Biomedical subjects
Publications and source records attributed to M Dumont.
From an observation of in utero suspected myelomeningocele, the authors underline interest of pattern of cholinesterases using acrylamide gel electrophoresis. The AChE isoenzyme band appears in some fetal malformations, particularly NTD. This biochemical test is considered as complementary of the AF alpha-fetoprotein assay.
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From an observation, authors underline the interest of two complementary tests: ultrasonography and amniotic fluid AFP determination. About the reported case, the chronology of facts is unusual: ultrasonography led initially to suspect anomaly, then elevated AFP result confirmed the malformation.
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815 internal monitored labors were compared with 610 non monitored labors in two groups monitored labor (group 1 without cesarean section, forceps, manual delivery, and group 2 with cesarean section, forceps or manual delivery); the incidence of post partum endometritis has been compared with the same group 1 and 2 of non monitored labor. In group 1 the rate of endometritis was higherr in monitored labors (15 endometritis among 468 cases; 3,2%) than in the non monitored labors (6 endometritis among 441 cases, 1,8%): the difference was in border line significance (p between 0,05 and 0,10). The rate of endometritis was also in group 2 higher (20 endometritis among 347 cases (5,2%) than in non monitored labor (3 endometritis among 169 cases (1,7%) (p < 0,05).
We report a case of pulmonary embolus which is presumed to have been of trophoblastic tissue in a woman in her second pregnancy who had a hyperactive hydatidiform mole. (The size of the uterus was 27 cm after thirteen weeks of amenorrhoea. The level of urinary H.C.G. was greater than 2 million international units per litre.) One hour after the uterus had been evacuated under chemotherapy a picture of acute dyspnoea appeared, and this made it necessary to transfer the patient to an intensive care unit and to incubate her and ventilate her. The analysis of the blood gas showed desaturation and hypoxaemia leading to a diagnosis of massive pulmonary embolus. These complications were resolved in 72 hours and the levels of H.C.G. went down later under the influence of chemotherapy which was started one month after the evacuation and continued for fourteen weeks (for six weeks after the plasma H.C.G. levels had become negative).
For a long time estimating body weight has not been the sole parameter of knowledge of the body constituents and the method of measuring "skin folds" only was of value in differentiating between the "thin mass" and the "fat mass". The authors used Thomasset's method of determination of body fluid compartments by electrical impedance measurements to measure objectively the extra-cellular water content and the total water content, which means the thin mass and the fat mass of the body. It is possible in pregnancy to work out how much of the increase in weight comes from the maternal structures and how much from the utero-fetal mass. The authors point out that the impedance method makes it possible to determine independently the maternal body constituents and those of the fetus carried by the mother. In this way it is easy to work out in cases of pathological weight gain whether this has arisen because of oedema or because of becoming fat. Furthermore the authors point out that what they call "eutrophy of pregnancy", which is the normal weight gain brought about by pregnancy, is similar to the state of affairs brought about by women taking oral contraceptives, which they call "oestroprogestative eutrophy".
This syndrome is seen essentially in a second or later pregnancy in a woman of modest social background, sometimes delivering prematurely and who is forced to perform certain domestic tasks or to wait for her husband before leaving for the place in which delivery has been planned. This type of untimely delivery may cause perineal lesions, vulval haematomas, post-partum haemorrhage, rupture of the umbilical cord or damage to the foetus.
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A prospective, controlled study was carried out to determine if there was an association between hiatus hernia and cholelithiasis. The prevalence of gallstones was calculated in 100 patients (50 men and 50 women) with radiological evidence of hiatus hernia. 100 subjects (50 men and 50 women) without hiatus hernia, matched for age, body-weight, and number of pregnancies, acted as controls. Gallstones were twice as common in the former group (34%) as in the control group (17%) (P less than 0.01). Moreover, a comparison of the lipid composition of the gallbladder bile in 15 subjects operated on for hiatus hernia with that in 17 patients operated on for another digestive disease showed that the molar percentage of choelsterol in the bile and the cholesterol saturation index were significantly higher in the patients with hiatus hernia (9.3 +/- 1.1, mean +/- S.E.M., 1.41) than in the control subjects (5.9 +/- 0.5; 0.97) (P less than 0.01). These results suggest an association between hiatus hernia and cholelithiasis. It is likely that common factors, probably related to a low-residue diet, predispose to the two diseases.
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