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Y Robert

Publications and source records attributed to Y Robert.

At least 91 records · Page 5Linked to original sources
PubMed1994

MR findings of ejaculatory duct cysts.

Ejaculatory duct cysts are a rare type of prostatic cysts. We report 3 cases of symptomatic ejaculatory duct cysts which have been explored by MR imaging. The MR findings were round or oval masses, medial or paramedial in the prostatic gland above the level of the verumontanum, extending into the prostatic base. They displayed a low signal intensity on T1-weighted images and high signal intensity on T2-weighted images (2 cases) or high signal intensity on both T1- and T2-weighted images (1 case). The diagnosis was confirmed by an ultrasonographically guided transperineal aspiration demonstrating spermatozoa in the cyst fluid.

Adult↗
PubMed1994

[Iatrogenic aneurysm of the hepatic artery. Treatment by percutaneous injection of thrombin and selective arterial embolization].

One case of hemobilia, revealing a right hepatic aneurysm, following a hepatic biopsy for active chronic hepatitis B, is reported. The diagnosis established by computed tomography and arteriography. Because of chronic hepatitis and the high localization of the aneurysm, surgery was not performed. A direct percutaneous thrombin injection was performed, owing to the fact that arterial catheterization was unsuccessful, and was followed by a decrease in volume of the aneurysm, but definitive recovery was achieved secondarily by arterial embolization (coil). This case illustrates the therapeutic alternative biopsy in intrahepatic arterial aneurysm treatment.

Aneurysm↗
PubMed1993

Interrelationship between ultrasonography and biology in the diagnosis of polycystic ovarian syndrome.

In order to compare the diagnostic significance of hormonal and ultrasonic criteria of polycystic ovarian syndrome (PCOS), the presence or the absence of ultrasonographic and hormonal features of PCOS were recorded in a heterogeneous population of 90 women presenting with hyperandrogenism and/or menstrual disorders. On clinical and hormonal grounds exclusively, these patients could be separated into five diagnostic subgroups: presumed cases of PCOS (n = 21), idiopathic hirsutism (IH) (n = 26), hypothalamic anovulation (HA) (n = 11), hyperprolactinemia (HPRL) (n = 9), and miscellaneous or undetermined diagnosis (n = 23). By the means of a computed automatic classification of patients (cluster analysis) using five hormonal and ultrasonic criteria of PCOS, four homogeneous clusters of patients were obtained. Cluster #1 (25 patients) had the most characteristic profile of PCOS. It included 15 cases of PCOS and 7 cases of IH. Cluster #4 (47 patients) had the less characteristic profile of PCOS. It included the majority of patients with HA and HPRL and the half of the patients with IH. Cluster #2 included only two hyperandrogenic patients, who were massively obese and in whom ultrasonography may have failed to detect PCOS. Cluster #3 (16 patients) included patients from each diagnostic group, who were gathered together because ultrasonographic and hormonal features were, respectively, present and absent in nearly all of them. With the same analysis, the criteria of PCOS could be graded according to their grouping potential. The presence of an abnormal ovarian stroma by ultrasonography appeared as the most potent criterion. Elevated serum testosterone and androstenedione levels and the polyfollicular pattern of ovaries gave intermediate results, while elevated basal LH level was a much weaker grouping parameter. In conclusion, the automatic classification of patients by cluster analysis using both hormonal and ultrasonographic criteria revealed that the classical diagnostic classification, relying upon hormonal data exclusively, may arbitrarily separate patients having the same disease; and that ultrasonography affords pertinent information that should help provide a better diagnostic definition of PCOS.

Adolescent↗
PubMed1993

Pattern electroretinogram and visual evoked potential amplitudes are influenced by different stimulus field sizes and scotomata.

The pattern electroretinogram and the visual evoked potential were recorded simultaneously with various stimulus fields and artificial scotomata of increasing sizes. In contrast to an earlier study, a smaller check size (20') and two stimulus field sizes (20 degrees x 20 degrees and 10 degrees x 10 degrees) for the scotomata were used. With a concentric decreasing stimulus field, a reduction of both the pattern electroretinogram and visual evoked potential was found. Both showed a simultaneous reduction of amplitudes, but, compared with the amplitude in the full field, the reduction was more extensive for the pattern electroretinogram at each test field size. This implies a greater contribution to the pattern electroretinogram from more eccentric retinal parts. An artificial central scotoma of increasing size in the 20 degrees x 20 degrees field had less influence on the pattern electroretinogram than on the visual evoked potential. The percentage amplitude loss of the visual evoked potential was more pronounced. The visual evoked potential was eventually abolished by a scotoma size from 10 degrees x 10 degrees upward, while the pattern electroretinogram was still registrable. When scotomata of similar size were introduced in a smaller (10 degrees x 10 degrees) field, percentage pattern electroretinogram and visual evoked potential amplitude losses were less separated than in a larger (20 degrees x 20 degrees) test field.

Adult↗
PubMed1993

Biomorphometry of the optic disc.

This review describes the goals and methods for biomorphometry of the papilla. Until a few years ago, analogue methods were used to process fundus photographs, but today digitized and computerized methods are applied. Thus, the examination has become considerably simplified and clinically practical. Two main points are discussed in connection with these modern methods. First, biomorphometry provides data useful for the understanding of glaucoma. Papillary size is meaningful with regard to the sensitivity of the papilla to pressure, and reversal of cupping depends on pressure as well. Second, for longitudinal studies to be dependable, the clinically applied methods must have a very small margin of error so that an observed papillary change can be ascribed to disease, and not to methodologic errors.

Glaucoma↗
PubMed1993

Embolization of two bleeding aneurysms with platinum coils in a patient with polyarteritis nodosa.

We describe a patient with polyarteritis nodosa who developed a large retroperitoneal hemorrhage from a ruptured suprarenal capsule artery aneurysm. Platinum coils were embolized selectively during arteriography and successfully controlled the aneurysmal bleeding. The vasculitis was controlled ten weeks later but our patient developed anemia and computerized tomography scan revealed a large retrogastric hemorrhage. A further arteriogram confirmed the presence of a ruptured gastric coronary artery aneurysm. A second embolization was performed with complete success. Selective embolization of small arteries with coils should be considered a good alternative to surgery in patients with polyarteritis nodosa and hemorrhage from a ruptured aneurysm; arteriography may be considered a potent diagnostic and therapeutic tool in the management of the treatment of polyarteritis nodosa.

Aneurysm↗
PubMed1993

[Value of puncture-biopsy under computed tomography of adrenal masses associated with bronchial cancer].

In patients with a non small cell bronchogenic carcinoma, the detection on a CT scan of a uni or bilateral adrenal gland mass requires determination of its metastatic nature. CT guided needle biopsy (CTGB) is a minimally invasive method and allowed us to achieve this goal. From August 1986 to October 1992, 30 patients underwent such a biopsy. In 14 cases, a metastasis was diagnosed and in 13 cases the mass was benign. There were 3 false negative results. Two of these were rectified: one by a second CTGB and the other by adrenalectomy. Our results showed that CT scan was unable to discriminate metastasis from benign masses. Magnetic resonance imaging (MRI) was used for 11 patients and seemed to be a more accurate method: allowing detection of a pheochromocytoma and avoiding a CTGB which may have been dangerous, predicting the benign nature of some masses when they were iso-intense in relation to the liver on T2 weighted images. Thus, even with the contribution of MRI, in most cases of bronchogenic carcinomas coexisting with an adrenal gland mass, CTGB appeared essential to determine correct therapy: surgery or medical treatment.

Adenocarcinoma↗
PubMed1992

Lateral differences indicate future glaucoma.

Since eye pairs are anatomically and pathologically asymmetrical, we attempted to determine whether the transition from ocular hypertension to glaucoma might be typified by lateral differences in either intraocular pressure (IOP), papillary excavation, or visual field. Such lateral differences were sought in a retrospective study of the medical records of 47 patients exhibiting ocular hypertension, of whom 25 remained hypertensives and 22 developed glaucoma during the period considered. Although all visual field indices in the latter group had remained within the normal range, the same side consistently yielded significantly worse results in mean sensitivity, and the absolute value for the lateral difference in these individuals was significantly higher than that found for the patients who did not develop glaucoma. Future glaucoma is manifested when the mean sensitivity remains worse in one eye.

Adult↗
PubMed1992

Protracted ruthenium treatment of recurrent pterygium.

By combining excision with 106ruthenium irradiation in 17 patients previously operated on for persistently recurrent pterygium, we have devised an effective therapy that produces virtually no side effects and further prevents events recurrence. The ruthenium applicator shell was left in place for 2-3 h, yielding a total dosage of 2000 cGy. Only 2 of 17 patients suffered even slight recurrences, and 2 more had either motility disturbance or corneal haze. Through application of the internationally accepted total dosage of 2000 cGy, but at a relatively low dose rate, which especially protects the tissue responsible for proper healing, strong support is provided for the principle of protracted irradiation in recurrent (and possibly even primary) pterygium, permitting milder treatment and fewer recurrences.

Adult↗
PubMed1992

[Autoregulation in the choroid].

The cerebral perfusion is continuously and highly sensitively dependent on arterial pCO2. Does the ocular perfusion behave in a similar manner? To answer this question, the authors measured the following parameters before and after the inhalation of 10% CO2: a) the increase of capillary pCO2, using a transcutaneous sensor, and b) the redness (pallor) of the retinal tissue, an expression of its hemoglobin content, was measured at two retinal locations with the Ocular Photometer (OPM). Initial results from young test-volunteers and patients with documented carotis stenoses show that the choroid is able to maintain constant its blood-volume even under changing loads.

Adult↗
PubMed1992

[Discrete media clouding and its effect of contrast transfer coefficients, the pattern ERG and contrast sensitivity].

As a model for our study we selected 11 pseudophacic patients with secondary cataracts who experienced good postoperative visual acuity after extracapsular cataract extraction. Besides best visual acuity and contrast sensitivity Pattern-ERG (PERG) and Contrast-Transfer-Ratio (CTR) were measured before and after YAG-Kapsulotomy was performed. Visual acuity and contrast sensitivity increased in all patients after treatment, whereas CTR increased in eight patients. PERG was measured in five patients, in two cases its amplitudes were higher, the other measurements revealed unchanged or lower amplitudes. Our model shows that in addition to the usual psychophysic tests, with CTR and PERG there are objective methods available to measure discrete opacities of the visual system.

Cataract↗
PubMed1992

Carbohydrate moieties of myelin-associated glycoprotein, major glycoprotein of the peripheral nervous system myelin and other myelin glycoproteins potentially involved in cell adhesion.

The myelin-associated glycoprotein (MAG) and the major glycoprotein of the peripheral nervous system myelin (P0) are two members of the family of cell adhesion molecules (CAMs). A role in cell adhesion of the carbohydrate moiety of these molecules has been attributed to the presence of N-glycans bearing the HNK-1 carbohydrate epitope. On the other hand, it has been suggested that these glycoproteins could be ligands of an endogenous mannose-binding lectin present in myelin, the cerebellar soluble lectin (CSL). In order to further document the heterogeneity of the glycans of these two CAMs, we have used several probes: an anti-carbohydrate antibody of the HNK-1 type, called Elec-39, the plant lectin concanavalin A (ConA), and the endogenous lectin CSL involved in myelin compaction. This study shows that CSL binds to a small proportion of the polypeptide chains of MAG found in adult CNS of rats and man and the polypeptide chains of P0 molecules from adult human and rat sciatic nerve. For MAG from adult rat brain, the binding of CSL is restricted to glycans of polypeptide chains which could be separated from the others according to their solubility properties. These MAG molecular entities react also with the Elec-39 antibody and with ConA. These results confirm that P0 and MAG are heterogeneous in their carbohydrate moieties.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Anatomy of the auditory tube: CT scan and MRI aspect].

The auditory tube is a bony and cartilaginous canal which connects the middle ear to the nasopharynx. The bony portion (protympanum), explored by computed tomography, is cone shaped, with a posterior base. The main relations are: the intrapetrous carotid, the tensor tympani muscle, the middle cerebral fossa and temporo-mandibular joint. The fibrocartilaginous portion is explored by computed tomography and mainly by magnetic resonance. The fibrocartilaginous tube is posteromedial; its upper margin is curled outward to form the roof of the cartilaginous tube. Anterioly and Laterally, the auditory tube is closed by a fibrous membrane extending along the inferior surface of the auditory tube to form its floor. The auditory tube is in contact with two main muscle: the tensor veli palatini anterolateral and the levator veli palatini posterolateral and inferior. They are bounded by fascia: the intrapharyngeal fascia is medial, the pharyngo basilar fascia (salpingopharyngeal fascia of Trölstch, is between the tensor and levator veli palatini muscles; the fascia of Weber Liel is lateral to the tensor veli palatini. The auditory tube and its muscles form the lateral wall of the rhinopharynx and prevent the extension of a pathologic process to the para pharyngeal and infratemporal spaces.

Eustachian Tube↗
PubMed1992

[Quality of sedation and neurologic evaluation following surgery of the posterior cranial fossa: the importance of propofol].

Following cerebral posterior fossa surgery, 23 patients were admitted in Intensive Care Unit for postoperative mechanical ventilation. Mean age was 45 +/- 16 years. Mean duration of surgical procedure was 09 h 20 min +/- 04 h 45 min. Heart rate, blood pressure, coma Glasgow scale, pupil reaction, respiratory pattern were recorded throughout the study. Following recovery from anaesthesia sedation was initiated by an intravenous bolus injection of propofol 2 mg.kg-1 followed by a continuous infusion starting at 1 mg.kg-1.h-1. The infusion rate was adjusted thereafter to ensure that the patient was sedated (Glasgow coma scale less than or equal to 6), unable to react to tracheal suction, well adapted to mechanical ventilation with a cardiovascular stability. Mean duration of sedation was 27 h 45 min +/- 04 h 45 min. Mean infusion rate of 3.81 mg.kg-1.h-1 allowed good sedation in 22 patients. There were no clinical changes in arterial pressure and heart rate. Propofol infusion was stopped transiently to assess neurologic status at 18 h +/- 02 h 45, 33 h 45 +/- 08 h 15, 49 h 10 +/- 16 h 50 after sedation onset. During these interruptions, the speed of recovery was assessed and arterial blood samples taken simultaneously. When the infusion was discontinued, adequate recovery was obtained in 48 +/- 26 min for 17 patients of 23, 64 +/- 58 min for 7 of 12, 70 +/- 65 min for 3 of 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Polycystic ovarian disease: contribution of vaginal endosonography and reassessment of ultrasonic diagnosis.

OBJECTIVE: We evaluated the superiority of vaginal ultrasonography (US) on the abdominal US for the diagnosis of polycystic ovarian disease (PCOD). DESIGN: The US pattern of ovaries was prospectively investigated by abdominal US and, whenever possible, by vaginal US. SETTING: Primary care, institutional. PATIENTS: One hundred forty-four women in whom PCOD was suspected on endocrine grounds and 62 other patients presenting with primary hyperprolactinemia (n = 23) or hypothalamic anovulation (n = 39). MAIN OUTCOME MEASURE: Vaginal US allowed a better analysis of the ovarian stroma. RESULTS: The external ovarian features of PCOD were observed by both routes in less than one third of the 144 patients with PCOD. The internal ovarian features of PCOD were much more frequently observed by vaginal US than by abdominal US (polycystic pattern: 66.7% versus 38.1%, P less than 0.05; increased ovarian stroma: 57.1% versus 4.8%, P less than 0.001). In the 62 patients without PCOD, US features of PCOD were observed in less than 10% of them, except for the uterine width/ovarian length ratio less than 1 and the polycystic pattern (abdominal US: 17% and 34%; vaginal US: 11% and 50%, respectively). CONCLUSIONS: An increased ovarian stroma seems to be the most sensitive and specific US sign of PCOD, providing that it can be investigated by vaginal US.

Abdomen↗
PubMed1991

[Is there an ideal surgical time for retinitis pigmentosa patients with cataract?].

According to the literature, a fully developed cataract should be removed generally when the macula is intact. However, patients with a slowly progressing retinal disease find themselves in a particularly difficult situation. In this clinical, retrospective study, 24 retinitis-pigmentosa (RP) patients after cataract surgery were asked whether they recommend cataract surgery early or late in the course of the development of the retinal disease. A correlation was found between the answers to this question and the time elapsed between each patient's own operation and his interview. Three preference groups resulted through statistical evaluation: 1) those who recommend an early operation (n = 8), 2) those who recommend a late operation (n = 8), and 3) those who were undecided (n = 8). All patients had been operated at the same time following the RP onset and cataract diagnosis. Those patients who preferred a late operation had been questioned in this regard considerably later after their own operation than those who preferred an early operation. In other words, the preference for an early or late operation depended on how much prior to the questioning the patient's own operation had been conducted. The RP patient, quite disease conscious, has an exact conception of the ideal time of cataract operation in RP patients in general, but this does not always coincide with the opinion of his physician. It is considerably more necessary to consider the individual situation of the RP-patient than that of normal cataract patients.

Cataract Extraction↗