Biomedical subjects
Publications and source records attributed to A Dupre.
One case of malignant degeneration on an ileostomy following proctocolectomy for familial intestinal polyposis is reported. On the basis of a review of the literature, the nosological context of this disease, the etiopathogenesis of cancerization and the surgical consequences are determined.
A series of 50 patients with carcinoma of the breast underwent omental transposition. This palliative procedure is indicated for recurrences after conservative treatment, radiation necrosis and Stage III or IV ulcerated tumors. The operative technique is described in detail. Omentoplasties were performed upon 33 right and 17 left mammary areas. Forty-five right pedicled flaps and only four left areas were used. One patient died on the fourth postoperative day because of massive pulmonary embolus. Local repair was satisfactory in 76 per cent of the patients. Four patients presented with herniation of the abdominal wall at the site of omental tunneling. In three, the treatment consisted of sectioning the vascular pedicle and reinforcing the parietal closure with Dacron (polyester fiber) mesh.
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The present study examines the effects of resuscitation fluid composition on myocardial function, myocardial high-energy phosphate content, and survival following third-degree anesthetic burn to 35-40% body surface area in the guinea pig. Treatment regimens used were 1) no resuscitation, 2) isotonic saline, 3) Ringer's lactate and 4) Ringer's acetate. Fluids were administered at the rate of 0.334 ml/kg/hr/% burn for 4 hr following injury, at which time myocardial function was assessed. Nonburned animals served as controls. In isolated working hearts, significant depression of myocardial function was observed in nonresuscitated and saline-resuscitated animals as evidenced by decreased cardiac output, dP/dt, -dP/dt, and stroke work. Lactate resuscitation produced some improvement in these parameters but did not restore them to those of nonburned control animals. In contrast, Ringer's acetate resuscitation resulted in normal cardiac output and contractility. Myocardial ATP content of hearts obtained from the various resuscitation groups did not differ from that of nonburned control hearts, except for hearts from Ringer's lactate group, which were significantly lower in myocardial ATP than those of the other groups. No differences were found in creatine phosphate content. Resuscitation with the different fluid regimens for 48 hr produced significant differences in survival. Fluids were given at the rate of 4 ml/kg/% burn for 24 hr. Half of the fluid was given in the first 8 hr and the rest during the remaining 16 hr. Nonresuscitated and saline-resuscitated animals showed significant mortality by 24 hr, whereas lactate- and acetate-treated animals had survival rates of 100% and 87.5%, respectively. However, by 48 hr, only acetate-treated animals survived. These data indicate that important differences exist in the effectiveness of different resuscitation fluids and that Ringer's lactate, the fluid most often utilized clinically, may not provide optimum benefit. In light of these results, serious consideration should be given to the substitution of acetate for lactate during the resuscitation of burn shock patients.
A patient had an unusual pigmentary disease induced by titanium dioxide. The use of a topical cream containing titanium dioxide caused a xanthomalike appearance on the patient's penis. Electron probe microanalysis was valuable in establishing the cause of this balanitis.
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A 51-year-old Caucasian man presented with a yellowish lesion containing multiple protuberances over his right cheek. Light and electron microscopic examination revealed an anhistic substance lacking definite characteristics of either amyloid or collid milium. The term paracolloid degeneration of the skin is introduced to designate this substance which is believed to derive from collagen. A review of the literature showed similar cases previously published under the names of nodular amyloidosis or disseminated colloid.
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We report a very curious case of a condition which has never been described before. Its features are comparable but not quite identical with those of Christensen's saltpetre-induced PXE which the author considers to be an exogenous variety of pseudoxanthoma elasticum. Since our case appeared spontaneously without any accidental episode we prefer to designate it under the name 'localized PXE'. The chequered appearance of the lesions seems to be the characteristic feature of the disease.
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The osmotic properties of human lymphocytes isolated from 15 ml of venous blood were examined. Measurements of the permeability of the membrane to water under an osmotic gradient were also made. The Boyle-Van't Hoff relation held very well for the human lymphocyte when the cells were shrunken in hyperosmotic media to concentrations twice isosmotic. The volume of osmotically inactive material or "b" value averaged 32% of the mean corpuscular volume. These values were independent of temperature. Ponder's R ranged between 0.8 and 0.9. The average value for Lp, the hydralic coefficient was 0.46 mu/min atm +/- 0.02 (S.E.M.) at 25 degrees C. No significant effect of age, sex, or race was noted. The effect of temperature between 10 degrees C and 37 degrees C was measured and heats of activation between 11.1 and 17.4 kcal/mole were calculated with a mean of 14.1 kcal/mole +/- 1.6 (S.E.M.). Concanavalin A at 10 microgram/1.5 X 10(6) lymphocytes produced blastogenesis of 25% or more of the lymphocytes without clumping, agglutination, or toxicity. The mean corpuscular volume increased by 21% after 72 hours due to an increase in the "b" value which increased by 80%. The volume of free water remained constant. Histograms of the distribution of cell volumes showed that volume changes were uniform throughout the population with no evidence of agglutination of clumping. The significance of these results is discussed in the context of membrane fluidity and the state of intracellular water.
We saw three patients with inflammatory linear verrucose epidermal nevus (ILVEN). The purpose of this study is to better delineate the histopathologic features of this type of nevus. In fact, in all three cases very particular, specific histologic lesions have been noted that permit us to better distinguish this recently outlined entity. The histologic features were depressed, cup-like areas of hyper-granulosis with overlying orthokeratotic hyperkeratosis, alternating (with sharp dermacation) with raised, level areas of agranulosis with overlying parakeratotic hyperkeratosis.