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Biomedical subjects

P Rouleau

Publications and source records attributed to P Rouleau.

At least 19 recordsLinked to original sources
PubMed2002

[Staging and follow-up of renal cell carcinoma].

Surgery is the only curative treatment of renal cell carcinoma (RCC). Preoperative staging is aimed at evaluating surgical possibilities and optimal surgical technique. Thoracic and abdominal CT is the best way to routinely evaluate locoregional and metastatic extension of the tumor. However, there is no consensus concerning which laboratory and imaging studies should be obtained to assess patients after radical nephrectomy or conservative surgery. Objectives of this review

Aftercare↗
PubMed2001

Familial form of cerebral cavernous malformations: evaluation of gradient-spin-echo (GRASE) imaging in lesion detection and characterization at 1.5 T.

The purpose of this study was to evaluate the turbo gradient-spin-echo sequence (GRASE) in the MR assessment of the familial form of cerebral cavernous malformations (CCM). Twenty-one patients (15 male, six female) aged from 21 to 68 years (mean = 42.2 years) were prospectively examined with cerebral MR imaging, including T2-weighted turbo gradient-spin-echo (TGSE), turbo spin-echo (TSE) and gradient-echo (GRE) sequences. All sequences were performed in the same plane, the same matrix and the same field of view and were analyzed for signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), susceptibility effects, number of CCM, size of CCM and signal of CCM. It was found that SNR and CNR in the TGSE sequence were significantly inferior to those in both TSE and GRE sequences. TGSE and TSE sequences were significantly less prone to susceptibility effects than the GRE sequence. The sensitivity of TGSE and TSE sequences in detecting CCM was significantly lower than that of the GRE sequence. TGSE and TSE sequences provided comparable information about CCM size and signal. It was concluded that GRASE imaging was less sensitive than the GRE sequence in the detection of CCM and provided information similar to that yielded by the TSE sequence in the characterization of lesions, but with a higher number of artifacts. GRASE imaging cannot therefore replace TSE or GRE sequences in the MR evaluation of the familial form of CCM.

Adult↗
PubMed2001

[Does renal transplantation increase the risk of breast diseases?].

PURPOSE: To evaluate the risk of breast pathology occurrence in a group of kidney transplanted patients. MATERIAL: and methods. In the last five years, 30 kidney-transplanted women underwent systematic breast evaluation in our institution and were included in this retrospective study (exposed-group). To compare with this exposed-group, 90 non transplanted women undergoing breast evaluation in the same period at our institution (non-exposed group), were retrospectively randomized. In both groups, results of breast evaluation were classified in two categories (normal and abnormal) and distribution of benign and malignant breast pathologies were evaluated. The mean exposition-time was determined in months in the exposed-group. Comparative analysis of both groups included a comparison of mean patients age and evaluation of the relative risk (RR) of breast pathology occurrence. RESULTS: Mean exposition time was 72.7+/-66.6 months. The percentages of benign breast pathology were 93.7% in the exposed-group and 83.3% in the non-exposed group. Percentages of cancer were respectively 6.3 and 16.7%. Mean patient age was quite similar in the exposed-group (50.7+/-10 years) and in the non-exposed group (50.6+/-10.5 years). The relative risk of breast pathology occurrence was 1.70 (0.99<RR<2.91) and was not significant. CONCLUSION: In this retrospective series, no risk of breast pathology occurrence was demonstrated in a population of kidney-transplanted patients.

Adult↗
PubMed2000

Uterine artery embolization in the primary treatment of uterine leiomyomas: technical features and prospective follow-up with clinical and sonographic examinations in 58 patients.

OBJECTIVE: The purpose of this study was to analyze the technical features of uterine artery embolization and to evaluate the effectiveness of this method as the primary treatment of uterine leiomyomas in a series of 58 patients monitored by clinical and sonographic examinations. SUBJECTS AND METHODS: Fifty-eight women (age range, 33-65 years; mean age, 44.5 years) with symptoms caused by uterine leiomyomas (abnormal bleeding, bulk-related symptoms, pelvic pain) were included in this prospective study. We performed embolization with a single catheter using the single-femoral artery approach, injection of particles (150-250 mm), and an absorbable gelatin sponge. Postprocedural pain was assessed using a visual analog scale. Systematic follow-up included clinical and sonographic examinations at 3 months for 58 patients, at 6 months for 46 patients, at 1 year for 27 patients, and at 2 years for seven patients. RESULTS: Embolization was performed without problems in 84% of the patients. Post-procedural pain control was excellent in 90% of the patients. In most patients, symptoms were improved or had resolved at 3 months (90%), 6 months (92%), and 1 year (93%), and all patients were symptom-free at 2 years. Clinical failure of treatment occurred in only two patients (3%). Progressive reduction in leiomyoma size was revealed during sonographic follow-up, and new leiomyomas were seen in one patient at 2 years. CONCLUSION: Uterine artery embolization is an endovascular method for the treatment of uterine leiomyomas that is clinically effective in most patients and that induces a progressive reduction in the size of the largest leiomyomas.

Adult↗
PubMed2000

[Sonographic evaluation of human male infertility].

The male partner is responsible for 50% of infertility in couples. Assessment of male infertility should include clinical examination, laboratory tests (semen analysis, dosage of gonadal and gonadotropic hormones) and sonographic examination of the urogenital tract. Male infertility is related to diverse abnormalities including testis lesions (infertility of secretory type) and obstructive disorders of the genital tract (infertility of excretory type). Sonographic examination with abdominal, scrotal and transrectal probes has become the major imaging modality to evaluate male infertility and especially to analyze infertility of excretory type related to inflammatory lesions, congenital agenesis of vas deferens and congenital cyst of the distal genital tract. The main purpose of this paper is to illustrate with sonography the normal anatomy of the male genital tract and to detail sonographic features of current pathologies responsible for human male infertility.

Diagnosis, Differential↗
PubMed2000

[An unusual thoracic opacity].

We report a case of a paraspinal meningocele in a 37-year-old man with no other clinical manifestation. The diagnosis was established on the basis of the computed tomography and magnetic resonance imaging features.

Adult↗
PubMed1999

Esophageal swallowing phase assessed by audiosignal recording: relationship with manometry in gastroesophageal reflux disease patients.

The acoustic technique has been used for pharyngeal exploration but to date no such technique has been devised to assess esophageal motility. The aim of this study was to demonstrate that displacement through the esophagus can be quantified using this method in healthy subjects and in patients with gastroesophageal reflux. Concurrent manometric and acoustic recordings were also performed in the patients. Fifteen controls (38.5 +/- 13 years old) and 10 patients (34.9 +/- 6 years old) were included. All were recorded during wet and dry swallow sequences with microphones placed below the cricoid cartilage and on the xiphoid appendix. Standard manometry was performed for lower esophageal sphincter (LES) exploration. For the acoustic technique, the frequency of xiphoid signals (FX), esophageal transit time (ETT), duration of xiphoid sound (SD), and for the manometric study, the duration of LES relaxation (RD) were recorded and mean values were calculated (FXm), (ETTm), (SDm), (RDm). FXm for wet (94 vs 81.6%) and dry swallows (86 vs 66.6%) decreased in patients. ETTm was significantly higher (P < 0.01) for wet than for dry swallows (5.6 +/- 0.9 vs 5.2 +/- 1.2 sec) for controls but not for patients. ETTm was significantly higher for patients for wet (7.2 +/- 2.1 sec) and for dry swallows (6.5 +/- 2.3 sec) than for controls and SDm was lower. Xiphoid sound appeared in the second half of LES relaxation. Our noninvasive acoustic technique is simple and reproducible. It is well correlated with manometry, and it allows characterization of the displacement of the bolus through the esophagus and the LES. The technique could be used alone to determine appropriate pharmacological and surgical treatments for esophageal motility disorders.

Acoustics↗
PubMed1998

[MRI diagnosis of sinus cavernous invasion by pituitary adenomas].

PURPOSE: To evaluate the preoperative MRI criteria of a sinus cavernous invasion by a pituitary adenoma. MATERIAL AND METHODS: Study of 102 cavernous sinuses among 51 patients who had had a surgical cure of pituitary adenoma. Thirteen patients had a surgical invasion of the cavernous sinus. RESULTS: A certain number of signs eliminated cavernous sinus invasion. The best means consisted in not crossing the intercarotid line (Sensitivity-Se = 100%, Specificity-Sp = 85% and Negative Predictive Value-NPV = 100%). The others means implied: not going past twelve o'clock on the internal carotid artery-ICA (NPV = 97.1%), symmetrical size of the cavernous sinus (NPV = 92.5%), non-convexity of the lateral wall (NPV = 90.2%), visualization of at least two venous groups of the laterosellar space (NPV = 90.2%) and finally, non-displacement of the ICA (NPV = 89.2%). The best criteria for diagnosis were passing by the intra and supracavernous ICA lateral tangent (Se = 84.6%, Sp = 95%) and the percentage of ICA encasement by the adenoma exceeding 25% (Se = 92.3%, Sp = 85%). CONCLUSION: Except the total encasement of the intracavernous ICA, the cavernous sinus can be invaded when the lateral tangent of the supra and the intracavernous ICA is crossed, and also when the percentage of ICA encasement exceeds 25%.

Adenoma↗
PubMed1997

Exploration of pharyngeal swallowing by audiosignal recording.

The aims of this study were to analyze the following by audiorecording of swallows: (1) the influence on the volume and consistency of ingested substances on the audiosignal recorded during separate swallows; and (2) the characteristics of successive swallows during ingestion of 100 ml of the same substances to define deglutitive behaviors. Volunteers followed two protocols. Protocol (P) 1 comprised ingestion of 100 ml of water or yoghurt in successive swallows and Protocol 2 comprised separate swallows of different volumes of the same substances. Audiosignal recordings were made with a dynamic microphone. The following parameters were measured in P1: total time of ingestion (TT), number of swallows necessary for ingestion (N), and spontaneous swallowing intervals (SI). In P2 the duration (d) of each signal was measured according to consistency and volume. Mean (m) values were then calculated (TTm, Nm, SIm, and dm). During P1, TTm for yoghurt was significantly longer than for water (23.1 vs. 6.5 sec (men) and 21.8 vs. 7.8 sec (women). Nm was also greater for yoghurt (10.1 vs. 4.3 (men) and 10.0 vs. 4.8 (women). Three types of swallowing behavior were defined according to SI: swallowing at regular intervals (Reg) with increasing intervals during ingestion (Prog) and swallowing at variable intervals (Irreg). These patterns did not differ significantly according to sex. In P2 the increase in volume swallowed increased the duration (dm) of the signal for water (600 msec for 5 ml and 960 msec for 15 ml). The dm for yoghurt was significantly less than for water (580 msec for 5 ml and 920 msec for 15 ml). Our technique of recording sounds of pharyngeal swallowing is simple, reproducible, and not expensive. It permitted the analysis of each swallow according to volume and consistency and the determination of three swallowing patterns (Reg, Prog, and Irreg), taking into account the spontaneous swallowing interval. Ingestion by successive swallows could be used to characterize certain pharyngoesophageal motor dysfunctioning in relation to this reference population and to integrate this into a deglutition rehabilitation program.

Acoustics↗
PubMed1997

Erythromycin elicits opposite effects on antro-bulbar and duodenal motility: analysis in diabetics by cineradiography.

We have previously demonstrated by cineradiography analysis that erythromycin (Ery) increases antral contractility and antropyloric coordination in diabetics. The aim of this study was to further characterize antro-bulbar and duodenal motility after Ery i.v. administration. Fourteen diabetic patients (mean age 61.2 years) were randomly allocated to receive either 100 or 500 mg of Ery intravenously 4 hours after a standard solid liquid meal. After ingestion of a barium sulfate suspension, a series of 15 fluorographic plates (one every two seconds) was performed. the same procedure was repeated twice for each subject with a delay of 3 days once before and once after Ery. Antral, bulbar and duodenal areas and evolution diagrams were calculated in baseline conditions and after Ery administration using a graphic table connected to a microcomputer. No differences were found between the two doses of the drug. Ery significantly decreased antral (1284 +/- 268 mm2 vs 704 +/- 181 mm2; P < 0.01) and bulbar areas (127 +/- 26 mm2 vs 73 +/- 21 mm2; P < 0.01). In contrast, duodenal areas were significantly increased after Ery (875 +/- 112 mm2 vs 575 +/- 112 mm2; P < 0.01). This study suggests that the known prokinetic effect of Ery on gastric emptying seen in diabetic patients could be related to an increase of motility in the antrum and in the bulb simultaneously with a relaxation in the duodenum.

Adult↗
PubMed1996

Time course of biodistribution and changes in density following administration of iobitridol in rabbits. A comparative study vs iohexol.

PURPOSE: A new nonionic low-osmolality contrast medium, iobitridol (Xenetix 350) was compared with iohexol (Omnipaque) after i.v. injection in anesthetized rabbits to assess efficacy in CT examinations and biodistribution. MATERIAL AND METHODS: The densities in test tubes and the pharmacogenetics and biodistribution of iobitridol 350 and iohexol were compared in rabbits. CT of the brain, liver, the abdominal aorta and the kidneys was performed before and after injection of the contrast media. RESULTS: In aqueous medium, iobitridol absorbed roentgen rays in a manner exactly identical to that of iohexol. Within 15 min following injection of iohexol and iobitridol at a dose of 300 mg I/kg, both contrast agents resulted in aortic enhancement which decreased with time. An increased attenuation of the liver also occurred, decreasing with time. There was no significant enhancement in the brain but enhancement was found in the renal pelvocalyceal cavities 10 min postinjection. No significant difference was found between the 2 contrast agents under the study conditions. CONCLUSION: As could be expected from its behavior as a tracer of extracellular fluid, iobitridol resulted in significant changes in the signal, corresponding to its vascular, hepatic and renal pharmacokinetics in rabbits.

Animals↗
PubMed1996

[Color Doppler ultrasonography of local recurrent breast cancer].

Local lesions occurring after conservative surgery for breast neoplasms require diagnostic means capable of detecting and assessing the recurrence of such cancers. In the present color-coded Doppler was used in 20 women who had under gone conservative surgery (mean 4 years before) to screen all suspect lesions. Among the 14 malignant lesions assessed histologically, one or more arterial vessels were detected inside or beside the lesion in 13. Among the 6 benign lesions, only of one arterial vessel was detected, in all cases far from the lesion (12.5 to 3.3 mm). No significant difference was observed for systolic velocities and resistance index. These results indicate high accuracy of color coded Doppler examination associated with echotomography and mammography for positive diagnosis of recurrent lesions in post-conservative follow-up of breast cancer.

Adult↗
PubMed1995

Immediate and delayed tolerance of iohexol and ioxaglate in lower limb phlebography: a double-blind comparative study in humans.

RATIONALE AND OBJECTIVES: We compared the tolerance and efficacy of iohexol-300, a nonionic low-osmolar monomer, with those of ioxaglate-320, an ionic low-osmolar dimer, in lower limb phlebography. METHODS: One hundred twenty inpatients were randomly divided into two groups in this double-blind comparative study. Two hundred milliliters of contrast medium (100 ml per leg) was injected intravenously. The immediate tolerance was classified as discomfort (i.e., sensation of warmth, pain, coldness related to the injection) and adverse events occurring up to 1 hr after administration. Delayed tolerance was followed up to 8 days after the examination. The main parameter was immediate adverse events. Image quality was assessed by a radiologist using a visual analog scale. RESULTS: The number of immediate adverse events was significantly higher in the ioxaglate group (p < .02). The more frequent events were digestive disorders and skin rashes; 13 of these events were reported in the ioxaglate group, but none were reported in the iohexol group (p < .001). The other parameters were not significantly different in the two groups. CONCLUSION: We found a similar efficacy and a better tolerance of iohexol-300 than ioxaglate-320 in lower limb phlebography.

Contrast Media↗
PubMed1994

[Minor aplasia of the ear: anatomical findings and results of functional surgery].

We report a retrospective study of 57 cases of minor aplasia of the ear. Each case was analyzed according to the clinical presentation, audiometric results and preoperative radiography. Intra-operative classification of the malformation was obtained in 56 of the 57 cases. The post-operative anatomic and functional results were analyzed. Stapedectomy in type II malformations (stapedo-vestibular ankylosis) gave the best results but this procedure also carries the highest risk for the inner ear. Globally, functional results were good or average in 48% of the patients. These results may appear unsatisfactory but must be appreciated in light of the fact that half of the patients benefited from the operation (particularly in eliminating further use of an external hearing aid). Nevertheless, the long-term stability of these audition results is unknown.

Adolescent↗
PubMed1994

[Simplified measurement of colonic transit time by one radiography of the abdomen and a single type of marker. Normal values in 82 volunteers related to the sexes].

Assessment of total and segmental colonic transit times (CTT) in man using a single type of radiopaque marker and one abdominal X-ray has been validated but not extensively studied. The aims of our prospective study were to establish normal values of this method as a function of age, gender and fiber intake in healthy subjects. Eighty-two healthy volunteers (51 men, 31 women, mean age 38 yr, range 21-61) with normal stool frequency (between 3/day and 3/week) and no history of gastrointestinal disease or medication were enrolled and ingested 10 small (3 mm edge) radiopaque markers every morning for 6 consecutive days. On the 7th day, an abdominal X-ray was performed to calculate total and segmental (right, left, rectosigmoid) CTT according to Arhan's method (CCT = 2.4 N; N = number of markers in the considered zone). During the study the number of stools was recorded and fiber intake estimated on a questionnaire. Stool frequency, total and segmental CTT were evaluated for differences due to age, gender and/or fiber intake. In volunteers, total, left and rectosigmoid CTT were closely related to stool frequency (P = 0.0001) being longer in women than in men (P < 0.02). In contrast, right CTT was independent of gender or stool frequency. Finally, in this group CTT were independent of age and fiber intake. This study confirms the influence of gender on CTT and demonstrate the ability of this simple and non-invasive method (0.08 mrad surface exposure) to assess CTT. Its use as a diagnostic tool in self-defined constipated patients would be of interest in clinical practice.

Adult↗