[Pleural effusion caused by uterine fibromyoma].
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Biomedical subjects
Publications and source records attributed to C Rey.
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High acetone levels occur in uncontrolled diabetes and after isopropanol administration to rats. In both conditions, very low density lipoproteins (VLDL) secretion is depressed. Acetone, hoever, failed to affect the VLDL secretion rate by the isolated perfused rat liver, suggesting that this metabolite is not involved in impaired VLDL production in diabetes and after isopropanol administration.
The case of a 50-year-old woman with a retroperitoneal paraganglioma and nephrotic syndrome is presented. After the tumor was removed deposits of amyloid material were observed in the paraganglioma, kidneys, and liver. There was no thrombosis of the renal vein. The clinical picture (fever and nephrotic syndrome) was similar to that of patients with amyloidosis associated with neoplasms. The nephrotic syndrome disappeared 8 months after the operation. The patient has not had fever or nephrotic manifestations over the past 4 years and is asymptomatic at the present time. We believe this to be the first reported case of paraganglioma associated with amyloidosis. Nor have we found any references to clinical and biological remission of the nephrotic syndrome following surgical removal of the concomitant neoplasm.
Echocardiography tracings of the pulmonary valve was recorded in 16 patients with pulmonic stenosis (PS) ranging in ages from 6 to 14 years (average 10 years). 11 patients had an isolated PS and 5 had a PS associated with atrial septal defect. In 2 patients with mild PS (gradient 15 mm Hg) the depth of the "a" wave was normal: 3 and 4 mm. In 14 patients with moderate or severe PS (gradient 40 mm to 200 mm Hg), the maximal depth of the "a" wave was less than 6 mm in 2 patients, and more than 6 mm in 12 patients (range 7 to 15 mm, average 10 mm). The motion of both anterior and posterior pulmonary valve leaflets was well recorded in 3 patients with severe PS. The "a" wave showed a posterior motion of the posterior leaflets and an anterior motion of the anterior leaflet. This motion is due to the premature pulmonary valve opening.
Pf 51 cases of Fallot's tetralogy who underwent preoperative angiography before a palliative anastomosis and then a second angiography before complete correction, 10 had developed pulmonary atresia (infundibular in 8 cases, valvular in 2 cases). The type of anastomosis (Blalock-Taussig of Waterston), and the interval between the two operations do not seem to be determinant factors. The initial severity of the stenosis seems to favour the development of atresia but this is not invariable. The authors discuss the aggravating role of the anastomosis and the consequences of this type of complication.
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The authors present their experience of heart disease in children with congenital abnormalities of alcoholic origin, of which they have seen 50 cases in 3 years. This syndrome, which was first described by Lemoine in 1968, appears to be fairly common. It shows the teratogenic properties of alcohol. It is characterised by facial abnormalities which are easy to recognise, gross failure to gain in height and weight, psychomotor retardation of varying severity and several other malformations. From amongst these, cardiac malformations are the most commonly encountered. These are usually in the form of septal defects (atrial and ventricular septal defects).
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The authors report 12 cases of Ebstein's disease, and have studied the echocardiographic findings in these cases. The results have been compared with those of a control series of 12 patients with an atrial septal defect and a large shunt effect. There are only two conditions which are important in the diagnosis of Ebstein's disease: the finding of the tricuspid valve beyond the midclavicular line, and a delay in the closure of the tricuspid valve greater than or equal to 0.06 seconds when compared with the mitral valve. Using these two criteria, the diagnosis could be made by echocardiography in 10 cases out of 12.
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Isolated ventricular discordance is a very rare malformation, most often lethal in the first months of life. A patient with this lesion survived to age 9 years in spite of the coexistence of a complete form of atrioventricular (A-V) canal. Surgical repair with a Mustard procedure was associated with correction of the endocardial cushion defect. Situs inversus itself caused no problem. Although permanent complete A-V block occurred, the result has been satisfactory so far. This case is thought to be the first successful correction of this malformation.