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Biomedical subjects

Y Robert

Publications and source records attributed to Y Robert.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Vertebral compression revealing acute lymphoblastic leukemia].

BACKGROUND: Vertebral compression is rarely the first manifestation of acute leukemia (AL) in children. CASE REPORT: Three children, 13, 4 and 13 years of age respectively, suffered from recent and persistent back pain. The first patient was considered as having psychosomatic problems despite thrombocytopenia at the first examination. The second patient was also pale with hematoma on his legs so that AL could be rapidly recognised. An initial diagnosis of Scheuermann disease was proposed for the third patient in whom hemogram was performed due to worsening of his general condition. The three patients had extended vertebral demineralisation on the first X-rays. CONCLUSION: Causes of back pain in children are often organic at this age of life. They must be searched by suitable examinations.

Adolescent↗
PubMed1996

Helical CT of the larynx: a comparative study with conventional CT scan.

AIM: To compare helical and conventional CT scans of the larynx. PATIENTS AND METHODS: Thirty-three patients underwent helical and conventional CT studies of the neck and the larynx using 3 mm section collimation for both studies and a table feed of 4 mm/sec for helical CT. Helical scans were reconstructed at 2 mm increments. Two independent observers rated the visibility of the laryngeal structures from 1 (poor and non diagnostic) to 5 (excellent and diagnostic), and motion artifacts from 1 (> or = 10 degraded scans) to 5 (no motion artifacts). RESULTS: The motion artifacts score was significantly better for helical CT. No significant difference was observed for the laryngeal structures score between helical and conventional CT studies. The interobserver kappa mean value was 0.756 and 0.68 for helical and conventional CT, respectively. CONCLUSION: Helical CT can be routinely performed and replace conventional CT study for the evaluation of laryngeal diseases.

Adult↗
PubMed1996

[Yellow discoloration of the lens in the diabetic patient].

BACKGROUND: The yellowing is a precursor of the cataract. In the diabetic patient this phenomenon is established earlier than in normal control groups. In the literature the yellowing is explained by elevated glucose levels. Does the duration of diabetes play a key role for this phenomenon? MATERIALS AND METHODS: The yellowing of the lens can be very well detected by the ocular photometer. Using this device, 52 well regulated diabetics without retinopathy and 19 diabetics with mild background retinopathy were examined. We determined the contrast-transfer ratio of the lens, which has been correlated with the age, the duration of diabetes, the weight of the patient, the bodymass index and the hemoglobin a1c of the patient. RESULTS: Without retinopathy none of the introduced correlations were significant. If the diabetes is well regulated, even a long duration of diabetes does not cause any yellowing of the lens. With mild retinopathy the yellowing of the lens could not be detected because of the sites of measurement, which were changing. A high correlation between the duration of diabetes and the intensity of the macula and the excavation has been found. The macula gets darker and the excavation gets brighter. CONCLUSIONS: The yellowing of the lens does not depend on any of the presented parameters. In diabetics with mild background retinopathy the macula gets darker. This can be interpreted as an hyperemia of the choroid. Most probably this phenomenon is caused by the decline of sympathetic nerve fibers.

Blood Glucose↗
PubMed1996

Petrous bone extension of middle-ear acquired cholesteatoma.

PURPOSE: To describe CT and MR features of extension to the petrous bone, which is a rare complication of acquired cholesteatoma (AC). MATERIAL AND METHODS: Postcontrast CT was performed in 4 patients, in axial (n=4) and coronal planes (n=2). The section thickness was 1.2 or 2.5 mm. MR was performed in 3 cases, using T1- and T2-weighted images (n=3) and postcontrast T1-weighted images (n=2). RESULTS: CT demonstrated a well-outlined lesion involving the petrous bone (n=4). Density could be assessed in 3 cases, showing a hypodense unenhanced mass. Lateral (n=1), superior (n=2), and posterior (n=2) semicircular canals were affected in 3 patients. AC extended to the vestibula, cochlea, and internal acoustic meatus (IAM) in 3 patients. Two ACs extended to the level of IAM, whereas 2 extended further, to the petrous apex. In one case the sphenoid sinus was affected. On MR imaging the lesion was hypointense relative to brain on T1-weighted images and hyperintense on T2-weighted images. MR imaging helped to delineate the lesion and to distinguish it from other cystic lesions of the petrous bone. CONCLUSION: CT and MR offer accurate preoperative assessment of the extension of cholesteatoma, which helps to choose the surgical approach.

Adult↗
PubMed1996

[Digestive amines of bacterial origin and behavior disorders. Apropos of a case].

Implication of amines in central nervous system diseases such as migraine, Parkinson disease, epilepsy and depressive illness, is well established. On an other hand, intestinal flora is responsible for the production of specific metabolites such as amines, particularly histamine, tyramine, putrescine and cadaverine. These amines can be absorbed in situ and, through unknown mechanisms, may affect the host's behavior. Most of the data about the pathological activities of bacterial amines concern animals. The concentrations of histamine, tyramine, putrescine and cadaverine in the feces of the studied "controls" appeared steady over time. For the patient presenting clastic crisis without any starting factor, variations appear to overcome the "controls" values, with a great variability. At least tyramine, putrescine and cadaverine concentrations variations are striking by superposed and seem associated to the arising hyper agressivity crisis.

Adrenergic Agents↗
PubMed1996

[Granulosa cell tumors: a case located in the broad ligament of the uterus with normal ovaries].

Granulosa cell tumours are relatively rare ovarian tumors. The incidence was 0.9 cases per 100,000 women per year. We describe a quite uncommon granulosa tumour found in the broad ligament. The patient was a 25-year-old, white woman, gravida 4, para 2. Surgical treatment was tumourectomy with homolateral salpingo-oophorectomy. From this observation, embryology, clinical and paraclinical aspects, treatment and prognosis of these tumours are reviewed.

Adult↗
PubMed1995

[Digital arteritis, thrombosis and hypereosinophilic syndrome: an uncommon complication].

Digital necrosis has been exceptionally described in association with the hypereosinophilic syndrome. We report a case of a smoking patient with idiopathic hypereosinophilic syndrome who developed digital arteritis with necrosis. A radial artery biopsy confirmed the vasculitis with inflammatory infiltrates which were predominantly eosinophilic granulocytes. The eosinophils may have an active role in the development of the vasculitis.

Adult↗
PubMed1995

Renal angiomyolipoma: growth followed up with CT and/or US.

PURPOSE: To follow up the growth of renal angiomyolipomas (AMLs). MATERIALS AND METHODS: Patients with known AML (n = 55) were divided into three groups on the basis of initial clinical and computed tomographic (CT) findings: group 1, isolated AML (n = 43); group 2, multiple AMLs without tuberous sclerosis (TS) (n = 6); group 3, multiple AMLs with TS (n = 6). Follow-up ultrasonography (US) and CT were performed in 55 and 31 patients, respectively. Growth of the AMLs (n = 59) was evaluated on the basis of area on initial and follow-up images. RESULTS: Mean percentage growth was 17%, 128%, and 47%, and mean growth rate per year was 5%, 22%, and 18% in groups 1, 2, and 3, respectively. New renal lesions were noted in three patients in groups 1 and 2, but no new lesions were detected in group 3, because of the large number of AMLs. New extrarenal lesions were observed in four, two, and three patients in groups 1, 2, and 3, respectively. No correlation was found between percentage of fatty tissue and growth rate. CONCLUSION: Multiple AMLs show more growth than solitary AMLs.

Adipose Tissue↗
PubMed1995

[Congenital neck masses. Embryonic origin and diagnosis. Report of the CIREOL].

Various congenital cervical anomalies are found in the neck region including defects of the branchial apparatus (branchial, thymic and parathyroid anomalies) and vascular anomalies. They manifest as cystic masses, sinuses, fistulas and as ectopic glands. This multicentric retrospective imaging study done in 5 different radiological centers (4 adult radiological departments and 1 pediatric radiological department) shows the result in understanding the congenital cervical anomalies and include 63 patients. The age of the patients varied between 24 days-81 years with a mean age of 23 years. This study included 27 patients having congenital branchial pouch anomalies (4 cases of anomalies of obliteration of the 4 th arch), 14 cases of cervical cystic hygromas, 11 thyroglossal tract cyst cases, 1 congenital laryngocele case, 1 case of jugular ectasia, 3 cases of capillary haemangioma. The embryologic basis of these different malformations were reviewed. Their characteristic findings and sites were illustrated together with their typical et atypical appearances. The frequency of occurrence of each branchial anomaly were plotted, the second branchial cleft cyst being by far the most common congenital cystic neck mass (70%). The study revealed the role of different imaging modalities in the diagnosis of various congenital cervical anomalies, especially in some particular complicated cases of congenital neck masses presenting in adult. Imaging study helps the clinician to anticipate any difficulties in unforeseen circumstances that may arise including infection haemorrhage, or parapharyngeal extension. Understanding the various radiologic appearances of these anomalies is greatly aided by familiarity with their embryologic origin. Moreover, considering the anatomic location and radiologic appearance, the precise embryologic origin can be accurately predicted.

Adolescent↗
PubMed1995

Congenital cholesteatoma of the temporal bone: MR findings and comparison with CT.

PURPOSE: To describe the MR findings of temporal bone congenital cholesteatoma and MR usefulness in preoperative diagnosis and follow-up, in comparison with CT. METHODS: Seven patients underwent CT and MR studies for facial palsy (n = 3), deafness (n = 3), vertigo (n = 1), tinnitus (n = 1), and otalgia (n = 1). Three patients had for congenital cholesteatoma previously undergone surgery. One of them was free of symptoms and referred for follow-up. Final diagnosis was obtained from surgical data in all the cases but one. RESULTS: Congenital cholesteatoma signal intensity was low or intermediate on T1-weighted images and high on T2-weighted images in all the cases. MR was useful in diagnosis in six cases, helping to differentiate congenital cholesteatoma from other nonenhancing tumors. When temporal bone wall erosion was observed with CT (n = 6), MR ruled out intracranial extension in five cases; in one case, MR found an associated epidermoid cyst of the cerebellopontine angle not identified with CT. However, CT assessed relationships with labyrinthine structures more easily. CONCLUSION: MR and CT are complementary in initial diagnosis and follow-up.

Adolescent↗
PubMed1995

Ultrasound assessment of ovarian stroma hypertrophy in hyperandrogenism and ovulation disorders: visual analysis versus computerized quantification.

OBJECTIVE: To extend our previous findings on the diagnostic validity of ovarian stroma hypertrophy in women with hyperandrogenic and/or menstrual disorders. DESIGN: Transvaginal ultrasonography was performed in 69 patients complaining of hyperandrogenism and/or menstrual disorders and in 48 normal ovulatory women in early follicular phase. To check the validity of stroma assessment by visual analysis, we used computer-assisted analysis, which allowed selective measurement of the stromal area on a longitudinal ovarian cut. Sensitivity and specificity of each method were estimated by using the normative data from the control group. RESULTS: Stromal area was considered to be increased using visual analysis and computer-assisted analysis in 74% and 61% patients, respectively. Specificity of this sign was 84% and 96% by visual analysis and computer-assisted analysis, respectively. In patients, the increase in stromal area correlated very significantly with the one of total ovarian area, whose upper normal limit was 5.5 cm2 per ovary. CONCLUSION: Visual assessment of stroma may be misleading in some cases, with the risk of overestimating its hypertrophy. An increased total ovarian area > 5.5 cm2 (which can easily be detected by carefully shaping a strict longitudinal ovarian cut) has the same diagnostic value as an increased stromal area by computerized measurement.

Adolescent↗
PubMed1995

[Polycystic ovaries: an imprecise ultrasonographic definition].

In the absence of a precise definition, the terms "ovarian dystrophy" are often erroneously used. Therefore we propose a more modern terminology which allows to distinguish two types of ovarian follicle pathology: the microfollicular disease results from a follicular arrest of maturation, leading to an accumulation of immature microfollicles in the ovarian cortex. The clinical correlate is anovulation. This disease encompasses two aetiologic entities: polycystic ovarian disease (PCO) and the multifollicular ovaries (MFO), which were previously gathered under the label of "endocrinal ovarian dystrophy"; the macrofollicular disease results from the excessive growth of one or several follicles with or without luteinisation. Its clinical correlate is pelvic pain. It includes three main aetiologies: macropolycystic ovaries, functional cysts and LUF syndrome. These could also be termed "mechanical or local dystrophy". This new classification allows to consider two distinct anatomical entities which represent the whole of functional ovarian pathology.

Diagnosis, Differential↗
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↗
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

[Surgical treatment of snoring and sleep apnea syndromes. Results apropos of 59 cases].

From 1991 to 1993, 59 patients underwent surgical cure for snoring. Polysomnography was performed 47 times when history taking and clinical signs revealed diurnal and nocturnal manifestations. Sleep apnea was confirmed in 20 patients with a mean apnea-hypnea index of 34.1. Treatment was based on surgery of the velum palatinum in 59% of the cases, the palatine tonsils in 39% and the basilingual tonsils in 1 patient. Snoring disappeared in 24 patients (40%) and improved for 75% satisfaction in 22 patients (37%).

Adult↗