[Congenital diaphragmatic hernia (Bochdalek hernia) well tolerated up to twenty-three, then strangulated and perforated at the seventh month of pregnancy (author's transl)].
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Biomedical subjects
Publications and source records attributed to J Cinqualbre.
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The dissociation of human adult liver parenchyma by collagenase followed by cell separation with centrifugal elutriation allows the Kupffer cells to be isolated. These cells, which may be maintained in culture, retain their main morphological and functional features.
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Severe hematuria after pyelonephrotomy was controlled by the selective injection of noradrenaline into the renal artery. The indications for this conservative therapeutic technique are defined as well as its place in relation to hemostatic surgical procedures.
The authors report two cases of renal pneumatisation immediately following renal artery embolisation performed for carcinoma of the kidney. The particularly painful and inflammatory (high fever, leucocytosis, increased sedimentation rate) led to abdominal X-rays which revealed signs of gas in the kidney. In the first case this consisted of rounded clear areas distributed in a linear fashion and indicative of intravascular pneumatisation. In case n degrees 2, intravascular pneumatisation was accompanied by gas in the calyces. In the absence of suppuration and of proven infectious cause, the authors failed to find any explanation for the presence of gas bubbles in the vessels and calyces of the embolised kidney.
The study of intravenous pyelograms taken immediately after delivery shows how the ureter has its dynamics modified during pregnancy. The role of parity and of urinary tract infection which sometimes is evidence of a pre-existing urological malformation is demonstrated.
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45 pulmonary embolectomies have been carried out successfully, 10 by Trendelenburg's procedure, 35 with extracorporeal circulation. The latter method gives satisfactory results (34 survivals out of 36 attempts since 1970) and appears to be the procedure of choice. Any pulmonary trauma should be avoided at operation; embolectomy is done by intra-vascular suction. The hemodynamic status was always abnormal: 5 initial cardiac arrests, 20 cases of severe shock (9 demonstrating cardiac arrest on the operating table) and 11 cases with less severe shock. In 9 cases cyanosis, respiratory distress and signs of acute cor pulmonale were the clinical features of the massive embolus. In 9 patients the operation was performed after an unsuccessful trial of thrombolysis. Preoperative pulmonary angiography could be performed in 30 cases and always showed extensive pulmonary vascular obstruction of 60 to 95 per cent. These data are important for diagnosis and for assessment of the prognosis. Despite of present medical treatment with fibrinolytics, surgery is still advisable in the treatment of massive pulmonary embolism. The indications are moribund patients, those in whom thrombolysis is contraindicated or unsuccessful and those with massive pulmonary obstruction (greater than 60 per cent). In this latter subset thrombolytic therapy carries a high level of mortality.
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In the child, renal transplantation is almost always carried out by placing the kidney within the peritoneum for a simple reason: the donors being adults, the kidneys are too large to be placed in extra-peritoneal position. However, all authors agree that placing the kidney in an extra-peritoneal position offers undoubted advantages.
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The authors report an exceptional case of fracture of the acetabulum complicated by tear of the small intestine due to injury to the loop of intestine by a piece of the fractured acetabulum. As it is rare, such a complication is often undiagnosed. Discovered in time, an operation avoids a fatal issue due to peritonitis.