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Guillaume Poillon Adrien Collin Ygal Benhamou Galle Clavel Julien Savatovsky Ccile Pinson Kevin Zuber Frdrique Charbonneau Catherine Vignal Herv Picard Tifenn Leturcq Sbastien Miranda Thomas Sen Emmanuel Gerardin Augustin Lecler 《European radiology》2020,30(4):1866-1875
To compare the diagnostic accuracy of 3D versus 2D contrast-enhanced vessel-wall (CE-VW) MRI of extracranial and intracranial arteries in the diagnosis of GCA. This prospective two-center study was approved by a national research ethics board and enrolled participants from December 2014 to October 2017. A protocol including both a 2D and a 3D CE-VW MRI at 3 T was performed in all patients. Two neuroradiologists, blinded to clinical data, individually analyzed separately and in random order 2D and 3D sequences in the axial plane only or with reformatting. The primary judgment criterion was the presence of GCA-related inflammatory changes of extracranial arteries. Secondary judgment criteria included inflammatory changes of intracranial arteries and the presence of artifacts. A McNemar’s test was used to compare 2D to 3D CE-VW MRIs. Seventy-nine participants were included in the study (42 men and 37 women, mean age 75 (± 9.5 years)). Fifty-one had a final diagnosis of GCA. Reformatted 3D CE-VW was significantly more sensitive than axial-only 3D CE-VW or 2D CE-VW when showing inflammatory change of extracranial arteries: 41/51(80%) versus 37/51 (73%) (p = 0.046) and 35/50 (70%) (p = 0.03). Reformatted 3D CE-VW was significantly more specific than 2D CE-VW: 27/27 (100%) versus 22/26 (85%) (p = 0.04). 3D CE-VW showed higher sensitivity than 2D CE-VW when detecting inflammatory changes of intracranial arteries: 10/51(20%) versus 4/50(8%), p = 0.01. Interobserver agreement was excellent for both 2D and 3D CE-VW MRI: κ = 0.84 and 0.82 respectively. 3D CE-VW MRI supported more accurate diagnoses of GCA than 2D CE-VW.
• 3D contrast-enhanced vessel-wall magnetic resonance imaging is a high accuracy, non-invasive diagnostic tool used to diagnose giant cell arteritis.
• 3D contrast-enhanced vessel-wall imaging is feasible for clinicians to complete within a relatively short time, allowing immediate assessment of extra and intracranial arteries.
• 3D contrast-enhanced vessel-wall magnetic resonance imaging might be considered a diagnostic tool when intracranial manifestation of GCA is suspected. 相似文献
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Nina?Dupuis Andrey?Mazarati Béatrice?Desnous Vibol?Chhor Bobbi?Fleiss Tifenn?Le Charpentier Sophie?Lebon Zsolt?Csaba Pierre?Gressens Pascal?Dournaud Stéphane?AuvinEmail author 《Journal of neuroinflammation》2016,13(1):307
Background
Infectious encephalitides are most often associated with acute seizures during the infection period and are risk factors for the development of epilepsy at later times. Mechanisms of viral encephalitis-induced epileptogenesis are poorly understood. Here, we evaluated the contribution of viral encephalitis-associated inflammation to ictogenesis and epileptogenesis using a rapid kindling protocol in rats. In addition, we examined whether minocycline can improve outcomes of viral-like brain inflammation.Methods
To produce viral-like inflammation, polyinosinic-polycytidylic acid (PIC), a toll-like receptor 3 (TLR3) agonist, was applied to microglial/macrophage cell cultures and to the hippocampus of postnatal day 13 (P13) and postnatal day 74 (P74) rats. Cell cultures permit the examination of the inflammation induced by PIC, while the in vivo setting better suits the analysis of cytokine production and the effects of inflammation on epileptogenesis. Minocycline (50 mg/kg) was injected intraperitoneally for 3 consecutive days prior to the kindling procedure to evaluate its effects on inflammation and epileptogenesis.Results
PIC injection facilitated kindling epileptogenesis, which was evident as an increase in the number of full limbic seizures at both ages. Furthermore, in P14 rats, we observed a faster seizure onset and prolonged retention of the kindling state. PIC administration also led to an increase in interleukin 1β (IL-1β) levels in the hippocampus in P14 and P75 rats. Treatment with minocycline reversed neither the pro-epileptogenic effects of PIC nor the increase of IL-1β in the hippocampus in both P14 and P75 rats.Conclusions
Hippocampal injection of PIC facilitates rapid kindling epileptogenesis at both P14 and P75, suggesting that viral–induced inflammation increases epileptogenesis irrespective of brain maturation. Minocycline, however, was unable to reverse the increase of epileptogenesis, which might be linked to its absence of effect on hippocampal IL-1β levels at both ages.16.
Abourazzak F Couchouron T Meadeb J Perdriger A Tattevin P Moutel A Le Goff B Hajjaj-Hassouni N Chalès G 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2008,29(11):932-935
Herpes zoster is a disease which occurs secondary to the reactivation of varicella-zoster virus. Motor involvement in acute herpes zoster is rare. We report a case of sciatica L5 due to herpes zoster infection with motor loss. Typical skin lesions occurred one week before the sciatica. Radiological finding did not explain the paresis. The diagnosis of zoster sciatica with motor involvement was suspected. Serological tests and cerebrospinal fluid examination established the diagnosis. The antiviral and physical treatment was conducted in order to improve functional outcome. 相似文献
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Eric Voog Boris Campillo-Gimenez Claude Elkouri Franck Priou Frederic Rolland Brigitte Laguerre Chaza Elhannani Jacques Merrer Christian Pfister Emmanuel Sevin Tifenn L'Haridon Ali Hasbini Laura Moise Annick Le Rol Jean Pierre Malhaire Remy Delva Elodie Vauléon Oana Cojocarasu Philippe Deguiral Isabelle Cumin Caroline Cheneau Friedrike Schlürmann Valérie Delecroix Elouen Boughalem Delphine Mollon Catherine Ligeza-Poisson Sophie Abadie-Lacourtoisie Erik Monpetit Thierry Chatellier Henry Desclos Elodie Coquan Florence Joly Jean Yves Tessereau Sandra Dupuy Delphine Déniel Lagadec Fanny Marhuenda Francoise Grudé 《International journal of cancer. Journal international du cancer》2020,146(6):1643-1651
The treatment landscape in metastatic renal cell carcinoma has changed fundamentally over the last decade by the development of antiangiogenic agents, mammalian target of rapamycin inhibitors and immunotherapy. Outside of the context of a clinical trial, the treatments are used sequentially. We describe results under real-life conditions of a sequential treatment strategy, before the era of immunotherapy. All patients were treated according to their prognostic score (either Memorial Sloan Kettering Cancer Center or International Metastatic Renal Cell Carcinoma Database Consortium) for advanced renal cell carcinoma. A treatment strategy involving 1 to 4 lines was determined including a rechallenge criterion for the repeat use of a treatment class. Three hundred forty-four patients were included over 3 years. Overall survival was 57 months in patients with good or intermediate prognosis and 19 months in patients with poor prognosis. In the former group, the proportions of patients treated with 2 to 4 treatment lines were 70%, 38% and 16%, respectively. The best objective response rates for lines 1 to 4 were 46%, 36%, 16% and 17%, respectively. Grade III/IV toxicity did not appear to be cumulative. The recommended strategy was followed in 68% of patients. A large proportion of patients with good or intermediate prognosis who progress after two lines of treatment still have a performance status good enough to receive a systemic treatment, which justifies such a strategy. Overall survival of patients with good and intermediate prognosis was long, suggesting a benefit from the applied approach. These results might be used as selection criterion for the treatment of patients in the era of immune checkpoint inhibitors. 相似文献
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Transitory anti-beta2-glycoprotein I antibodies in infections. 总被引:1,自引:0,他引:1
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Valérie?BoussonEmail authorView authors OrcID profile Tifenn?Leturcq Hang-Korng?Ea Olivier?Hauger Nadia?Mehsen-Cetre Bassam?Hamzé Caroline?Parlier-Cuau Jean-Denis?Laredo Thierry?Schaeverbeke Philippe?Orcel 《European radiology》2018,28(2):478-486