[Bilateral Chilaiditi's syndrome].
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Biomedical subjects
Publications and source records attributed to M Blery.
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ITIM-bearing molecules represent a novel family of inhibitory receptors expressed widely through the hematopoietic compartment. These molecules share certain features such as the presence in their intracytoplasmic domain of the so-called motif ITIM (ImmunoTyrosine-based Inhibition Motif). These molecules are able to recruit phosphatases on their phosphorylated ITIM and thus mediate a localized inhibition of the transduction pathways. The molecular basis of this inhibitory pathway is discussed below.
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The aim of this prospective study was to evaluate the frequency of postoperative fluid collection after laparoscopic appendectomy in patients with normal postoperative development. Twenty-eight patients were included. The surgical technique, histological data, and postoperative development during the first postoperative month were recorded. A sonographic analysis was performed on the 5th postoperative day by a radiologist who was not aware of the histological and surgical data. Ten cases of fluid collection were found (37%). The frequency was higher in cases of suppurated appendicitis and significantly higher with associated periappendicitis. Peritoneal irrigation or retrocecal dissection did not influence the occurrence of fluid collection. Postoperative serous fluid collection occurs with a high frequency after laparoscopic appendectomies, and one must be careful in interpreting sonographic analyses in looking for deep abscesses in patients with difficult postoperative development.
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One-hundred women suffering from acute pyelonephritis were hospitalized for less than 4 days on average, in order to make a diagnosis based on bacteriology and computerized tomography (CT) and to bring fever down with a 21-day antibiotic therapy. In cases of acute pyelonephritis due to a urinary tract obstacle, endoscopic uereteral drainage was added to the antibiotic treatment. In the absence of obstacle, medical treatment was sufficient to obtain apyrexia. Fluoroquinolone therapy made it possible to reduce the hospital stay to 2 or 3 days, depending on whether the lesions observed at CT were triangular or round.
Mesenteric panniculitis also known as lipodystrophy is an inflammatory condition of adipose tissue. A case of a 55 year old, female who presented a weight loss and a tender palpable mass located in the left flank is reported. CT patterns were not specific but might suggest the diagnosis: fatty mass, with a higher density than subcutaneous fat, located in the root of the mesentery and surrounding mesenteric vessels without distoting them. Intestinal loops were only pulled in periphery. This signs are not always present and even in this typical pattern mesenteric panniculitis could not be differentiated from liposarcoma. Thus an histological proof was needed. The evolution was good, with resolution of the abdominal pain. The knowledge of this rare Radioclinical syndrome should prevent any aggressive therapy.
The questionable reliability of the conventional procedures for detection of ingested drug packages triggered us to evaluate the accuracy of a method of contrast study of the bowel in 23 nonsurgically managed cocaine body-packers. A single dose (60 mL) of a water-soluble contrast compound (amidotrizoate + meglumine) was given orally after initial clinical examination and drug detection in urine. Thereafter, roentgenograms were performed daily after spontaneous passage until obtaining two packet-free stools and negative views. Roentgenograms showed packages when performed at least 3 h after the ingestion of the contrast compound. Sensitivity and specificity of the method with respect to the detection of residual packets in the body, assessed by subsequent examination of stools, was good and did not diminish as the number of packages decreased during the time spent in ward. No side-effects were observed. We conclude that oral administration of a water-soluble contrast compound is an easily performed, efficient, and safe method for the nonsurgical management of cocaine body-packers.
One hundred thirty-nine patients with pelvic cancers (101 bladder carcinomas, 27 prostatic carcinomas, and 11 testicular tumors) considered for radical surgery were studied with lymphography and percutaneous fine-needle aspiration (FNA) biopsy, and the results were correlated with lymphadenectomy. Adequate material for FNA was obtained in 97%, 88%, and 100% of the bladder, prostatic, and testicular tumors, respectively. For bladder carcinoma, the global accuracy was 58% for lymphography and 93% for FNA; the high false-negative rate for lymphography (48%) was lowered to 25% with FNA, providing that the obturator nodes were punctured. For prostatic carcinomas, it was not possible to evaluate the true-positive rate because the patients with positive FNA results did not under-go surgery. For testicular tumors, lymphography and FNA had almost the same global accuracy (73% and 75%), but FNA had a better specificity (100%) than lymphography (86%). FNA had no false-positive results, which means that positive biopsy results obviate radical surgery; when FNA results are negative a lymphadenectomy should be performed. With its mild morbidity, FNA has a role in the preoperative staging of pelvic carcinomas.
We report 1 patient with a necrolytic migratory erythema, a high plasma glucagon concentration and a metastatic pancreatic endocrine tumor who has now been treated effectively for 33 months with the somatostatin analogue octreotide (SMS 201-995) (400 micrograms/day). The results of SMS 201-995 in the treatment of glucagonoma syndrome are reviewed.
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Knowledge of the status of the pelvic lymph nodes is important for accurate staging and adequate treatment of patients with genitourinary tract cancer (bladder and prostatic carcinoma, testicular tumors, and uterine carcinoma). A total of 228 consecutive patients underwent preoperative evaluation of the lymph node status by lymphangiography combined with fine-needle aspiration biopsy. A lymphadenectomy was performed in 94 patients. The overall diagnostic accuracy was 93%. There were 5% false-negative results and no false-positive diagnoses. Fine-needle aspiration biopsy is an inexpensive method with which to detect the presence of metastatic lymph nodes visualized by bipedal lymphangiography. It is also a safe and well-tolerated method, with a low morbidity and no mortality. The various cytological features are described as are some possible pitfalls.
The case described is interesting for its unusual presentation related to its uncommon onset in youth and its revelation by a fracture which led to a first erroneous pathological diagnosis. In fact, retrospective analysis of the CT showing peripheral condensation could suggest the malignant chondroïd nature of the tumor. Subsequent radiological follow-up demonstrated the rapid growth of the tumor hence exhibiting a very invasive form. Myxoïd differentiation is commonly related to aggressive chondrosarcoma.
Confection of an ileal reservoir anastomosed to anal canal is a seductive issue after total coloproctectomy. In this prospective study, early complications, mainly anastomotic fistulae, were effectively detected by routine enemas with water soluble media. These complications affected 14% of patients. Preliminary results of functional exploration of reservoirs by defecography showed that continence muscle barriers were apparently unaltered by the operation, that the content of reservoirs in J was satisfactory and that difficulties in exoneration frequently met with in reservoirs in S were due to architectural anomalies of these ileal pouches rather than a disturbance in pelvic muscles play. Radiologic analysis can establish perfection of surgical mounting and guide possible recovery operations.
Efficacy of fine needle puncture and microbiopsy technics was compared in 19 patients with a solid pancreatic mass. Results showed sensitivity and global accuracy of 71 and 72% respectively for cytology, 92 and 82% for microbiopsy and 100 and 94% for their combined use. Global accuracy and negative predictive values reached 100% when repeat samples were collected because of insufficient material. No false positives were noted and no complications in this preliminary series.
Two patients were treated for lesions due to inhalation of mercury, one accidental and the other a suicidal attempt. The pulmonary image showed the mercury fragmented into numerous particles of very enhanced density. In one patient these particles were in the right basal pyramid while in the other they were disseminated throughout the lung fields. The immediate outcome was favorable in both cases.
119 patients with bladder tumors of category Ta, Tis, T4, considered for radical treatment because of local conditions were studied by pedal lymphography (LAG) and percutaneous fine needle aspiration biopsy (FNA). 41% had a positive LAG. Adequate material was obtained for FNA in 94% of the patients. Of 70 patients with normal LAG none had a positive FNA; only 36% of those with a positive LAG had a positive FN. The high rate of positive LAG with negative FNA is attributed to inflammatory changes due to previous transurethral resection. Radical lymphadenectomy (LND) was done in 64 patients of whom 54 had a negative FNA. In this group, 8 (17%) had a positive LND. There was no mortality and morbidity was mild. LAG with FNA has a role in the pre-operative staging of bladder carcinoma.
A case is reported of spondyloenchondrodysplasia associating platyspondylia and generalized enchondromatosis, affecting the spine also but absent in the extremities. A literature review enabled this entity to be grouped within the framework of other enchondroplasias with vertebral lesions. Radiologic signs and genetic data suggest heterogeneity of this group of affections.