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Biomedical subjects

O Marty

Publications and source records attributed to O Marty.

13 recordsLinked to original sources
PubMed2000

Usefulness of endoscopic ultrasonography in patients with "idiopathic" acute pancreatitis.

PURPOSE: No underlying cause is found in as many as 30% of patients with acute pancreatitis. The aim of this study was to evaluate the usefulness of endoscopic ultrasonography in the diagnosis of biliary tract pathology or chronic pancreatitis in these patients. SUBJECTS AND METHODS: We evaluated 168 patients who were referred with idiopathic pancreatitis. Diagnoses obtained by endoscopic ultrasonography were prospectively compared with those obtained at surgery in 101 patients, by endoscopic cholangiopancreatography in 49 patients, or by bile crystal analysis and medical follow-up in 18 patients. RESULTS: Endoscopic ultrasonography was abnormal in 135 (80%) patients, 124 of whom had biliary tract disease. When the results of endoscopic ultrasonography were compared with those made after multidisciplinary investigations, endoscopic ultrasonography correctly identified the cause-most commonly biliary tract disease-of the "idiopathic" pancreatitis in 155 (92%) of the 168 patients. CONCLUSIONS: Endoscopic ultrasonography is valuable in determining the cause of acute pancreatitis in patients initially considered to have idiopathic pancreatitis.

Acute Disease↗
PubMed2000

Choledocholithiasis: a prospective study of spontaneous common bile duct stone migration.

BACKGROUND: The rate of spontaneous migration of bile duct stones through the duodenal papilla is not well known. Endoscopic retrograde cholangiography (ERC) has been the standard method to diagnose bile duct stones, but accumulating data show there is a good agreement between ERC and endoscopic ultrasonography (EUS). The aim of the study was to evaluate the incidence and time course of stone migration in patients with bile duct stones by analyzing discrepancies between EUS and ERC as a function of the elapsed time between these two procedures. Stone migration was considered as the absence of stones at time of ERC regardless of the number of stones seen at EUS. METHODS: The main criterion for inclusion was the presence of bile duct stone as shown by EUS. Ninety-two consecutive patients were prospectively included in this study. RESULTS: Choledocholithiasis was absent at ERC in 12 patients. In univariate analysis, presence of gallbladder was significantly associated with an increased rate of stone migration (correction for multiple testing would remove this statistical significance). The size of the stone was the only independent factor to predict migration. CONCLUSION: Migration occurred in about 21% of cases within 1 month. Our study emphasizes the need to analyze carefully the results of comparative imaging studies of bile duct stones.

Adult↗
PubMed2000

[Cirrhosis with non alcoholic steatohepatitis: role of tamoxifen].

We report a case of non-alcoholic steatohepatitis with cirrhosis in a woman receiving tamoxifen as adjuvant treatment for breast cancer. Despite the presence of other risk factors for non-alcoholic steatohepatitis (such as diabetes, obesity and hyperlipidemia), the patient developed non-alcoholic steatohepatitis and cirrhosis only after tamoxifen was started. We suggest that patients receiving tamoxifen, especially patients with predisposing metabolic disorders, should be evaluated for non-alcoholic steatohepatitis, because progression to cirrhosis may occur.

Aged↗
PubMed1997

Endoscopic ultrasonography for the initial staging and follow-up in patients with low-grade gastric lymphoma of mucosa-associated lymphoid tissue treated medically.

BACKGROUND: Endoscopic ultrasonography is an appropriate procedure to assess the depth of tumoral infiltration in primary gastric lymphoma. The aims of the present study were to characterize the endoscopic ultrasonographic aspects of low-grade gastric lymphoma of mucosa-associated lymphoid tissue and to determine the value of this procedure in medical treatment assessment. METHODS: Between 1991 and 1996, 15 patients with low-grade gastric lymphoma of mucosa-associated lymphoid tissue were treated with oral cyclophosphamide and/or anti-Helicobacter pylori treatment. Endoscopic ultrasonography was carried out at the time of the diagnosis in all patients, 8 of whom (4 in complete remission and 4 with a stable or progressive disease) had at least one endoscopic ultrasonography examination within the treatment period (median follow-up 17 months). RESULTS: The initial procedure showed an increased gastric wall thickness from 6 to 12 mm in 8 patients, equal to 5 mm in 5 patients, and normal in 2 patients. The thickening was predominantly of the mucosa alone and/or the submucosa but never extended beyond the muscularis propria. No lymph node was found. Gastric wall thickness returned to normal in the 4 patients in complete remission and remained thick in 3 of the 4 patients with a stable or progressive disease. Of these 3 patients, at least one set of biopsy samples, carried out during follow-up, showed the absence of lymphoma, but histology performed subsequently found evidence of disease. CONCLUSIONS: Endoscopic ultrasonography differentiates superficial from infiltrative types of gastric lymphoma of mucosa-associated lymphoid tissue, which may have a prognostic significance and confirms remission or persistence of the disease with medical treatment during follow-up. When the gastric wall remains thick, even if histology is negative, repeated biopsies should be performed to detect evolving disease or relapse.

Adult↗
PubMed1995

[Prospective comparison of ultrasound endoscopy and computed tomography in the assessment of locoregional invasiveness of malignant ampullar and pancreatic tumors verified surgically].

OBJECTIVE: To compare, in a prospective study, results of endoscopic ultrasonography and computed tomography in staging of pancreatic and ampullary carcinoma tumours, assessed surgically. METHOD: From January 1990 to May 1993, 37 patients with pancreatic tumours had per-operative endoscopic ultrasonography and computed tomography. All patients underwent surgery and surgical and histological staging were performed. RESULTS: All the tumours were visualized by endoscopic ultrasonography, and 92% were correctly localized; 63% of the tumours were visualized by computed tomography. In lymph node involvement diagnosis (23 patients), endoscopic ultrasonography. In major portal vessel involvement diagnosis (14 patients), endoscopic ultrasonography sensitivity and specificity were respectively 71.4% and 95.65%, and 21.4% and 100% for computed tomography. In a vessel-by-vessel analysis, endoscopic ultrasonography was superior to computed tomography for veinous involvement diagnosis (sensitivity: 68.4% vs 26.3%), and the results were similar for arterial involvement diagnosis (sensitivity: 55.5% vs 66.6%). CONCLUSION: Endoscopic ultrasonography is more accurate than computed tomography in detection of metastatic lymph nodes and portal involvement, and their results are similar in detection of arterial involvement.

Adenocarcinoma↗
PubMed1993

[Biliary cystadenocarcinoma. Apropos of a case].

Biliary cystadenocarcinoma is rare biliary ductal neoplasm, usually occurring in middle-aged women, which arises in a healthy liver, with a better prognostic than other malignant tumors of the liver. We report a new case documented by echography, CT scan and MR. Echography showed multiple heterogeneous and septate masses with fluid-fluid level and dilatation of the intra-hepatic biliary ducts. CT showed multilocular cystic masses with internal septa and papillary excrescences showing contrast enhancement and no calcification. MR displayed a rather intense and variable signal in some parts of the masses on T1 weighted images, flasching on T2 weighted images, corresponding to a hemorrhagic fluid, confirmed by surgery. On T1 weighted images after gadolinium administration, the masses were less well visualized.

Bile Duct Neoplasms↗