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Biomedical subjects

J Roland

Publications and source records attributed to J Roland.

At least 91 records · Page 5Linked to original sources
PubMed1990

Long term hemodialysis spondylarthropathy: an atlanto-occipital location.

A 41 years old patient on hemodialysis for 17 years with a clinical and radiological picture of osteoarticular beta 2 microglobulin amyloidosis, is presented. The patient had skeletal involvements, included cystic lesions of the left hip and both humeral heads and a C5/C6 spondylarthropathy. She had also associated carpal tunnel syndrome. Radiological exploration of the atlanto-occipital articulation demonstrated destructive changes. Histology documented osseous and periarticular deposition of beta 2 microglobulin derived amyloid. This is an unusual location of destructive spondylarthropathy in a patient on chronic hemodialysis.

Adult↗
PubMed1990

A porcelain gallbladder affecting the assessment of bone mineral content.

Dual-photon absorptiometry is a reliable method for the assessment of bone mineral content (BMC). The presence of focal bone disease, degenerative joint disease, or aortic calcifications may complicate the evaluation of BMC and may lead to erroneous findings. The misleading effect of a porcelain gallbladder is described.

Absorptiometry, Photon↗
PubMed1990

[Report of a case of malignant vesical pheochromocytoma. Diagnosis and therapy].

Bladder pheochromocytoma is a rare, usually benign bladder tumor. An exceptionally malignant bladder pheochromocytoma is reported with more than 5 years follow-up. The study of our case, and the review of 15 other cases reported in the literature show that surgery is the only effective therapy. Partial cystectomy with regional lymphadenectomy, when feasible is the treatment of choice. Because metastatic occurrence may be late, we emphasize the importance of long term follow-up.

Adrenal Gland Neoplasms↗
PubMed1990

Dural fistulae of the tentorium cerebelli. Radioanatomical, clinical and therapeutic considerations.

Among the 84 intracranial dural fistulae treated in the Neuroradiology department of the University Hospital Centre of Nancy between August 1983 and April 1990, 10 (11.9%) were located on the tentorium cerebelli. The patients were 7 men and 3 women aged from 41 to 61 years at the time of diagnosis. All tentorial dural fistulae showed an exclusively cortical drainage, and only one of them was associated with probable thrombosis of a major sinus. Nine patients presented with at least one episode of neurological deficit (including 2 with progressive ascending myelopathy) associated with a cerebro-meningeal haemorrhage in 6 cases. In all patients the initial treatment was an endovascular one, subsequently reinforced by surgery in 2 patients. In every case the clinical condition was improved or stabilized and no recurrent haemorrhage was observed, but radioanatomical cure was obtained in only 3 patients: 1 treated by the endovascular route and 2 by embolization combined with surgery. The anatomical, physiopathological and clinical aspects of these particular fistulae and the different possible therapeutic approaches are discussed.

Adult↗
PubMed1990

[Spontaneous rhinorrhea of a rare etiology (apropos of empty sella turcica)].

The authors report a case of non traumatic rhinorrhea due to an empty sella turcica. Such an intra sellar arachnoidocele compress the pituitary gland against the posterior wall, erode the floor and lead to CSF rhinorrhea through the sphenoidal sinus. Diagnosis and treatment are best accomplished by a team approach involving otolaryngologist, neurosurgeon and neuroradiologist. CT Scan and IRM explain the diagnosis. Treatment can be accomplished by a transeptal transphenoidal approach with localization and repair of the leak in the absence of increased intracranial pressure.

Adult↗
PubMed1989

Application of Grimelius argyrophil staining to the study of tumour ultrastructure. III. Effects of osmium tetroxide.

The results obtained in electron microscopy for Grimelius (1968) argyrophil staining by the en bloc staining of Vassallo and the staining on section of Håkanson were compared on tumoral and non-tumoral tissue samples and were found to lead to different results. Our earlier results for the en bloc staining method indicated that the fixative used in this process was important and that embedding in resin followed by staining of section weakened silver impregnation. We examined here the effects of OsO4 post-fixation combined with such embedding and found that staining was obtained within a shorter period and was more intense. This staining on section was not specific enough, since it was observed in secretory granules of non-argyrophil cells such as those containing somatostatin. In addition, this staining was not confined to specific peripheral zone as it occurred after en bloc staining; particularly in secretory granules with double structure including a core such as those containing glucagon in the pancreas or certain granules in tumoral carcinoid tissue. Consequently silver deposits were located both in the core and peripheral zone of such granules. Moreover, after OsO4 post-fixation, embedding in resin, and staining on section, argentaffin and argyrophil properties intermingle.

Fixatives↗
PubMed1989

Continuous anterior acquisitions in gastric emptying: comparison with the mean.

Depth correction is necessary when gastric emptying is studied by means of a labeled meal. In this study continuous anterior images were acquired from the onset of the food ingestion. Differences in depth were measured using a left lateral view. A minimal and crude depth correction was performed. The results obtained with this correction method were compared with those obtained using the depth correction technique of the mean. The results obtained in the anterior projection without any depth correction were also compared with those obtained using the method of the mean. The results obtained with both correction techniques were identical in 18 gastric emptying studies. This approach also permits the creation of a time-activity curve over the duodenum in the anterior projection. In this way the lag phase can easily be assessed.

Adult↗
PubMed1989

Evaluation of oesophageal transit in patients with minor peptic oesophagitis.

Fifty-one adult patients with complaints suggesting peptic oesophagitis were submitted within the same week to a radionuclide swallow test (OT), an endoscopy and a manometry in order to evaluate the incidence of oesophageal peristaltic abnormalities in patients with only minor peptic oesophagitis. In all patients with normal endoscopy, OT did not show any transit abnormality. In the patients with slight (Stage I) or moderate (Stage II) oesophagitis, OT was abnormal in 60% of the cases. The results were at least as good as those obtained by means of manometry and suggest that OT is an accurate method for the detection of slight impairment of oesophageal contractility.

Adult↗
PubMed1989

Tuberculous aneurysm of the femoral artery: a complication of bacille Calmette-Guérin vaccine immunotherapy--a case report.

A case of bilateral femoral mycotic aneurysms resulting from bacille Calmette-Guérin vaccine, is reported in a 74-year-old man treated by intravesical immunotherapy. The diagnosis was made after histologic and bacteriologic examinations and biochemical analysis of the acid-fast-baccilli. Treatment consisted of resection and replacement of the femoral arteries, with an expanded polytetrafluoroethylene graft on the left side and a saphenous vein graft on the right side. After surgery the patient was treated with antituberculous chemotherapy for 1 year. The patient was doing well 18 months later.

Aged↗
PubMed1989

[Embolization of vertebral hemangioma. Technic-indications-results].

A series of 19 cases of vertebral hemangiomas treated by hyperselective embolization is reported. Localization is thoracic in 12 cases and lumbar in 7. Patients were referred for back pain in 10 cases, neurological signs of spinal cord compression in 5 and of radicular compression in 4. The first step is a precise analysis of the vascular pattern of each case with identification of the feeders of the spinal cord. Embolization as the only treatment, was proposed in 12 cases with painful manifestations. In 5 cases with symptoms of spinal cord compression, it was associated with surgery. The last 2 cases were not treated because of the close proximity of an Adamkiewicz artery. Results on painful symptoms were excellent in 9 cases and good in 3. There was no complications in this series. Therefore, we consider embolization to be a safe tool in the treatment of vertebral hemangiomas, with good efficiency on painful symptom and pre-operatively in case of spinal cord compression.

Adolescent↗
PubMed1989

The influence of cholecystectomy on the duodenogastric reflux of bile.

The effect of cholecystectomy on postprandial duodenogastric bile reflux was studied by biliary excretion scintigraphy in a group of 20 patients examined before and after gallbladder removal. Dyspeptic complaints were correlated with the presence of postprandial duodenogastric reflux in 37 patients admitted to the hospital for cholecystectomy. The removal of the gallbladder, whether functional or not, in patients presenting with gallstones, did not seem to influence the occurrence of postprandial duodenogastric bile reflux. Dyspeptic complaints were positively correlated with postprandial gastric reflux. This reflux was observed in 90% of dyspeptic patients, while only 7% of the patients without dyspepsia had reflux. The role of duodenogastric reflux in the production of dyspeptic complaints is open to discussion, but the removal of the gallbladder does not seem to interfere with the occurrence of bile reflux into the stomach after a milk meal.

Adult↗
PubMed1989

[Intracerebral cavernous angioma].

Thirty four cases (18 operated, 16 non-operated), of cavernous angioma are reported. The presenting symptoms and signs were epilepsy in 22 cases, neurologic deficit in 9 and cerebromeningeal hemorrhage without vigilance disorders in 3. In the operated group 15 angiomas were supratentorial, 3 were subtentorial. In the non-operated group symptoms and signs were epilepsy in 11 cases and a neurologic deficit related to a brain stem lesion in 4/5 cases. Follow-up of 2 to 39 years after the first fit episode and of 1 to 7 years after initial diagnosis suggested that the risk of hemorrhage is low. Indications for neurosurgery are discussed as a function of the site of the angiomas and of the operative hemorrhagic risk.

Adolescent↗
PubMed1989

[Intra-alveolar hemorrhage in immunodeficient patients].

Occurrence of intra-alveolar hemorrhage (whose theoretical causes are briefly reviewed) in an immunocompromised host raises a number of practical problems, mainly related to the interpretation of bronchoalveolar lavage (BAL) studies undertaken to identify one or more etiologies. An open lung biopsy is often needed in addition to the BAL. Three main nosological groups may be proposed: the acquired immunodeficiency syndrome, in which alveolar hemorrhage is more often caused by a Kaposi sarcoma than by a viral infection often combined with opportunistic diseases; aplasias, in which intra-alveolar hemorrhage may be caused not only by the thrombocytopenia but also by infectious or mycotic diseases; connective tissue diseases and vasculites, mainly systemic lupus erythematosus, that may cause vascular lesions of the lungs. Pathogenesis is still unelucidated, but a combination of alveolocapillary basement membrane lesions and diffuse alveolar damage may be involved.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Application of Grimelius argyrophil staining to the study of tumour ultrastructure. II. Effects of resin embedding: Epon.

2 methods have so far been proposed for staining samples by the argyrophil technique of Grimelius for electron microscopy. Vassallo et al. (1971) used en bloc staining after fixation with a mixture of glutaraldehyde and formaldehyde, then Håkanson et al. (1971) stained sections from samples previously fixed by double formaldehyde/OsO4 treatment and embedding in resin. Another investigation that concerned glutaraldehyde fixation showed the effect of this fixative in sample staining (Soranzo and Roland 1987). The present experiments demonstrated that Epon intervenes directly in argyrophil staining of sections. With this resin, the staining process lasted longer than with paraffin embedding materials and offered no guarantee of positivity. Granules with a double structure and dense core displayed different locality of argyrophilia before and after embedding.

Carcinoid Tumor↗
PubMed1988

[Schwannoma of the endothoracic phrenic nerve. General review apropos of a case].

A new case of schwannoma of the intrathoracic phrenic nerve in a 72-year old woman is reported. A review of the literature shows that this tumour is quite exceptional and that its clinical signs are few and non-specific. The most informative examinations, including MRI, merely provide arguments in favour of the diagnosis prior to surgery. The problems of preservation and repair of the phrenic nerve are discussed in the light of new microsurgical techniques. Our knowledge concerning malignant schwannoma and its recurrent forms is updated.

Adolescent↗
PubMed1988

[Immediate and severe epistaxis caused by traumatic rupture of the carotid siphon. Apropos of a case treated by intravascular approach].

The authors report a recent case of massive and immediate epistaxis resulting from a rupture of the internal intracavernous carotid artery caused by closed head injury. The point out the unusualness and the extreme severity of such lesions. The pathogenesis of these epistaxis can be explained by an immediate arterial rupture proceeding from a sphenoidal fracture. The emergency bilateral carotid angiography states precisely the diagnosis and the level of the rupture, allowing in the same time the intravascular treatment by detachable balloon.

Carotid Artery Injuries↗