[Conservative treatment of splenic injuries].
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Biomedical subjects
Publications and source records attributed to F Jung.
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Percutaneous needle aspiration was carried out in one case of suprarenal cysts which had already been evaluated by pyelography, echography and angiography. The characteristics of the aspirated liquid pointed towards a benign lesion, and enabled conservative treatment to be initiated. More generally, diagnosis of suprarenal tumors benefits from the direct approach already applied to other abdominal tumors.
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The dermato-oesophagoplasty had its hour of glory. The complexity of the dermato-oesophagoplasty has made it totally abandoned and it presents only a historic advantage today. However, the unexpected arrival after 45 years of a canceration of cutaneous duct like that was observed on the second case of dermato-oesophagoplasty published in France comes to solve some problems of pathogeny of a surgical technic that the authors analyse in the light of more recent labours on the oesophagoplasty.
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The present study examined the effects of various substances on salivary secretion in 25 psychiatric inpatients suffering from depression or schizoprenic disorders. It is well known that tricyclic neuroleptics and anti-depressants lower the rate of salivary excretion and lead to hyposalivation and a dry mouth. The following methods were studied on their effect to compensate hyposalivation: Distigminbromid, sweets, Glandosane, a new synthetic saliva, and water which was gustatory adopted. Salivary flow was measured according to Matzker (7). Subjective feelings of thirst and mouth dryness were recorded by selfconstructed tests. Only Glandosane and Distigminbromid compensated mouth dryness. The recorded amount of salivary flow was within the range of normal controls. There were no significant correlations between the subjective test answers and the objective measurement of salivary rate. Improvement of depression by application of Glandosane could not be observed. Patients treated with Glandosane felt most comfortable whereas in those treated with Distigminbromid side effects as digestive disorders, urinary disorders and changes in perspiration were observed.
Two cases of a rare complication of this tumor have been reported. A hepatoma can provoke an intra-peritoneal hemorrhage in two different ways: either by tearing through the hepatic tissue which surrounds it or by necrosis and hemorrhage of the tumor itself. This complication may be the initial symptom and may require emergency surgery. Local hemostasis if often precarious and does not resolve the underlying oncological problem. At best, survival is limited to several months. Rapid removal of the tumor seems to be the only means of prolonging survival although there is not yet much data on this in the literature. At any rate the poor general condition of the patient, the frequent multiplicity of the tumoral locations and the habitual cirrhotic nature of the rest of the liver would rule out any possible surgical removal in 90% of cases. In the remaining 10% where surgery is possible, the average survival rate is 13 months.
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On 200 Wistar white rats the authors experiment the effects of an original solution administered by the mouth on the evolution of a chronic gastric ulcer experimentally induced. This solution tuning for the prevention or the treatment of the stress ulcer seems to aggravate the chronic ulcers in the way of formation but on the contrary accelerates in a way highly significant the cicatrization of constituted chronic ulcers. The local and general effects of different components of this solution produce these double actions and do not contraindicate its clinic utilisation.
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The authors report an exceptional case of fat embolism with neuro-psychiatric signs, following a digestive by-pass operation for hypercholesterolemia. They emphasize the difficulty in diagnosis and attach value to the lipuria when it is massive. A short review of the literature recalls the various pathogenic theories of fat embolism.
A series of 30 cases of post-operative peritoneal irrigation dialysis for generalised peritonitis. In the light of peritoneal physiology, details are given of the technique for insertion of the peritoneal drains as well as the composition of the dialysate. In addition to its mechanical role, continuous lavage of this type is useful in restoring and maintaining water and electrolyte balance, the limitations of which are described, together with a direct anti-infectious action and temperature equilibration. P.I.D. seems to be associated with a considerable reduction in mortality from acute generalised peritonitis (1 case out of 30). It also limits morbidity, since only 5 minor complications were seen. The simplicity and harmlessness of the method makes it possible to widen, without major reservations, the scope of therapeutic solution to the problem of acute generalised peritonitis.
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The authors report an experimental study of the pathology and cervico-cerebral hemodynamics in the dog and discuss the normal anatomy of the carotid arteries in the dog. These results include the interpretation of 30 selective angiographies and numerous anatomical dissections. Many points distinguish the carotid arteries in the dog from those in man. Firstly, in their distribution, where the internal carotid artery appears particularly narrow the internal maxillary artery particularly large. Then and above all, their function, it seems that external carotid artery is more important than the internal carotid artery in the dog, so that the blood supply of the central nervous system seems to be obtained almost entirely through the vertebro-basilar system. Finally, there exists between each network of internal carotid arteries, the external carotid artery and the vertebral arteries numerous anastomoses. Contrary to the distrubution of arteries in man, these anastomoses usually function permanently.