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Biomedical subjects

L Lemaitre

Publications and source records attributed to L Lemaitre.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Evaluation of bladder volume by ultrasonography].

The aim was to evaluate bladder volume measurement using computerized calculation in comparison with usual formulas. Twenty-eight volunteers underwent bladder ultrasonography, which was recorded for computerized measurement of bladder volume. From diameters and/or areas measurements, bladder volume was calculated using 12 different formula. True bladder volume was obtained from voided volume measurement. Computerized measurement was not more accurate than formulas. No formulas displayed association of low percentage error and standard deviation and good accuracy. The best accuracy was obtained with the combined formula F12 ([(DSc x DAPc x DT x 0.523) + (DT x AS)]/2). Formula (F4) using the three diameters, with reference to anterior bladder recessus and 0.625 correction factor displayed good results on the average.

Humans↗
PubMed1995

[Congenital pyeloureteral junction syndrome in adults treated with laparoscopic surgery].

OBJECTIVES: To perform pyeloplasty as described by Andrson, Hynes and Küss by laparoscopic surgery for the treatment of ureteropelvic junction syndrome (UPJS): METHODS: In patients with an indication for treatment for UPJS, we proposed laparoscopic pyeloplasty via a trans-abdominoretroperitoneal incision. The ureteroplevic junctions were exposed after detachment of the colon and were resected. Three Vicryl 4/0 running sutures were performed : two for the ureteropelvic anastomosis and one for the pelvic racket handle. The lower pole vessels were transposed posteriorly to the urinary tract and all anastomoses were protected by a previously inserted stent. Operating times and postoperative hospital stays, and volume of blood loss were recorded. At three months, five patients are evaluable clinically and radiologically by comparison of pre- and postoperative urographies. RESULTS: From May 1994 to May 1995, seven consecutive patients (mean age : 33.4 years, range : 17-65 years) presented with symptomatic congenital UPJS. Three patients had a lower pole artery crossing the anterior surface of the junction, and two had a giant renal pelvis. The mean operating time was 120 minutes (max : 147 min; min. : 90 min). The blood loss was always less than 50 ml. The mean hospital stay in the absence of complications (1 case) was three days (max. : 4 days, min. : 1.5 days). This one complication was due to a postoperative fistula resulting from a technical error requiring an additional fortnight in hospital. The five evaluable patients are asymptomatic. Radiological results showed frank improvement in four out of five cases, while the dynamic appearance was improved in the other case. CONCLUSIONS: UPJS can be treated by laparoscopic surgery according to proven surgical principles, provided it is performed in a perfectly equipped operating room, by a surgeon and operating team experienced in this type of surgery. Laparoscopic pyeloplasty therefore constitutes an alternative to open surgery and endopyelotomy, as the patients benefit from the advantages of laparoscopic surgery without impairing the efficacy of treatment of UPJS.

Abnormalities, Multiple↗
PubMed1994

Serial anatomy of the auditory tube: correlation to CT and MR imaging.

Serial anatomy of the auditory tube (AT), was studied in nine anatomical specimens, according to transverse, coronal and specific oblique planes and was correlated to computed tomography and magnetic resonance imaging. In order to assess the orientation of the oblique plane, parallel to the AT, 30 AT specimens were catheterized: the mean angle between the AT and the Virchow plane or the bony palate was 34 degrees. The bony portion is better explored with CT, whereas the cartilaginous portion is better studied with MR. The cartilage, posterior and medial, is closed anteriorly and inferiorly by a fibrous membrane (lamina membranacea), which is not seen on CT or MR images. The AT is closely related to the tensor veli palatini muscle (TVPM) anterolaterally, and the levator veli palatini muscle inferiorly (LVPM); both are well imaged on the oblique plane. They are bounded by fascias: the submucosal fascia (tela submucosa) is medial, the pharyngobasilar fascia runs between the TVPM and the LVPM and the auditory tube; the fascia of Weber-Liel is lateral to the TVPM. Fascias are difficult to distinguish from the surrounding fatty tissue and the adjacent muscles. The auditory tube and its muscles, forming the lateral wall of the nasopharynx, are well studied by CT and MR imaging, using the transverse or, preferably oblique plane, together with coronal plane.

Eustachian Tube↗
PubMed1994

Ovarian stromal hypertrophy in hyperandrogenic women.

OBJECTIVE: By using vaginal endosonography, ovarian stromal hypertrophy has been shown to be a strong diagnostic feature of polycystic ovarian syndrome and related states. However, this sign is difficult to quantify and to correlate with other findings because of its subjectivity. We have evaluated the use of computer assisted analysis of ultrasound scans to provide more objective measurements of ovarian structure and size. DESIGN: We used a computer assisted method for the reading of ultrasound scans. It allowed selective calculation of the stromal area by subtraction of the cyst area from the total ovarian area on a longitudinal ovarian section. PATIENTS: A consecutive series of 57 patients with hyperandrogenism (group 1), 17 patients with hypothalamic anovulation (group 2) and 20 normal women (group 3). RESULTS: By computerized measure, 75% patients from group 1 had a bilateral stromal area above the mean +2 SD (700 mm2) of women from group 3. All patients from group 2 were below this threshold. Serum LH level was above the normal range in 45% patients from group 1. The stromal area correlated positively with the serum delta 4-androstenedione (r = 0.47, P < 0.005) and 17 alpha-hydroxyprogesterone (r = 0.39, P < 0.005) levels, exclusively in group 1. It did not correlate with the basal serum testosterone, LH or insulin levels. The cyst area did not correlate with any hormonal parameter. CONCLUSION: Ovarian stromal hypertrophy is a frequent and specific feature of hyperandrogenism. It correlates with the ovarian androgenic dysfunction. Its presence is not always linked with elevated serum immunoreactive LH levels. Further data are needed to elucidate the role of insulin and ovarian growth factors.

17-alpha-Hydroxyprogesterone↗
PubMed1994

MR findings of ejaculatory duct cysts.

Ejaculatory duct cysts are a rare type of prostatic cysts. We report 3 cases of symptomatic ejaculatory duct cysts which have been explored by MR imaging. The MR findings were round or oval masses, medial or paramedial in the prostatic gland above the level of the verumontanum, extending into the prostatic base. They displayed a low signal intensity on T1-weighted images and high signal intensity on T2-weighted images (2 cases) or high signal intensity on both T1- and T2-weighted images (1 case). The diagnosis was confirmed by an ultrasonographically guided transperineal aspiration demonstrating spermatozoa in the cyst fluid.

Adult↗
PubMed1994

[Iatrogenic aneurysm of the hepatic artery. Treatment by percutaneous injection of thrombin and selective arterial embolization].

One case of hemobilia, revealing a right hepatic aneurysm, following a hepatic biopsy for active chronic hepatitis B, is reported. The diagnosis established by computed tomography and arteriography. Because of chronic hepatitis and the high localization of the aneurysm, surgery was not performed. A direct percutaneous thrombin injection was performed, owing to the fact that arterial catheterization was unsuccessful, and was followed by a decrease in volume of the aneurysm, but definitive recovery was achieved secondarily by arterial embolization (coil). This case illustrates the therapeutic alternative biopsy in intrahepatic arterial aneurysm treatment.

Aneurysm↗
PubMed1993

Interrelationship between ultrasonography and biology in the diagnosis of polycystic ovarian syndrome.

In order to compare the diagnostic significance of hormonal and ultrasonic criteria of polycystic ovarian syndrome (PCOS), the presence or the absence of ultrasonographic and hormonal features of PCOS were recorded in a heterogeneous population of 90 women presenting with hyperandrogenism and/or menstrual disorders. On clinical and hormonal grounds exclusively, these patients could be separated into five diagnostic subgroups: presumed cases of PCOS (n = 21), idiopathic hirsutism (IH) (n = 26), hypothalamic anovulation (HA) (n = 11), hyperprolactinemia (HPRL) (n = 9), and miscellaneous or undetermined diagnosis (n = 23). By the means of a computed automatic classification of patients (cluster analysis) using five hormonal and ultrasonic criteria of PCOS, four homogeneous clusters of patients were obtained. Cluster #1 (25 patients) had the most characteristic profile of PCOS. It included 15 cases of PCOS and 7 cases of IH. Cluster #4 (47 patients) had the less characteristic profile of PCOS. It included the majority of patients with HA and HPRL and the half of the patients with IH. Cluster #2 included only two hyperandrogenic patients, who were massively obese and in whom ultrasonography may have failed to detect PCOS. Cluster #3 (16 patients) included patients from each diagnostic group, who were gathered together because ultrasonographic and hormonal features were, respectively, present and absent in nearly all of them. With the same analysis, the criteria of PCOS could be graded according to their grouping potential. The presence of an abnormal ovarian stroma by ultrasonography appeared as the most potent criterion. Elevated serum testosterone and androstenedione levels and the polyfollicular pattern of ovaries gave intermediate results, while elevated basal LH level was a much weaker grouping parameter. In conclusion, the automatic classification of patients by cluster analysis using both hormonal and ultrasonographic criteria revealed that the classical diagnostic classification, relying upon hormonal data exclusively, may arbitrarily separate patients having the same disease; and that ultrasonography affords pertinent information that should help provide a better diagnostic definition of PCOS.

Adolescent↗
PubMed1993

[Value of puncture-biopsy under computed tomography of adrenal masses associated with bronchial cancer].

In patients with a non small cell bronchogenic carcinoma, the detection on a CT scan of a uni or bilateral adrenal gland mass requires determination of its metastatic nature. CT guided needle biopsy (CTGB) is a minimally invasive method and allowed us to achieve this goal. From August 1986 to October 1992, 30 patients underwent such a biopsy. In 14 cases, a metastasis was diagnosed and in 13 cases the mass was benign. There were 3 false negative results. Two of these were rectified: one by a second CTGB and the other by adrenalectomy. Our results showed that CT scan was unable to discriminate metastasis from benign masses. Magnetic resonance imaging (MRI) was used for 11 patients and seemed to be a more accurate method: allowing detection of a pheochromocytoma and avoiding a CTGB which may have been dangerous, predicting the benign nature of some masses when they were iso-intense in relation to the liver on T2 weighted images. Thus, even with the contribution of MRI, in most cases of bronchogenic carcinomas coexisting with an adrenal gland mass, CTGB appeared essential to determine correct therapy: surgery or medical treatment.

Adenocarcinoma↗
PubMed1991

Compressive strength of some polyalkenoates with or without dental amalgam alloy incorporation.

The present study compares the compressive strength after one week of some conventional glass-ionomer restorative materials with that of glass ionomers reinforced by the addition of ceramic-coated silver or dental amalgam alloy particles to the aluminosilicate glass powder. Apart from the commercially available Ketac Silver and Miracle Mix, experimental mixtures of Fuji II glass-ionomer powder, the old as well as the new version, with various amounts of either a spherical or lathe-cut amalgam alloy were investigated. For the conventional glass ionomers, the mean compressive strength based on all measurements amounts to 159.9 +/- 4.5 MPa. Both formulations of Fuji II have a comparable strength after one-week maturation. The compressive strength of Ketac Silver does not differ significantly from that of Ketac Fill or from that of the conventional glass ionomers investigated. The effect of admixing amalgam alloy on the compressive strength is found to be determined by the shape and the amount of the alloy particles. Moreover, both parameters are interactive with the formulation of the Fuji glass ionomer used for preparation of the mixture. The results indicate that when dental amalgam alloy is added to the glass ionomer, lathe-cut particles are to be preferred but only in an amount up to 20% by weight.

Analysis of Variance↗
PubMed1991

Polycystic ovarian disease: contribution of vaginal endosonography and reassessment of ultrasonic diagnosis.

OBJECTIVE: We evaluated the superiority of vaginal ultrasonography (US) on the abdominal US for the diagnosis of polycystic ovarian disease (PCOD). DESIGN: The US pattern of ovaries was prospectively investigated by abdominal US and, whenever possible, by vaginal US. SETTING: Primary care, institutional. PATIENTS: One hundred forty-four women in whom PCOD was suspected on endocrine grounds and 62 other patients presenting with primary hyperprolactinemia (n = 23) or hypothalamic anovulation (n = 39). MAIN OUTCOME MEASURE: Vaginal US allowed a better analysis of the ovarian stroma. RESULTS: The external ovarian features of PCOD were observed by both routes in less than one third of the 144 patients with PCOD. The internal ovarian features of PCOD were much more frequently observed by vaginal US than by abdominal US (polycystic pattern: 66.7% versus 38.1%, P less than 0.05; increased ovarian stroma: 57.1% versus 4.8%, P less than 0.001). In the 62 patients without PCOD, US features of PCOD were observed in less than 10% of them, except for the uterine width/ovarian length ratio less than 1 and the polycystic pattern (abdominal US: 17% and 34%; vaginal US: 11% and 50%, respectively). CONCLUSIONS: An increased ovarian stroma seems to be the most sensitive and specific US sign of PCOD, providing that it can be investigated by vaginal US.

Abdomen↗
PubMed1991

[Normal imaging of facial sinuses].

The high spatial resolution of computed tomography allows visualisation of the fine structures of the facial skeleton and gives precise information about the anatomy of the nasal cavity, the paranasal sinuses and their relations with adjacent structures. A detailed knowledge of the normal anatomy, particularly of the nasal cavity and ethmoid, is very useful to provide to the surgeon with a precise pre operative surgical map, before transnasal endoscopic ethmoidectomy or management of paranasal sinuses tumors.

Humans↗
PubMed1990

[Computed tomography of the abdomen in 8 cases of pancreatic trauma].

Computed tomography (CT) is an accurate method for detecting pancreatic trauma. There are two pitfalls to its use: the indication of CT and the risk of misinterpretation. The purpose of this study was to evaluate these 2 difficulties. We report our experience and results obtained in 8 patients with pancreatic trauma (7 closed, 1 open). Peritoneal lavage demonstrated an increased amylase level in the fluid in 2 of our patients. Computed tomography was performed as an emergency diagnostic test for 2 patients and secondarily in 6 patients. In 5 patients, the pancreatic injury was considered to be deep with suspicion of a major pancreatic duct lesion and in 3 patients, the lesion was superficial. Six patients had operative confirmation of the CT results. Pancreatic injuries were classified according to Hervé and Arrighis. Four were grade III, 1 grade II, 1 grade I, while CT showed 5 deep injuries and 1 superficial injury in these patients. Two patients with CT signs of superficial injury were not operated. When there is a clinical suspicion and/or a high amylase level in serum, urine or fluid collected from peritoneal lavage, CT must be carried out as part of in the overall strategy of management of isolated pancreatic trauma. We believe that CT is a valuable tool to evaluate the extent of the injury to the pancreatic parenchyma.

Adolescent↗
PubMed1990

[A superior vena cava syndrome of unusual etiology: compression syndrome of the innominate veins].

A 65-year-old hypertensive and atheromatous presented with "unilateral superior vena cava syndrome". Venography and computed tomography scan with hemodynamic studies demonstrated an intermittent compression of the left innominate vein by the supra-aortic trunks, mainly due to the left subclavian artery, during expiration. The late development of symptoms might be due to arterial atheroma coupled with a narrow superior mediastinum. The case described here is a thoracic equivalent of Cockett's syndrome and so can be called "innominate vein compression syndrome".

Aged↗
PubMed1989

A model for the corrosion behavior of dental amalgams.

At high frequencies, electrochemical impedance behavior for corroding dental amalgams cannot be interpreted in terms of a simple Randles equivalent circuit. This may often be ascribed to the imperfect cell geometry resulting in a nonuniform current distribution. However, the insertion of a constant phase element (CPE) in the non-faradaic branch of the equivalent circuit offers a new scope for interpretation as the circuit provides an m-parameter corresponding to the degree of distortion. The decrease of m as a function of time was explained by a mathematical model reflecting an increasing number of pores. Moreover, that same model allows a better understanding of the passivating effect of NaHCO3 and of the differences between conventional and Cu-rich dental amalgams.

Biocompatible Materials↗