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Biomedical subjects

L Durand

Publications and source records attributed to L Durand.

At least 109 records · Page 6Linked to original sources
PubMed1981

[Air embolus after Caesarean section (author's transl)].

This is case history of a primigravid woman on whom Caesarean section was carried out in normal conditions for fetal distress, the patient being placed in Trendelenburg position. After the abdomen had been closed there was a sudden collapse with cyanosis, right bundle branch block and then coma with hypertonicity, hyperreflexia and transitory hemiplegia. The only possible diagnosis that could be made was of air embolus following Caesarean section in the light of many investigations that were carried out and the improvement under hyperbaric oxygen treatment and the very irregular progress of the neurological symptoms. Published case histories are rare [12] (published by Walrop, 1953 and Nelson 1960) and over all the result has been unfavourable. The diagnosis can be proven when gas has been found in the blood vessels at autopsy or by the finding of certain clinical signs which indicate the presence of air in the heart or in the blood vessels (water mill sound and the sound of air in the blood vessels). Diagnosis is made by exclusion. The differential diagnosis must be made with amniotic fluid embolus and the other cerebro-vascular accidents, as well as obstetrical shock. The principal factors that bring about air embolus are the entry of air into the dilated uterine veins which is helped by the negative pressure achieved by the Trendelenburg position. As soon as this diagnosis is made it is important to start hyperbaric oxygen treatment and symptomatic resuscitation.

Adult↗
PubMed1980

The Doppler stethoscope in the diagnosis of subclinical varicocele.

Fifty-six patients (112 testicular cords) were examined using the Doppler stethoscope. Venous reflux was detected in all patients with a clinically obvious varicocele and in 77% of patients where a varicocele was suspected but not clinically demonstrated. The incidence of bilateral varicoceles was 21%. The Doppler stethoscope showed that 20% of patients continued to have venous reflux post-operatively. It is concluded that the Doppler stethoscope is a useful instrument in the diagnosis of clinical varicoceles and in the assessment of post-operative results.

Auscultation↗
PubMed1980

[Corneoscleral trabecular collagen. Ultrastructural changes and immunotyping in chronic and cortisone-induced glaucoma].

Ultrastructural changes in connective matrix of corneoscleral trabeculum in primary open-angle glaucoma and corticosteroid-induced glaucoma are described. Four forms of collagen fibers were observed: typical, hyper-, segmented fibers and cross-banded collagen. Light and electron microscopy, using antibodies against collagen types, demonstrates the presence of type I collagen widely distributed in trabecular connective matrix and type III collagen in perivascular zones. Type IV collagen is located on basal membranes on endothelial lamina. In glaucomatous disease, the ultrastructural aspect of connective matrix reflects a continuous remodelling process associating fibrolysis and fibrogenesis.

Adolescent↗
PubMed1980

[Ergotism of therapeutic origin. A report of 4 new cases (author's transl)].

The observations concern ischemic accidents with various localizations (lower limbs, tongue, uterus, intestine, heart, liver) corresponding to 4 observations for which ergot derivatives (ergotamine tartrate) can be responsible. The most typical accidents are localized at the level of limbs and especially of lower limbs. In the greatest part of observations, a specific terrain (puerperium, vasomotor disorders, suspicion of temporal arteritis) can be considered and favouring factors (infection, and especially associated medicinal treatments with triacetyloleandomycin [2 observations] and Doxycyclin [1 observation]). The posologies of ergot alcaloïds were either superior to the limit prescription or normal. The duration of prescription was variable, but generally short. The arteriography confirms a vascular spasm. In an observation with very severe evolution, various ischemic localizations inducing amputation, two intestinal resections and an hemodialysis for lactic acidosis were noted. These ischemic accidents have to be noticed as early as possible in order to start a treatment; the best one seems to be the association of sodium nitroprussiate in intravenous perfusion with peri-dural anesthesia in an antalgic aim.

Adolescent↗
PubMed1978

Ultrastructural aspects of corneal fibrous tissue in the Scheie syndrome.

An ultrastructural study of the corneal fibrous tissue was performed in a case of Scheie's syndrome. Mucopolysaccharidosis deposits in keratocytes were observed as electron-clear and electron-dense inclusions. Modifications of the extracellular space included modifications of lamellar collagen organization and local hypertrophy of collagen bundles; presence of microfibrillar dense material isolating large irregular collagen fibers; and presence of fibrous long spacing type collagen fibers. The significance of these changes is discussed. This special form of collagen organization is supposed to appear in a modified microenvironment, that is the presence of an abnormal concentration of proteoglycans.

Biopsy↗
PubMed1977

[Scleroderma en coup de sabre with homolateral chronic glaucoma (author's transl)].

A 37 years old woman presented with scleroderma en coup de sabre of the head with chronic homolateral ocular hypertony. Skin disorders appeared in the childhood and extended slowly until the age of 20. Glaucoma, found 5 years earlier, was unimproved by medical treatment; the opposite eye was normal. Two goniotomia in 1974 were uneffective. A trabeculectomy in 1975 was followed by scleral fistula with important ocular hypotonia. A scleral flap was followed by the disappearance of hypotonia with no return to previous hypertony. The connections between scleroderma and glaucoma are discussed; vascular and neurologic mechanisms are suggested. Up to now, glaucoma has been reported in patients with systemic soleroderma and Romberg disease.

Adult↗