Biomedical subjects
Publications and source records attributed to J Hureau.
The analysis of the caliceal cavities of 30 pairs of Kidneys shows a dichotomous distribution of two types: cranio-caudal for the major calices, ventro-dorsal for the minor ones. The dichotomous organization does not result from the initial division of the ureteral bud: but it should depend upon the renal arteries growth commanding a new caliceal pattern during the morphogenesis of the Kidney.
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Among 1,645 biliary operation carried out between 1952 and 1974, the authors count 177 organic stenoses of the Oddi region. They recall the authenticity of chronic odditis, the pathological substratum of which is Oddi sclerodystrophy, a primary and progressive lesion. They emphasise the radiomanodebimetric criteria. The risk of an error of interpretation was 2% in this series. After discussing the etiopathogenesis and the physiopathological consequences of Oddi sclerodystrophy, they discuss the therapeutic choice between sphincterotomy and choledoco-duodenostomy. Temporary gall bladder drainage is only of interest in inflammatory labile manifestations without sclerodystrophy. The interest of diagnosis and initial surgical treatment of the lesion is that the classical post-cholecystectomy syndrome almost disappears.
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Based on a series of 159 cases of headache during oral contraception, the authors confirm the part plainly favouring and aggravating of oral contraceptives on headaches. They are dominated by the frequency of migraines and happen with predilection at the time of hormonal weaning. We deduct from this, that oral contraceptives generally aggravate or reveal a latent sensitivity to hormonal variations, especially clear with older women.
The authors report a new case of hepatic adenoma apparently related to oral contraception continued for more than 9 years with a pill containing mestranol. The clinical presentation suggested an attack of hepatic colic with swollen gall bladder. The preoperative diagnosis of a tumour of segment VI of the liver was made by radiological examination of neighbouring organs. Hepatic arteriography, hepatic radioisotope scan using technetium phytate and echotomography. Surgical removal of segment VI confirmed by histological study showed that it was an adenoma with multiple foci, associated with hepatic involvement. One of the tumours was the site of central included hemorrhage, responsible for the clinical syndrome. In connection with this case the authors review the possible relationship between hepatic adenoma and oral contraception.
A study of 75 lumbar sympathectomy helped the authors in specifying the indications of this operation for arteritis of the lower limbs. Lumbar sympathectomy is based on precise anatomical facts : para-vertebral sympathetic chain is usual but a collateral chain must be searched if the latter appears too thin. Lumbar sympathectomy can be performed alone or in association with reconstructive procedures. It is used alone in old people for its antalgic and moderately functional effect in accordance with their level of activity. Also it is used alone in cases of gangrene localized or pending or in the absence of a runoff vasculature. It is associated to repair if one wants to improve an incompetent peripheral perfusion. The authors record 79% of favourable results of which 52% were maintained when lumbar sympathectomy was used alone. In patients where direct vascular surgery is added, favorable results account for 82% of which 78% long lasting.
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The authors report a few unusual cases of Crohn's disease of the colon and discuss the diagnostic problems which are raised in such cases. They then review the various colonic diseases liable to be considered in a differential diagnosis, and which may be linked to colonic Crohn's disease, e.g. ulcerative colitis, intestinal tuberculosis, carcinoma of the colon, colonic diverticulosis and sarcoidosis. In a chapter on treatment, they emphasize the favourable effect of acexamic acid and the necessity for very wide colonic resection, and they note a complication which they encountered during surgery for Crohn's disease: lymphatic peritonitis on the 8th day after right colectomy.
The authors have observed on two occasions, a diffuse peritoneal syndrome in the post-operative period after right hemi-colectomy for Crohn's disease, and interpret, in the absence of complications at the level of the anastomosis, as peritonitis due to septic lymphorrhea. According to them, it does not seem that this syndrome has the same significance as that described following appendicectomy in children.
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The correct anatomy of the external palpebral ligament is demonstrated, based on microscopic studies. An analogy to the structures of the internal palpebral ligament is found.
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