Search PubMed⌕ Search

Biomedical subjects

L Henry

Publications and source records attributed to L Henry.

At least 91 records · Page 5Linked to original sources
PubMed1996

The inter-rater and test-retest reliabilities of prodromal symptoms in first-episode psychosis.

OBJECTIVE: As part of the DSM-IV field trial for psychotic disorders, the authors endeavoured to determine the reliability of the DSM-IV prodromal features for schizophrenia in a first-episode sample. METHOD: Fifty first-episode psychotic patients were assessed using a semi-structured instrument to determine the presence/absence of nine prodromal symptoms. Inter-rater reliability data were calculated for 25 of the patients, and test-retest data were calculated for the remaining 25 patients. RESULTS: Levels of reliability were poor. CONCLUSIONS: The results lend some support to American Psychiatric Association and World Health Organization decisions to omit specific criteria for prodromal features from their respective nosologies.

Adolescent↗
PubMed1996

[Ano-perineal fistula in MRI. Contribution of T2 weighted sequences].

INTRODUCTION: Anal fistulae are pathological conditions observed in infections of the Hermann and Defosses' glands or related to Crohn's diseases. The success and the lack of complication of surgical treatment depends on how accurately the tracks are assessed. The contribution of MRI in anal fistulas is now well established but the imaging appearance is not well discribed. The purpose of this work was to discribe the different patterns of lesions. MATERIAL AND METHODS: Eighteen patients with anal fistulas were examined with MRI before operation (mean delay: 14 days. range: 1-56). SE T2 sequences, in coronal and axial planes referred to the anal canal were performed. The examinations were reviewed and compared with the results of surgical assessment to correlate imaging and surgical findings. RESULTS: Lesions were hyperintense on T2-weighted sequences but were also iso- or poorly hyper-intense when they did not contain fluids but only inflammatory tissue. When involving the supra-levator space, lesions were nodular. They were well limited if they occurred in the supra-levator space itself. On the contrary, the rectal wall was thickened and hyper-intense when the fistulous tract reached it. Lesions were similar in Crohn's disease, except for anal fissures which were seen as a tubular hypersignal in contact with the anal lumen. On T2 sequences, healed fistulas were not visible. CONCLUSION: The simple SE T2 sequences can discriminate between different patterns of lesions, especially for supra-levator extensions, fissures in Crohn's disease and chronic inflammatory lesions without fluid. The use of more recent machines or fat suppression sequences may improve the detectability of lesions, especially the more chronic ones.

Crohn Disease↗
PubMed1995

A cardiovascular intensive care nursing staff response to managed care: a change in practice.

Managed care has brought competition to the health care workplace. This competitive atmosphere creates challenges to attain quality outcomes while minimizing costs. A large community hospital in the mid-Atlantic region, in a collaborative effort with all members of the health care team, undertook the challenge to revise the way care was delivered to the cardiac surgical patient. This article will report the changes the cardiovascular intensive care nursing staff had to undergo and the methods that were used to incorporate these changes.

Cardiovascular Diseases↗
PubMed1995

Spurious precision: procedural validity of diagnostic assessment in psychotic disorders.

OBJECTIVE: Very few studies have quantified the level of agreement among alternative diagnostic procedures that use a common set of fixed operational criteria. The authors examined the procedural validity of four independent methods of assigning DSM-III-R diagnoses of psychotic disorders. METHOD: The research was conducted as a satellite study to the DSM-IV Field Trial for Schizophrenia and Related Psychotic Disorders. The setting was the National Health and Medical Research Council Schizophrenia Research Unit's Early Psychosis Prevention and Intervention Centre, which focuses on first-episode psychosis. Consecutively admitted patients (N = 50) were assessed by independent raters who used four different procedures to determine a DSM-III-R diagnosis. These procedures were 1) the diagnostic instrument developed for the DSM-IV field trial, 2) the Royal Park Multidiagnostic Instrument for Psychosis, 3) the Munich Diagnostic Checklists, and 4) a consensus DSM-III-R diagnosis assigned by a team of clinician researchers who were expert in the use of diagnostic criteria. RESULTS: Concordance between pairs of diagnostic procedures was only moderate. Corresponding levels of percent agreement, however, ranged from 66% to 76%, with converse misclassification rates of 24%-34% (assuming one procedure to be "correct"). CONCLUSIONS: These findings have significant research and clinical implications. Despite the introduction of operationally defined diagnoses, there remained an appreciable level of differential classification or misclassification arising from variability in the method of assigning the diagnostic criteria rather than the criteria themselves. Such misclassification may impede neurobiological research and have harmful clinical effects on patients with first-episode psychosis.

Adolescent↗
PubMed1995

Extracorporeal high-intensity focused ultrasound for VX2 liver tumors in the rabbit.

High-Intensity Focused Ultrasound (HIFU) can produce radical tissue necrosis. We wanted to assess tumor destruction, proliferation, and tumorigenesis after HIFU, in an animal model of hepatic tumor. New Zealand rabbits bearing VX-2 solitary liver tumors were treated with extracorporeal HIFU under ultrasound (US) guidance and standardized conditions. Groups differed only for the administration of either one or two consecutive HIFU procedures. Tissue destruction was assessed by stereomicroscopy and planimetry, cell proliferation was estimated by in vivo intra-arterial injection of 1200 muCi [3H]thymidine, and tumorigenesis was tested by reimplantation of treated or untreated pieces of liver tumors into the thighs of nontumor-bearing animals. Mortality was 0. Tumor destruction rates were 76.3% +/- 16% after one procedure and 94.2% +/- 7.3% after two procedures. Nuclear staining was heavy in control tumors and was absent in treated tumors. Untreated hepatic tumors induced measurable tumors at 3 weeks in thighs of all recipients, 7.8 +/- 2.4 cm3 in volume. Hepatic tumors treated with one HIFU procedure induced tumors in the thigh of recipients in 31.3% of cases (0.47 +/- 0.06 cm3), and those treated with two HIFU procedures induced tumors in 0% even after 8 weeks of follow-up. In conclusion, HIFU allows a noninvasive approach to the destruction of liver tumors in this model, with little toxicity but significant effects on proliferation and tumorigenesis. The repetition of HIFU procedures may improve results.

Animals↗
PubMed1994

[Treatments of biliary fistulas following the removal of a Kehr tube after orthotopic liver transplantation].

Biliary tract complications are a major source of morbidity after liver transplantation. From October 1990 to September 1992, 77 patients, including 13 children and 64 adults, received 80 liver transplants. Biliary reconstruction was performed using a choledochocholedochostomy with a T-tube in 40 recipients. We report the management of bile leaks following T tube removal in 6 patients. In all cases, bile leak was diagnose by ultrasound examination requested for abdominal pain. In the first 2 patients, a surgical treatment was applied: Roux-en-Y choledochojejunostomy was performed on the first patient and simple suture of the fistula in the second patient. Two patients were managed nonoperatively using endoscopic and radiological procedures allowing placement of bile duct prosthesis and abdominal drainage. In 2 patients with small localized sub-hepatic collection, no surgical or radio-endoscopic treatment was attempted; spontaneous resolution of the collections was achieved in 2 months on ultrasound examination. All patients are alive, although, the patient who was operated on with a roux-en-Y choledochojejunostomy developed thrombosis of the right hepatic artery and biliary anastomotic stenosis which required further operations. We advocate endoscopic placement of endobiliary prosthesis and percutaneous biliary drainage as first-line therapy for significant fistula after T-tube removal. The use of choledochocholedochostomy without a T-tube when possible for biliary reconstruction in liver transplantation could be an effective procedure, but requires further evaluation.

Adult↗
PubMed1993

Hepatic involvement in hereditary hemorrhagic telangiectasia: clinical, radiological, and hemodynamic studies of 11 cases.

BACKGROUND: Hepatic involvement in hereditary hemorrhagic telangiectasia (HHT) is infrequent and poorly studied. The aim of this study was to describe the clinical, radiological, and hemodynamic patterns of this involvement. METHODS: Eleven consecutive patients with HHT and hepatic involvement observed within 12 years were retrospectively studied. They were 8 females and 3 males, mean age, 47. RESULTS: The patients presented with heart failure (4 cases), hepatomegaly and murmur of the right hypochondrium (7 cases), and digestive hemorrhage (6 cases). Eight patients had anicteric cholestasis. Celiac angiography showed a dilated hepatic artery in 8 cases, disseminated intrahepatic telangiectasias in 10, and early opacification of the hepatic veins in 7. Liver dynamic computed tomography (CT) scan performed in 7 patients allowed the diagnosis of liver involvement in each case. Hemodynamic studies were performed in 5 patients. A left-to-right intrahepatic shunt was proven in the 5 patients. Shunt output was estimated between 25% and 58% of cardiac output. Mild pulmonary hypertension was observed in the 5 cases. CONCLUSIONS: Diagnosis of liver involvement in HHT can be made by dynamic CT scan or celiac angiography. The main feature of this involvement is high output heart failure due to left-to-right intrahepatic shunt. Thus, right-heart catheterization is necessary in these patients to confirm and evaluate the shunt.

Angiography↗
PubMed1993

Characterization of extracorporeal ablation of normal and tumor-bearing liver tissue by high intensity focused ultrasound.

Treatment parameters of extracorporeal high intensity focused ultrasound (HIFU) were analysed in normal and tumor-bearing rabbit liver. HIFU was generated with a 1 MHz transducer and energy was provided by a 7.5 kW power amplifier. In vivo experiments were conducted on 74 New Zealand rabbits. Normal rabbits and rabbits bearing an intrahepatic VX2 tumor were used. In group 1, spatial peak temporal peak (SPTP) intensities ranging from 1470 to 5500 W cm-2 and exposure times from 0.5 to 5 s were tested at a constant depth in the liver; in group 2, the output power was adjusted as a function of the target depth in order to keep constant the focal in situ intensity in the liver; in group 3 (liver tumors), the focal in situ intensity was 1365 W cm-2 in eight rabbits and 500 W cm-2 in nine. In groups 1, 2 and 3, rabbits were sacrificed 48 h after the treatment. Groups 4 and 5 were designated for analysis of the lesion in the normal liver 4 weeks after treatment at 1000 W cm-2 and 3000 W cm-2 SPTP intensities, respectively. In normal rabbits, the lesion volume increased with exposure time at constant intensity; there was a negative correlation between intensity and exposure time (group 1). When the output power was adjusted as a function of the path length, the lesion size was nearly constant (group 2). In VX2 rabbits, tumor destruction rates were significantly higher in rabbits treated at 500 W cm-2 than in rabbits treated at 1365 W cm-2 (p < 0.05; group 3). As in the normal liver, the lesion volume increased with the exposure time at constant intensity. HIFU lesions treated at 1000 w cm-2 (SPTP) healed as thin fibrous scars, and no severe complication occurred (group 4); at 3000 W cm-2 (SPTP), scars were larger and perforation of a neighbouring organ was seen in 7 of 11 rabbits (group 5).

Animals↗
PubMed1993

Metal deposition in post-surgical granulomas of the urinary tract.

Fourteen cases of post-surgical granulomatous inflammation of the urinary tract were studied to investigate the possible deposition in the tissues of metals derived from the diathermy instruments used. The granulomas showed central necrosis, palisaded histiocytes and giant cells. On electronmicroscopy both amorphous material and electrondense particles were seen in the granulomas. The former appeared to be necrotic tissue. The particles were metallic in nature. Energy dispersive analysis of X-rays showed the presence of tungsten, iron, copper, nickel, chromium, zinc and vanadium. Tungsten particles were always pure. Other single particles contained two or more of the remaining elements, indicating the presence of alloy metals. Analysis of the diathermy instruments showed the cutting loops to be pure tungsten and the 'rollerballs' to be nickel silver containing copper, zinc, nickel, manganese and iron. Both the loops and balls are supported on stainless steel wires containing iron, chromium, nickel, manganese, molybdenum, copper and vanadium. It is proposed that metallic fragments from the instruments were deposited in the tissues during the surgical procedures and elicited an immunological reaction with granuloma formation. Tungsten is probably inert but nickel, chromium, copper and zinc are immunogenic. Under certain circumstances both nickel and chromium may also be carcinogenic.

Aged↗
PubMed1993

Villous adenoma of the bladder.

A case of villous adenoma of the bladder associated with cystitis glandularis of intestinal type is described. Only three villous adenomas have been reported to date, of which two were also accompanied by cystitis glandularis. The lesion can be confused with polypoid hyperplasia in cystitis glandularis. Neutral mucins, acidic sulphomucins, and sialomucins were identified within the villous adenoma and adjacent areas of cystitis glandularis. It is suggested that the villous adenoma may form an intermediary stage in the development of some of the primary adenocarcinomas of the bladder arising in metaplastic intestinal mucosa.

Adenocarcinoma↗
PubMed1992

Ovarian steroid receptor expression in endometriosis and in two potential parent epithelia: endometrium and peritoneal mesothelium.

Endometriosis is an oestrogen dependent condition and it is expected that the tissue of origin of endometriosis will express receptors for the ovarian steroids. Two epithelia, endometrium and peritoneal mesothelium, are the potential parent epithelium. Oestrogen and progesterone receptor expression has been studied immunohistochemically in (i) timed endometrial biopsies from 25 normal subjects and 27 patients with endometriosis, (ii) 25 endometriotic biopsies and (iii) 42 peritoneal biopsies. Endometrium but not peritoneal mesothelium expresses both oestrogen and progesterone receptors. No difference in the intensity of staining between endometria of normal subjects compared with the endometria of patients with endometriosis was noted. In paired endometrial and endometriotic biopsies, the intensity of staining for the oestrogen receptor in stromal cells and for the progesterone receptor in both glandular and stromal cells was less in the endometriotic biopsies. These data provide circumstantial evidence for an endometrial origin for endometriosis although quantitative differences exist in receptor expression between endometrium and endometriosis.

Endometriosis↗
PubMed1992

Is polyurethane lead insulation still controversial?

A controversy arose some 10 years ago over the reliability of polyurethane lead insulation. On the basis of one of the longest standing and largest databanks worldwide, the authors compare the cumulative survival of several thousand polyurethane, standard silastic, and high-performance silastic electrodes as it pertains to the failure criterion described as insulation degradation. With the possible exception of the Medtronic 6972 (Medtronic, Inc.) electrode, polyurethane electrodes have a 100% reliability at 84 months, which is similar to silastic electrodes.

Databases, Factual↗