Biomedical subjects
Publications and source records attributed to C Chatelain.
The role of the left spermatic vein as a replacement in cases of obstruction of the inferior vena cava is discussed in connection with a case of varicocele revealing a thrombosis of the inferior vena cava.
The extension of renal cell cancer into the vena cava is not inaccessible to treatment. In the absence of any other effective treatment, only surgical resection is able to provide a chance of long term survival. The authors report their experience of 40 cases, 24 of which underwent complete resection of their lesions. The survival rates in these cases were 47.6% at 1 year, 28.6% at 2 years, 15% at 3 years and 9.5% at 5 and 7 years. A selective approach to the right auricle was performed in three patients and the technique of this operation is outlined. The global mortality was 8.8%. The various technical possibilities and the prognostic factors are also reviewed.
The authors report the case of a patient with a crush fracture of the pelvis associated with rupture of the urethra, rupture of the bladder and ano-rectal disruption. The emergency and subsequent management of the urinary tract and gastrointestinal lesions is discussed. A review of the literature reveals the rarity of the association of ano-rectal and urinary tract lesions in the context of pelvic fractures and the unique nature of the present case.
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To ensure vascular access, a biological graft was inserted in 44 patients from August 1982 to February 1985 at the Department of Urology, Pitié Hospital, Paris. Forty-nine grafts were used, including 39 saphenous veins and 10 carotid arteries from calves. Four patients free of renal failure had insertion of a graft to allow chemotherapy (3 cases) or plasmapheresis (1 case). Graft patency rate in these four patients is 50%. Among the 40 patients with renal failure, 11 have not yet had dialysis, 26 are currently under dialysis, 2 have been lost to follow up, and 1 died before dialysis. All but one of the patients with renal failure not treated by dialysis have a patent graft. Graft patency rate after one year in the 26 patients under dialysis is 83% for non-reoperated patients and 91% for reoperated and non-reoperated patients as a group. As concerns complications, an interesting fact is that thrombosis of the graft usually required graft replacement, whereas most delayed stenoses were treated by surgery with preservation of the graft. No case of infection or aneurysm was recorded throughout follow up. These results pertain chiefly to saphenous vein grafts as use of carotid arteries from calves is recent. In view of the 95% immediate graft patency rate and of the satisfactory results at one year in these patients usually selected because of the poor condition of accessible arteries and veins, we believe biologic grafts constitute an outstanding material in vascular access surgery for hemodialysis.
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A system for the accurate and rapid measurement of the ploidy of cultured megakaryocytes derived from megakaryocytic colony-forming cells (CFU-M) has been developed. Thirty thousand murine marrow cells per milliliter were cultured for varying time periods in agar in the presence of horse serum and pokeweed mitogen-stimulated spleen cell-conditioned medium (PWM-SCM). To ensure the inclusion of all the megakaryocytic cells in the analysis, entire agar discs were transferred onto glass slides and dried. Cells of the megakaryocytic lineage were identified by staining for acetylcholinesterase (AchE) for two hours. Subsequently, the nuclei of the cells were stained using 1.7 X 10(-5) mol/L chromomycin A3, a specific DNA-binding fluorochrome. Megakaryocytic colonies (greater than or equal to 2 AchE+ cells) were located under transmission light. The fluorescence emission of each cell of the colony was then measured by a photometer interfaced with a computer. The mean fluorescence emission of about 20 random granulocytes per slide was used as a 2N standard. There was no significant cell loss, quenching of fluorescence by AchE staining, or overlapping of colonies or cells. Approximately 100 megakaryocytes per hour could be analyzed. Modal ploidy of cultured megakaryocytes increased from 2N to 32N between days 3 and 6 in culture. Varying concentrations of PWM-SCM from 5% to 20% did not affect the ploidy distribution when examined at day 5. The heterogeneity of the ploidy of cells within colonies increased continuously with increasing cell numbers per colony. Clonal analyses of mean ploidy and ploidy heterogeneity did not show distinct types or classes of colonies; rather, the data show that megakaryocytic colonies are structured as a continuum. An inverse correlation was found between the number of cells constituting the colonies and their mean DNA content. To determine if short-term in vivo exposure of CFU-M to a thrombocytopenic environment could affect the ploidy of their progeny, mice were given rabbit antimouse-platelet serum while control animals were given normal rabbit serum. Twenty-four hours after injection, marrow derived from these animals was cultured. At day 5, the ploidy distributions and ploidy heterogeneity were identical in both treated and control groups. Thus, factor(s) that promote CFU-M proliferation do not affect megakaryocytic endoreduplication, while stimuli that acutely influence megakaryocytic ploidy in vivo do not determine the ultimate ploidy potential of megakaryocytes derived from a CFU-M.
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This article concerns a case of anuria in a pregnant woman, apparently caused by compression of the urinary tract. The case is compared to the behavior of the excretory tract during a normal pregnancy. Four similar cases, taken from the literature are also discussed.
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Schistosoma haematobium eggs may occasionally be found in the renal parenchyma, usually with no pathological consequences, the main risk to the kidney being obstruction of the urinary tract by bilharzial lesions. Egg deposits in the submucosa and muscles of the excretory tract induce obstruction and sclerosis, mainly in the ureters. Bilateral stenosing bilharzial ureteritis results in mechanical obstruction of the renal function, sometimes, unfortunately, accentuated by sepsis and pyelonephritis. This condition is a strong indication for surgical repair of the stenotic lesions of the urinary tract, which must be performed before the onset of irreversible damage to the renal function.
The Döppler ultrasonic examination proposed for the diagnosis of acute painful scrotal syndromes has been used during 4 months. The presence of false negative results in the literature and in the series reported here throws some doubt on the reliability of the method and confirms that systematic surgical exploration remains imperative at the slightest doubt.