[Perforations of the cervical esophagus during attempts at tracheal intubation. Report of 7 cases and review of the literature].
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Biomedical subjects
Publications and source records attributed to B Debesse.
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Histochemical muscle fibre composition was studied in biopsies from the diaphragm, the external and internal intercostal muscles in the fifth intercostal space and horizontal and vertical parts of the serratus in 8 subjects with normal lung function and in 18 patients with abnormal lung function (6 restrictive and 12 obstructive). Muscle fibres were classified as type I (slow twitch) or type II (fast twitch) on the basis of their myofibrillar ATPase pH lability. All the muscles studied showed a mosaic pattern with the two fibre types. In every respiratory muscle, the percentage of type I fibres was higher than 50%. There was no significant difference between the three groups (normal, restrictive and obstructive) for each of the six muscles studied. The fibre diameters were similar for all types and muscles (range of means: 41-63 micron), except for the diaphragm in which the diameters of type I and type II fibres were significantly higher in the normal subjects as compared to the obstructive and restrictive patients. Moreover, there was a significant linear correlation between the diameter of the diaphragmatic fibres and vital capacity and FEV1. A low "atrophy factor" was found for each muscle studied with a large intra-individual variation. The results support the idea that the increased respiratory loading due to disease do not hypertrophy the respiratory muscles and suggest that the effect of the disease on the respiratory muscles is more related to the increased mechanical impedance of the respiratory system rather than to the changes in thoracic configuration.
A patient had been operated 4 years ago for a hypoglycemic tumor of the pleura. The lesion could be separated from the lung, and histological examination demonstrated an undifferentiated markedly cellular appearance of the tumor. Ultrastructural features were not in favor of a mesothelial tumor. Prognosis in such cases depends upon the histological type of tumor present, but remains uncertain, particularly in some apparently morphologically benign forms. Th most valid hypothesis to explain the genesis of this syndrome involves the role played by the non-suppressible insulin-like activity of a substance secreted by the tumor. This is a glycoprotein, molecular weight 90 000, which has recently been isolated, and which could play an important role as a non-suppressible insulin-like protein.
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