1
|
Rabattu PY, Sole Cruz E, El Housseini N, El Housseini A, Bellier A, Verot PL, Cassiba J, Quillot C, Faguet R, Chaffanjon P, Piolat C, Robert Y. Anatomical study of the thoracic duct and its clinical implications in thoracic and pediatric surgery, a 70 cases cadaveric study. Surg Radiol Anat 2021; 43:1481-1489. [PMID: 34050781 DOI: 10.1007/s00276-021-02764-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/04/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Given the high variability and fragility of the thoracic duct, good knowledge of its anatomy is essential for its repair or to prevent iatrogenic postoperative chylothorax. The objective of this study was to define a site where the thoracic duct is consistently found for its ligation. The second objective was to define an anatomically safe surgical pathway to prevent iatrogenic chylothorax in surgery for aortic arch anomalies with vascular ring, through better knowledge of the anatomical relationships of the thoracic duct. METHODS Seventy adult formalin-fixed cadavers were dissected. The anatomical relationships of the thoracic duct were reported at the postero-inferior mediastinum, at levels T3 and T4. RESULTS The thoracic duct was consistently situated between the left anterolateral border of the azygos vein and the right border of the aorta between levels T9 and T10, whether it was simple, double, or plexiform. It was located medially, anteromedially, or posteriorly to the left subclavian artery in 51%, 21%, and 28% of the cases, respectively, at the level of T3. At T4, it was posteromedial in 27% of the cases or had no direct relationship with the aortic arch. CONCLUSION These results favor mass ligation of the thoracic duct at levels T9-T10 between the right border of the aorta and the azygos vein, eventually including the latter. To prevent iatrogenic postoperative chylothorax in aortic arch anomalies with vascular ring surgery, we recommend remaining strictly lateral to the left subclavian artery at the level of T3 to reach the aortic arch anomalies with vascular ring at T4.
Collapse
Affiliation(s)
- P Y Rabattu
- LADAF, Anatomical Laboratory, Univ. Grenoble Alpes, Grenoble University Hospital, 38000, Grenoble, France
- Department of Pediatric Surgery, Children's Hospital, University Hospital of Grenoble, 38000, Grenoble, France
| | - E Sole Cruz
- LADAF, Anatomical Laboratory, Univ. Grenoble Alpes, Grenoble University Hospital, 38000, Grenoble, France
- Department of Pediatric Surgery, Children's Hospital, University Hospital of Grenoble, 38000, Grenoble, France
- ID17 Biomedical Beamline, European Synchrotron Radiation Facility, 38000, Grenoble, France
| | - N El Housseini
- LADAF, Anatomical Laboratory, Univ. Grenoble Alpes, Grenoble University Hospital, 38000, Grenoble, France
| | - A El Housseini
- LADAF, Anatomical Laboratory, Univ. Grenoble Alpes, Grenoble University Hospital, 38000, Grenoble, France
| | - A Bellier
- LADAF, Anatomical Laboratory, Univ. Grenoble Alpes, Grenoble University Hospital, 38000, Grenoble, France
| | - P L Verot
- Department of Pediatric Surgery, Children's Hospital, University Hospital of Grenoble, 38000, Grenoble, France
| | - J Cassiba
- Department of Pediatric Reanimation, Children's Hospital, University Hospital of Grenoble, 38000, Grenoble, France
| | - C Quillot
- Department of Digestive Surgery, Nantes University Hospital, 44000, Nantes, France
| | - R Faguet
- Department of Pediatric Surgery, Children's Hospital, University Hospital of Grenoble, 38000, Grenoble, France
| | - P Chaffanjon
- LADAF, Anatomical Laboratory, Univ. Grenoble Alpes, Grenoble University Hospital, 38000, Grenoble, France
- GIPSA-Lab, Univ. Grenoble Alpes, CNRS, Grenoble INP, 38000, Grenoble, France
| | - C Piolat
- Department of Pediatric Surgery, Children's Hospital, University Hospital of Grenoble, 38000, Grenoble, France
| | - Y Robert
- LADAF, Anatomical Laboratory, Univ. Grenoble Alpes, Grenoble University Hospital, 38000, Grenoble, France.
- Department of Pediatric Surgery, Children's Hospital, University Hospital of Grenoble, 38000, Grenoble, France.
| |
Collapse
|
2
|
Solé Cruz E, Rabattu PY, Lupin M, Broche L, Bonnard M, Robert Y, Chaffanjon P, Bellier A. An inferior vena cava discontinuity with an hepato-renal accessory vein development: A radio-anatomical morphometric case study. Morphologie 2021; 106:46-51. [PMID: 33431253 DOI: 10.1016/j.morpho.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Inferior vena cava (IVC) agenesis is an uncommon congenital vascular anomaly stemming from aberrant development during embryogenesis. It results from the failure of one or more of the supracardinal veins, subcardinal veins, vitelline veins or postcardinal veins to connect. The symptomatology resulting from this vascular malformation can be either absent or extremely rich and varied. METHODS Thoracoabdominal-pelvic CT scan projections following iodine-based contrast product injection were analyzed and a three-dimensional model of vascularization constructed. RESULTS Herein, an asymptomatic case of IVC agenesis with absence of the suprarenal and renal segments, with azygos continuation, presenting an accessory hepatorenal vein is reported. The presence of this type of accessory vein has never been described in the literature to date. The etiology of this case of IVC agenesis is explored in depth. We also analyzed the morphometric parameters of the IVC remnant segments and the azygos vein in order to quantify the dilatation of the collateral venous pathway overdeveloped to handle blood return. CONCLUSION Using the findings from this case and those reported in the literature, we provide general recommendations that should be taken into account before managing a patient, symptomatic or asymptomatic, admitted to the hospital with IVC agenesis.
Collapse
Affiliation(s)
- E Solé Cruz
- Laboratoire d'Anatomie Des Alpes Françaises, Grenoble Alpes University, place du commandant Nal, Domaine de La Merci, 38700 La Tronche, France; ID17 Biomedical Beamline, European Synchrotron Radiation Facility, 38000 Grenoble, France; Department of Pediatric Surgery, Children's Hospital, University Hospital of Grenoble, 38000 Grenoble, France
| | - P Y Rabattu
- Laboratoire d'Anatomie Des Alpes Françaises, Grenoble Alpes University, place du commandant Nal, Domaine de La Merci, 38700 La Tronche, France; Department of Pediatric Surgery, Children's Hospital, University Hospital of Grenoble, 38000 Grenoble, France
| | - M Lupin
- Laboratoire d'Anatomie Des Alpes Françaises, Grenoble Alpes University, place du commandant Nal, Domaine de La Merci, 38700 La Tronche, France
| | - L Broche
- University Grenoble Alpes, Inserm, UA7, STROBE Laboratory, 38000 Grenoble, France
| | - M Bonnard
- Laboratoire d'Anatomie Des Alpes Françaises, Grenoble Alpes University, place du commandant Nal, Domaine de La Merci, 38700 La Tronche, France
| | - Y Robert
- Laboratoire d'Anatomie Des Alpes Françaises, Grenoble Alpes University, place du commandant Nal, Domaine de La Merci, 38700 La Tronche, France; Department of Pediatric Surgery, Children's Hospital, University Hospital of Grenoble, 38000 Grenoble, France
| | - P Chaffanjon
- Laboratoire d'Anatomie Des Alpes Françaises, Grenoble Alpes University, place du commandant Nal, Domaine de La Merci, 38700 La Tronche, France; GIPSA-Lab-Dpt. Parole et Cognition, UMR 5216, Grenoble Campus, 11, rue des Mathématiques, BP46, 38402 Saint Martin d'Hères cedex, France
| | - A Bellier
- Laboratoire d'Anatomie Des Alpes Françaises, Grenoble Alpes University, place du commandant Nal, Domaine de La Merci, 38700 La Tronche, France.
| |
Collapse
|
3
|
Vérot PL, Rabattu PY, Chabre O, Gayot A, Sartelet H, Faguet R, Robert Y, Piolat C. Pediatric pheochromocytoma in association with Von Hippel-Lindau disease: Focus on screening strategies. Arch Pediatr 2020; 27:497-501. [PMID: 33067065 DOI: 10.1016/j.arcped.2020.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/19/2020] [Accepted: 09/19/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Von Hippel-Lindau disease (VHL) is a syndrome of familial predisposition to the development of malignant and benign tumours, due to mutations in the VHL tumour suppressor gene. Pheochromocytoma is a tumour that develops in the adrenal gland, rare in pediatric age, and may be associated with genetic abnormalities including mutations in the VHL gene. Systematic screening of pheochromocytoma in children carrying a VHL mutation has been proposed. However, some VHL patients who have been screened may develop symptoms associated with pheochromocytoma despite screening. Here, we report on such a case. CLINICAL CASE A 13-year-old boy, known to be a carrier of a mutation of the VHL gene, undergoing annual screening, was admitted to our hospital for clinical symptoms related to a right adrenal pheochromocytoma discovered on abdominal imaging. After hemodynamic stabilisation, the pheochromocytoma was surgically resected. Histology confirmed the diagnosis of pheochromocytoma. The postoperative care was simple. The event-free period is currently 2 years. DISCUSSION The present case has led us to reflect on the French and international screening strategies for pheochromocytoma in children carrying a mutation of the VHL gene. Between 2013 and 2018, six different recommendations were proposed for pheochromocytoma screening in secondary prevention for children with a VHL mutation, with variability regarding the age of onset and complementary examinations to be carried out. Despite the existence of these recommendations, our case demonstrates that a pheochromocytoma can develop by escaping well-performed screening. The role of early abdominal imaging should be redefined to improve the efficiency of screening. CONCLUSION The discovery of a pheochromocytoma in a child must be systematically investigated for an underlying genetic cause. In the particular case of children carrying a mutation of the VHL gene, annual abdominal imaging should be included in the pheochromocytoma screening protocol from the age of 5 years.
Collapse
Affiliation(s)
- P-L Vérot
- Pediatric Surgery, pôle couple-enfant, CHU Grenoble-Alpes, Quai Yermoloff, 38700 La Tronche, France.
| | - P-Y Rabattu
- Pediatric Surgery, pôle couple-enfant, CHU Grenoble-Alpes, Quai Yermoloff, 38700 La Tronche, France
| | - O Chabre
- Endocrinology, pôle couple-enfant, CHU Grenoble-Alpes, Quai Yermoloff, 38700 La Tronche, France
| | - A Gayot
- Pediatric Intensive Care, pôle couple-enfant, CHU Grenoble-Alpes, Quai Yermoloff, 38700 La Tronche, France
| | - H Sartelet
- Pathology, pôle couple-enfant, CHU Grenoble-Alpes, Quai Yermoloff, 38700 La Tronche, France
| | - R Faguet
- Pediatric Surgery, pôle couple-enfant, CHU Grenoble-Alpes, Quai Yermoloff, 38700 La Tronche, France
| | - Y Robert
- Pediatric Surgery, pôle couple-enfant, CHU Grenoble-Alpes, Quai Yermoloff, 38700 La Tronche, France
| | - C Piolat
- Pediatric Surgery, pôle couple-enfant, CHU Grenoble-Alpes, Quai Yermoloff, 38700 La Tronche, France
| |
Collapse
|
4
|
Vitales D, García-Fernández A, Garnatje T, Vallès J, Font J, Robert Y, Vigo J. <em>Pellaea calomelanos</em> (Pteridaceae) en Cataluña: es realmente una disyunción ancestral? Collect Bot 2019. [DOI: 10.3989/collectbot.2019.v38.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Pellaea calomelanos es una especie que fue descubierta en África y cuya área de distribución se ha ido ampliando más recientemente a Asia y a una única localidad europea, que comprende tres poblaciones, en Cataluña. El hecho de pertenecer a los helechos y de presentar esta distribución disyunta alimentaron la idea de una especie relicta resultante de distribución amplia en tiempos remotos. Los valores 2C van desde 16,45 pg para el individuo de la Isla de la Reunión hasta 17,40 pg para la población de Boadella (Cataluña). Aunque existe una cierta variabilidad, no se han encontrado diferencias estadísticamente significativas entre ellos. El análisis filogenético revela un clado bien soportado que agrupa a todos los individuos de las diferentes poblaciones de P. calomelanos pero sin ningún tipo de resolución interna. Los resultados del presente trabajo, basado en medidas de cantidad de ADN nuclear y en secuencias de dos regiones del ADN cloroplástico, junto con las características de su hábitat, permiten a los autores hipotetizar sobre una colonización reciente del continente europeo por esta especie.
Collapse
|
5
|
Isnard M, Hullo E, Robert Y, Piolat C, Durand C, Lantuejoul S, Garnaud C, Pin I. [Post-traumatic pulmonary aspergilloma]. Rev Mal Respir 2018; 35:342-346. [PMID: 29602478 DOI: 10.1016/j.rmr.2017.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 05/05/2017] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Aspergillomas occur due to colonization of a pre-existing pulmonary, bronchial or pleural cavity by Aspergillus spp. Often asymptomatic, this pathology can reveal itself by recurrent haemoptysis or when bacterial superinfections occur. Aspergillomas occurring in post-traumatic cavities are rare and their management is poorly codified. CASE REPORT A child suffered from a chest wound at the age of 13 years. Two years later, investigation of recurrent haemoptysis revealed a residual pneumatocele in the right lower lobe colonized by Aspergillus spp. Initial treatment with systemic azole antifungals was unsuccessful because of digestive and ophthalmological intolerance. Surgical treatment by right lower lobectomy was finally decided on by the multidisciplinary team. This revealed an intrabronchial foreign body of vegetal type with cellulosic reinforcement, causing a polymorphic granulomatous reaction around, and associated with a proliferation of filamentous fungi including Aspergillus fumigatus. Surgery was followed by liposomal amphotericin B treatment for three weeks with a favourable outcome. CONCLUSIONS This clinical case illustrates the benefits of surgical management of post-traumatic aspergillomas, even in children, in order to eradicate the aspergillus implant and to remove any foreign body to prevent recurrence.
Collapse
Affiliation(s)
- M Isnard
- CS10217, clinique universitaire de pneumologie, CHU de Grenoble-Alpes, 38043 Grenoble cedex 9, France
| | - E Hullo
- CS10217, clinique universitaire de pédiatrie, CHU de Grenoble-Alpes, hôpital Couple-Enfants, 38043 Grenoble cedex 9, France
| | - Y Robert
- CS10217, clinique universitaire de chirurgie pédiatrique, CHU de Grenoble-Alpes, 38043 Grenoble cedex 9, France
| | - C Piolat
- CS10217, clinique universitaire de chirurgie pédiatrique, CHU de Grenoble-Alpes, 38043 Grenoble cedex 9, France
| | - C Durand
- CS10217, clinique universitaire d'imagerie pédiatrique, CHU de Grenoble-Alpes, hôpital Couple-Enfants, 38043 Grenoble cedex 9, France
| | - S Lantuejoul
- CS10217, département de pathologie, institut de biologie et pathologie, CHU de Grenoble-Alpes, 38043 Grenoble cedex 9, France
| | - C Garnaud
- CS10217, laboratoire de parasitologie-mycologie, institut de biologie et pathologie, CHU de Grenoble-Alpes, 38043 Grenoble cedex 9, France; UMR 5525 CNRS-UGA, laboratoire TIMC-IMAG-TheREx, université Grenoble-Alpes, domaine de la Merci, 38706 La Tronche, France
| | - I Pin
- CS10217, clinique universitaire de pédiatrie, CHU de Grenoble-Alpes, hôpital Couple-Enfants, 38043 Grenoble cedex 9, France; Inserm 1209, institut pour l'avancée des biosciences, 38042 Grenoble cedex 9, France.
| |
Collapse
|
6
|
Abstract
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.
Collapse
|
7
|
Tesnière M, Robert Y, Provoost L, Durand C, Griffet J. Pneumatocèle post-traumatique. Arch Pediatr 2015. [DOI: 10.1016/j.arcped.2015.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
8
|
Tesnière M, Robert Y, Provoost L, Durand C, Griffet J. Chute en trottinette. Arch Pediatr 2015; 22:982, 996-7. [DOI: 10.1016/j.arcped.2015.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 05/27/2015] [Indexed: 10/23/2022]
|
9
|
Faguet R, Robert Y, Jacquier C, Teklali Y, Sibaï S, Antoine S, Durand C, Piolat C. P-014 – Torsion aigüe de trompe utérine chez l'enfant: piège clinique et échographique à ne pas méconnaître. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30199-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
10
|
de Schlichting E, Robert Y, Selek L, Palombi O, Chaffanjon P. A three-dimensional (3D) representation of pericardial cavity based on computed tomography (CT). Surg Radiol Anat 2014; 37:199-204. [PMID: 25159320 DOI: 10.1007/s00276-014-1362-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 08/16/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE The 3D modeling of human anatomy is more and more often used in medical education and in computer-augmented medicine. The lack of a 3D model of the pericardium has led us to its implementation. METHODS The pericardium was reconstructed from a CT scan recording of a young, healthy subject. The anonymous CT scan data were blindly reviewed and interpreted by two independent radiologists. Stage one consisted in reconstructing the entire heart with the main afferent and efferent vessels. As the pericardial layers cannot be observed only with the CT scan, the second stage was to draw its reflection line following the most frequent model of pericardium defined in one of our prior studies. Afterwards, the epicardium had to be milled to finally create a pericardial sac area. RESULTS Firstly, a model of one normal heart was reconstructed. Secondly, parietal and visceral layers of the pericardium have been achieved from the representation of their line of reflection. A short video shows recesses and sinuses and particularly, the transverse sinus crossed by a virtual object. CONCLUSIONS The resulting model is subject to certain limits, including reproducibility linked to the operator, individual anatomical variation, and scanner resolution but it represents a pericardial pouch true to its more common anatomical morphology. It offers a very precise educational tool. It must be considered as the first step of an automatic segmentation and reconstruction process to modelize normal and pathological pericardium. This is also the first step before a 3D dynamic model, synchronized with heartbeats.
Collapse
Affiliation(s)
- E de Schlichting
- Ladaf, Laboratoire d'Anatomie des Alpes Françaises, UFR de Médecine, Université Grenoble-Alpes, Domaine de la Merci, 38706, La Tronche Cedex, France
| | | | | | | | | |
Collapse
|
11
|
Robert Y, Rabattu P, Lantuejoul S, Jouk P, Piolat C. SFCP CO-13 - Contribution à l’étude anatomique et embryologique des kystes congénitaux dérivés du proentéron. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71651-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
12
|
Rabattu P, Robert Y, Thong Vanh C, Hitter A, Piolat C. SFCP P-087 - Tératomes thyroidiens géants de diagnostic prénatal : 2 cas d’EX utero Intrapartum Therapy (EXIT) procedure. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71802-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
13
|
Bellier A, Cavalié G, Robert Y, Chaffanjon PCJ. Relationship between the ansa cervicalis and the omohyoid muscle: clinical consequences in parathyroid surgery. Surg Radiol Anat 2013; 36:621-6. [PMID: 24154634 DOI: 10.1007/s00276-013-1216-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 10/10/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To determine the position of the lower loop of the ansa cervicalis (AC) compared to the inferior edge of the omohyoid muscle to guide minimally invasive surgery for the lateral oblique approach of parathyroid glands. METHODS Authors performed 36 anatomical dissections in the laboratory of anatomy (Laboratoire d'Anatomie Des Alpes Françaises) of the Grenoble medical school in 2012 on human cadavers. They independently measured the distance between the caudal extremity of the AC and the lower edge of the superior belly of the omohyoid muscle. Then, they controlled this measure on pictures. RESULTS The study shows a majority of long AC (under the omohyoid muscle) in 66.7 % of cases. In addition, the AC was located on an average value of 0.1 cm below the lower edge of the omohyoid muscle (median -0.5 cm). Thus, two-thirds of AC are between 0 and -2 cm under the omohyoid muscle. Furthermore, the AC is generally non-symmetrical: there is a mean difference of 1.3 cm between the left and right AC. In this series, there are as many long AC on the right side as on the left side. CONCLUSIONS These results are in contradiction with literature data. To preserve the ansa cervicalis and its phonatory functions, it is necessary for the surgeon to perform a systematic per operative identification of the AC because the position of the AC is mainly under the omohyoid muscle and because of an asymmetry. Per operative neurostimulation and/or magnified lenses might be helpful during the surgical approach.
Collapse
Affiliation(s)
- A Bellier
- Laboratoire d'Anatomie Des Alpes Françaises (LADAF), UFR de médecine de Grenoble, Domaine de la Merci, 38706, La Tronche Cedex, France
| | | | | | | |
Collapse
|
14
|
Ding Y, Aviles-Espinosa R, Cataluna MA, Nikitichev D, Ruiz M, Tran M, Robert Y, Kapsalis A, Simos H, Mesaritakis C, Xu T, Bardella P, Rossetti M, Krestnikov I, Livshits D, Montrosset I, Syvridis D, Krakowski M, Loza-Alvarez P, Rafailov E. High peak-power picosecond pulse generation at 1.26 µm using a quantum-dot-based external-cavity mode-locked laser and tapered optical amplifier. Opt Express 2012; 20:14308-14320. [PMID: 22714493 DOI: 10.1364/oe.20.014308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In this paper, we present the generation of high peak-power picosecond optical pulses in the 1.26 μm spectral band from a repetition-rate-tunable quantum-dot external-cavity passively mode-locked laser (QD-ECMLL), amplified by a tapered quantum-dot semiconductor optical amplifier (QD-SOA). The laser emission wavelength was controlled through a chirped volume Bragg grating which was used as an external cavity output coupler. An average power of 208.2 mW, pulse energy of 321 pJ, and peak power of 30.3 W were achieved. Preliminary nonlinear imaging investigations indicate that this system is promising as a high peak-power pulsed light source for nonlinear bio-imaging applications across the 1.0 μm - 1.3 μm spectral range.
Collapse
Affiliation(s)
- Y Ding
- School of Engineering, Physics and Mathematics, University of Dundee, Dundee DD1 4HN, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
Menometrorrhagia is a frequent cause of medical consulting. After a clinical examination showing the uterine origin of bleeding and that excludes a cervical or vulvo-vaginal origin, transvaginal sonography (TVS) represents the first-line technique examination. TVS allows to identify endometrial diseases (atrophy, polyps or diffuse hyperplasia), endometrial carcinoma, myometrial disorders (adenomyosis, leiomyoma or vascular abnormalities), and adnexal disorders. Color Doppler sonography and hysterosonography are useful complementary tools for ultrasound performance improvement. MR imaging should be performed if TVS is not contributive or is highly recommended for staging of uterine cancers. All these techniques provide useful information for optimal planning treatment.
Collapse
Affiliation(s)
- M Bazot
- Hôpital Tenon, service de radiologie, 4, rue de la Chine, 75970 Paris cedex 20, France.
| | | |
Collapse
|
16
|
|
17
|
Jani J, Cannie M, Sonigo P, Robert Y, Moreno O, Benachi A, Vaast P, Gratacos E, Nicolaides KH, Deprest J. Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol 2008; 32:793-799. [PMID: 18956430 DOI: 10.1002/uog.6234] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To investigate the potential value of antenatally determined total fetal lung volume (TFLV) by magnetic resonance imaging (MRI) in the prediction of the postnatal survival in congenital diaphragmatic hernia (CDH). METHODS We examined fetuses with isolated CDH, in which MRI was used at 22-38 weeks of gestation to measure TFLV and assess intrathoracic herniation of abdominal viscera, that were liveborn after 30 weeks of gestation and had postnatal follow-up until death or discharge from hospital. Regression analysis was used to investigate the effect on survival of gestational age at diagnosis, observed to expected (o/e) TFLV, intrathoracic herniation of the liver, side of CDH, gestational age at MRI, institution, year and gestational age at delivery. In 76 fetuses measurements of o/e TFLV and the lung area to head circumference ratio (LHR) were performed within 2 weeks of each other; in these cases o/e TFLV and o/e LHR were compared for their prediction of postnatal survival. RESULTS In the 148 cases that fulfilled the entry criteria, multiple regression analysis demonstrated that significant predictors of survival were the presence or absence of intrathoracic herniation of the liver and o/e TFLV. The area under the receiver-operating characteristics curves for prediction of postnatal survival from o/e TFLV was 0.786 (standard error, 0.059; P < 0.001) and that from o/e LHR was 0.743 (standard error, 0.069; P = 0.001). CONCLUSIONS In the assessment of fetuses with CDH, MRI-based o/e TFLV is useful in the prediction of postnatal survival.
Collapse
Affiliation(s)
- J Jani
- Radiology and Fetal Medicine Unit of King's College Hospital, London, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Piolat C, Robert Y, Morand B, Durand C, Pasquier D, Dyon J. SFCP-P61 – Chirurgie viscérale – Fente cervicale médiane congénitale. Une rare malformation du cou à connaître. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72065-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Hendrickson P, Robert Y. Klinische Bestimmung des funktionellen Trübungsgrades einer Katarakt (PAP/MAK-Verhältnis): Theorie und Technik. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1050672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
20
|
|
21
|
|
22
|
Wildberger H, Robert Y, Bär P, Eckardt H. Retinale Nervenfaserschicht und Lichtunterschiedsempfindlichkeit bei Opticusneuropathien. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1050133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
23
|
|
24
|
Boukerrou M, Mesdagh P, Yahi H, Crépin G, Robert Y, Cosson M. Évaluation IRM des chirurgies du prolapsus. ACTA ACUST UNITED AC 2006; 34:1024-8. [PMID: 17052937 DOI: 10.1016/j.gyobfe.2006.07.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2006] [Accepted: 07/13/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To bring to the fore the differences in terms of anatomical restoration between the abdominal and vaginal approach of pelvic floor repair. We compared the short-term anatomical results of the sacropexy and the sacrospinous fixation and paravaginal repair. PATIENTS AND METHODS Magnetic Resonance Imagery (MRI) allowed us to obtain a reproducible and objective comparison of location of the various pelvic organs. Forty-three patients benefited from a MRI a pre- and postoperative evaluation according to the position of organs with regard to the pubo-coccygeal line. We noted cystocele, hysterocele or enterocele when the bladder, the uterine cervix, or the Douglas' cul-de-sac came under this line during efforts of push. We measured length modifications and lateral and anteroposterior vaginal axis. RESULTS After the surgery, we noted that all pelvic organs were found above the reference line. On the other hand, bladders are significantly situated less high after vaginal pelvic floor repair. There is no postoperative difference as regards of the vaginal wall location. The lengths and vaginal axis are comparable in pre- and postoperative evaluation. DISCUSSION AND CONCLUSION In our study, the anatomical results of pelvic floor repair performed by vaginal or abdominal route are short-term comparable and the vaginal approach is not responsible for decrease of length or vaginal reorientation. Standardized and longer term evaluated, the MRI can represent an objective and reproducible help to the staging of pelvic floor dysfunction.
Collapse
Affiliation(s)
- M Boukerrou
- Pôle de chirurgie gynécologique, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille, France.
| | | | | | | | | | | |
Collapse
|
25
|
Abstract
Intra-uterine arteriovenous malformations are a possible etiology of persistent metrorrhagia especially in the event of a history of miscarriages, cornuale pregnancy, molar pregnancy or gravidic trophoblastic diseases. We report 4 cases of patients having an intra-uterine arteriovenous malformation. The diagnosis of such lesions calls upon first intention Doppler echography. This diagnosis is confirmed thereafter by angiography. The first intention treatment is embolization which can save time if carried out at the same time as the angiography. This treatment is rapid and final, enabling the patients to have other pregnancies later on. An echographic follow-up, according to a schedule which remains to be defined, is necessary in order to check the good involution of this type of vascular malformation.
Collapse
Affiliation(s)
- H Yahi-Mountasser
- Clinique de Gynécologie Obstétrique, Maternité Jeanne de Flandre, CHU de Lille, 1, rue Eugène-Avinée, 59037 Lille Cedex.
| | | | | | | | | | | |
Collapse
|
26
|
Pigny P, Jonard S, Robert Y, Dewailly D. Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab 2006; 91:941-5. [PMID: 16368745 DOI: 10.1210/jc.2005-2076] [Citation(s) in RCA: 319] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
CONTEXT Despite its frequency, the polycystic ovary syndrome (PCOS) is still a difficult diagnosis in endocrinology, gynecology, and reproductive medicine. To help solve this issue, the Rotterdam consensus conference proposed to include the ultrasonographic follicle count as a new diagnostic criterion, in addition to hyperandrogenism and oligo-anovulation. Unfortunately, its assessment does not offer sufficient reliability worldwide. OBJECTIVE The aim of our study was to check whether anti-Müllerian hormone (AMH) measurement in the serum could be a surrogate for antral follicle count in the diagnostic criteria of PCOS. DESIGN, SETTING, AND PATIENTS Serum AMH was measured with a second-generation immunoassay in a cohort of 73 PCOS patients and 96 controls, and its diagnostic power was evaluated by receiver operating characteristic curves. PCOS was diagnosed according to the Rotterdam definition. RESULTS Serum AMH levels were 3-fold higher in PCOS patients than in controls (81.6 vs. 33.5 pmol/liter; P < 0.001) and were significantly related to the follicle number in the two groups. The area under the receiver operating characteristic curve for the AMH assay was 0.851, indicating a good diagnostic potency. Setting the threshold at 60 pmol/liter offered the best compromise between specificity (92%) and sensitivity (67%). CONCLUSIONS The serum AMH level is an accurate marker of the ovarian early antral follicle number and offers a good diagnostic potency. In situations where accurate ultrasonographic data are not available, AMH could thus be used instead of the follicle count as a diagnostic criterion and incorporated as such in the Rotterdam definition of PCOS.
Collapse
Affiliation(s)
- P Pigny
- Laboratoire de Biochimie et Hormonologie, Parc Eurasanté, Centre Hospitalier Régional Universitaire, 59037 Lille cedex, France.
| | | | | | | |
Collapse
|
27
|
Rubod C, Mubiayi N, Verhulst P, Robert Y, Vinatier D. [Uterine intravenous leiomyomatosis. A case report]. ACTA ACUST UNITED AC 2005; 33:991-3. [PMID: 16324869 DOI: 10.1016/j.gyobfe.2005.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2005] [Accepted: 09/10/2005] [Indexed: 11/30/2022]
Abstract
Uterine intravenous leiomyomatosis is a rare benign tumor. We report the case of a 41-year-old woman, with no history, who presented an abdominopelvic mass arising from the uterus. Histological examination revealed uterine intravenous leiomyomatosis. The specificity of this tumor is hormonodependency and potential vascular extension.
Collapse
Affiliation(s)
- C Rubod
- Service de gynécologie chirurgicale et d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, France
| | | | | | | | | |
Collapse
|
28
|
Thumerelle C, Pouessel G, Errera S, Penel-Capelle D, Morillon S, Santos C, Robert Y, Deschildre A. [Radiologic manifestations of pulmonary tuberculosis]. Arch Pediatr 2005; 12 Suppl 2:S132-6. [PMID: 16129325 DOI: 10.1016/s0929-693x(05)80029-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pulmonary tuberculosis is an endemic infection. Chest radiography is the mainstay in the evaluation of pulmonary tuberculosis. High resolution CT is required to detect fine lesions overlooked on chest radiographs, to define equivocal lesions, to determine disease activity in some cases and to evaluate complications or sequels. We review indications of chest radiograph and CT, the radiologic features of primary and post-primary tuberculosis, and outcome of tuberculous lesions.
Collapse
Affiliation(s)
- C Thumerelle
- Unité de pneumologie et allergologie pédiatriques, hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille cedex, France.
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Rubod C, Mubiayi N, Robert Y, Vinatier D. Malformation artérioveineuse utérine. Une cause rare de métrorragies récidivantes. ACTA ACUST UNITED AC 2005; 33:511-3. [PMID: 16005663 DOI: 10.1016/j.gyobfe.2005.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Accepted: 05/06/2005] [Indexed: 11/24/2022]
Abstract
Uterine arteriovenous malformation is a rare condition. We report a case with acquired arteriovenous malformation arising from the left uterine artery. She was diagnosed by color Doppler ultrasound and treated with a selective uterine artery embolization.
Collapse
Affiliation(s)
- C Rubod
- Service de gynécologie chirurgicale, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | | | | | | |
Collapse
|
30
|
Sabban F, Boukerrou M, Mubiayi N, Houpeau JL, Robert Y, Vinatier D. Métastase ovarienne d'un mélanome malin : à propos d'un cas. ACTA ACUST UNITED AC 2005; 33:409-11. [PMID: 15927509 DOI: 10.1016/j.gyobfe.2005.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2005] [Accepted: 04/04/2005] [Indexed: 11/16/2022]
Abstract
The diagnosis of malignant melanoma metastatic to the ovary is rare. The primary lesion can be followed by metastasis site after few years. We describe the case of a 31 year-old woman who presented an acute pelvic pain in relation with a right ovarian cyst. This patient presented many metastatic melanoma few years ago. The ovarian metastatic diagnosis is strongly suspected by the use of preoperative magnetic resonance imaging. The operating piece immunohistochemical studies demonstrated the positivity for S-100 protein, HMB-45 and negativity for keratin in cytoplasm cells. The surgical treatment (right salpingo-oophorectomy) would be followed by chemotherapy. The patient had a good postoperative recovery. She is in good health at six months.
Collapse
Affiliation(s)
- F Sabban
- Service de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, France.
| | | | | | | | | | | |
Collapse
|
31
|
Jonard S, Pigny P, Jacquesson L, Demerle-Roux C, Robert Y, Dewailly D. The ovarian markers of the FSH insufficiency in functional hypothalamic amenorrhoea. Hum Reprod 2005; 20:101-7. [PMID: 15513979 DOI: 10.1093/humrep/deh560] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The purpose of this work was to revisit the gonadotrophin insufficiency of functional hypothalamic amenorrhoea (FHA) with the use of relevant ovarian markers. METHODS Serum anti-Mullerian hormone (AMH), estradiol (E2), inhibin B, LH and FSH were immunoassayed in 31 women with FHA and in 30 healthy women in early follicular phase. The ovarian antral follicle number (FN) was determined within two distinct diameter ranges (2-5 and 6-9 mm) by ultrasound in real time, the same day as the blood sampling. RESULTS The 2-5 mm FN was similar between the two groups, while the 6-9 mm FN was significantly less in FHA than in controls, in relation with lower serum FSH levels (r=0.428; P<0.024). Nine (29%) FHA patients had a low serum basal FSH level (i.e. <4.5 IU/l, 5th percentile of control values). In the 22 (71%) patients with apparently normal FSH, the mean 6-9 mm FN was similar to controls. However, in this sub-group, the mean AMH serum level and the AMH:2-5 mm FN ratio were significantly higher and the mean inhibin B serum level was significantly lower than in controls. No significant relationship was found between the serum LH levels and the FN, AMH or inhibin B values. CONCLUSION Only a minority of patients with FHA have a low serum basal FSH level, and we show that this is associated with fewer 6-9 mm follicles at the ovarian level. Despite a normal serum FSH level and 6-9 mm FN in the majority of patients with FHA, the functional follicle markers are abnormal. This suggests that the FSH action on the ovary is incomplete and is not properly reflected by its serum level nor by FN at ultrasound.
Collapse
Affiliation(s)
- S Jonard
- Department of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, C.H.R.U., 59037 Lille, France
| | | | | | | | | | | |
Collapse
|
32
|
Pouessel G, Thumerelle C, Santos C, Copin MC, Deschildre A, Robert Y. Hamartochondrome pulmonaire : une cause rare de nodule pulmonaire solitaire en pédiatrie. ACTA ACUST UNITED AC 2005; 86:79-82. [PMID: 15785421 DOI: 10.1016/s0221-0363(05)81326-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Solitary pulmonary nodules are rare in children. We report an eleven year-old girl evaluated for recurrent respiratory symptoms diagnosed with an intraparenchymal pulmonary hamartochondroma. Spiral computed tomography showed a pulmonary nodule in the middle lobe, 17 mm in diameter, without any specific features. In asymptomatic adult patients, guidelines for the management of solitary pulmonary nodules have been described. The management of solitary pulmonary nodules in pediatric patients is discussed.
Collapse
Affiliation(s)
- G Pouessel
- Unité de pneumologie et allergologie, clinique de pédiatrie, Hôpital Jeanne de Flandre, France
| | | | | | | | | | | |
Collapse
|
33
|
Holder-Espinasse M, Escande F, Mayrargue E, Dieux-Coeslier A, Fron D, Doual-Bisser A, Boute-Benejean O, Robert Y, Porchet N, Manouvrier-Hanu S. Angel shaped phalangeal dysplasia, hip dysplasia, and positional teeth abnormalities are part of the brachydactyly C spectrum associated with CDMP-1 mutations. J Med Genet 2004; 41:e78. [PMID: 15173244 PMCID: PMC1735815 DOI: 10.1136/jmg.2003.013904] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
34
|
Dewailly D, Fline MH, Jonard S, Robert Y. The ovarian follicle number at ultrasonography (U/S) predicts the ovulatory response to clomiphene citrate (CC) in patients with polycystic ovary syndrome (PCOS). Fertil Steril 2004. [DOI: 10.1016/j.fertnstert.2004.07.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
35
|
Jonard S, Vandaele C, Robert Y, Dewailly D. Revisiting the ovarian volume as a criterion for the diagnosis of polycystic ovaries. Fertil Steril 2004. [DOI: 10.1016/j.fertnstert.2004.07.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
36
|
Jonard S, Robert Y, Pigny P, Decanter C, Dewailly D. The ovarian markers of the gonadotropin insufficiency in functional hypothalamic amenorrhea. Fertil Steril 2004. [DOI: 10.1016/j.fertnstert.2004.07.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
37
|
Vaast P, Houfflin-Debarge V, Dubos JP, Bonnevalle M, Storme L, Robert Y, Puech F. [Lung abnormalities: from fetus to adult, which management: prenatal diagnosis and prognosis]. Arch Pediatr 2004; 11:518-9. [PMID: 15158816 DOI: 10.1016/j.arcped.2004.03.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P Vaast
- Service de pathologie maternelle et foetale, hôpital Jeanne-de-Flandre, 2, avenue Oscar-Lambret, CHRU de Lille, 59000 Lille, France.
| | | | | | | | | | | | | |
Collapse
|
38
|
Grenier JL, Toth E, De Serres G, Ménard S, Roussel R, Tremblay M, Landry M, Robert Y, Skowronski DM. Safety of revaccination of patients affected by the oculo-respiratory syndrome (ORS) following influenza vaccination. Can Commun Dis Rep 2004; 30:9-16. [PMID: 14964915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
- J L Grenier
- Quebec National Institute of Public Health of Quebec
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
Congenital pharyngolaryngeal band (PLB) is an extremely rare congenital abnormality, characterized by a fibrous web extending from the nasopharynx to the epiglottis. We report a case of unilateral pharyngolaryngeal band in a new-born who presented severe airway obstruction and feeding difficulties. The band extended from the right postero-inferior part of the nasopharynx to the right lateral margin of the larynx. Faucial pillars and tonsil were absent on this side. Endoscopic and radiological assessments excluded associated cervicofacial abnormality. Two endoscopic laser resection procedures were necessary to liberate the larynx from PLB. Clinical and radiological assessment advocated a second pharyngeal pouch development failure as the origin to PLB.
Collapse
Affiliation(s)
- P Fayoux
- Service d'ORL et Chirurgie Cervicofaciale, Hôpital Claude Huriez--CHRU Lille, 2 Ave Oscar Lambret, Lille 59037, France.
| | | | | | | | | |
Collapse
|
40
|
Sabban F, Narducci F, Mestdagh P, Robert Y, Crepin G, Cosson M. [Dynamic MRI in the assessment of surgical results in genital prolapse: report of a case]. ACTA ACUST UNITED AC 2003; 37:248-51. [PMID: 14606312 DOI: 10.1016/s0003-4401(03)00097-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We wish to discuss the importance of MRI in association with the clinical pelvic examination for the study of vaginal prolapse, especially for the posterior compartment (rectocele, elytrocele). The increased sensitivity of static and dynamic MRI allowed a clinico-radiology relation more exactly for the study of prolapse. We describe a clinical observation where the RMI used before and after surgery is more reliable than the only clinic examination.
Collapse
Affiliation(s)
- F Sabban
- Hôpital Jeanne-de-Flandre, CHU Lille, avenue Eugène-Avinée, 59037 Lille, France
| | | | | | | | | | | |
Collapse
|
41
|
Launay S, Cuilleret V, Boyer C, Mestdagh P, Moisan S, Vaast P, Bourgeot P, Denes M, Rocourt N, Robert Y. [Magnetic resonance imaging applications in obstetrics]. J Gynecol Obstet Biol Reprod (Paris) 2003; 32:205-20. [PMID: 12773923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
PURPOSE To review the main indications and results of magnetic resonance imaging in the pregnant women. MATERIAL AND METHOD We reviewed MRI practice during the pregnancy based on our own experience in a prenatal diagnostic center and data in the literature. Rapid improvement in MRI technology has allowed more extensive use, giving a good contrast-to-noise ratio and multiplanar imaging. RESULTS Although ultrasound provides primary screening information, final diagnosis may require further investigations. MRI, to be performed in the second and third trimester, is the non-invasive second line tool of choice in this context. The most widespread indications are for brain disease: search for a cause of ventriculomegaly or biometric abnormality, confirmation of a malformative or acquired lesion. Progressively, indications were widened to head and neck, thorax, abdomen and pelvis areas. Moreover, systematic indications include previous fetal pathology or the pregnancy context. Other MRI indications have been suggested: placental malposition, pelvimetry and maternal genito-urinary tract. CONCLUSION MRI is becoming the natural and necessary second line imaging technique, with increasing indications. It must be kept in mind however that all pathological conditions cannot be depicted by these morphological studies.
Collapse
Affiliation(s)
- S Launay
- Service de Radiologie et d'Imagerie Médicale, Hôpital Jeanne-de-Flandre, 2, avenue Oscar-Lambret, 59037 Lille Cedex
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Affiliation(s)
- M Siméon-Gélu
- Division of Gastroenterology, Hepatology and Nutrition, Lille University Faculty of Medicine and Children's Hospital, Lille, France
| | | | | | | | | | | | | |
Collapse
|
43
|
Jonard S, Robert Y, Cortet-Rudelli C, Pigny P, Decanter C, Dewailly D. Ultrasound examination of polycystic ovaries: is it worth counting the follicles? Hum Reprod 2003; 18:598-603. [PMID: 12615832 DOI: 10.1093/humrep/deg115] [Citation(s) in RCA: 203] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study revisited the ultrasonographic diagnostic criteria of polycystic ovary syndrome (PCOS) and studied the relationship between the major hormonal and metabolic features of PCOS and the follicle number per ovary (FNPO). METHODS This prospective study included 214 women with PCOS compared with 112 women with normal ovaries. Main clinical, biological and ultrasonographic markers of PCOS were assessed during the early follicular phase. RESULTS The mean FNPO of follicles 2-5 mm in size was significantly higher in polycystic ovaries than in controls, while it was similar within the 6-9 mm range. Setting the threshold at 12 for the 2-9 mm FNPO offered the best compromise between specificity (99%) and sensitivity (75%). Within the 2-5 mm follicular range, we found significant positive relationships between the FNPO and androgens. The FNPO within the 6-9 mm range was significantly and negatively related to body mass index and fasting insulin serum level. CONCLUSIONS We propose to modify the definition of polycystic ovaries by adding the presence of > or =12 follicles measuring 2-9 mm in diameter (mean of both ovaries). Also, our findings strengthen the hypothesis that the intra-ovarian hyperandrogenism promotes excessive early follicular growth and that further progression cannot proceed normally because of hyperinsulinism and/or other metabolic influence linked to obesity.
Collapse
Affiliation(s)
- S Jonard
- Department of Diabetology and Endocrinology, Clinique Marc Linquette, C.H.R.U., 59037 Lille, France
| | | | | | | | | | | |
Collapse
|
44
|
Acker O, Robert Y, Carpentier F, Vinatier D, Cosson M. [Symptomatic bladder or ureteral endometriosis: report of 8 cases and review of the literature]. Ann Chir 2003; 128:34-9. [PMID: 12600326 DOI: 10.1016/s0003-3944(02)00010-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to determine the symptoms of bladder and ureteral endometriosis and to review the treatment approaches. MATERIALS AND METHODS We conducted a retrospective studyover the period November 1989-July 2000. We reviewed the medical data of all women with bladder or utereral endometriosis who underwent a major surgery (ureteral reimplementation on psoas bladder, partial resection of the ureter, partial cystectomy). RESULTS Eight women met the defined selection criterion, three with bladder injuryand five with ureteral injury. The only adverse postoperative complication was a passive ureteral reflux following ureteral reimplementation on psoas bladder. No recurrence on the urinary tract were reported. CONCLUSION Surgical treatment is indicated for patient suffering from symptomatic bladder or ureteral endometriosis. Isolated bladder injuries due to endometriosis are mostly treated by laparoscopic surgery. Ureteral endometriosis may deteriorate the renal function. The initial step of the treatment may include an uterolysis by coelioscopy or an ureteral dilatation by ureteroscopy together with a medical treatment. The renal function must be closely monitored. In case of persistent or recurrent endometriosis, an ureteral resection would be justified.
Collapse
Affiliation(s)
- O Acker
- Service de gynécologie obstétrique, centre hospitalier de Roubaix, pavillon Paul-Gelle, 91, avenue J.-Lagache, BP 359, 59056 Roubaix cedex 1, France
| | | | | | | | | |
Collapse
|
45
|
Robert Y, Launay S, Mestdagh P, Moisan S, Boyer C, Rocourt N, Cosson M. [MRI in gynecology]. J Gynecol Obstet Biol Reprod (Paris) 2002; 31:417-39. [PMID: 12379827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVES To review the complementary role and contribution of magnetic resonance imaging (MRI) in gynecology diseases. RESULTS Tissue characterization can be obtained with T2, T1 weighted images before and after contrast medium injection and T1 fat sat sequences. Localization of the lesion and relationships with adjacent structures are facilitated by multiplanar imaging. Endometrium and ovarian follicles display high signal intensity, visualizing the normal uterine and ovarian components. The relative high signal intensity of uterine tumors facilitates evaluation of extension. Uterine leiomyoma diagnosis is supported by its low signal intensity, allowing localization, size, and number assessment, and to distinguish adenomyoma. In doubtful malformation cases, MRI may be contributive. Ovarian mass characterization can be done with MRI, particularly for dermoid cyst and endometrioma. In this case, deep endometriosis can be associated and be extensive. Recent technical advances enable fast imaging, which can be useful for pelvic floor assessment with dynamic evaluation. CONCLUSION MRI is becoming the complementary reference imaging tool for us. Its increasing indications are: gynecologic cancer, pelvis endometriosis, pelvis floor, indeterminate pelvis mass and fibroleiomyoma.
Collapse
Affiliation(s)
- Y Robert
- Service de Radiologie et d'Imagerie Médicale, Hôpital Jeanne-de-Flandre, CHRU Lille, rue E. Avinée, 59037 Lille Cedex.
| | | | | | | | | | | | | |
Collapse
|
46
|
Launay S, Robert Y, Valat AS, Thomas D, Devisme L, Rocourt N, Vaast P. [Cerebral fetal MRI and ventriculomegaly]. J Radiol 2002; 83:723-30. [PMID: 12149589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVE To evaluate MRI usefulness in diagnosis and management of fetuses with cerebral ventriculomegaly at US. PATIENTS AND METHODS Sonography depicted cerebral ventriculomegaly in 61 fetuses. Management included MRI in all cases and infectious screening, and karyotype in 51 cases. Final diagnosis was supported by fetal autopsy (n=24), postnatal follow-up>6 months (n=19), infectious screening or karyotype (n=8), and MR imaging when diagnosis was obvious (n=16). RESULTS MRI was more informative than ultrasonography in 32.8% of cases with identification of the etiology in 21.3% of cases. In 45% MRI and sonography were considered to be normal. In the remaining cases, MRI confirmed the ultrasound diagnosis of cerebral malformation. Ultrasonography never depicted more anomalies than MR imaging. The 2 false negatives were gyration disorders but MR imaging was performed too early. CONCLUSION US is the imaging modality of choice in the evaluation of fetal anomalies but MRI has to be systematically performed in case of cerebral ventriculomegaly because MRI demonstrates its usefulness in patient counseling, even if there are a few false negative results.
Collapse
Affiliation(s)
- S Launay
- Service de radiologie et d'imagerie médicale, Hôpital Jeanne de Flandre, 2, avenue Oscar Lambret, 59037 Lille cedex
| | | | | | | | | | | | | |
Collapse
|
47
|
Bieganski A, Launay S, Biserte J, Robert Y. [Urethral duplication type II in a male child: a case report]. J Radiol 2002; 83:650-2. [PMID: 12063429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Urethral duplication is a rare congenital anomaly, most common in male. The clinical presentation varies because of the various anatomical variant. A case of complete duplication with an accessory channel arising from a diverticulum, in a male child is reported. The clinical presentation, the imaging findings, and the management are described.
Collapse
Affiliation(s)
- A Bieganski
- Service de radiologie, Hôpital Jeanne de Flandres, Avenue Eugène Avinée, 59037 Lille Cedex, France.
| | | | | | | |
Collapse
|
48
|
Broussin B, Favre R, Subtil D, Bidat L, Chabaud JJ, Potier A, Sarramon MF, Nisand I, Boog G, Collet M, D'ercole C, Droulle P, Lemery D, Maugey-Laulom B, Philippe HJ, Puech F, Robert Y, Rudigoz R, Ville Y. [Reflections on the use of obstetric echography]. Gynecol Obstet Fertil 2002; 30:259-61; author reply 261-5. [PMID: 11998218 DOI: 10.1016/s1297-9589(02)00314-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
49
|
el Hajjar M, Launay S, Hossein-Foucher C, Foulard M, Robert Y. [Power Doppler sonography and acute pyelonephritis in children: comparison with Tc-DMSA scintigraphy]. Arch Pediatr 2002; 9:21-5. [PMID: 11865544 DOI: 10.1016/s0929-693x(01)00689-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
UNLABELLED Acute pyelonephritis is a common infection in children. The clinical and biological diagnosis is still sometimes difficult. For most authors, Technecium 99m dimercaptosuccinic acid scintigraphy is considered as the gold standard tool for diagnosis but it is invasive and expensive. The aim of our study was to compare the sensitivity and the specificity of B-mode sonography and power doppler to DMSA-Tc scintigraphy in acute pyelonephritis. PATIENTS AND METHODS Forty-nine children were enrolled in this study with suspicion of pyelonephritis. All infants underwent doppler sonography and scintigraphy within 48 hours after their hospitalization. Doppler sonography criteria were increased kidney size, thickness of sinus wall, vascular defect, and various echogenicity of the kidneys (focal or diffuse hyperechogenicity or focal hypoechogenicity). RESULTS Among 28 children with a positive scintigraphy, 15 had a positive doppler sonography (sensitivity 54%) and 13 had a negative doppler sonography. Among 21 children with a negative scintigraphy, 20 had a negative doppler sonography (specificity 95%) and one had a positive doppler sonography. CONCLUSION In clinically suspected acute pyelonephritis, doppler sonography has a high specificity. A positive doppler sonography should avoid the use of scintigraphy.
Collapse
Affiliation(s)
- M el Hajjar
- Unité de néphrologie pédiatrique, hôpital Jeanne-de-Flandre 2, avenue Oscar-Lambret 59037 Lille, France
| | | | | | | | | |
Collapse
|
50
|
Robert Y, Mestdagh P, Ziereisen F, Launey S, Avni F. [Clinical case: questions--answers. Imaging of the female pelvis in adolescence]. J Radiol 2001; 82:1781-2. [PMID: 11917647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
|