J. Garcier - Academia.edu (original) (raw)
Papers by J. Garcier
Journal de Radiologie, 2006
Impact of computed tomography on patient's care in nontraumatic acute abdomen: 90 patients
Journal de radiologie
To report our experience with the treatment of 34 patients with SVC syndrome from neoplastic orig... more To report our experience with the treatment of 34 patients with SVC syndrome from neoplastic origin using the Wallstent. Thirty-four patients were treated between January 2000 and February 2007: 21 males and 13 females, aged 44-81 years, with non-small-cell lung carcinoma in 27 cases (79%), small-cell lung carcinoma in 5 cases (15%) and metastatic breast adenocarcinoma to the mediastinum in 2 cases (6%). All patients were treated using the stainless steel self-expanding Wallstent. A dual brachial-femoral access was used in all cases. Stent placement was possible in all cases. Per procedure acute respiratory distress occurred in 2 cases: 1 case of acute pulmonary edema and 1 case of tamponade. Symptoms resolved within 24 hours. Twenty-six patients died from disease progression, 8 during the first month, and 16 within 32-545 days post-procedure (mean: 213.4 days). Five patients with recurrent SVC syndrome underwent repeat treatment (restenosis in 3 cases, fracture in 1 case, thrombosi...
Journal des maladies vasculaires, 2000
Acute embolic renal artery occlusion is usually clinically typical. In case of early diagnosis, a... more Acute embolic renal artery occlusion is usually clinically typical. In case of early diagnosis, an in situ thrombolysis may be effective. As thrombosis often progressively completes a severe renal artery stenosis, the classical clinical description of renal infarction (lumbar pain, hematuria) is frequently not present. The kidney parenchyma downstream from the renal arterial occlusion is not always irreparably lost: collateral circulation may preserve nephron viability, which requires a lower perfusion pressure than glomerular filtration. An iodine, isotopic, or MR gadolinium nephrogram may prove this viability. Over the last 10 years, we attempted 21 percutaneous recanalizations of renal artery occlusion. Mean patient age was 62 years (44-85). All were hypertensive. Serum creatinin level of 17 patients was above 130 micromoles/ml. Three patients were previously hemodialysed. We observed 8 failures, without any complication. Thirteen immediate technical successes occurred, but one r...
Bulletin de l'Association des anatomistes, 1996
Comparative study of static curves of the thoracic and lumbar spine in men and women has been rea... more Comparative study of static curves of the thoracic and lumbar spine in men and women has been realized under constraints of compression by weightlifting and elongation by exercise to parallel bars. In two athletic practices, curves decrease their arrow, ending to a straighter and more rigid column. This behavior expresses muscular actions. The greatest amplitude of displacement, observed in female series, shows lesser muscular forces in connection with a poor practice of exercises of body building.
Collection de la Société française d’imagerie cardiaque et vasculaire, 2012
Journal de Radiologie Diagnostique et Interventionnelle, 2015
ABSTRACT La présence de graisse au sein d’une lésion hépatique n’est pas classique et peut orient... more ABSTRACT La présence de graisse au sein d’une lésion hépatique n’est pas classique et peut orienter le radiologue dans sa démarche diagnostique. Le but de cette revue iconographique est de préciser les différentes lésions hépatiques susceptibles de contenir de la graisse ainsi que leur aspect en imagerie en coupes et en particulier à l’IRM. Une corrélation anatomo-pathologique est également proposée pour les tumeurs les plus fréquentes. L’identification de graisse au sein d’une tumeur hépatique, en association avec les autres signes radiologiques, ainsi que la prise en compte du contexte clinique et épidémiologique peuvent permettre de poser le diagnostic ou de l’évoquer, avec confirmation si nécessaire, par l’examen histologique.
Objective: To compare CT scan abnormalities found in children with congenital deafness to the aud... more Objective: To compare CT scan abnormalities found in children with congenital deafness to the audiology data, notably to the type and severity of deafness of children. Patients and methods: Retrospectively, we studied the records of 87 children with different types and variable degrees of congenital deafness who had a CT scan of that part of the temporal bone lodging the ear within a period of 39 months in a tertiary reference centre. The data gotten were compared and correlated amongst themselves with a threshold significance of p < 0.05. Results: The sex ratio was 1.35 boy/girl for a mean age of 4.6 years at the first CT scan. One hundred and fifty ears out of 174 presented with deafness, with hearing loss of greater than 70dB in 57 cases (38%). The average hearing loss was 55±35dB. CT scan abnormalities predominated in ears presenting with moderate perception deafness. Four cases of external ear aplasia and tympano – ossicular abnormalities were the commonest lesions in the pr...
Journal de Radiologie, 2004
Journal de Radiologie, 2011
Journal de Radiologie, 2004
Surgical and Radiologic Anatomy, 1999
Conclusion Ce travail global a permis d'observer des éléments qui doivent être analysés plus... more Conclusion Ce travail global a permis d'observer des éléments qui doivent être analysés plus précisément par des investigations complémentaires :- influence d'autres positions des art. coxo-fémorales (adduction, rotations médiale ou latérale, flexion), ou des genoux (flexion), sur la cinématique de la colonne lombaire et thoracique ;- analyse opto-électronique des variations angulaires des capteurs au cours de la réalisation d'un mouvement du tronc dans un plan anatomique ;- détermination des mécanismes précis et des structures musculo-ligamentaires concernées par les techniques anatomiques, de comportement des matériaux et de robotique.
Surgical and Radiologic Anatomy, 2001
The aim of this study was to determine the topography of the origin, implantation angle and initi... more The aim of this study was to determine the topography of the origin, implantation angle and initial course of the renal arteries in the transverse and frontal planes, from a prospective analysis of angiograms and helical CT-scans of 40 patients. In the frontal plane, the implantation angles of the right and left renal arteries were 73.8 ± 17˚ and 65.6 ± 16˚ respectively 17.9% of the right renal arteries were straight compared with only 5% of the left ones. The first sinuosity was observed to be at a distance greater than the aortic diameter for 43.6% of right renal arteries and at a distance less than the aortic diameter for 62.5% for the left renal a. In the transverse plane, the right renal a. had an implantation angle of 65.6 ± 15.7˚ compared with 95.7 ± 16.85% for the left renal a. The artery was rectilinear in 2.6% of the cases on the right side, and in 2.5% of the cases on the left. The first sinuosity occurred before the lateral margin of the spine was reached in 60.5% of right renal arteries and after the margin of psoas major muscle for 55% of left renal arteries. A knowledge of the anatomy of the origin and initial course of the renal arteries is important when considering vessel dilatation and the implantation of stents in the renal arteries. No correlation was observed between the origin, sinuosity or angulation of the renal arteries which could aid interventional procedures. Only the main renal aa. were evaluated, any accessory polar aa. were not considered in the analysis. Thus the variability of the blood supply to the kidneys was not investigated. From the CT-scans the angle of origin of each renal a. in the transverse plane was determined with respect to the median sagittal plane, which was defined as a line passing between the apex of the spinous process and the anterior junction of the two laminae (Fig. 1). A line perpendicular to the median sagittal plane was drawn at the greatest diameter of the aorta. At the level of the ostium of the renal a., a line from its centre to the middle of the aorta was drawn the angle made by this line with the sagittal plane measured from 0˚ (anterior) to 180˚ (posterior).
Surgical and Radiologic Anatomy, 1998
The overall movement of the trunk is made up of two components, namely the movements of the pelvi... more The overall movement of the trunk is made up of two components, namely the movements of the pelvic girdle and the vertebrae. In the frontal plane, the amplitude of the pelvic movements appears to be relatively limited compared to the vertebral column whereas the pelvis makes the major contribution to the total rotational movement in the axial plane. This article completes a series of studies conducted by our team concerning the biomechanics of the human vertebral column.
Surgical and Radiologic Anatomy, 2003
To determine the evolution of the diameter of the thoracic aorta with age in order to detect dila... more To determine the evolution of the diameter of the thoracic aorta with age in order to detect dilatation more reliably by imaging, we performed a retrospective analysis of the MRI examinations of the normal thoracic aorta of 66 subjects aged 44.1±19.1 years (range 19.1-82.4 years) obtained between 1991 and 2000 on a Magnetom SP 42 1T apparatus (Siemens) using T1-weighted spin echo sequences with electrocardiographic synchronization. Sixteen measurements were made in the axial plane, the oblique sagittal plane in the axis of the aortic arch, and the oblique frontal plane perpendicular to the latter at the level of the ascending aorta, the arch and the descending thoracic aorta. We found an increase in the thoracic aorta diameter and a significant relationship between this diameter and the age of our subjects, wherever the measure was performed. However, there was no systematic correlation between aortic diameter and age. The aortic diameter evolved with age and a marked difference seemed to exist in measurements made in groups younger and older than 40 years. This study, conducted on a small population of 66 patients, thus helps to define a normal aortic diameter, thereby making the diagnosis of pathological dilatation of the aorta more reliable. Diame`tre normal de l'aorte thoracique chez l'adulte. Etude en imagerie par re´sonance magne´tique Re´sume´Pour de´terminer l'e´volution du diame`tre de l'aorte thoracique en fonction de l'aˆge afin de pouvoir juger d'une e´ventuelle dilatation sur les examens d'imagerie, les auteurs ont analyse´re´trospectivement des Imageries par Re´sonance Magne´tique d'aortes thoraciques normales de 66 sujets aˆge´s de 44,1±19,1 ans (19,1 a8 2,4 ans) re´alise´s de 1991 a`2000 sur un appareillage Magnetom SP 42 de 1 T (Siemens, Erlangen) en se´quences de spin e´cho ponde´re´es en T1 avec synchronisation a`l'e´lectrocardiogramme; 16 mesures e´taient ef-fectue´es dans les plans transversal, sagittal oblique dans l'axe de l'arc de l'aorte, et frontal oblique perpendiculaire au pre´ce´dent au niveau de l'aorte ascendante, l'arc de l'aorte et l'aorte thoracique descendante. Il existait un accroissement significatif du diame`tre de l'aorte sur les mesures effectue´es en fonction de l'aˆge. En revanche il n'existait pas de corre´lation syste´matique entre diame`tre aortique et aˆge. Le diame`tre aortique e´voluait en fonction de l'aˆge de manie`re significative avec une diffe´rence qui paraissait nette entre la cohorte des sujets de moins de 40 ans celle des patients de plus de 40 ans. Cette e´tude, effectue´e sur une courte se´rie de 66 patients, permet donc d'approcher le diame`tre aortique normal et d'aider au diagnostic de dilatation pathologique de l'aorte.
Surgical and Radiologic Anatomy, 1999
The motion of the thoracic and lumbar spine segments was analysed by mean of the skin landmarks m... more The motion of the thoracic and lumbar spine segments was analysed by mean of the skin landmarks method in 14 volunteers (7 males, 7 females). The results demonstrated that there was no significant difference between men and women and there was either facilitation or limitation of the motion of the characteristic landmarks of spinal segments during trunk motion in perpendicular planes. The mobility of spinal segments was associated with pelvic girdle motion in order to obtain the planned amplitude, and varied with hip joint abduction. The analysis of the precise mechanisms of relaxing or stretching of the pelvivertebral musculo-ligamentous structures constitutes a large field of investigation that necessitates the study of other lower limb postures and the use of robotic techniques.
The Journal of Urology, 2002
Magnetic resonance imaging (MRI) was performed to determine anatomical correlations with respect ... more Magnetic resonance imaging (MRI) was performed to determine anatomical correlations with respect to physical examination using the Pelvic Organ Prolapse (POP) staging system. In addition, the standard POP staging system was analyzed to obtain normative data and determine any risk factors for prolapse. A total of 52 continent women 19 to 67 years old participated in our study. Pelvic MRI was performed at 1.5 Tesla. The vagina, bladder and rectum were opacified. Subjects performed pelvic floor contraction, relaxation and straining maneuvers for T1-weighted imaging. One-way analysis of variance, Fisher&amp;amp;amp;amp;amp;amp;amp;#39;s exact test and multinomial logistic regression were used to analyze the data. POP stage is quantified from 0 to IV. Stage was 0 to II in 56%, 27% and 17% of cases. POP stage was not significantly influenced by the number of cesarean sections (p = 0.64) or smoking (p = 0.91) but the number of vaginal deliveries significantly correlated with stage. Women with 1 vaginal delivery were at increased risk for a stage I condition (p = 0.018), whereas those with more than 1 were at increased risk for stage II (p = 0.013). On MRI stages 0 versus I or II differed significantly in regard to bladder descent (p = 0.01 and &amp;amp;amp;amp;amp;amp;amp;lt;0.0001, respectively), while stages 0 versus I differed in regard to levator angle (p = 0.007). No significant staging differences were observed in regard to the posterior urethrovesical angle or stages I versus II with respect to all 3 MRI measurements. MRI appears to detect anatomically measurable changes in POP stage 0 versus other stages in regard to bladder descent and the levator angle and yet it is not sensitive enough to detect differences in stages I and II. It is not unusual for continent women to have a moderate degree of pelvic prolapse and previous vaginal delivery appears to increase this risk.
Clinical Nephrology, 2008
Patients with severe hyponatremia have a high risk for centropontine myelinolysis (CPM) during tr... more Patients with severe hyponatremia have a high risk for centropontine myelinolysis (CPM) during treatment, but the incidence rate and risk factors have not been well-assessed. This study was conducted in a medical intensive care unit (ICU) of a university teaching hospital. All patients with a serum sodium concentration < 120 mmol/l and a serum osmolality level < 250 mosmol/kg upon ICU admission were enrolled in this prospective study and were included if they underwent a baseline brain computerized tomography scan (CT scan) and a follow-up brain magnetic resonance imaging 1 month after admission. The diagnosis of CPM was based on cerebral magnetic resonance imaging findings, i.e. T1-weighted images with T2-weighted images showing hyperintense signal in the corresponding areas which were not apparent on the initial cerebral CT scan. RESULTS. Of the 22 patients included, 12 were considered as having acute hyponatremia and 8 were chronic alcoholics. In 12 patients, the increase in serum sodium level was < 12 mmol/I in any 24-hour period. CPM was diagnosed in 7/22 patients (31.8%) and was asymptomatic in 4 of them. CPM was present in 4 patients with acute hyponatremia and in 4 chronic alcoholics. It was associated with a lower baseline potassium level (p = 0.05) and NaCl administration during the first 24 hours (p = 0.005). However, non-acute hyponatremia, chronic alcoholism and rapid correction of serum sodium did not appear as risk factors. The incidence rate of CPM following severe hyponatremia is high and can develop even when there is a slow correction of serum sodium level. Hypokalemia is a predisposing factor.
CardioVascular and Interventional Radiology, 2008
To evaluate the potential of uterine artery embolization to minimize blood loss and facilitate ea... more To evaluate the potential of uterine artery embolization to minimize blood loss and facilitate easier removal of fibroids during subsequent myomectomy. This retrospective study included 22 patients (median age 37 years), of whom at least 15 wished to preserve their fertility. They presented with at least one fibroid (mean diameter 85.6 mm) and had undergone preoperative uterine artery embolization (PUAE) with resorbable gelatin sponge. No complication or technical failure of embolization was identified. Myomectomies were performed during laparoscopy (12 cases) and laparotomy (9 cases). One hysterectomy was performed. The following were noted: easier dissection of fibroids (mean 5.6 per patient, range 1-30); mean intervention time 113 min (range 25-210 min); almost bloodless surgery, with a mean peroperative blood loss of 90 ml (range 0-806 ml); mean hemoglobin pretherapeutically 12.3 g/dl (range 5.9-15.2 g/dl) and post-therapeutically 10.3 g/dl (range 5.6-13.3 g/dl), with no blood transfusion needed. Patients were discharged on day 4 on average and the mean sick leave was 1 month. Preoperative embolization is associated with minimal intraoperative blood loss. It does not increase the complication rate or impair operative dissection, and improves the chances of performing conservative surgery.
Journal de Radiologie, 2006
Impact of computed tomography on patient's care in nontraumatic acute abdomen: 90 patients
Journal de radiologie
To report our experience with the treatment of 34 patients with SVC syndrome from neoplastic orig... more To report our experience with the treatment of 34 patients with SVC syndrome from neoplastic origin using the Wallstent. Thirty-four patients were treated between January 2000 and February 2007: 21 males and 13 females, aged 44-81 years, with non-small-cell lung carcinoma in 27 cases (79%), small-cell lung carcinoma in 5 cases (15%) and metastatic breast adenocarcinoma to the mediastinum in 2 cases (6%). All patients were treated using the stainless steel self-expanding Wallstent. A dual brachial-femoral access was used in all cases. Stent placement was possible in all cases. Per procedure acute respiratory distress occurred in 2 cases: 1 case of acute pulmonary edema and 1 case of tamponade. Symptoms resolved within 24 hours. Twenty-six patients died from disease progression, 8 during the first month, and 16 within 32-545 days post-procedure (mean: 213.4 days). Five patients with recurrent SVC syndrome underwent repeat treatment (restenosis in 3 cases, fracture in 1 case, thrombosi...
Journal des maladies vasculaires, 2000
Acute embolic renal artery occlusion is usually clinically typical. In case of early diagnosis, a... more Acute embolic renal artery occlusion is usually clinically typical. In case of early diagnosis, an in situ thrombolysis may be effective. As thrombosis often progressively completes a severe renal artery stenosis, the classical clinical description of renal infarction (lumbar pain, hematuria) is frequently not present. The kidney parenchyma downstream from the renal arterial occlusion is not always irreparably lost: collateral circulation may preserve nephron viability, which requires a lower perfusion pressure than glomerular filtration. An iodine, isotopic, or MR gadolinium nephrogram may prove this viability. Over the last 10 years, we attempted 21 percutaneous recanalizations of renal artery occlusion. Mean patient age was 62 years (44-85). All were hypertensive. Serum creatinin level of 17 patients was above 130 micromoles/ml. Three patients were previously hemodialysed. We observed 8 failures, without any complication. Thirteen immediate technical successes occurred, but one r...
Bulletin de l'Association des anatomistes, 1996
Comparative study of static curves of the thoracic and lumbar spine in men and women has been rea... more Comparative study of static curves of the thoracic and lumbar spine in men and women has been realized under constraints of compression by weightlifting and elongation by exercise to parallel bars. In two athletic practices, curves decrease their arrow, ending to a straighter and more rigid column. This behavior expresses muscular actions. The greatest amplitude of displacement, observed in female series, shows lesser muscular forces in connection with a poor practice of exercises of body building.
Collection de la Société française d’imagerie cardiaque et vasculaire, 2012
Journal de Radiologie Diagnostique et Interventionnelle, 2015
ABSTRACT La présence de graisse au sein d’une lésion hépatique n’est pas classique et peut orient... more ABSTRACT La présence de graisse au sein d’une lésion hépatique n’est pas classique et peut orienter le radiologue dans sa démarche diagnostique. Le but de cette revue iconographique est de préciser les différentes lésions hépatiques susceptibles de contenir de la graisse ainsi que leur aspect en imagerie en coupes et en particulier à l’IRM. Une corrélation anatomo-pathologique est également proposée pour les tumeurs les plus fréquentes. L’identification de graisse au sein d’une tumeur hépatique, en association avec les autres signes radiologiques, ainsi que la prise en compte du contexte clinique et épidémiologique peuvent permettre de poser le diagnostic ou de l’évoquer, avec confirmation si nécessaire, par l’examen histologique.
Objective: To compare CT scan abnormalities found in children with congenital deafness to the aud... more Objective: To compare CT scan abnormalities found in children with congenital deafness to the audiology data, notably to the type and severity of deafness of children. Patients and methods: Retrospectively, we studied the records of 87 children with different types and variable degrees of congenital deafness who had a CT scan of that part of the temporal bone lodging the ear within a period of 39 months in a tertiary reference centre. The data gotten were compared and correlated amongst themselves with a threshold significance of p < 0.05. Results: The sex ratio was 1.35 boy/girl for a mean age of 4.6 years at the first CT scan. One hundred and fifty ears out of 174 presented with deafness, with hearing loss of greater than 70dB in 57 cases (38%). The average hearing loss was 55±35dB. CT scan abnormalities predominated in ears presenting with moderate perception deafness. Four cases of external ear aplasia and tympano – ossicular abnormalities were the commonest lesions in the pr...
Journal de Radiologie, 2004
Journal de Radiologie, 2011
Journal de Radiologie, 2004
Surgical and Radiologic Anatomy, 1999
Conclusion Ce travail global a permis d'observer des éléments qui doivent être analysés plus... more Conclusion Ce travail global a permis d'observer des éléments qui doivent être analysés plus précisément par des investigations complémentaires :- influence d'autres positions des art. coxo-fémorales (adduction, rotations médiale ou latérale, flexion), ou des genoux (flexion), sur la cinématique de la colonne lombaire et thoracique ;- analyse opto-électronique des variations angulaires des capteurs au cours de la réalisation d'un mouvement du tronc dans un plan anatomique ;- détermination des mécanismes précis et des structures musculo-ligamentaires concernées par les techniques anatomiques, de comportement des matériaux et de robotique.
Surgical and Radiologic Anatomy, 2001
The aim of this study was to determine the topography of the origin, implantation angle and initi... more The aim of this study was to determine the topography of the origin, implantation angle and initial course of the renal arteries in the transverse and frontal planes, from a prospective analysis of angiograms and helical CT-scans of 40 patients. In the frontal plane, the implantation angles of the right and left renal arteries were 73.8 ± 17˚ and 65.6 ± 16˚ respectively 17.9% of the right renal arteries were straight compared with only 5% of the left ones. The first sinuosity was observed to be at a distance greater than the aortic diameter for 43.6% of right renal arteries and at a distance less than the aortic diameter for 62.5% for the left renal a. In the transverse plane, the right renal a. had an implantation angle of 65.6 ± 15.7˚ compared with 95.7 ± 16.85% for the left renal a. The artery was rectilinear in 2.6% of the cases on the right side, and in 2.5% of the cases on the left. The first sinuosity occurred before the lateral margin of the spine was reached in 60.5% of right renal arteries and after the margin of psoas major muscle for 55% of left renal arteries. A knowledge of the anatomy of the origin and initial course of the renal arteries is important when considering vessel dilatation and the implantation of stents in the renal arteries. No correlation was observed between the origin, sinuosity or angulation of the renal arteries which could aid interventional procedures. Only the main renal aa. were evaluated, any accessory polar aa. were not considered in the analysis. Thus the variability of the blood supply to the kidneys was not investigated. From the CT-scans the angle of origin of each renal a. in the transverse plane was determined with respect to the median sagittal plane, which was defined as a line passing between the apex of the spinous process and the anterior junction of the two laminae (Fig. 1). A line perpendicular to the median sagittal plane was drawn at the greatest diameter of the aorta. At the level of the ostium of the renal a., a line from its centre to the middle of the aorta was drawn the angle made by this line with the sagittal plane measured from 0˚ (anterior) to 180˚ (posterior).
Surgical and Radiologic Anatomy, 1998
The overall movement of the trunk is made up of two components, namely the movements of the pelvi... more The overall movement of the trunk is made up of two components, namely the movements of the pelvic girdle and the vertebrae. In the frontal plane, the amplitude of the pelvic movements appears to be relatively limited compared to the vertebral column whereas the pelvis makes the major contribution to the total rotational movement in the axial plane. This article completes a series of studies conducted by our team concerning the biomechanics of the human vertebral column.
Surgical and Radiologic Anatomy, 2003
To determine the evolution of the diameter of the thoracic aorta with age in order to detect dila... more To determine the evolution of the diameter of the thoracic aorta with age in order to detect dilatation more reliably by imaging, we performed a retrospective analysis of the MRI examinations of the normal thoracic aorta of 66 subjects aged 44.1±19.1 years (range 19.1-82.4 years) obtained between 1991 and 2000 on a Magnetom SP 42 1T apparatus (Siemens) using T1-weighted spin echo sequences with electrocardiographic synchronization. Sixteen measurements were made in the axial plane, the oblique sagittal plane in the axis of the aortic arch, and the oblique frontal plane perpendicular to the latter at the level of the ascending aorta, the arch and the descending thoracic aorta. We found an increase in the thoracic aorta diameter and a significant relationship between this diameter and the age of our subjects, wherever the measure was performed. However, there was no systematic correlation between aortic diameter and age. The aortic diameter evolved with age and a marked difference seemed to exist in measurements made in groups younger and older than 40 years. This study, conducted on a small population of 66 patients, thus helps to define a normal aortic diameter, thereby making the diagnosis of pathological dilatation of the aorta more reliable. Diame`tre normal de l'aorte thoracique chez l'adulte. Etude en imagerie par re´sonance magne´tique Re´sume´Pour de´terminer l'e´volution du diame`tre de l'aorte thoracique en fonction de l'aˆge afin de pouvoir juger d'une e´ventuelle dilatation sur les examens d'imagerie, les auteurs ont analyse´re´trospectivement des Imageries par Re´sonance Magne´tique d'aortes thoraciques normales de 66 sujets aˆge´s de 44,1±19,1 ans (19,1 a8 2,4 ans) re´alise´s de 1991 a`2000 sur un appareillage Magnetom SP 42 de 1 T (Siemens, Erlangen) en se´quences de spin e´cho ponde´re´es en T1 avec synchronisation a`l'e´lectrocardiogramme; 16 mesures e´taient ef-fectue´es dans les plans transversal, sagittal oblique dans l'axe de l'arc de l'aorte, et frontal oblique perpendiculaire au pre´ce´dent au niveau de l'aorte ascendante, l'arc de l'aorte et l'aorte thoracique descendante. Il existait un accroissement significatif du diame`tre de l'aorte sur les mesures effectue´es en fonction de l'aˆge. En revanche il n'existait pas de corre´lation syste´matique entre diame`tre aortique et aˆge. Le diame`tre aortique e´voluait en fonction de l'aˆge de manie`re significative avec une diffe´rence qui paraissait nette entre la cohorte des sujets de moins de 40 ans celle des patients de plus de 40 ans. Cette e´tude, effectue´e sur une courte se´rie de 66 patients, permet donc d'approcher le diame`tre aortique normal et d'aider au diagnostic de dilatation pathologique de l'aorte.
Surgical and Radiologic Anatomy, 1999
The motion of the thoracic and lumbar spine segments was analysed by mean of the skin landmarks m... more The motion of the thoracic and lumbar spine segments was analysed by mean of the skin landmarks method in 14 volunteers (7 males, 7 females). The results demonstrated that there was no significant difference between men and women and there was either facilitation or limitation of the motion of the characteristic landmarks of spinal segments during trunk motion in perpendicular planes. The mobility of spinal segments was associated with pelvic girdle motion in order to obtain the planned amplitude, and varied with hip joint abduction. The analysis of the precise mechanisms of relaxing or stretching of the pelvivertebral musculo-ligamentous structures constitutes a large field of investigation that necessitates the study of other lower limb postures and the use of robotic techniques.
The Journal of Urology, 2002
Magnetic resonance imaging (MRI) was performed to determine anatomical correlations with respect ... more Magnetic resonance imaging (MRI) was performed to determine anatomical correlations with respect to physical examination using the Pelvic Organ Prolapse (POP) staging system. In addition, the standard POP staging system was analyzed to obtain normative data and determine any risk factors for prolapse. A total of 52 continent women 19 to 67 years old participated in our study. Pelvic MRI was performed at 1.5 Tesla. The vagina, bladder and rectum were opacified. Subjects performed pelvic floor contraction, relaxation and straining maneuvers for T1-weighted imaging. One-way analysis of variance, Fisher&amp;amp;amp;amp;amp;amp;amp;#39;s exact test and multinomial logistic regression were used to analyze the data. POP stage is quantified from 0 to IV. Stage was 0 to II in 56%, 27% and 17% of cases. POP stage was not significantly influenced by the number of cesarean sections (p = 0.64) or smoking (p = 0.91) but the number of vaginal deliveries significantly correlated with stage. Women with 1 vaginal delivery were at increased risk for a stage I condition (p = 0.018), whereas those with more than 1 were at increased risk for stage II (p = 0.013). On MRI stages 0 versus I or II differed significantly in regard to bladder descent (p = 0.01 and &amp;amp;amp;amp;amp;amp;amp;lt;0.0001, respectively), while stages 0 versus I differed in regard to levator angle (p = 0.007). No significant staging differences were observed in regard to the posterior urethrovesical angle or stages I versus II with respect to all 3 MRI measurements. MRI appears to detect anatomically measurable changes in POP stage 0 versus other stages in regard to bladder descent and the levator angle and yet it is not sensitive enough to detect differences in stages I and II. It is not unusual for continent women to have a moderate degree of pelvic prolapse and previous vaginal delivery appears to increase this risk.
Clinical Nephrology, 2008
Patients with severe hyponatremia have a high risk for centropontine myelinolysis (CPM) during tr... more Patients with severe hyponatremia have a high risk for centropontine myelinolysis (CPM) during treatment, but the incidence rate and risk factors have not been well-assessed. This study was conducted in a medical intensive care unit (ICU) of a university teaching hospital. All patients with a serum sodium concentration < 120 mmol/l and a serum osmolality level < 250 mosmol/kg upon ICU admission were enrolled in this prospective study and were included if they underwent a baseline brain computerized tomography scan (CT scan) and a follow-up brain magnetic resonance imaging 1 month after admission. The diagnosis of CPM was based on cerebral magnetic resonance imaging findings, i.e. T1-weighted images with T2-weighted images showing hyperintense signal in the corresponding areas which were not apparent on the initial cerebral CT scan. RESULTS. Of the 22 patients included, 12 were considered as having acute hyponatremia and 8 were chronic alcoholics. In 12 patients, the increase in serum sodium level was < 12 mmol/I in any 24-hour period. CPM was diagnosed in 7/22 patients (31.8%) and was asymptomatic in 4 of them. CPM was present in 4 patients with acute hyponatremia and in 4 chronic alcoholics. It was associated with a lower baseline potassium level (p = 0.05) and NaCl administration during the first 24 hours (p = 0.005). However, non-acute hyponatremia, chronic alcoholism and rapid correction of serum sodium did not appear as risk factors. The incidence rate of CPM following severe hyponatremia is high and can develop even when there is a slow correction of serum sodium level. Hypokalemia is a predisposing factor.
CardioVascular and Interventional Radiology, 2008
To evaluate the potential of uterine artery embolization to minimize blood loss and facilitate ea... more To evaluate the potential of uterine artery embolization to minimize blood loss and facilitate easier removal of fibroids during subsequent myomectomy. This retrospective study included 22 patients (median age 37 years), of whom at least 15 wished to preserve their fertility. They presented with at least one fibroid (mean diameter 85.6 mm) and had undergone preoperative uterine artery embolization (PUAE) with resorbable gelatin sponge. No complication or technical failure of embolization was identified. Myomectomies were performed during laparoscopy (12 cases) and laparotomy (9 cases). One hysterectomy was performed. The following were noted: easier dissection of fibroids (mean 5.6 per patient, range 1-30); mean intervention time 113 min (range 25-210 min); almost bloodless surgery, with a mean peroperative blood loss of 90 ml (range 0-806 ml); mean hemoglobin pretherapeutically 12.3 g/dl (range 5.9-15.2 g/dl) and post-therapeutically 10.3 g/dl (range 5.6-13.3 g/dl), with no blood transfusion needed. Patients were discharged on day 4 on average and the mean sick leave was 1 month. Preoperative embolization is associated with minimal intraoperative blood loss. It does not increase the complication rate or impair operative dissection, and improves the chances of performing conservative surgery.