The concept of acute renal failure with anuria due to malignant nephro-angiosclerosis, is uncommon. We report two cases and compare them with others in the world literature. Knowledge of this disease entity is of triple interest: In diagnosis and classification in the field of acute vascular nephropathy with anuria. We cannot emphasise too much the interest of early renal biopsy after correction of abnormal blood pressure. In physiopathology, these malignant nephro-angioscleroses give rise to hypertension of pressor type with high renin levels. Finally therapeutic, for there exist drugs adapted to this type of hypertension. The association of acute renal failure and malignant nephro-angiosclerosis should be treated as an emergency, to avoid the passage to terminal and irreversible renal failure.

Acute Kidney Injury↗

PubMed1977

Pathology of sinoatrial node. Correlations with electrocardiographic findings in 111 patients.

Histological study of the sinoatrial node (SAN) was performed in 111 patients in order to estabilsh correlations between the ECG findings and the anatomical lesions. This series includes both patients with sinus rhythm and patients with atrial arrhythmias. The results are as fololows: (a) the amount of nodal cells in the SAN was found to be inversely proportional to the age of the patients (p less than 0.001); (b) normal sinus rhythm was present in some cases with severe fibrosis of the SAN; (c) the present study does not support lesions of the SAN as responsible for atrial fibrillation; (d) chronic sinoatrial block was associated with extensive lesions of the approaches of the AV node or the AV node itself; (e) the auricular tachycardia-bradycardia syndrome was associated in most cases with both lesions of the main feature of the SAN lesion. The pathogenesis of these fibrotic lesions are discussed.

Adolescent↗

PubMed1977

[Current aspects of gas gangrene, apropos of 47 cases collected over a 3-year period (1974-1976)].

On the basis of 47 cases of gas gangrene collected over the three year period between 1974 and 1976, the authors review the circumstances surrounding its development, the clinical features and the prognosis of the disorder which remains grave despite a well-defined therapeutic protocol combining surgery, antibiotics and hyperbaric oxygen. There would appear to be a real resurgence of the disease at the present time. Post-traumatic and surgical aetiologies predominate, giving rise to two types of gangrene: clostridial gas gangrene secondary to contamined wounds, with a quasi-constant vascular element, affecting predominantly the limbs, and nonclostridrial gangrene, the increasing prevalence of which involves essentially spetic abdomino-pelvic surgery. In the light of this study, prognosis would appear to be related to the underlying terrain in which the gangrene occurs, to certain features of the clinical picture and, above all, to the possibilities of early application of the complete therapeutic protocol. Strict prophylactic measures would alone seem capable of preventign the worrying increase in the number of cases of gas gangrene.

Adult↗

PubMed1977

[Determination of global diffusion of CO2 and its partial components under assisted respiration. Technical problems and practical value in respiratory resuscitation].

A study of partial CO2 ductance has been performed in patients under assisted ventilation. The authors propose methods for simultaneous measurement of paCO2, PAECO2, PECO2 and PICO2. This methodology is used in patients presenting different conditions accounting for respiratory resuscitation: barbiturate poisoning with healthy lungs, bronchial stasis, acute lung involvement, obstructive bronchopneumopathy and pulmonary embolism.

Carbon Dioxide↗

PubMed1977

[Atrioventricular blocks of bacterial endocarditis. 8 cases comprising histological study of the conduction system].

The authors report 8 cases of complete atrio-ventricular block (AVB) which came on during bacterial endocarditis. The aortic valve was more frequently affected (6/8). The conduction disorder is necessarily unstable. The prognostic significance of AVB is always very grave--all the patients have died. The valve lesions are often severe. A histological study of the conducting pathways has been carried out. The classically described aneurysm of the membranous septum was not responsable for any cases of AVB in this series. The most frequent cause of the AVB (5/8) was an infiltration of the prenodal area and the A-V nod itself, starting from the posterior aortic cusp and, in one case, from the tricuspid valve. The bundle of His is affected either by extension of the A-V node lesion or by the focus on the right cusp. Strings of inflammatory cells may follow the sheath of the bundle branches. Haematogenous micro-abscesses are sometimes found in the conducting tissues.

Adult↗

PubMed1977