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Pérez-Dueñas B, Pujol J, Soriano-Mas C, Ortiz H, Artuch R, Vilaseca MA, Campistol J. Global and regional volume changes in the brains of patients with phenylketonuria. Neurology 2006; 66:1074-8. [PMID: 16606920 DOI: 10.1212/01.wnl.0000204415.39853.4a] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Although phenylketonuria is a treatable disease, patients with late or nonoptimal phenylalanine-restricted diet may experience brain damage. The authors used tridimensional MRI and a voxelwise analysis method to investigate possible volume changes in the brain parenchyma of patients with phenylketonuria.Methods: The authors assessed 27 treated patients (mean age ± SD, 20 ± 7 years) and 27 matched control subjects. Global tissue volumes were compared, and statistical parametric maps of between-group regional volume differences were obtained for gray and white matter. Anatomic data were correlated with relevant clinical and biochemical variables.Results: Patients with phenylketonuria showed smaller gray matter volumes that were associated with lower IQ and older age at diagnosis. Voxel-based maps revealed that significant gray matter volume reduction occurred in motor and premotor cortex and thalamus. A relative increase in gray matter volume was observed in the ventral part of the striatum. The authors found no group differences for global white matter measurements. Higher recent phenylalanine levels, however, were associated with larger global white matter volume in early-treated patients. Voxel-based maps showed a relative volume reduction in periventricular white matter and a relative increase in the region of the internal capsule, extending to the adjacent thalamus and striatum.Conclusions: Treated patients may show significant gray and white matter volume changes related to the duration and strict observation of dietary treatment. Further studies are needed to investigate whether the presence of neurologic symptoms may be explained by specific anatomic alterations.
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Bentounes M, Coumenges P, Senadji K, Pujol J. [Primary pneumococcal peritonitis]. Ann Biol Clin (Paris) 2006; 64:190-1. [PMID: 16688885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
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Pujol J, Breton J, Gervais R, Tanguy M, Quoix E, David P, Janicot H, Depierre A, Gameroft S, Geneve J. O-159 A prospective randomized phase III, double-blind, placebo-controlled study of thalidomide in extended-disease (ED) SCLC patients after response to chemotherapy (CT). Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80293-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pujol J, Barlesi F, Daures J. PD-079 Should chemotherapy combinations for advanced non-small cell lung cancer (NSCLC) be platinum-based? A literature-based meta-analysis of phase III randomised trials. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80412-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jacot W, Colinet B, Bertrand D, Lacombe S, Bozonnat M, Pujol J. PD-073 A new simplified comorbidity score as prognostic factor innon-small cell lung cancer (NSCLC) Patients: Description and comparison with the Charlson's index. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80406-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Morlà RM, Pujol J, de Rivas P. [Not Available]. REUMATOLOGIA CLINICA 2005; 1:56-57. [PMID: 21794238 DOI: 10.1016/s1699-258x(05)72714-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Taourel P, Baud C, Lesnik A, Le Guen V, Pujol J, Bruel JM. Le péritoine acteur de la pathologie abdominale. ACTA ACUST UNITED AC 2004; 85:574-90. [PMID: 15184805 DOI: 10.1016/s0221-0363(04)97632-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The peritoneum is an important actor in diseases of the abdomen: defects of the peritoneum or mesos may lead to internal hernias; developmental anomalies of the peritoneum may lead to volvulus and bowel obstruction; diffuse or localized primary or secondary tumors of the peritoneum may develop; infectious, inflammatory or ischemic primary diseases of the peritoneum may cause abdominal pain, sepsis or result in the formation of fluid collections. The purpose of this presentation is to illustrate the role of imaging in the diagnosis of these different diseases and to provide some guidelines allowing their detection and characterization.
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Pujol J, Gispets J, Arjona M. Optical performance in eyes wearing two multifocal contact lens designs. Ophthalmic Physiol Opt 2003; 23:347-60. [PMID: 12828625 DOI: 10.1046/j.1475-1313.2003.00127.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The optical performance of eyes wearing soft multifocal contact lenses was studied using the double-pass technique. Retinal image quality was measured in a group of six eyes wearing two different designs of multifocal lenses: an aspheric design and a spheric multicurve design. Measurements were performed for far, intermediate and near vision conditions and with two different pupil diameters: 3 and 5 mm. The results show that the best optical performance is obtained for far vision conditions when no lens is worn. For near vision conditions, the optical performance when the lens is worn is, in general, better than when no lens is worn. When the lens is worn, the optical performance for far and intermediate vision conditions is similar for the aspherical design, but it decreases for near vision conditions. For the spherical multicurve design, the optical performance obtained for far vision conditions is similar to that obtained for intermediate vision conditions for low values of object vergence, but decreases when the object vergence is high and therefore also for near vision. In general, the differences in optical performance are greater for small pupil diameters (3 vs 5 mm). The general trends of the results obtained by computing the modulation transfer function of the contact lens-eye system can also be shown qualitatively by means of double-pass images or quantitatively by computing the Imax/Imed of the image.
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Taourel P, Kessler N, Lesnik A, Pujol J, Morcos L, Bruel JM. Helical CT of large bowel obstruction. ABDOMINAL IMAGING 2003; 28:267-75. [PMID: 12592477 DOI: 10.1007/s00261-002-0038-y] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Boulet P, Taourel P, Prat X, Pujol J. Tumour detection and staging by contrast enhanced MRI. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2002; 21:37-8. [PMID: 12585652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
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Gispets J, Arjona M, Pujol J. Image quality in wearers of a centre distance concentric design bifocal contact lens. Ophthalmic Physiol Opt 2002; 22:221-33. [PMID: 12090637 DOI: 10.1046/j.1475-1313.2002.00021.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The optical performance of eyes wearing bifocal concentric contact lens was studied using the double-pass technique. Retinal image quality was measured for four subjects wearing CIBA Bisoft contact lenses presenting the central zone for correcting distance vision. Lenses with two different central optic zone diameter (COZD), 3.2 and 3.8 mm, were studied and the influence of pupil diameter and viewing distance were analysed. Results show that the best optical performance is obtained for far vision conditions when no lens is worn even if the pupil coverage by the COZD is complete. For near vision conditions, the optical performance when the lens is worn is, in general, better than when no lens is worn. When the lens is worn the best optical performance corresponds to a pupil diameter of 3 mm and far vision conditions. For this pupil diameter, variations in the situations analysed can be explained by changes in the percentage of pupil coverage corresponding to the far or the near vision zone of the lens. For a pupil diameter of 5 mm, the retinal image quality is more similar in all situations studied and pupil coverage alone cannot explain the results obtained and the influence of other parameters related to the design or contact lens fitting characteristics must be considered.
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Alaez C, Infante E, Pujol J, Duran C, Navarro JL, Gorodezky C. Molecular analysis of HLA-DRB1, DQA1, DQB1, DQ promoter polymorphism and extended class I/class II haplotypes in the Seri Indians from Northwest Mexico. TISSUE ANTIGENS 2002; 59:388-96. [PMID: 12144622 DOI: 10.1034/j.1399-0039.2002.590505.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The study of the genetics of the Major Histocompatibility Complex (MHC) in Amerindians is of great value in understanding the origins and migrations of these native groups, as well as the impact of immunogenetics on the epidemiology of diseases affecting these populations. We analyzed, using Polymerase Chain Reaction and Sequence Specific Oligonucleotide Probes (PCR-SSOP), DRB1, DQA1, DQB1 alleles and the promoter regions of DQA1 and DQB1 genes in 31 unrelated and 24 related Seri, a Mexican Indian group, from the state of Sonora (Northwest Mexico). The class II genotypes of this population were found to be in genetic equilibrium. The allele frequency (AF) of the prevalent DRB1 alleles were DRB1*0407 (48.4%), DRB1*0802 (33.9%) and DRB1*1402 (16.1%). The most frequent DQA1 and DQB1 alleles were DQA1*03011 (AF = 50.00%), DQA1*0401 (AF = 33.87%) and DQA1*0501 (AF = 16.13%); DQB1*0302 (AF = 50.00%), DQB1*0402 (33.87%) and DQB1*0301 (16.13%); which were in combination with DRB1*0407, DRB1*0802 and DRB1*1402, respectively. Three QAP and three QBP alleles were present (QAP 3.1, 4.1, 4.2; QBP 3.1, 3.21, 4.1) associated with the typical published DQA1 and DQB1 alleles. Four class II haplotypes were present in family members: DRB1*0407-QAP-3.1-DQA1*03011-QBP-3.21-DQB1*0302; DRB1*0802-QAP-4.2-DQA1*0401-QBP-4.1-DQB1*0402; DRB1*1402-QAP-4.1-DQA1*0501-QBP-3.1-DQB1*0301 and DRB1*0701-QAP-2.1-DQA1*0201-QBP-2.1-DQB1*0201. The family data were used to confirm extended haplotypes. A total of 21 haplotypes were found when A* and B* loci were also considered. The three most frequent combinations included A*0201-B*3501-DRB1*0407, A*3101-B*5101-DRB1*0802, and A*0201-B*40-DRB1*1402.
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Balladares S, Alaez C, Pujol J, Duran C, Navarro JL, Gorodezky C. Distribution of TAP gene polymorphisms and extended MHC haplotypes in Mexican Mestizos and in Seri Indians from northwest Mexico. Genes Immun 2002; 3:78-85. [PMID: 11960305 DOI: 10.1038/sj.gene.6363835] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2001] [Revised: 11/14/2001] [Accepted: 11/15/2001] [Indexed: 11/08/2022]
Abstract
The study of the genetic structure is very useful for investigating the biological significance of polymorphism and may provide clues to understand population origins. We present TAP1/TAP2 gene analysis in the Seri indians from Sonora, and in Mestizos from the highlands of Mexico. Thirty-two Seri and 89 Mestizos were studied. TAP genes were typed using the ARMS-PCR technique. The most frequent alleles in Seri were: TAP1*0101/02, (68.8%); TAP1*02011/02012, (31.2%); TAP2*0201, (38.7%) and TAP2*0101, (29.0%). TAP1*0301, TAP1*0401, TAP2*0102 TAP2*0103 and TAP2H were absent in them. For Mestizos, the prevalent alleles were: TAP1*0101/02 (75.8%); TAP1*02011/12 (20.3%); TAP2*0101 (45.4%) and TAP2*0201 (29.3%). These results are similar to those found in Kaingang and Caucasians from Brazil, four Mediterranean, other Caucasians, two Oriental and one African group. In Seri, the extended prevalent haplotypes are typically Amerindian, such as TAP1*0101/2-TAP2*0201-QBP3.21-DQB1*0302-QAP*3.1-DQA1*03011-DRB1*0407-B*3501-A*0201 (HF = 16.6%). Thirty-two extended haplotypes were found in Seri, although TAP contributed scarcely to diversity. Mestizos show Amerindian and Caucasian combinations. No difference was detected in the distribution of amino acids in the individual variable sites, between both groups. These findings are the basis for further anthropological studies and to explore the contribution of TAP genes to disease expression in Mexicans.
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Martí-Fàbregas J, Valencia C, Pujol J, García-Sánchez C, Roca-Cusachs A, López-Contreras J, Solé MJ, Martí-Vilalta JL. Blood pressure variability and leukoaraiosis amount in cerebral small-vessel disease. Acta Neurol Scand 2001; 104:358-63. [PMID: 11903090 DOI: 10.1034/j.1600-0404.2001.00082.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To analyze the correlation between blood pressure (BP) variability and leukoaraiosis (LA) amount in patients with symptomatic cerebral small-vessel disease. MATERIALS AND METHODS We included 25 hypertensive patients: 13 with Binswanger's disease (BD) and 12 with a first-ever lacunar infarction (LI). Baseline office BP was obtained for 3 consecutive weeks. From a 24-h ambulatory BP monitoring performed 1 week later we obtained average systolic (SBP) and diastolic (DBP) BP for daytime, nighttime and 24-h periods. SBP and DBP variability was defined as the within-subject standard deviation of all readings. A standardized cerebral MR was performed in each patient and an LA score was calculated. RESULTS No statistically significant correlation was obtained between the LA score and any of the following BP values: 1) Baseline SBP and DBP; 2) 24-h, daytime or nighttime SBP and DBP, and 3) 24-h, daytime or nighttime SBP and DBP variability. CONCLUSION Increased BP variability is not associated with greater amounts of leukoaraiosis.
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de Azpiazu P, Salamero M, Pujol J, Cuevas R. [Aggressive behaviour in dementia. RAGE scale, validation of the version in Spanish]. Rev Neurol 2001; 33:928-30. [PMID: 11785003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
INTRODUCTION Aggressive behaviours are frequent in the different phases of dementia s evolution. These not only constitute a major problem for the families and the caring staff, but cause fatigue and bur out among them. As these behaviours cannot be predicted or understood, the carers experience very complex and anguishing situations. To avoid subjective factors, Patel and Hope designed and validated a scale named RAGE that can be easily used. OBJECTIVE. Adaptation and validation of the RAGE Scale into Spanish. PATIENTS AND METHODS The scale has been translated, and then retrotranslated to guarantee the semantic equivalence. Afterwards it has been tested on a group of 60 patients (n= 60). All these patients followed the dementia criteria in DSM-IV and their behaviours were considered as relevantly aggressive by their carers. RESULTS The total score reliability got an r= 0.93 Spearman coefficient. The internal consistency was determined by Cronbach s alpha (0.90) and the valiability test-retest, analysed by Cohen s kappa, obtained a range from 0.57 to 0.85. CONCLUSIONS All these elements show similar data in comparison to the original scale validation and therefore this version can be considered adequate for Spanish speaking patients within the Spanish culture.
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Pujol J, De Azpiazu P, Salamero M, Cuevas R. [Depressive symptoms in dementia. The Cornell scale: validation of the Spanish version]. Rev Neurol 2001; 33:397-8. [PMID: 11708268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Alonso P, Pujol J, Cardoner N, Benlloch L, Deus J, Menchón JM, Capdevila A, Vallejo J. Right prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: a double-blind, placebo-controlled study. Am J Psychiatry 2001; 158:1143-5. [PMID: 11431238 DOI: 10.1176/appi.ajp.158.7.1143] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The efficacy of repetitive transcranial magnetic stimulation (rTMS) of the right prefrontal cortex for patients with obsessive-compulsive disorder (OCD) was studied under double-blind, placebo-controlled conditions. METHOD Patients were randomly assigned to 18 sessions of real (N=10) or sham (N=8) rTMS. Treatments lasted 20 minutes, and the frequency was 1 Hz for both conditions, but the intensity was 110% of motor threshold for real rTMS and 20% for the sham condition. RESULTS No significant changes in OCD were detected in either group after treatment. Two patients who received real rTMS, with checking compulsions, and one receiving sham treatment, with sexual/religious obsessions, were considered responders. CONCLUSIONS Low-frequency rTMS of the right prefrontal cortex failed to produce significant improvement of OCD and was not significantly different from sham treatment. Further studies are indicated to assess the efficacy of rTMS in OCD and to clarify the optimal stimulation characteristics.
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Guyot L, Dubuc M, Pujol J, Dutour O, Philip N. Craniofacial anthropometric analysis in patients with 22q11 microdeletion. AMERICAN JOURNAL OF MEDICAL GENETICS 2001; 100:1-8. [PMID: 11337741 DOI: 10.1002/1096-8628(20010415)100:1<1::aid-ajmg1206>3.0.co;2-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Microdeletions in the 22q11 region are associated with a wide range of overlapping phenotypes. The main manifestations of the syndrome include palatal anomalies such as cleft palate or velopharyngeal insufficiency, conotruncal heart defects, hypocalcemia, immune disorders, and minor facial anomalies. Because of the wide variability, facial changes appear to be the most constant manifestation of the syndrome and characteristic for informed physicians. The purpose of this study is to report the preliminary results of a detailed analysis of anthropometric data (35 measurements) in 15 patients (7 females and 8 males between 5 and 38 years of age, all white Europeans) with a 22q11 microdeletion. Objective anthropometric study showed that 19 measurements and 7 indexes were significantly different between 22q11 patients and normative database. The typical face showed a short forehead with an anterior vertical excess. Downslanting eyes and large binocular width were the most common anomalies in the orbital area. The nose showed anomalies with a large root, a short tip, and a narrow alar base. There was a narrowing of the mouth and thin lips. Ears were small and slightly disharmonic for the children. Statistical comparison between children (10 cases) and adults (5 cases) showed that craniofacial assessment was more demonstrative in children than in adults.
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Taourel P, Prat X, Boulet P, Valmorin J, Pujol J. [Breast magnetic resonance imaging and breast cancer]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2001; 29:249-53. [PMID: 11300050 DOI: 10.1016/s1297-9589(00)00070-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Pujol J, Vendrell P, Deus J, Junqué C, Bello J, Martí-Vilalta JL, Capdevila A. The effect of medial frontal and posterior parietal demyelinating lesions on stroop interference. Neuroimage 2001; 13:68-75. [PMID: 11133310 DOI: 10.1006/nimg.2000.0662] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Functional imaging has consistently shown that attention-related areas of medial frontal and posterior parietal cortices are active during the attentional conflict induced by color naming in the presence of distracting words (Stroop task). Such studies, however, have provided few details of the correlational nature between observed regional brain activations and reaction time delay occurring in this situation. We analyzed the effect of medial frontal and posterior parietal lesions on the Stroop response in a group of patients with multiple sclerosis, a neurological disorder in which Stroop response speed is affected to varying degrees. Forty-five patients were assessed using a computer-presented verbal version of the Stroop task and specific MRI protocol. Demyelination areas were measured on five anatomical divisions of the medial frontal white matter and on white matter of the posterior parietal lobe. We found that a combination of frontal and parietal lesion measurements accounted for 45% of the Stroop interference time variance. Patients with more right frontal than left parietal demyelination showed slowed Stroop responses, whereas the predominance of lesions in the left posterior parietal region was associated with a reduced Stroop interference. These results may contribute to defining the specific participation of these attention-related brain areas in the conflict of attention represented by the Stroop paradigm. They also help to explain the variability of the Stroop effect in multiple sclerosis patients and suggest that the Stroop test does not assess just a single cognitive operation, but rather the combined effect of anatomically segregated neural processes.
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Pujol J, Monells J, Tolosa E, Soler-Insa JM, Valls-Solé J. Pseudoathetosis in a patient with cervical myelitis: neurophysiologic and functional MRI studies. Mov Disord 2000; 15:1288-93. [PMID: 11104231 DOI: 10.1002/1531-8257(200011)15:6<1288::aid-mds1046>3.0.co;2-l] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
This study addresses the visualization of crack locations in bone-cement material using a three-dimensional acoustic emission source location technique. Computer software based on an earthquake location technique was developed to determine AE source locations and was used to investigate material cracks formed at the tip of a notch in bone cement. The computed locations show that the cracks form linear features with dimensions between 0.1 and 0.2 mm although larger linear features (almost 3.5 mm) also are present. There is a difference of about 2.5 mm between the average of the event locations, and the location of the tip of the notch is 2.5 mm, which may be due to the finite size of the sensors (5 mm in diameter).
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Pujol J, Bello J, Deus J, Cardoner N, Martí-Vilalta JL, Capdevila A. Beck Depression Inventory factors related to demyelinating lesions of the left arcuate fasciculus region. Psychiatry Res 2000; 99:151-9. [PMID: 11068196 DOI: 10.1016/s0925-4927(00)00061-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This study was conducted to further establish the significance of the previously reported association between depressive symptoms and demyelinating lesions in the region of the left arcuate fasciculus in multiple sclerosis patients. The Beck Depression Inventory (BDI) was broken down into its main symptom categories on the basis of well-established factor analyses from the literature, and the correlation pattern between the resulting BDI subscores and lesion measurements was analyzed. We found that lesions of the left arcuate fasciculus region were selectively associated with BDI items expressing patients' Affective Symptoms and Somatic Complaints. Specifically, lesion measurements from this brain location accounted for 26% of symptom score variance of the BDI part that includes only these two factors. Performance Difficulties and Cognitive Distortions were not consistently associated with the lesion measurement. Performance Difficulties, however, showed a high correlation with the neurologic deficit detected in the physical examination. These results show that lesions in the left arcuate fasciculus region are associated with the core of the depressive syndrome rather than marginal symptoms and, thus, further suggest that this left suprainsular brain region involves white matter tracts relevant to mood regulation.
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Corominas H, Domènech M, González-Juan D, González-Suárez B, Díaz C, Pujol J, Vázquez G, Baiget M. [Aplasia after azathioprine administration: role of the thiopurine methyltransferase genetic polymorphism]. Med Clin (Barc) 2000; 115:299-301. [PMID: 11093885 DOI: 10.1016/s0025-7753(00)71540-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Azathioprine is an immunosuppressor drug widely used in the treatment of autoimmune diseases. Adverse effects during treatment are related to the activity of thiopurine methyltransferase (TPMT), an enzyme which plays a role in azathioprine metabolism. The presence of the allelic variants of the TPMT gene allows us to classify patients into three different groups: high, moderate and low risk of myelosuppression after receiving standard doses of azathioprine. PATIENTS AND METHODS Study of the allelic variants of the TPMT gene in the positions 460 and 719 with PCR methods in a patient with Crohn's disease, who developed aplasia after receiving azathioprine. The study was extended to his relatives. RESULTS The patient under study carried the most frequent variant allele of the TPMT gene associated with low enzymatic activity. The mother and one sister of the patient were also carriers of this allelic variant. CONCLUSIONS Genotyping the allelic variants of the TPMT gene is a useful method to identify patients at moderate or high risk of myelosuppression after administration of azathioprine.
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Pujol J, Daures J, Riviere A, Quoix E, Depierre A, Breton J, Lemarie E, Poudex M, Milleron B, Moro D, Debieuvre D, Quantin X, Le Chevalier T. Etoposide-cisplatin (EP) versus four-drug combination etoposide-cisplatin-epirubicin-cyclophosphamide (PCDE) in extensive disease small cell lung cancer (ED-SCLC). A FNCLCC phase III multicentre study. Lung Cancer 2000. [DOI: 10.1016/s0169-5002(00)80093-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pujol J, Roset-Llobet J, Rosinés-Cubells D, Deus J, Narberhaus B, Valls-Solé J, Capdevila A, Pascual-Leone A. Brain cortical activation during guitar-induced hand dystonia studied by functional MRI. Neuroimage 2000; 12:257-67. [PMID: 10944408 DOI: 10.1006/nimg.2000.0615] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Focal hand dystonia in musicians is a strongly task-related movement disorder. Typically, symptoms become apparent only when players execute specific overpracticed skilled exercises on their instrument. We therefore examined five guitarists with functional MRI during dystonic symptom provocation by means of an adapted guitar inside the magnet. The activation patterns obtained in comparable nondystonic guitarists and in the study patients when performing normal-hand exercise served as references. A 1.5-T system equipped with echo-speed gradients and single-shot echoplanar imaging software was used. Data acquisition was centered on the cortical motor system encompassed in eight contiguous slices. Dystonic musicians compared with both control situations showed a significantly larger activation of the contralateral primary sensorimotor cortex that contrasted with a conspicuous bilateral underactivation of premotor areas. Our results coincide with studies of other dystonia types in that they show an abnormal recruitment of cortical areas involved in the control of voluntary movement. However, they do suggest that the primary sensorimotor cortex, rather than being underactive in idiopathic dystonic patients, may be overactive when tested during full expression of the task-induced movement disorder.
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Quantin X, Rebattu P, Pujol J, Morere J, Azarian M, Khial F, Dumortier A, Schuller-Lebeau M. A phase I–II study of docetaxel (D) and gemcitabine (G) combination in patients (pts) with non-small cell lung cancer (NSCLC). Lung Cancer 2000. [DOI: 10.1016/s0169-5002(00)80337-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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80
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Plenevaux A, Weissmann D, Aerts J, Lemaire C, Brihaye C, Degueldre C, Le Bars D, Comar D, Pujol J, Luxen A. Tissue distribution, autoradiography, and metabolism of 4-(2'-methoxyphenyl)-1-[2' -[N-2"-pyridinyl)-p-[(18)F]fluorobenzamido]ethyl]piperazine (p-[(18)F]MPPF), a new serotonin 5-HT(1A) antagonist for positron emission tomography: An In vivo study in rats. J Neurochem 2000; 75:803-11. [PMID: 10899958 DOI: 10.1046/j.1471-4159.2000.0750803.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The in vivo behavior of 4-(2'-methoxyphenyl)-1-[2'-[N-(2"-pyridinyl)-p-[(18)F]fluorobenzamido ]ethyl]-piperazine (p-[(18)F]MPPF), a new serotonin 5-HT(1A) antagonist, was studied in awake, freely moving rats. Biodistribution studies showed that the carbon-fluorine bond was stable in vivo, that this compound was able to cross the blood-brain barrier, and that a general diffusion equilibrium could account for the availability of the tracer. The great quantity of highly polar metabolites found in plasma did not contribute to the small amounts of metabolites found in hippocampus, frontal cortex, and cerebellum. Exvivo p-[(18)F]MPPF and in vitro 8-hydroxy-2-(di-n-[(3)H]propylamino)tetralin autoradiography were compared both qualitatively and quantitatively. Qualitative evaluation proved that the same brain regions were labeled and that the p-[(18)F]MPPF labeling is (a) in total agreement with the known distribution of 5-HT(1A) receptors in rats and (b) characterized by very low nonspecific binding. Quantitative comparison demonstrated that the in vivo labeling pattern obtained with p-[(18)F]MPPF cannot be explained by differences in regional blood flow, capillary density, or permeability. The 5-HT(1A) specificity of p-[(18)F]MPPF and binding reversibility were confirmed in vivo with displacement experiments. Thus, this compound can be used to evaluate parameters characterizing 5-HT(1A) binding sites in the brain.
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Abstract
Diffuse leiomyomatosis of the oesophagus is a rare entity among oesophageal diseases. Histopathologically it is characterized by diffuse hypertrophy of the muscular layer extending to the whole oesophagus predominantly in the lower third, where it can result in tumour formation. Leiomyomatosis can involve the upper part of the stomach and is frequently associated with genital or tracheobronchial (bronchitracheal) muscular localizations. Also, it can be associated with Alport's syndrome in familial cases. For diagnosis, barium swallow, computerized tomography (CT) scan and, in recent years, endoscopic ultrasonography are used. Oesophageal resection is the only suitable treatment in symptomatic cases. We report three observations during 1979-95.
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Gracia E, Targarona EM, Garriga J, Pujol J, Trias M. [Laparoscopic treatment of colorectal polyps]. GASTROENTEROLOGIA Y HEPATOLOGIA 2000; 23:224-7. [PMID: 10902274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
UNLABELLED Endoscopic removal is the treatment of choice for colorectal polyps. However, this therapeutic option is limited by the size of the tumor, sessile implantation, or technical impossibility. These cases are ideal for laparoscopic treatment because of the anatomy of the colon is and because the risk of manipulating a malignant lesion is lower. However, there is the added difficulty of identifying the lesion. In other cases, unsuspected neoplastic invasion of an endoscopically removed polyp makes surgery necessary. AIM To evaluate the results of laparoscopic surgery in the treatment of colorectal polyps. MATERIAL AND METHODS Between December 1997 and November 1999, 270 endoscopic polypectomies were performed. In 15 patients, endoscopic removal was technically impossible or contraindicated. These patients were treated laparoscopically. One patient who was found to have an invasive carcinoma following polypectomy was also treated laparoscopically. The technical characteristics of the operation (duration, conversion, morbi-mortality, postoperative stay, size of the polyp and number of ganglions) were analyzed and compared with 43 other laparoscopic operations in the colon carried out for other reasons (n = 43). RESULTS In nine patients, surgery was indicated because of the size of the polyp, in three for technical reasons, in three for severe atypia and in one because of an invasive carcinoma following polypectomy. The operation was completed by laparoscopy in 15 patients (94%). Ten right hemicolectomies, five sigmoidectomies and one anterior resection assisted by hand port were carried out. The diameter of the lesions was 4.4 +/- 2.4 cm. Histological studies revealed carcinoma in situ in five, infiltrating carcinoma in two, non-malignant adenoma in six and lipoma in one. Comparison of the results of patients who underwent colectomy for polyps with those of the group who underwent surgery for other reasons revealed lower morbidity (24% vs. 22%) and need for conversion (7% vs. 16%), as well as a significant decrease in operating time (130 +/- 10 vs. 148 +/- 32 min, p < 0.05) and in postoperative stay (6.6 +/- 1.4 vs. 8.3 +/- 2.5 days, p < 0.02). CONCLUSION Laparoscopic colonic resection is particularly suitable in the treatment of colorectal polyps.
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Marcos T, Salamero M, de Azpiazu P, Pujol J, Boget T, Peri JM, Lázaro ML. [Neuropsychological pattern of cognitive impairment in Alzheimer type dementia and vascular dementia]. Med Clin (Barc) 2000; 114:566-70. [PMID: 10846674 DOI: 10.1016/s0025-7753(00)71365-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cummings et al, 1987, hypothesized that Alzheimer dementia type (ADT) patients would present poorer performances than vascular dementia (VD) patients on the neuropsychological tests that mainly involve cortical neurological structures, and that VD would perform worse on tests that mainly involve subcortical structures. The main purpose of the research was to identify a cognitive impairment pattern that discriminates the type of dementia in the initial stages. METHOD Two groups of patients, one affected by mild ADT (n = 30) and the other by multi-infarct dementia (VD, n = 30) were given a neuropsychological battery. The battery was composed by Temporal Orientation (Benton et al.); Vocabulary, Similarities, Digits, Coding and Kohs (WAIS) of Wechsler; the Colour-Form Test of Weigh; the Trail Making Test (A and B) (Halstead-Reitan Neuropsychological Battery); Tapping (McQuarrie); Logical Memory, Visual Memory and Paired Association (Wechsler Memory Scale) of Wechsler; Delayed Memory (Russell). The two groups were similar in age and socio-cultural features. The z-score and its statistical significance on the Mann-Whitney test were made and we performed an exploratory discriminant analysis to the classification. RESULTS In general, results were poorer in the ADT group. But we detected no significant differences in the tests, although some test (Immediate Visual Memory and Kohs' Blocks) almost reached significance. The discriminant analysis reached a classification of the 67% of the subjects into the ADT group and the 70% of the subjects into the VD group. CONCLUSIONS In the initial stages of dementia it is difficult to differentiate between a cortical pattern of cognitive impairment in ADT and a subcortical pattern in VD, a distinction that the other researchers have reported. When complex tests were used the performance depended on the coordination of multiple related systems. These findings are in agreement with the holistic models of higher mental functions.
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Catafau AM, Kulisevsky J, Bernà L, Pujol J, Martin JC, Otermin P, Balanzó J, Carrió I. Relationship between cerebral perfusion in frontal-limbic-basal ganglia circuits and neuropsychologic impairment in patients with subclinical hepatic encephalopathy. J Nucl Med 2000. [PMID: 10716310 DOI: 10.1016/s0002-9270(01)04132-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Early detection of neuropsychologic impairment in cirrhotic patients with subclinical hepatic encephalopathy (SHE) is important for their prognosis and quality of life. Abnormal MRI and MR spectroscopy (MRS) findings have been proposed as early markers of brain damage in these patients, but the role of functional neuroimaging in this field still has to be defined. In this study, the SPECT perfusion pattern in patients with SHE was investigated, and the relationship between regional cerebral blood flow (rCBF) and the MRI, MRS, neuropsychologic evaluation and biochemical data of these patients was assessed. METHODS Data were obtained from 13 cirrhotic patients with SHE and 13 age-matched healthy volunteers. Fasting venous blood ammonia and manganese sampling and a battery of standardized neuropsychologic tests related to basal ganglia function and sensitive to the effects of liver disease were all performed on the same day. MRI and 99mTc-hexamethyl propyleneamine oxime SPECT were performed within 2 wk. RESULTS A pattern of decreased prefrontal rCBF was found in patients with SHE compared with healthy volunteers. Basal ganglia and mesial temporal rCBF correlated inversely with performance on motor tasks involving speed (Purdue pegboard test) and frontal premotor function (Luria graphic alternances and Stroop tests). Thalamic rCBF correlated positively with T1-weighted MRI signal hyperintensity in the globus pallidus and with abnormal MRS findings. Neither the MRI signal intensity of the globus pallidus nor MRS correlated with neuropsychologic test results. CONCLUSION Cirrhotic patients with SHE show a SPECT pattern of impaired prefrontal perfusion that does not seem to account for their neuropsychologic deficits. On the other hand, perfusion in some parts of the limbic system and limbic-connected brain regions, such as the striatum and the mesial temporal regions, increased with neuropsychologic impairment. These findings suggest that brain SPECT may be more sensitive than MRI in delineating cirrhotic patients requiring in-depth clinical testing to reveal basal ganglia-related neuropsychologic alterations.
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Lladó L, Pujol J, Jaurrieta E, Escalante E, Serra J, Pita AM. [Percutaneous translumbar inferior vena cava cannulation. Alternative access for home TPN]. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE PATOLOGIA DIGESTIVA 2000; 92:113-4. [PMID: 10757872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Del Rio M, Demoly P, Koros AM, Laurent J, Mani J, Pau B, Pujol J. JLP5B9: new monoclonal antibody against polysialylated neural cell adhesion molecule is of value in phenotyping lung cancer. J Immunol Methods 2000; 233:21-31. [PMID: 10648852 DOI: 10.1016/s0022-1759(99)00179-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Non-small-cell lung cancer (NSCLC) is currently one of the most prevalent malignant tumors. It displays a wide variety of phenotypes which includes neuroendocrine markers commonly found on small-cell lung cancers (SCLC) such as the neural cell adhesion molecule (NCAM) and in particular its highly polysialylated isoform, embryonic NCAM (eNCAM). NSCLC with neuroendocrine differentiation may represent a subset of tumors whose cells have a more aggressive biological behavior. A tumor marker that distinguishes this latter sub-type could be of clinical relevance. Accordingly, we have raised a monoclonal antibody of the IgM type (JLP5B9) directed against capsular polysaccharides of N. meningitidis B which bears polysialic acid groups. We have demonstrated that JLP5B9 recognizes eNCAM with high affinity and that it is specifically directed against the polysialic acid moieties of NCAM. JLP5B9 was also found to react with human SCLC, NSCLC and neuroblastoma cell lines. We then used JLP5B9 as a specific probe for the detection of tissue eNCAM and found that it was expressed on up to 20% of tumor cells obtained from 5 out of 13 patients with NSCLC. This mAb deserves further investigation to evaluate its potential as a tool for serodiagnosis of lung cancer.
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Puig P, Urgell E, Capellá G, Sancho FJ, Pujol J, Boadas J, Farré A, Lluís F, González-Sastre F, Mora J. A highly sensitive method for K-ras mutation detection is useful in diagnosis of gastrointestinal cancer. Int J Cancer 2000. [PMID: 10585586 DOI: 10.1002/(sici)1097-0215(20000101)85:1<73::aid-ijc13>3.0.co;2-#] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Detection of molecular features such as K-ras mutations has been used to evaluate potential tumour markers in a wide variety of clinical samples. Here we have applied a recently developed highly sensitive method for detection of K-ras codon 12 mutations to colorectal and pancreatic cancer diagnosis. We analysed 67 faecal samples from patients undergoing diagnostic colonoscopy under suspicion of colorectal cancer. PCR products were obtained in 62 of 67 (93%) faecal samples. Mutations were detected in exfoliated cells in 6 of 22 (27%) of the adenomas and in 6 of 11 (55%) of adenocarcinomas. No false positives were observed. Agreement between faecal samples and corresponding tissues was 100% for adenocarcinomas and 65% for adenomas. Mutations were also analysed in 61 pancreatic fine-needle aspirates. Mutations were detected in 36 of 45 (80%) of the pancreatic aspirates diagnosed as pancreatic cancer without false positives. Our findings suggest that, when colorectal cancer is suspected, detection of K-ras codon 12 mutations in faecal samples using this new method is specific for colorectal tumours. Additionally, this technique is a good alternative for evaluation of pancreatic masses.
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88
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Cretot M, Pujol J. [Developmental tendencies of the sagittal tooth axis between 10-13 years of age and the end of life; impact on retention?]. Orthod Fr 2000; 71:49-55. [PMID: 10838863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
In this study, 854 lateral cephalograms of normal toothed subjects from 10 to 87 years old who had no orthodontic treatment are analyzed. The posterior angles established by molars and sagitally examined maxillo-mandibular incisor-canine groups during occlusion are measured with age. These modifications are quantified in a general manner and then depending on facial typology.
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Puig P, Urgell E, Capellá G, Sancho FJ, Pujol J, Boadas J, Farré A, Lluís F, González-Sastre F, Mora J. A highly sensitive method for K-ras mutation detection is useful in diagnosis of gastrointestinal cancer. Int J Cancer 2000; 85:73-7. [PMID: 10585586 DOI: 10.1002/(sici)1097-0215(20000101)85:1<73::aid-ijc13>3.0.co;2-#] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Detection of molecular features such as K-ras mutations has been used to evaluate potential tumour markers in a wide variety of clinical samples. Here we have applied a recently developed highly sensitive method for detection of K-ras codon 12 mutations to colorectal and pancreatic cancer diagnosis. We analysed 67 faecal samples from patients undergoing diagnostic colonoscopy under suspicion of colorectal cancer. PCR products were obtained in 62 of 67 (93%) faecal samples. Mutations were detected in exfoliated cells in 6 of 22 (27%) of the adenomas and in 6 of 11 (55%) of adenocarcinomas. No false positives were observed. Agreement between faecal samples and corresponding tissues was 100% for adenocarcinomas and 65% for adenomas. Mutations were also analysed in 61 pancreatic fine-needle aspirates. Mutations were detected in 36 of 45 (80%) of the pancreatic aspirates diagnosed as pancreatic cancer without false positives. Our findings suggest that, when colorectal cancer is suspected, detection of K-ras codon 12 mutations in faecal samples using this new method is specific for colorectal tumours. Additionally, this technique is a good alternative for evaluation of pancreatic masses.
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Conesa G, Pujol J, Deus J, López-Obarrio L, Gabarrós A, Marnov A, Rodriguez R, Navarro R, Capdevila A, Isamat F. EPI functional MRI: a useful tool for preoperative rolandic fissure localization. FRONTIERS OF RADIATION THERAPY AND ONCOLOGY 1999; 33:23-7. [PMID: 10549472 DOI: 10.1159/000061243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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91
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Iranzo A, Martí-Fábregas J, Domingo P, Catafau A, Molet J, Moreno A, Pujol J, Matias-Guiu X, Cadafalch J. Absence of thallium-201 brain uptake in progressive multifocal leukoencephalopathy in AIDS patients. Acta Neurol Scand 1999; 100:102-5. [PMID: 10442451 DOI: 10.1111/j.1600-0404.1999.tb01046.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the presence of thallium-201 brain uptake determined by thallium-201 brain SPECT (Tl-201 SPECT) in patients with progressive multifocal leukoencephalopathy (PML) and AIDS. MATERIAL AND METHODS Six AIDS patients with stereotactic biopsy diagnosis of PML were prospectively evaluated with Tl-201 SPECT, Magnetic Resonance Imaging (MRI), and proton magnetic resonance spectroscopy (1H-MRS). Tl-201 SPECT results were compared with 2 patients with AIDS and biopsy proven primary CNS lymphoma. RESULTS In all patients with PML, Tl-201 SPECT studies showed lack of uptake while MRI demonstrated subcortical white matter focal brain lesions and 1H-MRS disclosed metabolic abnormalities. Intense thallium uptake (uptake ratios of 3.2 and 5.6) was demonstrated in the 2 patients with primary CNS lymphoma. CONCLUSIONS The present study shows that PML lesions are not detectable on Tl-201 SPECT while MRI and 1H-MRS demonstrate abnormalities, and intense thallium-201 uptake may be detected in primary CNS lymphoma. These results suggest that Tl-201 SPECT is a method which, combined with other non-invasive techniques such as MRI and 1H-MRS, may help in the diagnostic approach of PML and to differentiate PML from other high proliferative brain lesions characterized by positive thallium uptake.
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Pujol J, Viladrich M, Rafecas A, Lladó L, García-Barrasa A, Figueras J, Jaurrieta E. Laparoscopic adrenalectomy. A review of 30 initial cases. Surg Endosc 1999; 13:488-92. [PMID: 10227949 DOI: 10.1007/s004649901019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Laparoscopic adrenalectomy is a good option for removal of the adrenal gland that is becoming preferred over the conventional open technique. METHODS We reviewed the initial 30 laparoscopic adrenalectomies (in 27 patients) that were performed at our institution from 1995 to 1998. We used the lateral decubitus transperitoneal approach in 26 cases and the retroperitoneal approach in only one case. The indications for adrenalectomy were Conn's adenoma in eight patients, pheochromocytoma in six, Cushing's syndrome in five, nonfunctional adenomas in seven, and metastasis in one case. RESULTS Only two patients (7%) were converted to laparotomy. Operating time ranged from 75 to 240 min. Average adrenal gland size was 6.1 cm (range, 4-9 cm). There was no mortality, and morbidity occurred in only two patients (8%)-one case of self-limited gastrointestinal bleeding and one case of hypercapnia and subcutaneous emphysema (in the only patient operated by the retroperitonal approach). Mean hospital stay was 3 days (range, 1-6). CONCLUSIONS Laparoscopic adrenalectomy is a safe and useful procedure for nearly all adrenal pathologies. Lateral decubitus transperitoneal approach is the procedure of choice in most cases.
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Puig P, Urgell E, Capellá G, Villanueva A, Grau M, Sancho FJ, Pujol J, Lluís F, González-Sastre F, Mora J. Improved detection of K-ras codon 12 mutations in fecal exfoliated cells. J Transl Med 1999; 79:617-8. [PMID: 10334573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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Pujol J, Torres L, Deus J, Cardoner N, Pifarré J, Capdevila A, Vallejo J. Functional magnetic resonance imaging study of frontal lobe activation during word generation in obsessive-compulsive disorder. Biol Psychiatry 1999; 45:891-7. [PMID: 10202577 DOI: 10.1016/s0006-3223(98)00099-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Functional imaging studies have demonstrated abnormal patterns of brain activity in obsessive-compulsive disorder, which consistently suggest the alteration of frontal lobe functioning. We performed a brain activation study in obsessive-compulsive disorder using a cognitive task involving the frontal lobes. METHODS Twenty patients and 20 healthy control subjects were assessed with functional magnetic resonance imaging during a phonologically guided word generation task. The study analysis was based on the comparison of group average time-course functional changes occurring at the site of largest frontal cortex activation during alternating rest and task periods. RESULTS In terms of relative signal changes, patients showed a significantly greater activation during word generation and a defective suppression of this activation during the following rest period. Both abnormal imaging findings significantly correlated with the severity of the clinical process assessed by the Yale-Brown Obsessive-Compulsive Scale. CONCLUSIONS The results indicate that functional magnetic resonance imaging during cognitive challenge may be useful to reveal distinctive features of latent brain dysfunction in obsessive-compulsive disorder.
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Iranzo A, Moreno A, Pujol J, Martí-Fàbregas J, Domingo P, Molet J, Ris J, Cadafalch J. Proton magnetic resonance spectroscopy pattern of progressive multifocal leukoencephalopathy in AIDS. J Neurol Neurosurg Psychiatry 1999; 66:520-3. [PMID: 10201428 PMCID: PMC1736302 DOI: 10.1136/jnnp.66.4.520] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The objective was to determine whether the use of intermediate echo times (135 ms) in proton magnetic resonance spectroscopy (1H-MRS) detects a homogenous pattern in progressive multifocal leukoencephalopathy (PML) in HIV-1 infected people, and to confirm the results of previous studies. Six patients infected with HIV-1, with PML established by biopsy, and six healthy age and sex matched volunteers were evaluated to define their spectroscopic pattern. 1H-MRS spectra performed at 1.5 T were obtained with the STEAM sequence: TE/TM/TR, 20 ms/13.7 ms/2000 ms; 2500 Hz, size 2048 points, 256 acquisitions (STEAM-20) and with the PRESS sequence; TE/TR, 135 ms/2000 ms; 2500 Hz, size 2048 points, 256 acquisitions (PRESS-135). A single voxel was placed on the lesions and on the parieto-occipital white matter of controls. The peaks of N-acetylaspartate (NAA), choline (Cho), myoinositol (mI), lactate, and lipids were considered, and the results were expressed using creatine as reference. Spectra of PML lesions were characterised by significantly reduced NAA, lactate presence, and by significantly increased Cho and lipids compared with control group values. These results indicate that 1H-MRS detects a homogenous pattern in PML lesions. Recent studies, together with this, suggest that 1H-MRS may help in the diagnostic approach to patients with suspected PML lesions associated with AIDS.
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Pujol J, Deus J, Losilla JM, Capdevila A. Cerebral lateralization of language in normal left-handed people studied by functional MRI. Neurology 1999; 52:1038-43. [PMID: 10102425 DOI: 10.1212/wnl.52.5.1038] [Citation(s) in RCA: 428] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To use functional MRI (fMRI) to further define the occurrence of left-hemisphere, bilateral, and right-hemisphere language in a normal left-handed population. METHODS A total of 100 healthy volunteers, consisting of 50 left-handed subjects and a reference group of 50 right-handed subjects, were studied by fMRI of the frontal cortex during silent word generation. RESULTS Ninety-six percent of right-handed subjects showed fMRI changes lateralized to the left hemisphere, whereas 4% showed a bilateral activation pattern. In contrast, left-hemisphere lateralization occurred in 76% of left-handers, bilateral activation in 14%, and right-hemisphere lateralization in the remaining 10%. The predominance of right-hemisphere activation, however, was weak in these cases; only a single left-handed subject (2%) showed complete right-hemisphere lateralization. CONCLUSIONS Silent word generation lateralizes to the left cerebral hemisphere in both handedness groups, but right-hemisphere participation is frequent in normal left-handed subjects. Exclusive right-hemisphere activation rarely occurred in the frontal lobe region studied.
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Pujol J, Arjona M, Arasa J, Badia V. Influence of amount and changes in axis of astigmatism on retinal image quality. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 1998; 15:2514-2521. [PMID: 9729863 DOI: 10.1364/josaa.15.002514] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We measured retinal image quality in astigmatic eyes, using the double-pass technique. We analyzed the influence of the amount of astigmatism and changes in axis of astigmatism on the eye's optical performance. Different amounts of astigmatism were obtained by variation of the cylindrical power of a lens situated in front of the eye, between 0.25-diopter (D) overcorrection and 1-D undercorrection at intervals of 0.25 D. Changes in the axis of astigmatism were obtained by rotation of the lens, which neutralizes the astigmatism in an angle of +/- 10 degrees at 5 degrees intervals. The results show the decrease in retinal image quality and the increase in the degree of image astigmatism obtained when the amount of astigmatism increases or the angle between the lens and the eye axis is other than zero. In general, the largest variations correspond to when the astigmatism changes from 0 to 0.25 D or when the axis changes from 0 degree to +/- 5 degrees. The reduction in optical performance is smaller in living eyes than in an eye model or in an artificial eye. The aberrations present in the living eye reduce the relative loss of retinal image quality introduced by astigmatism.
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Lamarque JL, Pujol J, Cherifcheikh J, Laurent JC, Taourel P, Boulet P, Daurès JP, Séguret F, Guizard AV, Delande G, Negre M. Cost evaluation of breast cancer screening in France. Acad Radiol 1998; 5 Suppl 2:S336-9. [PMID: 9750847 DOI: 10.1016/s1076-6332(98)80347-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Pujol J, Pascual-Leone A, Dolz C, Delgado E, Dolz JL, Aldomà J. The effect of repetitive magnetic stimulation on localized musculoskeletal pain. Neuroreport 1998; 9:1745-8. [PMID: 9665594 DOI: 10.1097/00001756-199806010-00014] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Current magnetic coil stimulators can efficiently activate neural structures without deep electrode placement and the local discomfort associated with transcutaneous electrical stimulation used in pain control. We tested the possibility of reducing pain in patients with localized musculoskeletal processes by applying repetitive magnetic stimulation on the tender body region. Thirty patients were randomized to receive 40 min of real or sham magnetic stimulation. After a single session, real magnetic stimulation significantly exceeded the sham effect: a 101-point pain score decreased by 59% in the treated group and 14% in sham-treated patients (z = -3.26, p = 0.001). The pain relief attained regularly persisted for several days. Results indicate that powerful magnetic coil stimulation can efficiently reduce pain originating from localized musculoskeletal injuries.
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Velasco FJ, López R, Pujol J, Sancho F, Llauradó JM, Lluís F, Clavé P. [The use of anorectal manometry and dynamic proctography in patients for diagnosis of solitary rectal ulcer syndrome]. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE PATOLOGIA DIGESTIVA 1998; 90:454-8. [PMID: 9708010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Solitary rectal ulcer syndrome is caused by rectal prolapse and/or anismus. The diagnosis by physical examination, or using endoscopy or radiology alone is difficult. AIM To evaluate the diagnostic utility of videoproctography and anorectal manometry in solitary rectal ulcer syndrome. PATIENTS AND METHODS We studied six patients (5 women/1 man; 21-66 years) with rectal lesions suggestive of solitary rectal ulcer. By videoproctography, we measured the changes in the anorectal angle and the shape of the rectal wall during voiding. By manometry, we measured the resting pressure of the anal canal, and the pressure during maximal voluntary contraction and during straining. RESULTS Proctography showed a rectal prolapse in 5 patients (non-exteriorized in 4). Both manometry and proctography demonstrated the normal relaxation of puborectalis and external sphincter during straining in 4 patients, manometry found sphincteric weakness in two of these patients. Both manometry and proctography evidenced anismus in a patient with rectal prolapse. CONCLUSION The high prevalence of rectal prolapse in our patients allows us to recommend proctography in patients with morphological lesions suggestive of solitary rectal ulcer. The manometric examination identifies patients at risk of developing incontinence. Both techniques contribute to ascertain the presence of anismus and are indispensable in the selection of the adequate treatment for patients with solitary rectal ulcer.
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