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Biomedical subjects

P Marache

Publications and source records attributed to P Marache.

50 records · Page 3Linked to original sources

[Right ventricular dysplasia: Uhl's disease. Echocardiography and tomodensitometry study. Apropos of a case in an adult].

The author discusses Uhl's disease in a 60 year old patient as indicated by right ventricular insuficiency without troubles of the ventricular rhythm. Echocardiography revealed the distinctive symptoms of this illness (dilation of the right cavities, diastolic opening of the pulmonary valve, delayed closing of the tricuspid valve) emphasizing its diagnostic value. The contribution of tomodensitometry is considered.

Echocardiography↗

[Thrombo-embolic disease of pregnancy. Methods and indications for surgical prevention].

Thrombo-embolic disease can generally benefit from anticoagulant treatment. Nevertheless, there are circumstances that require surgical prevention of pulmonary embolism. The vena caval circulation can be interrupted using clips, which necessitates a general anaesthetic and laparotomy, or intravenous procedures such as Mobin-Udin or Greenfield filters may be inserted. The indications for these procedures depend on how advanced the pregnancy is. The authors point out the indications for interruption of the vena caval flow during pregnancy in the light of four recent case histories. The main one is failure of medical treatment. Interruption of the vena caval flow is to be recommended when there is impaired circulation or when a thrombus is threatening. The diagnosis of this condition does require invasive tests; and whether these are toxic for the fetus is discussed.

Adult↗

[Mediastinal pseudo-tumor from portal hypertension (author's transl)].

A radiological opacity of the posterior and inferior mediastinum should evoke a lesion of vascular origin. The venous nature of the mass can be easily confirmed by morphological changes apparent during the respiratory cycle and changes in position. Investigations to establish etiology of this venous ectasia arising from the azygos vein require more extensive radiological examinations, and computed tomography may be of value. Portal hypertension is one cause of increased venous blood flow in the azygos systems, and should be systematically considered.

Azygos Vein↗

[Chronic unilateral obstruction to pulmonary venous return. A study on 6 cases and review of the published literature (author's transl)].

The authors describe 6 cases of unilateral obstruction to pulmonary venous return: two cases of Halasz syndrome and postoperative obstruction of the reimplanted collector vein, one patient with Halasz syndrome and spontaneous obstruction of the vein in the form of a scimitar, one case of neoplastic invasion of the atrium-vein junction, one with unilateral absence of the right intra- and extraparenchymatous regions of the pulmonary veins, and lastly, a case of juxta-auricular interruption in the right pulmonary veins. The anatomy and physiopathology of the collateral venous pathways are briefly described, together with the relations between systemic arterial hypervascularization and pulmonary venous obstruction. The authors then review the radiological, clinical, and angiohemodynamic features of the unilateral venous obstruction syndrome, and conclude that precise diagnosis of venous occlusion, its location, and its tolerance are essential for deciding the therapeutic measures required.

Adult↗

[Pathogenetic left tracheal bronchus. A review of the literature in connection with four cases (author's transl)].

The so-called left "tracheal" bronchus is usually found to be a transposition of the segmental apicoposterior bronchus of the upper left lobe onto the terminal portion of the main trunk. This systematisation abnormality is less common on the left than on the right. In our experience, based on 1,500 bronchographs carried out on adults and children, we have discovered seven left "tracheal" bronchi four of them associated with an obstructive emphysema in the same area. Although this malformation is rarely encountered in the etiologies of interlobular or poly-segmental emphysemas in children, it does however appear that an upper left emphysema has two etiologies which are peculiar to it: segmental bronchial atresia and left "tracheal" bronchi. Why the left "tracheal" bronchi is more often pathogenetic in comparison with the right is open to speculation. As in many other examples of tracheo-bronchial compression for vascular reasons, the close contact between the hyperarterial ectopic bronchi and the left pulmonary artery seems, logically, to be the culprit.

Adolescent↗