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Clichy, France

Dioguardi Burgio M.,University of Palermo | Bruno O.,Hospital Beaujon | Agnello F.,University of Palermo | Torrisi C.,University of Palermo | And 11 more authors.
Expert Review of Gastroenterology and Hepatology

ABSTRACT: Focal steatosis and fatty sparing are a frequent finding in liver imaging, and can mimic solid lesions. Liver regional variations in the degree of fat accumulation can be related to vascular anomalies, metabolic disorders, use of certain drugs or coexistence of hepatic masses. CT and MRI are the modalities of choice for the noninvasive diagnosis of hepatic steatosis. Knowledge of CT and MRI appearance of focal steatosis and fatty sparing is crucial for an accurate diagnosis, and to rule-out other pathologic processes. This paper will review the CT and MRI techniques for the diagnosis of hepatic steatosis and the CT and MRI features of common and uncommon causes of focal steatosis and fatty sparing. © 2016 Informa UK Limited, trading as Taylor & Francis Group. Source

The most important current concept in therapeutic management of female genital prolapse is the use of non absorbable prosthesis through a vaginal approach. The application of these surgical techniques to repair prolapse aims to restore the anatomic position of the pelvis, while preserving urinary, bowel and sexual functions. Since 2005, we use the Apogee® prosthesis for the treatment of both the vault prolapse and associated posterior colpocele. The purpose of this paper is the detailed description of the technique of placement of Apogee® prosthetic system, so that it can be useful to clarify the key points of this surgical reconstructive surgical technique and different gestures associated with the placement of this type of prosthesis. Source

Gaujoux S.,University Paris Diderot | Sauvanet A.,University Paris Diderot | Belghiti J.,Hospital Beaujon
Targeted Oncology

Neuroendocrine tumors (NET) are usually slowgrowing neoplasms carrying an overall favorable prognosis. Surgery, from resection to transplantation, remains the only potential curative option for these patients, and should always be considered. Nevertheless, because of very few randomized controlled trials available, the optimal treatment for these patients remains controversial, especially regarding the place of surgery. We herein discuss the place of surgical resection in the treatment strategy in neuroendocrine tumors of the digestive tract. © Springer-Verlag 2012. Source

Luton D.,Hospital Beaujon | Azria E.,Hospital Bichat | Polak M.,French Institute of Health and Medical Research | Carr A.,French Institute of Health and Medical Research | And 3 more authors.
Hormone Research in Paediatrics

Background/Aims: A mild increase in thyrotropin (thyroid-stimulating hormone; TSH) is common among Down syndrome patients but is rarely detected by neonatal screening at birth. We hypothesized that Down syndrome was associated with fetal hypothyroidism and tried to determine whether Down syndrome fetuses had evidence of hypothyroidism. Methods: We performed a prospective observational study on 13 fetuses with Down syndrome diagnosed prenatally. TSH and free thyroxine (FT4) levels were measured in fetal blood. The results were analyzed and compared with the findings from fetal sonography and histopathology. Results: Of the 13 fetuses, 6 had TSH values greater than the 95th percentile, and FT4 values were low. None of the fetuses had sonographic evidence of goiter. The thyroids were normal by gross examination but exhibited small follicles and histological features suggesting delayed maturation. Conclusion: The absence of goiter even in fetuses with hyperthyrotropinemia suggests a mild decrease in TSH responsiveness. Copyright © 2012 S. Karger AG, Basel. Source

Tripon S.,Hepatology and Liver Intensive Care | Francoz C.,Hepatology and Liver Intensive Care | Francoz C.,University Paris Diderot | Albuquerque A.,Hospital Beaujon | And 8 more authors.
Transplant International

Refractory ascites may appear in liver transplant recipients with recurrence of hepatitis C virus infection, even in the absence of advanced fibrosis. The mechanisms are unclear. The aim was to determine whether post-transplant cryoglobulinemia could be a predisposing factor for ascites in this population. Retrospective data of 82 liver transplant recipients with HCV recurrence surviving more than 1 year were collected. Cryoglobulinemia was systematically tested after transplantation. All patients had 1-year protocol biopsy with assessment of sinusoidal distension, perisinusoidal fibrosis, and centrolobular necrosis. Additional biopsies were performed when needed. Fourteen of 82 patients (17%) developed refractory ascites. When ascites appeared, fibrosis was stage F0-F1 in 36% and F2-F3 in 57%. Factors independently associated with post-transplant ascites were pretransplant refractory ascites (P = 0.001), fibrosis ≥stage 2 at 1 year (P = 0.002), perisinusoidal fibrosis at 1 year (P = 0.02), and positive cryoglobulinemia (P = 0.02). Patients with ascites had a significantly worse prognosis compared to those without ascites. Refractory ascites may occur in liver transplant recipients with HCV recurrence in the absence of advanced fibrosis. The finding that both positive cryoglobulinemia and perisinusoidal fibrosis at 1 year were significantly associated with ascites suggests that liver microangiopathy is involved in the mechanisms of HCV-related ascites. © 2014 Steunstichting ESOT. Source

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