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Biomedical subjects

C Gillot

Publications and source records attributed to C Gillot.

At least 19 recordsLinked to original sources
PubMed2005

Subcutaneous emphysema and mediastinitis: unusual complications of tonsillectomy.

INTRODUCTION: Subcutaneous emphysema and mediastinitis are rarely reported complications of tonsillectomy. CASE REPORT: We describe two patients who developed subcutaneous emphysema, one of them with mediastinitis, within a few days after tonsillectomy. The diagnosis was based on the clinical presentation and confirmed by computed tomography (CT). For the patient without mediastinitis, the emphysema disappeared after a short period of reintubation and administration of antibiotics. For the patient with mediastinitis, surgical drainage of a cervico-mediastinal purulent collection was necessary to obtain healing. DISCUSSION: The events leading to subcutaneous emphysema and mediastinitis have not been entirely clarified. They probably include direct introduction of air into the neck via either the tonsillar bed or a laryngeal or pharyngeal wound caused by intubation. The clinical presentation, treatment and possible pathophysiology of subcutaneous emphysema and medisastinits are discussed. CONCLUSION: Emphysema and mediastinitis after tonsillectomy occur seldomly. If rapidly recognised and appropriately managed, mortality can be avoided.

Adult↗
PubMed2002

[Microscopic vascular study of the colon with the corrosion casting technique].

The aim of this study is, firstly, to assess the accuracy of vascular casts obtained at various times after death and secondly to describe the mucosal microvascular architecture of the cat colon. Two injections were realized, the first one on a non-embalmed human corpse, 12 days after the death, and the other one on a cat, immediately following euthanasia. Results show that this second cast seems finer and more detailed than the cast stemming from the human corpse; indeed, the finest vessels obtained are about 6 microns while they are about 15 microns on the human corpse. This could be explained by a post-mortem obstruction of microvessels, that prevented the passage of the injected product or by an insufficient amount of product injected. Finally, the vascular cast of the cat colic mucosa presents a regular honeycomb-like network that bounds the colonic mucosal glands, a finding consistent with the results reported previously.

Aged↗
PubMed2001

The origin of the azygos venous system, as deduced from an anatomical and radiological study employing a corrosion technique.

The aim of this study is not only to describe the origin of the human azygos venous system by performing a 3-D reconstruction of a CT scan but also to evaluate the value of the techniques employed in investigating the topographical anatomy of a venous system in the body. Following perfusion with saline to wash away the blood, we injected an ALTUFIX/MINIUM mixture into the azygos vein of a cadaver. The head and trunk were subsequently corroded with hydrochloric acid (HCl). A CT scan of the trunk was obtained both before and after corrosion. According to the spatial resolution of the CT scan, the thinnest identifiable detail was measurable as 0.5 mm. The vertebral lumbar venous system was described, specifying the nomenclature of the lumbar veins (the lumbar veins being designated according to the vertebral body along which they run). On the right side, the lumbar veins at L2 and at L3 formed the lateral root of the azygos vein. On the left side, the vein at L2 formed the reno-azygo-lumbar arch (of Lejars). The lumbar veins, and the origin of the azygos system, were described and compared with previous studies. The 3-D reconstruction showed the importance of veins associated with the posterior paravertebral muscles. This description poses the problem of the metamerisation of the veins, but further evidence is required. Comparisons of the CT scans, 3-D reconstructions, and the ALTUFIX models of the veins obtained from the corrosion technique allowed verification of the 3-D reconstruction and correction of the errors inherent in a computer reconstruction. It is concluded that the description, and understanding, of such a complex system as the vertebral venous system is more valid when the results obtained using different techniques are compared.

Aged↗
PubMed1999

[Organ procurement from cardiac arrest donors: outcome of kidney grafts and recommendations].

OBJECTIVES: To compare literature data with results obtained with organs procured from donors who died from cardiac arrest and to make proposals for this mode of organ procurement in France. METHODS: Over the last 10 years, 10 organ donors (2%) among a series of 486 donors in a state of brain death, had died of cardiac arrest. The arrest were perfused with double-balloon catheters. The outcome of the subsequent kidney grafts was compared with data in the literature. RESULTS: Fifteen of the 18 kidneys from cardiac arrest donors were functioning 1 month after implantation compared with 17 of the 20 kidneys from braindeath donors with beating hearts. The rate of acute tubular necrosis was 55% in the cardiac arrest kidneys and 40% in the beating-heart kidneys. Serum creatinine at 1 yeart was 145 +/- 69 mumol/l 17 +/- 29 mumol/l respectively. DISCUSSION: These results and those reported in the literature demonstrate that kidney procurement from cardiac arrest donors is feasible. If intensive care and surgery units are well organized, this type of organ procurement could provide a larger number of organs for transplantation. Emergency teams must be available for preparing and transferring the organs.

Cadaver↗
PubMed1999

[Superficial veins of the leg].

This clinical work studies the normal pattern of the saphenous veins, their main variations with a short embryological reference. Some pathological cases are described; the perforator veins are very important; the role of the valves at the groin is emphasized.

Anastomosis, Surgical↗
PubMed1999

[The lumbar vein at L2 and the reno-azygo-lumbar arch: anatomic and radiologic studies].

The lumbar vein at L2 was described by C. Gillot and B. Singer (1974). On the right side, after drawing off the 12th intercostal vein, it forms the lateral root of the azygos vein. Its way is as a frame, transverse going along the body of the 2nd lumbar vertebra, then upward along the spine after having integrated the veins of the L2-L3 intervertebral foramen. In its typical form, the vein is at L2 but it can be at L1 or L3. It takes the name of lateral root of the azygos vein only after receiving the 12th intercostal vein. Because of its diameter (5 mm), it forms a cavo-caval anastomosis via the azygos vein. The renal azygo-lumbar arch of Lejars is the equivalent on the left side of the right vein at L2. This arch contributes to the formation of the lateral root of the hemi-azygos vein. The right vein at L2 and the reno-azygo-lumbar arch were studied by dissections and by radiologic protocols. The radiologic studies (CT, MRI, 3D reconstructions) were carried out after injections of gelatin-gadolinium-minimum and altufix-minimum mixtures. The results showed the numerous variations of origin of the azygos system. The use of multiple and complementary technics are very helpful to describe these variations.

Azygos Vein↗
PubMed1998

Technique for injection of the lumbar vertebral venous plexuses employed in anatomic, computed tomography and magnetic resonance imaging studies.

The aim of this study was to develop a technique for injection of the vertebral venous plexuses allowing anatomic, computed tomography (CT) and magnetic resonance imaging (MRI) studies of the same anatomic specimen. It proved in practice that only a correctly adjusted mixture of different agents allowed attainment of this objective. This mixture, composed of gelatin, gadolinium and minium, enabled us to attain this end. The description of the technique of injecting the vertebral venous plexuses, the difficulties encountered and the results of the different imaging techniques are analysed in this study without entering into details of the anatomic description. The core of the study consists of 11 unembalmed subjects. Three were injected with gelatin mixed with gadolinium, one with latex mixed with minium, one with latex mixed with gadolinium, and 6 with gelatin mixed with both gadolinium and minium. Only the mixture of gelatin-gadolinium-minium allowed study of the same anatomic specimen in terms of anatomy, CT and MRI. Two different MRI sequences are described, evidence of the different properties of the injection mixture (gelatin, gadolinium). The latex-minium mixture gave good CT density but was unsuitable for MRI studies. Numerous artifacts caused interference with the radiologic images, calling for perfect injection technique. The use of several radiologic techniques for a single cadaveric injection allows better correlation of the images, and comparison and verification of results between the techniques.

Adult↗
PubMed1998

Anatomy of spontaneous splenorenal and gastrorenal venous anastomoses. Review of the literature.

Portal hypertension is characterised by the development of a collateral portocaval circulation. Among these venous reroutings, some are situated posteriorly in the left subphrenic compartment. These are the spontaneous splenorenal and gastrorenal anastomoses. Their incidence is estimated at around 16%. On the one hand, there are the direct shunts, which anastomose the spelling v. to the left renal v., of an anecdotal nature, and on the other the spontaneous indirect splenorenal shunts, characterised by the presence of a complete neurovascular pedicle traversing the gastrophrenic ligament. This relates to the gastric collateral v., which is connected to the left renal v. via the inferior v. of the left crus of the diaphragm and the middle capsular v., hence the name "gastro-phreno-capsulo-renal shunt". At an advanced stage of portal hypertension these splenorenal shunts may acquire a major caliber and behave like actual surgical shunts.

Collateral Circulation↗
PubMed1997

[Superficial veins of the lower limbs].

This study, limited to the superficial veins of 123 limbs (108 normal and 15 suffering from frank varicose disease) and only vessels with a caliber of at least 2 mm, reveals a certain degree of constancy of anatomical pattern. The initial network is defined embryologically and subsequent haemodynamic phenomena model the final veins. In particular, the topography of the main perforating veins is relatively fixed. Due to their double antihypertensive valve and aspirating pump function while walking, these vessels drain into saphenous veins. They are beneficial when they return reflux into the deep vessels. Conversely, perforator incompetence contaminates the superficial network in the case of deep reflux. The perforating vessels also have a relatively fixed position in relation to other structures: the main saphenous collateral veins, their duplicated branches, their communicating veins and the main valves. This results in large junctions typically associating a saphenous valve, one or several collateral veins, one or several communicating veins, and one or several perforating veins. Typical examples are the garter junction for the long saphenous vein, and the junction of the tip of the calf for the short saphenous vein. Other haemodynamic levels are situated at various sites, particularly in the leg, reflecting the existence, in some cases, of symmetrical "mirror", medial and lateral perforating veins. Morphological analysis of 15 limbs with obvious varicose veins of the trunk of the long saphenous vein defined the routes of transmission of reflux to the leg. Finally, the authors present several technical considerations which they hope will be useful for Doppler operators and surgeons.

Femoral Vein↗
PubMed1996

The pterygoid venous plexuses.

The pterygoid venous plexuses are closely adjacent to the lateral pterygoid m. and occupy a considerable part of the infratemporal fossa (ITF). We have conducted a study after injection of colored latex in 10 unemblamed subjects in order to define the arrangement of the venous network and to assess the frequency of the different types of plexuses found. In all the subjects symmetry was noted between the right and left plexuses, with predominance of the venous layer in the upper part of the ITF. The pattern most often encountered was plexiform and complex. The development of these plexuses follows that of the masticatory muscles, whose contraction promotes drainage and represents an alternative venous pathway for drainage of the cranial cavity.

Cadaver↗
PubMed1996

The lumbar anterior epidural cavity: the posterior longitudinal ligament, the anterior ligaments of the dura mater and the anterior internal vertebral venous plexus.

The contents of the anterior epidural cavity were studied to elucidate the relationship between veins, ligaments, and membranous formations. Anatomical, radiological and histological studies on human specimens after latex or gelatin/gadolinium venous injection at the level of the lumbar spine show that the posterior longitudinal ligament is a cross-shaped formation which includes the septum, the superficial part extending into the intervertebral foramen and the anterior ligaments of the dura mater. The anterior epidural cavity contains two medial and two lateral spaces. The two medial cavities enclose anterior and medial venous plexuses, which together receive the basivertebral veins; the two lateral cavities receive the anterior longitudinal veins. Contents of the medial and lateral cavities pass freely between the two. The lateral cavity connects with the intervertebral canal and dorsally into the posterior epidural space.

Dissection↗
PubMed1994

MRI of the epidural space after gelatin/gadolinium venous injection.

The head and vertebral column from two human cadavers were injected with a solution of gelatin and gadolinium (Dotarem) and imaged using magnetic resonance imaging (MRI). Comparisons between gross anatomic slices and corresponding images of the lumbar vertebral column confirmed the usefulness of a paramagnetic agent for visualising the epidural venous plexus. This technique provides accurate images of the posterior longitudinal ligament.

Contrast Media↗
PubMed1993

Reflections and suggestions on the nomenclature of the prostate.

The prostate has been given different and contradictory nomenclatures. The nomenclature of the normal prostatic gland must allow for the concepts of comparative anatomy, human anatomy and pathologic anatomy. The object of this study, based on a review of the literature, is to analyse the discordant terminologies, which give rise to misunderstandings, and to suggest a simple nomenclature conformant to anatomic rules and the descriptions of leading authors. It seems necessary to suggest a schema utilising the studies of comparative anatomists and the original descriptions of Albarran and correlating all this information. One must distinguish between the prostate, the prostatic gland and the periprostatic fibromuscular tissue. The central glands are those situated at the center of the prostate in the urethral wall. The prostatic glands themselves are found around the urethra. Within these glands there is a distinction between the cranial glands situated around the ejaculatory ducts, which drain above the seminal colliculus, and the caudal glands situated below the ejaculatory ducts which drain into the urethra below the colliculus. Between the wall of the urethra which contains the central glands and the peripheral glands is the transitional zone.

Animals↗
PubMed1992

[Phlegmasia caerulea dolens . Acute venous stasis and ischemic phlebothrombosis].

On the basis of the data of the literature and of 25 personal cases, the problem of phlegmasia caerulea is contemplated in its whole. Grégoire made an outstanding description of the condition in 1938; it was related to an arterial spasm, but later works showed the importance of the venous block and the secondary character of the arterial involvement. A severe form of venous thrombosis, phlegmasia caerulea dolens often occurs in elderly patients (11/25 in our series) or in persons in a poor general condition. The primary phenomenon is the occurrence, in various etiological circumstances, of an acute venous stasis giving rise to a number of phenomena, including extensive thrombosis and arterial involvement, which lead to irreversible lesions and to gangrene. Thus there is a first reversible phase of acute venous stasis with a still moderate arterial involvement, and a second phase of evolution with marketed ischemia, in which the tissular lesions can become irreversible. The necrosis results from the massive obliteration of the cutaneous venulae, not from the arterial failure. The old term of venous gangrene (Cruveilhier) points out to the mechanism and makes the practicioner aware of the extreme severity of any ischemic phlebitis, which can reach an irreversible stage within a few hours. The condition is therefore an emergency, and venous drainage must be re-established as quickly as possible in the limb, thus breaking the pathological cycle leading to irreversible lesions. In the simple venous stasis phase, a medical treatment may be attempted, but it must not be continued if it is not effective. Venous thrombectomy, a quick and safe procedure, therefore is the solution to choose either at once or after a short trial of medical treatment. Phlegmasia caerula certainly is the best indication for this procedure. If operated on time, the results are excellents: however, in very advanced cases with massive and total thrombosis of the venous system, amputation remains the only solution.

Acute Disease↗
PubMed1990

[Harvesting multiple organs].

The development of organ transplants is limited by the shortage of organs. The improvement of this situation depends on two factors: increased awareness by the general public that refraining from refusing the removal of organs from the body of a patient with brain death is the most modern form of solidarity; and increased awareness by the medical profession that removal of organs should be proposed for every patient with brain death and that adequate resuscitative techniques should be used to preserve the organs in these patients. When the decision to harvest organs is taken, the transplant specialists must decide whether an organ should be used or not. Advances have been made in preservation techniques but are still insufficient to allow a reduction in immunosuppression. The UW solution is a major advance for liver, kidney and pancreas transplants. During harvesting, the separation of the vascular pedicles requires a good knowledge of surgical anatomy. Furthermore, the needs of the other surgical groups should be taken into account and concessions made to allow the harvesting of the greatest possible number of organs and consequently the treatment of the largest number of patients awaiting organs.

Brain Death↗
PubMed1990

[A double balloon catheter for the procurement of abdominal organs].

When harvesting kidneys, a double balloon catheter can be inserted either at the bedside if cardiac arrest occurs or in the operating room. This catheter reduces the time required for dissection of the aorta and decreases the amount of fluid needed to cool the organs.

Catheterization↗
PubMed1989

Anatomical basis of whole pancreas transplantation.

Combined liver and whole pancreas procurement is feasible provided that anatomical variations of the hepatic a. are kept in mind and recognised. In case of a single middle hepatic a., the pancreas can be procured with the celiac axis and the superior mesenteric a. The liver is harvested with all its artery. In case of a left hepatic a., the liver should have the celiac axis, the left and the middle hepatic a. The pancreas is harvested with the superior mesenteric a. on which the splenic a. will be implanted, provided that the dorsal pancreatic a. is really coming from the splenic a. In case of a right hepatic a., the liver is procured with the middle hepatic a., the right hepatic a. and the superior mesenteric a. The pancreas will have the celiac axis, the common hepatic a. with the gastroduodenal branch and the splenic a.

Humans↗