[Perianeurysmal retroperitoneal fibrosis].
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Biomedical subjects
Publications and source records attributed to G Benoit.
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Five focal non typhoid salmonellosis (NTS) are reported in a group of 342 kidney transplant recipients. There is no relationship between the unusual presentation of NTS (septicemia, pneumonia, orchitis, prostatis, urinary tract infections) and the serotypes (S. typhi-murium, S. panama). With the therapeutic immunodepression, many host factors are important to induce the unusual presentation of NTS: major surgery, urologic abnormalities, preexisting uraemic state. The major importance of decreased host resistance is emphasized by the absence of relationship between death and bacterial resistance. The use of lysotypes exclude the role of an intrahospital contamination.
Kidneys of potential donors undergoing sudden cardiac arrest are generally not gathered because the warm ischemia time is too long until nephrectomy. A rapid in situ cold perfusion technique was developed to preserve kidneys in 21 brain-dead patients after cardiac arrest not responding to cardiac resuscitation. In 7 of the 21 potential donors, the in situ perfusion was unsuccessful. In 14 other subjects this technique permitted to save 15 transplantable kidneys; 1 month after grafting, the renal function was similar to that observed in kidneys gathered in living patients. The in situ perfusion technique allows to increase by nearly 10% the efficacy of kidney gathering.
The authors report a case of complete avulsion of the ureter occurring during the vaginal evacuation of a fetus that had died in utero in the second trimester. This case leads us to discuss the diagnostic and therapeutic measures that should be taken in this kind of situation. At present there are people who wish to increase the number of indications for second trimester terminations of pregnancy. As this is so, we wish to draw attention to a rare but very serious complication of late evacuation of the uterus, namely damage to the ureter.
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The authors describe five cases of renal allograft rupture as a result of acute rejection. In one case of perineal hematoma, no operation was performed. The evolution of the hematoma led to a periureteral sclerosis, which was successfully operated. The authors advocate deferring the surgical management of allograft ruptures. Once the diagnosis has been established with the aid of physical examination, electrography and computerized scanography, the extra time can be devoted to following the evolution of the rejection. If the rejection is irreversible, a nephrectomy has to be performed, but if it is reversible, they favour conservative treatment followed by operative intervention around the tenth day.
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Twenty one patients suffering from carcinoma of the prostate, confirmed histologically and previously untreated, received treatment in the form of 17 beta-estradiol administered percutaneously. At a dose of 6 mg of estradiol per day, testosterone levels fell to a mean of 1 ng/ml. No change in lipids, lipoproteins nor cholinesterase were detected.
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Two cases of epididymotesticular metastases are reported: one epididymal from a carcinoma of the kidney by retrograde venous spread and the other testicular secondary to a carcinoma of the prostate and apparently by arterial spread. Epididymotesticular metastases of carcinomas are rare. When the initial carcinoma is known, or even treated, the development of a large testis should lead to consideration of the possibility. Treatment should consist of inguinal orchidectomy with ligation of the spermatic cord as high as possible.
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A natural estrogen, 17 beta-estradiol, was given percutaneously to 21 patients with untreated cancer of the prostate. The follow-up lasted three to six months, and the results of the survey were encouraging. The hormonal controls showed good plasma diffusion of estrogen, a significant drop in plasma testosterone, and decreased hypophyseal secretion as shown by lower follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels. Triglycerides and very low density lipoproteins (VLDL) which are considered to be good indicators of cardiovascular risk were unchanged.