[Postoperative subphrenic abscess. Study of 25 cases].
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Biomedical subjects
Publications and source records attributed to C Meyer.
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From 2 personal cases the authors present a pathological appraisal of appendicular mucoceles. They distinguish between a benign kind with an atrophic mucous membrane and a malignant type with a hyperplasic epithelium arranged in papillary and vegetating structures; this is a neoplasm with local malignancy. This variety remains the most liable to become a peritoneal pseudo-myxoma representing the most serious complication of the appendicular mucecele. Treatment of the mucocele, which consists in an appenicectomy or a right bemi-colectomy, usually yields good results provided operative rupture can be avoided. Contrarily the peritoneal pseudo-myxoma remains a serious disease with a disappointing treatment.
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Adenosine-triphosphate-phosphoribosyl transferase from Escherichia coli reacts with S-dinitrophenyl-6-mercaptopurine-riboside 5'-phosphate. In this reaction the dinitrophenyl group becomes attached to the enzyme, while the nucleotide is split off. Most aliphatic high and low-molecular-weight-SH compounds react with the thioether in the opposite way, i.e. bind the nucleotide and split off dinitrothiophenol. It appears that the dinitrophenyl moiety of the thioether interacts with the enzyme in a specific way, and that this interaction activates the bond between the dinitrophenyl group and the sulfur atom. In support of this it was found that dinitrophenol inhibits the transferase reaction with half maximal effect at 0.4 mM. The inhibition is competitive with ATP. Dinitrophenol also competes with ATP in binding studies.
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In 50 patients with peptic ulcer (48 duodenal ulcers and 2 pyloric channel ulcers) proximal gastric vagotomy was performed. The diagnosis was confirmed by radiology and endoscopy in all cases. Pentagastrin-stimulated maximal acid output (MAO) was measured preoperatively. At 6-12 months after the operation a pentagastrin test (6 mug/kg) and an insulin test (12 units regular insulin intravenously) were carried out. The results of the insulin tests were assessed by 5 criteria. In patients with 3 or more positive criteria the vagotomy was considered incomplete. 30 patients had "complete" and 20 "incomplete" vagotomy. MAO was reduced by 56%. The mean reduction of MAO was 63% in cases of "complete" vagotomy and 46.5% in "incomplete" vagotomy. The purpose and indication of postoperative studies of gastric secretion are discussed.
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Although high localisations of villous tumours may be treated by wide removal, which alone guarantees cure without risk of relapse, the use of such an operation in low villous tumours is less obvious owing to the mutilation which may result. Local removal of small volume tumours by the anal route, by the trans-sacral route when they are larger or more broadly implanted, is preferred by us in rectal localisations, i.e. each villous tumour should be treated taking into considération all its characteristics.
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After description of a method of continuous measurement of partial pressure of blood gases, the authors describe the technical difficulties : behaviour of the electrodes, problems associated with continuous measurement, and emphasise the influence of the method on the results, e.g. heparinisation, blood flow rate, quantity of blood consumed. The results obtained under suitable physiological conditions show the difficulty of interpretation of continuous measurement of gaseous parameters and show interest in short but significant function tests.
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