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Biomedical subjects

M Levesque

Publications and source records attributed to M Levesque.

At least 19 recordsLinked to original sources
PubMed1992

Detection of liver metastases from colorectal cancer: comparison of intraoperative US and CT during arterial portography.

A prospective study was performed to compare the sensitivities of intraoperative ultrasound (US) and computed tomography during arterial portography (CTAP) in the depiction of hepatic metastases from colorectal cancer. Twenty-five patients with hepatic metastases from colorectal cancer were evaluated. All patients underwent partial hepatectomy, and 56 metastases were pathologically proved. Preoperatively, CTAP depicted 51 of the 56 metastases (91%). Intraoperative US depicted 54 of the 56 metastases (96%). Intraoperative US depicted three metastases (5%) that were not depicted with CTAP and two that were missed with palpation (3%). Furthermore, intraoperative US did not demonstrate any false-positive lesions. There was no statistically significant difference in sensitivity between the two techniques. The authors concluded that intraoperative US does not enable detection of more liver metastases from colorectal cancer when CTAP is considered as the preoperative standard of reference. Nevertheless, the results of the study suggest that intraoperative US and CTAP are complementary techniques, and the preoperative use of CTAP for determining the feasibility of hepatic resection cannot prevent the use of intraoperative US.

Adult↗
PubMed1992

Hepatic metastases from colorectal cancer: influence of hepatic volumetric analysis on surgical decision making.

A prospective study was performed to determine the impact of preoperative assessment of estimated postoperative liver volume on surgical decision making for liver metastases from colorectal cancer. Assessment of estimated postoperative liver volume was performed before surgery in 25 patients. Mean estimated postoperative liver volume +/- standard deviation (SD) was 697 cm3 +/- 317 (range, 320-1,532 cm3). Mean relative estimated postoperative liver volume +/- SD was 51% +/- 16 (range, 20%-90%). In two patients, relative estimated postoperative liver volumes of less than 35% prevented resection. These two patients underwent preoperative portal vein embolization, which resulted in marked hypertrophy of the unembolized healthy part of the liver and subsequent safe resection. Before surgery, all patients had a relative estimated postoperative liver volume of greater than 35%, and no cases of postoperative liver failure occurred. The results demonstrated that assessment of estimated postoperative liver volume provides vital preoperative data for reducing the risk of postoperative liver failure.

Adult↗
PubMed1992

Preoperative assessment of resectability of hepatic metastases from colonic carcinoma: CT portography vs sonography and dynamic CT.

OBJECTIVE: A retrospective study was performed to determine the influence of CT portography vs sonography and dynamic CT on the preoperative assessment of the resectability of hepatic metastases from colorectal cancer. MATERIALS AND METHODS: Results of sonography, bolus dynamic CT, and CT portography in 28 patients who underwent surgical exploration (resection or intraarterial catheter placement) for hepatic metastases from colorectal cancer were retrospectively reviewed by two abdominal radiologists and one hepatic surgeon. For each patient, the resectability and surgical approach were decided on the basis of the results of combined sonography-bolus dynamic CT and compared with the decision made from the CT portographic results alone. The final approach suggested was compared retrospectively with the surgical procedure actually performed. RESULTS: Sixty-nine metastases were identified at surgery and pathologically proved. Combined sonography-bolus dynamic CT and CT portography showed 52 (75%) and 64 (93%) metastases, respectively. Twelve metastases in five patients were seen only with CT portography. In four patients, CT portography depicted additional metastases, which changed the surgical approach that had been chosen on the basis of results of sonography and bolus dynamic CT. In one patient, CT portography showed four additional metastases, precluding hepatic resection. CONCLUSION: Findings from CT portography provide vital data unattainable with sonography and bolus dynamic CT that improve the preoperative assessment of the resectability of liver metastases from colonic carcinoma.

Colorectal Neoplasms↗
PubMed1992

[Anguilluliasis of the small intestine and AIDS. A case and review of the literature].

The authors report about one patient with an Acquired Immune Deficiency Syndrome (AIDS) presenting with strongyloidiasis involving the small bowel. On the basis of this observation, they describe the appearances of small bowel involvement by strongyloidiasis in patients with AIDS. They emphasize the main features differentiating these cases from the usual affection, namely the severity and diffusion of the lesions, as well as the presence of a very extensive associated lymphoid nodular hyperplasia.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Magnetic resonance imaging of malignant hepatic tumors in adults].

Recently, magnetic resonance imaging (MRI) had an important place in imaging techniques of malignant primitive tumors of the liver. For many authors, this technique appears as the reference modality for hepatic tumor evaluation. Nevertheless, MRI is considered to be primarily a problem-solving rather than a screening modality. This specific goal of this technique is due to a more precise characterization of the lesions compared to other imaging modalities. The authors, according to recent data in literature and their own experience, present MRI findings of the more frequent malignant hepatic tumors encountered in adult.

Adenoma, Bile Duct↗
PubMed1992

[Nonresectable fibrolamellar hepatocellular carcinoma: outcome of 4 cases treated by intra-arterial chemotherapy].

We evaluated the role of locoregional intraarterial treatment in the management of non-resectable fibrolamellar hepatocellular carcinomas (FLHCC) in 4 women. Three patients underwent transcatheter oily chemoembolization (TOCE) (7 courses), and one received intraarterial iodized oil with chemotherapeutic drug after surgical intraarterial catheter placement (1 course). The latter procedure resulted in marked discomfort and was therefore not repeated. The courses were performed in average every 4 months. TOCE was well tolerated and resulted in a decrease in tumor size in 2 patients, which subsequently permitted a safe hepatic resection. In one patient, TOCE provided a stabilization of tumor size. We conclude that TOCE is a valuable therapeutic tool for the management of non-resectable FLHCC, in particular as it may be followed by hepatic resection.

Adult↗
PubMed1992

[Amebic abscess of the caudate lobe. An uncommon topographic form].

Amebic liver abscess is the most common extraintestinal complication of invasive amebiasis. Amebic abscess is most often located in the right lobe of the liver which is affected four times as often as the left lobe. Location in the caudate lobe is exceptional. We report herein a case of amebic abscess located in the caudate lobe.

Humans↗
PubMed1991

Preoperative segmental localization of hepatic metastases: utility of three-dimensional CT during arterial portography.

To evaluate the accuracy of a fast three-dimensional (3D) reconstruction technique in determining the segmental location of hepatic metastases, 14 patients (40 metastases) were prospectively investigated before surgery with dynamic two-dimensional (2D) computed tomography during sequential arterial portography (CTAP). All patients underwent subsequent hepatic tumor resection within 4 days. After computer-generated mapping of hepatic venous structures with high attenuation and metastases with low attenuation, 3D reconstruction was performed. Thirty-six of the 40 lesions (90%) were detected with 2D and 3D CTAP. The accuracy in determining the segmental location of hepatic metastases was 78% (28 of the 36 metastases) for 2D CTAP and 94% (34 of the 36 metastases) for 3D CTAP. The difference in localization rates between 2D CTAP and 3D CTAP was statistically significant. The 3D CTAP technique provides vital data unattainable with other imaging modalities that improve the preoperative assessment of the resectability of hepatic metastases and allows planning a safer surgical approach.

Adult↗
PubMed1991

[Hemoperitoneum caused spontaneous rupture of hepatocellular carcinoma. Role of hepatic artery embolization in the therapeutic procedure].

A 73-year-old man with intraperitoneal haemorrhage due to spontaneous rupture of hepatocellular carcinoma was successfully treated by emergency transcatheter hepatic artery embolization. A safe hepatic resection was performed 30 days after the procedure. The patient was still alive four months after surgery. We concluded that emergency arterial embolization is an effective alternative to surgery to control hemorrhage resulting from spontaneous rupture of hepatocellular carcinoma and permits, when possible, a safe subsequent surgical treatment of the disease.

Aged↗
PubMed1990

[Prevention of intolerance to iodized contrast media ].

The exact mechanisms of adverse reactions to contrast media are still imperfectly known. However, these reactions may be classified as idiosyncratic. Non-idiosyncratic reactions can be prevented by using new, non-ionic contrast agents. Idiosyncratic reactions can be prevented by specific premedication. Patients with a history of idiosyncratic reaction may benefit from corticosteroids and antihistamines administered prophylactically. Patients who seem to be more likely than others to react to contrast media must be premedicated, the risk of reaction being identified and evaluated by questioning. It has recently been suggested that all patients about to receive an intravascular injection of contrast medium should also be premedicated.

Adrenal Cortex Hormones↗
PubMed1989

The effects of carbon dioxide inhalation on plasma MHPG, plasma hormones respiratory rate, and behavior in the rhesus monkey.

The effects of inhalation of air and 3 concentrations of carbon dioxide (CO2) on plasma levels of the norepinephrine metabolite, MHPG, plasma hormones, and behavioral activation were assessed in eight chair-adapted Rhesus monkeys (Macaca mulatta). In comparison to air, inhalation of 5%, 7.5% and 10% CO2 for 180 minutes produced significant dose-dependent increases in respiratory rate, plasma MHPG, cortisol, growth hormone and prolactin. CO2 at the 7.5% concentration produced peak changes in behavior at 15, growth hormone at 30, and cortisol and MHPG at 180 minutes without producing changes in prolactin. The lack of previously reported CO2 induced changes in MHPG, growth hormone and prolactin in humans exposed to 7.5% CO2 for only 15 minutes, may therefore relate to the relatively short duration of CO2 exposure.

Administration, Inhalation↗
PubMed1989

[Protein-losing enteropathy caused by intestinal metastases of melanosarcoma].

We report about the case of one patient with diffuse small bowel metastases of melanosarcoma, which were revealed by signs of malabsorption 2 years after the exeresis of the initial skin tumor. Metastases of melanosarcoma in the digestive tract, especially the small bowel, have polymorphic and hardly suggestive clinical signs. We lay stress on the high percentage of small bowel metastases of melanosarcoma pointed out by the anatomicopathological literature and on the lack of systematic clinical and radiological search for such metastases in the assessment and follow-up of the primary melanosarcoma.

Humans↗
PubMed1989

[Zollinger-Ellison syndrome of ovarian origin. Apropos of a case with a review of the literature].

We report a case of Zollinger-Ellison syndrome due to secretory G and D cells in an ovarian mucinous cystadenoma. Surgical resection of the tumour led to disappearance of clinical symptomatology and laboratory signs. Four other cases were found in the literature. The prognosis of the Zollinger-Ellison syndrome, due to a secretory ovarian tumour, appears to be favourable after oophorectomy.

Adult↗
PubMed1989

[Echographic study of gallbladder contraction: normal and pathologic aspects. Apropos of 115 patients].

The gallbladder volume was measured on abdominal ultrasonography in 115 patients consisting of three population groups, before and after ingestion of a fatty meal and/or intravenous administration of cholecystokinin. The variation in volume, estimated as a percentage, was used to assess gallbladder contraction. The first group, consisting of 40 normal individuals without gallstones or impaired gallbladder or hepatic function, can be considered to constitute a control group. In this population, gallbladder contraction exceeded 50% in every case. The second group consisted of 40 cases of acute cholecystitis, including 30 cases with acute gallstones and 10 cases of stone-free acute cholecystitis proven surgically (7 cases) or by guided aspiration (3 cases). Gallbladder contraction was less than 15% in every case. Lastly, a third group of 35 patients with uncomplicated gallstones discovered on routine ultrasonography, demonstrated gallbladder contraction of between 10 and 85%. In this last group, 12 patients with vague gastrointestinal symptoms and gallbladder contraction less than 15% were operated: the histological results demonstrated severe lesions of chronic gallstone cholecystitis. The authors believe that absent or weak gallbladder contraction after endogenous stimulation is a supplementary sign to be taken into consideration in a context suggestive of the diagnosis of acute stone-free cholecystitis and to suggest, in the presence of gastrointestinal symptoms not directly related to the gallbladder, the hypothesis of chronic gallstone cholecystitis.

Acute Disease↗