Biomedical subjects
Publications and source records attributed to R Mosimann.
In 1931, Abrikossoff described a tumor, usually benign, which only rarely appears in the esophagus. In a 30-year-old man, we found an 8 mm tumor in the distal esophagus; it was removed surgically. We discovered 30 similar cases in the literature. Characteristics and treatment are discussed.
Verneuil's disease or hidradenitis suppurativa is not frequent. Nevertheless since VERNEUIL's classic description in 1854, many cases have been reported. It is a disease of the apocrine sweat glands, that may arise on each of their localizations: axilla, breast areolae, umbilicus, perineum, groin, buttocks. The chronic suppurative disease of these glands give rise to multiple fistulous constantly infected tracts. The typical appearance usually allows a clinical diagnosis. Other disease may nevertheless look like hidradenitis suppurativa. We present two cases and discuss the differential diagnosis between the hidradenitis suppurativa and the chronic infection of a pilonidal cyst.
Thoraco-abdominal oseophagus was removed in continuity with the stomach during autopsy of 30 patients--two patients had undergone troncular vagotomy and pyloroplasty, the other 28 had not been operated on. In 22 cases (including the 2 which had undergone vagotomy) one or more branches of the thoracic vagus nerve existed. These branches (intramural nerves) reached the stomach after passing for 1.5 to 10 cm between the two muscular layers (of the oesophagus). They originated more often from the anterior (18) than from the posterior vagus nerve (-6). Intramural nerves are spared during abdominal vagotomy: are they the cause of some therapeutic failures of vagotomy?
Double gallbladders represent a large spectrum of malformations; on an embryological base these anomalies are divided into true duplications and accessory gallbladders according to whether both cystic ducts are fused or separated to join the common bile duct. The authors have observed four cases one of which is discussed for diagnostic and therapeutic considerations.
Of all different surgical treatments of ascites, the peritoneo-venous shunt actually seems to be the less risky method. Our short experience confirms the success of this method, but also its contradictions and reveals a little known complication: the thrombosis of the superior vena cava. Its superiority over the lympho-venous anastomosis has been proven in one of our patients.
Nine cases of portal hypertension of unusual etiology are presented: 1 with retroperitoneal fibrosis, 2 with alveolar hydatid disease, 3 with arterio-portal fistula, 2 with primary biliary cirrhosis and 1 with sarcoidosis.
Fifty arterial implants in animals and sixteen arterial implants in man have been examined with the scanner electronic microscope. After these examinations it appears to be that the form of biological reaction of the vessel graft is mostly determined by the condition of the host artery. If the host artery is healthy, even a synthetic prothesis will undergo a kind of revitalisation. However, if the host artery shows arteriosclerotic changes, even a healthy implant will be changed into a fibrotic tube.
First known as an inert and harmless substance, starch powder has been used from 1950 by surgical gloves factories in place of talcum. Its innocuousness is now being denied, but many surgeons still do not know its adverse side effects. 13 cases of glove starch peritonitis, seen between 1971 and 1978, allow the authors to review clinical signs, diagnostic and treatment possibilities as well as the risk of a new operation. To limit the quantity of starch powder introduced into the peritoneal cavity is so far the only mean to prevent this complication and to compel the surgical team to strict discipline.
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131 cases of acute arterial obstruction were treated during 1973-1977, 70 (52%) of these cases were seen in patients of over 70 years of age and 20 out of them died during the first two months of the surgical treatment, 8 patients were amputed. The long term evaluation of 40 patients who survived for more than two months after the surgical treatment shows a very high mortality (14 of the 40 surviving patients died during the first two years of the surgical treatment). Satisfactory results were obtained in 18 patients. The long term results after arterial obstruction in old patients has high mortality and the number of amputations is directly proportional to the delay before commencement of the surgical treatment.
Infection after vascular surgery is a feared complication whose mortality rate remains high, inspite of an aggressive surgical approach, actually admitted by most of the authors. From 1970 to 1977 we have observed 6 infections after 1049 arterial operations: 5 out of 228 synthetic by-passes and 1 out of 296 venous by-passes. The global infection rate is 0.5%. This complication occurred in 2.1% of the cases after synthetic by-passes. Two out of these 6 infected patients had to be amputated and they died. We think that the general accepted treatment remains valuable in most of the cases, but that a more simple and less aggressive surgical approach can be of great interest in particular situations.
The present communication deals with the decomposition of thrombi and the formation of an endothelium in two different vascular prothesis. Devitalized bovine arteries which were enzymatically reduced to a collagen reticulum, and tubes made of autologous fascia lata were implanted into the arterial bloodstream of dogs. The implants were left in place for a time ranging between 30 min and four months. They were examined by scanning electronmicroscope with the cortical point method. This enabled us to reach the following conclusions: unprepared autologous fascia lata implanted into the arterial bloodstream has much more thrombogenous qualities than solcograft. The decomposition of thrombi and the formation of an endothelium is much faster accomplished in fascia lata than in the devitalized bovine artery. It is not possible to distinguish solcograft and fascia lata by the formation of endothelium only.
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Research on possible effects of ionizing radiations:study of four patients having developed malignant tumor after radiotherapy for primary cancer of female reproductive system: adenoacanthoma and adenocarcinoma of uterine corpus, squamous cell carcinoma of uterine cervix, right ovary adenocarcinoma. Our observations comprise three epithelial tumors (muciparus adenocarcinoma of caecum and sigmoid colon, squamous cell carcinoma of rectum and anal canal) respectively 17, 10 and 9 years after radiotherapy, and one mesenchymatous tumor (peritoneal fibrosarcoma) 4 years after radiotherapy.
We observed 16 patients suffering from postoperative gastritis: 8 after a truncal vagotomy with pyloroplasty, 6 after a Billroth II type gastrectomy, 1 after a truncal vagotomy with a Billroth I type antrectomy, 1 after correction of a hiatal hernia with pyloroplasty. Symptoms appeared from 1 month to 16 years after surgery. They consisted in epigastric pain, nausea, vomiting, weight loss. The diagnosis is established essentially on the clinical picture and the endoscopy, which shows the presence of bile in the stomach and hyperemia of the mucosa. Microscopic lesions are constant, but there is no histologic specificity. 12 of 16 patients were operated on (Roux-enY loop). The reflux was suppressed in each case. Results of the operation were excellent or good in 10 patients, fair in one and unsatisfactory in one.
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