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Biomedical subjects

L Lemaitre

Publications and source records attributed to L Lemaitre.

At least 19 recordsLinked to original sources
PubMed2005

[Imaging in the management of urinary tract infections].

This review analyzes the role of imaging in the diagnosis, follow-up and management of urinary tract infections. Uncomplicated infection of the urinary tract is frequent and usually resolves rapidly with treatment; in such cases imaging is unnecessary except to exclude dilatation or the existence of an obstacle. Progression towards complex infection often occurs in patients with predisposing factors. Imaging helps in evaluating the extent of the disease; it has a role in the selection of therapy and interventional procedures.

Chronic Disease↗
PubMed2004

[Urogenital bilharziasis: imaging diagnosis].

Urogenital bilharziasis is a well-known disease that seldom is encountered in western countries. Therefore, bilharziasis usually only is considered after tuberculosis, the main differential diagnosis, has been excluded. Using this case, we will discuss the value of different imaging techniques (especially that of CT combined with transrectal US) for diagnosing bilharziasis and review specific criteria to more easily distinguish both pathologies.

Adult↗
PubMed2004

Low-grade tubular myxoid renal tumors: a clinicopathological study of 3 cases.

We report 3 cases of a new renal cell tumor entity with a review of the literature. These 3 cases were retrieved from the files of this institution from 1991 to 2002. The clinical data and all histologic slides were reviewed and an immunohistochemical study was performed. Patients were all females. Tumors were almost similar with well-defined margins. Tumor architecture was tubular and focally fusiform with an abundant myxoid stroma. Tumor cells were low cuboidal, slightly eosinophilic with low nuclear grade. Immunohistochemistry was in favor of a distal nephron differentiation. All patients were healthy after surgery. We describe 3 cases of a new clinicopathological entity entitled low-grade tubular myxoid renal tumor with a benign clinical course.

Adult↗
PubMed2002

[Clinical implications of acoustic neuromas growth rate in volumetric study].

OBJECTIVE: The pattern of neuroma growth is of great importance in choosing the appropriate management. This paper tests the clinical impact of tumor growth rate assessed by volumetry. There is a conviction that some slowly growing tumors could be observed for many years. METHOD AND PATIENTS: Volume measurements were performed on T1- weighted MR images (spin echo sequences) after injection of gadolinium using a special dedicated software. The studied group included 17 patients in whom at least two MRI examinations were carried out and tumor growth was confirmed. The intervals between initial and the first follow-up examination were 14.2 months on the average. In 7 cases tumor evolution was observed in 2 periods (3 MRI studies) and in 4 cases in 3 periods (4 MRI studies). RESULTS: The growth rate depended on tumors volume and clinical stage (P<0.01). Small tumors can be observed more safely than advanced tumors because their increase in mass is lower. CONCLUSION: The observation with the tumoral volume measurements appears to be a useful and accurate tool to estimate the tumor growth rate. The growth rate is a major factor for choosing the appropriate management.

Follow-Up Studies↗
PubMed2001

Lymph node metastases from head and neck squamous cell carcinoma: MR imaging with ultrasmall superparamagnetic iron oxide particles (Sinerem MR) -- results of a phase-III multicenter clinical trial.

The aim of this study was to compare the clinical usefulness of ultrasmall superparamagnetic iron oxide (USPIO) MR contrast media (Sinerem, Guerbet Laboratories, Aulnay-sous-Bois, France) with precontrast MRI in the diagnosis of metastatic lymph nodes in patients with head and neck squamous cell carcinoma, using histology as gold standard. Eighty-one previously untreated patients were enrolled in a multicenter phase-III clinical trial. All patients had a noncontrast MR, a Sinerem MR, and surgery within a period of 15 days. The MR exams were analyzed both on site and by two independent radiologists (centralized readers). Correlation between histology and imaging was done per lymph node groups, and per individual lymph nodes when the short axis was > or = 10 mm. For individual lymph nodes, Sinerem MR showed a high sensitivity (> or = 88%) and specificity (> or = 77%). For lymph node groups, the sensitivity was > or = 59% and specificity > or = 81%. False-positive results were partially due to inflammatory nodes; false-negative results from the presence of undetected micrometastases. Errors of interpretation were also related to motion and/or susceptibility artifacts and problems of zone assignment. Sinerem MR had a negative predictive value (NPV) > or = 90% and a positive predictive value (PPV) > or = 51%. The specificity and PPV of Sinerem MR were better than those of precontrast MR. Precontrast MR showed an unexpectedly high sensitivity and NPV which were not increased with Sinerem MR. The potential contribution of Sinerem MR still remains limited by technical problems regarding motion and susceptibility artifacts and spatial resolution. It is also noteworthy that logistical problems, which could reduce the practical value of Sinerem MR, will be minimized in the future since Sinerem MR alone performed as good as the combination of precontrast and Sinerem MR.

Adult↗
PubMed2001

Bilateral renal oncocytosis with renal failure.

Oncocytosis is a term recently used to describe diffuse renal involvement by numerous oncocytic nodules. We report herein a case of a 53-year-old man with end-stage renal disease requiring hemodialysis. His kidneys were involved by numerous tumors. Histologic examination revealed more than 100 oncocytomas and an associated papillary renal cell carcinoma in the right kidney.

Adenoma, Oxyphilic↗
PubMed2001

[Diagnostic methods for obstruction of the upper urinary tract: which tests are available in 2001].

The presence of upper urinary tract obstruction, its site and its nature can be determined and the most appropriate treatment can be defined in the majority of clinical cases. However, in some circumstances, non-invasive or minimally invasive methods, such as ultrasonography, intravenous urography, urography with diuretic test, conventional and diuretic nephrography and MR urography, are unable to confirm the presence of obstruction, requiring assessment of the upper urinary tract by antegrade pyelomanometry. This investigation measures the pressure in the upper urinary tract perfused at a constant rate by a percutaneous catheter and allows evaluation of the obstruction. The authors discuss the place of the various upper urinary tract investigations to confirm the definitive diagnosis of upper urinary tract obstruction.

Humans↗
PubMed2000

Correlation between Ki-67 index and some clinical aspects of acoustic neuromas (vestibular schwannomas).

Evaluation of the proliferation activity of neuromas has a practical meaning when there are doubts about the complete resection of the tumor. Evaluation of the clinical aspects connected with increased proliferation activity may have a much broader application. The aim of this study was to correlate selected clinical and radiologic aspects of vestibular schwannomas with the results of the Ki-67 index. The studied group included 23 males and 20 females. Unilateral neuromas were stated in 38 cases (mean age, 52.2 years) and bilateral tumors in 5 cases (mean age, 44.2 years). The immunohistochemical tests (Ki-67) were performed on the specimens preserved in formalin and stored in paraffin. The Ki-67 index was estimated in a semiquantitative study. The mean value of Ki-67 index was 1.86%. In case of unilateral neuromas (n = 38), the average Ki-67 index was 1.74%. In 5 cases of bilateral tumors, the index amounted to 2.79% (P = 0.278). No significant correlation was found by comparing the value of the Ki-67 index with the age of patients (P = 0.410: r = 0.128). Significant differences in the value of the Ki-67 index were noted in the sub-groups of tumors that were evaluated radiologically as growing and stable. The mean value of Ki-67 index was 3.17% in the first subgroup; in stable neuromas, it was significantly lower, amounting to 1.11% (P = 0.020). Such results may confirm that the growth rate of vestibular schwannomas varies and may explain the difficulties in estimating the growth of neuromas on the basis of clinical aspects only.

Adolescent↗
PubMed2000

Cochlear fossa enhancement at MR evaluation of vestibular Schwannoma: correlation with success at hearing-preservation surgery.

PURPOSE: To describe a sign in magnetic resonance (MR) imaging that could reflect the state of the cochlear nerve before hearing-preservation surgery in small vestibular schwannomas. MATERIALS AND METHODS: Thirty-one patients with serviceable hearing underwent 1.5-T MR imaging before hearing-preservation surgery. The presence of cochlear fossa enhancement on T1-weighted spin-echo images obtained after the administration of contrast material was compared with the results of hearing-preservation surgery. RESULTS: Cochlear fossa enhancement was present in 13 patients, and all of them had total hearing loss after surgery. There was no cochlear fossa enhancement in 18 patients; 15 maintained serviceable hearing after surgery, and three had postoperative hearing loss with no serviceable hearing (sensitivity, 81%; specificity, 100%). CONCLUSION: Cochlear fossa enhancement on T1-weighted spin-echo images seems to be a reliable sign for analyzing the state of the cochlear nerve. The absence of cochlear fossa enhancement could become an additional criterion for selecting the surgical approach in vestibular schwannomas.

Adult↗
PubMed2000

[Role of systematic scrotal ultrasonography in the management of male infertility: prospective study of 609 cases].

OBJECTIVES: To assess the benefit and diagnostic contribution of systematic scrotal ultrasound in the management of infertile men. MATERIAL AND METHODS: Between 1st January and 31st December 1997, the authors conducted a consecutive and prospective study of 609 infertile patients corresponding to 418 cases of oligoasthenoteratospermia and 191 cases of azoospermia. All patients were investigated by scrotal ultrasound. RESULTS: 133 patients (21.8%) did not present any clinical or ultrasound abnormality. 60 patients (9.9%) presented isolated clinical abnormalities and 125 patients (20.5%) presented a discordance between clinical findings and ultrasound results. 9 patients (1.5%) presented an ultrasound nodule, 6 of which were discovered incidentally. 22 patients (3.6%) in whom the clinical features were more difficult to interpret, presented unambiguous findings. CONCLUSION: Scrotal ultrasound makes a considerable contribution to more appropriate management of infertile men and diagnoses 1.5% of testicular tumours.

Adult↗
PubMed2000

[Prostatic malacoplakia: report of 3 cases].

Malakoplakia is a granulomatous inflammatory disorder occurring rarely in the prostate. We report our experience with three patients aged from 54 to 75 years old. Clinical presentations were unspecific. All patients presented with a past history of urinary tract infection. Ultrasound study revealed hypoechoic peripheral zone lesions. Histological examination showed a diffuse granulomatous inflammation with numerous histiocytes containing Michaelis-Gutmann bodies. In the prostate, malakoplakia is a histological variant of granulomatous chronic prostatitis following urinary infections. Clinically and radiologically, the differential diagnosis with adenocarcinoma is difficult. The symptoms disappear with a prolongated antibiotic treatment.

Aged↗
PubMed1999

Spontaneous retroperitoneal hematoma from rupture of an aneurysm of the ovarian artery following delivery.

We describe a case involving spontaneous retroperitoneal hematoma caused by rupture of an aneurysm of the right ovarian artery 4 days after delivery in a multiparous woman. Diagnosis was achieved by arteriography. Bleeding was stopped by embolization via selective arteriography. Hematoma was drained by lomboscopy. The pathophysiological mechanisms underlying development and treatment of these aneurysms are discussed.

Adult↗
PubMed1999

The growth of acoustic neuromas in volumetric radiologic assessment.

OBJECTIVE: The volumetric assessments of neuroma were applied for radiologic observation of tumor growth. The hypothesis that most of neuromas are stable or show only slight growth was tested. STUDY DESIGN: This was an observational study. SETTING: The study was performed in the university centers. PATIENTS: The study group included 27 patients with 15 unilateral tumors and 12 bilateral tumors. All patients had at least 2 magnetic resonance imaging (MRI) examinations, and the average interval between initial and control examinations was 11.4 months. MAIN OUTCOME MEASURE: Volume measurements were performed on T1- weighted MRI spin echo sequences after injection of gadolinium using special software. Growth of the tumors was estimated by comparison of the results of three measurements from the initial and control MRI examinations. RESULTS: The growth was confirmed in 17 of 27 tumors (63%). Growth was found in 10 of 12 neuromas of neurofibromatosis type 2 (83.7%). In 15 unilateral neuromas, growth was found in 7 (43%). Unilateral neuromas were observed for a shorter period of time (6.3 months) than bilateral tumors (14.7 months). The correlation between a neuroma volume gain and the follow-up period was statistically significant (p = 0.003, r = 0.544). CONCLUSIONS: The growth of tumors can be confirmed despite a short follow-up period.

Adolescent↗