and a specificity of 52.1%, versus 95.2 and 40%, respectively, for CT scan. Three cases of perirenal extension were detected by MRI. The sensitivity of MRI was higher than that of CT scan for the demonstration of adenopathy (71.4% versus 57.1%) with specificities of 92.3 and 88.8%, respectively. Fourteen cases were associated with tumour extension into the proximal renal vein, which extended into the distal segment of this vein in 12 cases, into the inferior vena cava in 6 cases and as far as the right atrium in 2 cases. The performance of MRI was always better than that of CT scan in relation to venous segments of surgical interest (respective sensitivities of 70% and 83.33% in the distal renal vein and 66.6% and 83.33% in the inferior vena cava: and respective specificities of 84.8% and 97% in the distal renal vein and 91.8% and 97.5% in the inferior vena cava), provided the results of T1-weighted spin echo sequences and FLASH gradient echo sequences were assessed conjointly. CONCLUSION: These results lead us to now prefer MRI to CT scan for the preoperative staging of renal cancer, in the presence of a contraindication to iodinated contrast agent injection, very large tumours, and whenever venous extension is suspected on ultrasonography.

Adult↗
PubMed1994

[Percutaneous transluminal angioplasty of subclavian, axillary and brachiocephalic trunk arteries. Apropos of 18 patients].

The authors report the immediate and mid term results of percutaneous transluminal angioplasty of stenosis of the subclavian (16 cases), brachiocephalic (1 case) and axillary arteries (1 case) in a series of 18 patients. These lesions were responsible for isolated ischaemia of the arm in 6 cases, vertebrobasilar insufficiency in 6 cases and an association of the two presentations in 2 cases; in 4 asymptomatic patients, the procedure was undertaken to maintain cerebral perfusion. A technical success was obtained in all cases, with one femoral haematoma and one episode of transient visual disturbance, which were spontaneously regressive, as the only complications. The good results were sustained clinically at the end of follow-up (4 to 40 months, average 17.7 months) in 13 of the 14 patients who were followed up. The symptoms recurred after 26 months in the final case which led to the diagnosis of restenosis which was successfully redilated.

Aged↗
PubMed1994

[Role of transrectal echography in the evaluation of male infertility. Apropos of 91 studies].

Ninety-one infertile men with oligospermia and normal FSH serum level have been explored by transrectal ultrasound, biochemical sperm study and spermoculture. Ultrasound data concerning ejaculatory ducts, seminal vesicles and prostate distinguished images evocative of constitutive abnormalities (18 patients, whom sperm fructosis level was low in only one among 12) and images evocative of inflammatory processes (44 patients, whom limited correlations with biological datas were found). Transrectal ultrasound appears as a complement of biological data in infertile man evaluation, offering a better approach of vesiculo-deferentography's indication.

Adult↗
PubMed1993

[Pattern of blood creatinine levels in 140 hypertensive patients after successful percutaneous transluminal angioplasty for renal artery stenosis].

Long term effects on creatinine serum level of successful percutaneous transluminal renal angioplasty were retrospectively studied in 140 patients. 3 groups were distinguished: the first one (80 patients) included unilateral renal angioplasties, with normal contralateral kidney and renal artery; the second group (35 patients) included bilateral renal angioplasties; the third group (25 patients) included solitary kidney renal artery angioplasties. In each group, subgroups were defined whether creatinine serum level was upper or lower than 130 mumol/l. Renal function was considered to be improved if serum creatinine was reduced by 20% or more, maintained if serum creatinine variations were below 20%, worsened if its increase was upper than 20%. Global complication rate was 4.9% (9 between 185 patients) of whom 1 (0.54%) needed a surgical revascularization. At the end of follow-up (mean between 4 and 10 months), subgroups improvement and stabilization rates varied between 67 and 100%, with the best scores in the second group (96.2 and 100%) and solitary kidney with renal insufficiency subgroup (77.25%).

Angioplasty, Balloon↗
PubMed1991

[Revascularization of occluded renal arteries. A case].

After recent treatment with an angiotensin converting enzyme inhibitor, a 62-year old woman with diabetes, hyperlipidemia and hypertension was admitted for oliguric acute renal failure due to bilateral renal artery lesions (right stenosis and left thrombosis). Hemodialysis was instituted. Percutaneous transluminal angioplasty (PTA) of the right renal artery did not improve the patient's condition, whereas left renal PTA, three weeks after admission, restored diuresis and renal function, allowing hemodialysis to be discontinued. This case underlines the capacity of functional recovery after late recanalization of a totally occluded renal artery. The best outcome predictor is the development of a collateral circulation and the visualization of distal renal arteries at arteriography. The kidney can be recanalized by surgery or PTA.

Angioplasty, Balloon↗
PubMed1991

[Percutaneous recanalization of renal arterial occlusion. Apropos of a case].

Percutaneous recanalization of a left occluded renal artery has been performed 10 days after percutaneous transluminal angioplasty of a controlateral renal stenosis. Improvement of the renal function is keeping normal 8 months after, although hypertension control is not very well. 26 case-reports have been found. These preliminary results are encouraging and suggest that this technique should be used against severe hypertension, especially if the kidney is functionnaly solitary, to avoid dialysis in patients with increased operative risk.

Acute Kidney Injury↗
PubMed1991

[Study of the supra-aortic trunks using the humeral Seldinger technique and digitalized angiography of the aortic arch. Apropos of 175 cases].

Screening of cerebrovascular disease by transbranchial arch injection. One hundred and seventy five patients underwent non selective intra arterial digital subtraction angiography using a transbranchial approach. Unilateral failure occurred in eight patients, but contralateral approach was then possible. Transient cerebral ischaemia affected one patient. Seven locoregional complications occurred, five of them underwent among the seventy three first procedures. Experience of the examining radiologist, duration of procedure and diameter of the catheter (4 or 5 F) are essential safety factors. Three false-negative and one false-positive in carotid bifurcations appears with surgical results reviews. This safe and efficient technique is often sufficient for a therapeutic decision, especially for surgery, but, in a few cases, additional selective injections can be necessary. Possible in out patients, this approach is chosen when femoral artery catheterization is impossible, or before reconstructive aorto-ilio-femoral surgery, to decrease septic risk.

Adult↗
PubMed1990

[Arteriovenous fistula of the renal pedicle following nephrectomy responsible for heart failure. Report of 2 cases].

The authors report two cases of acquired post-nephrectomy arteriovenous fistula. The large shunt was responsible for cardiac failure. The first case was treated by percutaneous embolisation and the second by reoperation. The clinical results were excellent. These two cases illustrate the value of different imaging techniques and therapeutic approaches: direct surgery or embolisation.

Arteriovenous Fistula↗
PubMed1988

[Natural history of arterial hypertension due to primary hyperreninism].

This case report deals with an eight-year duration severe high renin hypertension and its consequences. In 1975, a 13 years old girl was found to have blood pressure (BP) levels of 240/150 mmHg with bilateral papilloedema. Hypokalemic alkalosis, a 45 mm Sokolow index (SI) and very high peripheral renin activity (PRA) were also noticed. Renal vein renin sampling (RVRS) suggested secretion from the left kidney but intravenous pyelography and renal arteriography were normal. BP levels were first controlled by triple treatment but rose one year later, despite adjunction of beta-blockers. High PRA was again found, but without hormonal gradient on a second RVRS. From 1977 to 1982, BP never fell to normal levels despite quadruple treatment. In 1982, a stage II optic fundus, a 58 mm SI and 2 g/day proteinuria are noticed, so that a new complete etiologic work up is undertaken in 1983: PRA is still high, with a dramatic acute BP fall after captopril and no gradient on a third RVRS, but intravenous pyelography, tomodensitometry and selective arteriography disclose a 4 cm diameter poorly vascularized tumour on the surface of the lower pole of the right kidney. BP levels are controlled for three months by captopril + chlorothiazide. The tumour is removed in january 1984. RVRS by direct peroperative punction indicates (a posteriori) hormonal secretion from the right kidney lower pole. Histologic examination and immunofluorescence with antirenin serum corroborate the juxtaglomerular origin of the tumour. Eighteen months later, BP is permanently normal, SI is 30 mm, and there is no proteinuria.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Contribution of radiological technics to the study of the mandibular canal. Application to human fossils and comparison with modern man and Pongidae].

Fossil mandibles from the "La Chapelle-aux-Saints" Man and Cro-Magnon "old man" are considered to be representative of Neanderthal and Cro-Magnon era. Radiographic studies of such mandibles - including C. T. Scan and panoramic views in common use in maxillofacial surgery - allowed the authors to make useful comments: the mandibular canals are nearly similar to those in Modern Man and quite different from those in Pongidae; the imaging was of adequate quality for a good evaluation of fossil internal structures.

Animals↗
PubMed1982

[True orientation of the acetabulum as determined by CAT scan. Preliminary results (author's transl)].

Valid clinical correlations with biomechanical data require three-dimensional visualization of a joint, in order to determine the true spatial configuration of the various segments of the part studied. The CAT scan has opened a new pathway in this direction, as it supplies precise mathematical information on the segments explored. An original analytical programme was employed in humans to establish the true spatial orientation of the acetabular cavity. The validity of the method was confirmed by comparing results in 31 subjects with the rare cases where such measurements were made, reported in the published literature. The method could be extended to other body regions.

Acetabulum↗