Biomedical subjects
Publications and source records attributed to G Godlewski.
From a series of 110 trans-uterine venographies, the authors present the normal radiological anatomy of the uterine venous vascularization and of its efferent venous drainage. They also present the most frequent variations from normal and examples of the pathologies encountered.
The hepatic structures appearing during Carnegie stages 11-14 were analyzed in a series of 61 OFA rat embryos. The group of embryos (crown-rump length 2-7 mm, 10th-12th days after coitus) was composed of 52 specimens of the somite period (stages 11 and 12) and of 9 specimens of the postsomite period (stages 13 and 14). The embryos were submitted to serial histological sectioning with graphic reconstruction. Stage 11 was characterized by the development of the hepatic diverticulum induced by differential growth of the endodermal plate and fixed contact between the entoderm and endothelium lining the heart. Stage 12 presented obvious signs of cellular differentiation, the septum transversum giving the liver stroma and the hepatic diverticulum the epithelial trabecula. At stage 13 the epithelial cords enmeshed the stromal capillaries, while hepatocardiac veins drained the hepatic flow into the sinus venosus. Stage 14 was recognized by the presence and development of the hepatic lobes and the enlargement of vascular channels. The cystic bud was never observed. The identification of these features permits to precise the hepatic developmental staging in rats and to obtain accurate criteria for the characterization of the end of the somite period and the beginning of the postsomite period.
The authors report a pancreatic metastasis of sinusal squamous cell carcinoma in a 69 year-old man, 18 years after the first excision of the primary neoplasm. The metastases appearing in a patients having previously presented several tumors, was detected by a rising CA 19-9 level and a pancreas head enlargement at the CT. The diagnosis was identified at laparotomy by tumor biopsy. The vascular involvement of the tumor obliged to perform double bypass. 103 cases of pancreatic metastases, published in the literature from 1983 to 1991, are reviewed. Generally the pancreatic mass is visualized by CT but the diagnosis is only carried out on microscopy. Treatment depends on anatomical and pathological characteristics of primary and secondary tumours. Solitary metastasis of renal carcinoma origin have the best prognosis after radical surgery. In other cases palliative procedures are widely used. First case of pancreatic metastasis originated from recurrent sinusal squamous cell carcinoma with poly-tumoral clinical presentation.
An unusual association of a secreting renal oncocytoma and a parathyroid adenoma is described. The high level of hypercalcemia and of blood parathormone (PTH 44-68), partially reduced by nephrectomy and totally normalized by parathyroidectomy, as well as the renal tumor PTH evaluation and the ultrastructural features showing secretory granules in oncocytic cells of kidney, advocate for a double site of PTH secretion. Removal of both tumors permits a complete recovering.
The 8-point scores, evidenced in the human embryo of stage 23, were analysed in the rat at the end of the embryonic period. Eleven OFA rat embryos-crown-rump length 16 mm, 16th postcoital day--were submitted to serial histological sections with graphic reconstruction. The 8 internal key structures, previously observed in man by O'Rahilly--i.e. the cornea, optic nerve, cochlear duct, adenohypophysis, vomeronasal organ, submandibular gland, metanephros and humerus--were readily recognizable. The identification of these anatomical features permits to determine the end of the embryonic period and to obtain a clear distinction between this and the fetal period. The similarity and the presence of the same organs in man and rats at this period of development permits to consider the rat as a good experimental model of teratology.
The authors report a case of pancreatic cystadenocarcinoma developed within a few days as a voluminous cyst of the left hypochondriac region, pushing away the organs of the supramesocolic zone. The tumor removal is easily performed because it was surrounded by a fibrotic capsule and their was no precise attach to the neighbouring organs. Diagnosis is carried out by microscopic examination revealing a tubulo-papillary cystadenocarcinoma of the pancreas. Quasi synchronous apparition of disseminated hepatic metastases advocates for heavy malignancy and justifies intrahepatic chemotherapy.
Seven cases of pelvic endometriosis of the urinary or digestive tracts are reported: 4 cases of vesical endometriosis, 1 case of ureteral involvement, 1 rectal case and 1 sigmoid location. The authors point out the difficulty of the clinical preoperative diagnosis--in despite of cyclic troubles--and underline the interest of complementary explorations performed at the time of periods: ultrasound, cystoscopy, rectosigmoïdoscopy and coelioscopy. The MR imaging, showing high intensity a T1-weighted images and prominent high intensity on T2-weighted images, is very suggestive of an endometrial lesions. A joint medical and surgical treatment is required. Endoscopic excision, endoprothetic tube, excision-suture, resection-anastomosis and a complementary medical treatment using Danazol, Decapeptyl or progestational agents have to be proposed. Per-operative microscopy is advised as routine procedure in order to avoid excessive surgery.
A case of mucinous cystadenocarcinoma discovered into a voluminous benign mucocele of the appendix, is presented. The clinical feature is a tumor of the right iliac fossa. The identification of a limited area of epithelial degenerescence in the cyst wall--by peroperative microscopic examination--permits immediate enlargement of the cystectomy by a right hemicolectomy. The prognosis of the tumor is generally excellent as soon as the diagnosis is early and the removal large enough.
The end of the embryonic somite period--stage 12 according of the Carnegie Institution--was identified in the rat. The series was composed of 23 embryos taken out from uterus on day 11/4H, day 11/5H and day 11/10H post fertilization. The specimens were submitted to external macroscopic examinations and to histological sections. The rat development of this stage was characterized by the closure of the caudal neuropore, the evidence of 3 pharyngeal archs, the closure of the otic vesicle, the presence of the fore limb buds, the beginning of the cardiac septa. This stage, being similar to this of human embryos, the authors concluded that rat could be an excellent comparative model for experimental Teratology.
One step DNA staining procedures are very easy to use. Reduced staining time and small amount of needed components explain the world wide use of these protocols. The heterogeneity of the results obtained with these technics during a study of different mice organs has let the authors to think that there was a close relationship between this heterogeneity and DNA staining technics. The authors have observed the same discordances with some human tissues (parathyroid, prostatic adenoma...). They disappear when the same cells are stained with a procedure that associates to propidium iodide and RNAse a pretreatment of nuclei by trypsin and spermin. These molecules are DNA stabilizing components. So one can develop the hypothesis that the abnormalities observed with the one step procedures are due to a decondensated state of DNA that allows the fixation of a higher amount of stain. The main point will be to find a direct relationship with different physiological or pathological states. Now, it is necessary to sensibilise users against the risk of false abnormal DNA content detection through the one step procedures.
Thirty-six deep hepatic lesions of localized photocoagulation were induced in 11 pigs by means of a neodymium-YAG laser. Laser applications of 80 W/10 sec (10.190 W/cm2) were transmitted through a handpiece coupled to a water-cooling circulation system to protect the quartz fiber and positioned through an echo-guided trocar. During irradiation, temperature was sufficient for vaporization up to 5 mm from the laser source and high enough for tumor cell kill at a 10-mm distance (54 degrees C/60 sec). Intraoperative ultrasound visualized increasing photocoagulation (12-18 mm), and further controls demonstrated an echo-free core of vaporization progressively covered by increasing fibrosis, well demarcated from normal parenchyma. Microscopy revealed central coagulative necrosis marginated from the third day by a growing fibrosis. By day 20 immunoblasts and mast cells were in profusion in the lesion border, and by day 120 a fibrotic network had invaded the scar and confirmed healing free of complication. This technique is proposed for deep vaporization of disseminated hepatic metastases.
Thirty six deep focal hepatic lesions were induced in eleven piglets by means of an Nd-YAG laser. Laser shots of 80 W power and 10 s duration were used, the beam being transmitted through an echoguided stereotaxic handpiece. From day 0 to day 120, the animals underwent ultrasonographic and morphological controls. At lasering time an hyperechoic image--12-18 mm in diameter--appeared due to boiling of tissue water. During the twenty postoperative days the lesion core was an echo-free area due to tissue vaporization, surrounded by an hyperechoic ring of increasing fibrosis, containing neovascularization and biliary ductules, while the hypoechoic outer area represented the peripheral halo of edema. In the long term, hyperechoic structures--swollen fibrotic septa of homogeneous fibrotic network--invaded the lesion site confirming good healing.
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Thirty six hepatic lesions (12-18 mm) of localized hyperthermia are induced in eleven pigs by means of a Nd-YAG laser. Laser shots of 80 W/10 sec. are transmitted through a stereotaxic handpiece coupled to a water cooling circulation protecting the optic fibre. The handpiece placement is performed through an ultrasound-guided trocar. The efficiency of the irradiation is visualized by immediate temperature increasing, by ultrasonographic imaging and by anatomical verifications from operating time to four months. The center of lesion initially occupied by coagulative necrosis is rapidly marginated by a gaining ground fibrosis. At long term a fibrotic network invades the scar and confirms healing free of complications. This ultrasonographically assisted technique is proposed for deep vaporisation of disseminated hepatic metastases.
The study was performed using 45 pelvic half section specimens (41 fetal ones and four adults). The macroscopic dissection followed the nerve branches from their spinal roots up to the external anal sphincter. Three nerve branches were found: the anterior ramus arising from the external perineal nerve, the inferior rectal nerve and an independent posterior branch. The anterior and the inferior rectal nerve branches always emerged from the pudendal plexus. The posterior branch arising either from S4 or from the inferior rectal nerve was only found in (31%) of our cases. Five anatomical distributions are described, percentages of every type notified. The fibre content of these nerve bundle branches was evaluated through histological sections using Heidenhain's azan stain and Luxol fast blue. The branches consisted of 2,896 to 2,137 fibres, 20% of them being unmyelinated and 80% containing various myelinated fibres. The nomenclature of these nerve branches has to be debated. The terms of anterior, middle and posterior anal nerves seem more suitable.
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Study on the left colonic arteries in 15 human fetuses (195 to 360 mm VC). The arterial system was injected 9 times with a mixture of gelatin and Indian ink, 6 times with red coloured stratyl. The left hemicolectomic resections are treated with the Spalteholtz method. The arterial axes are constant: left colic artery, the middle colic artery, the middle branch of the left colic artery, the sigmoïd arteries. A paracolic arch, often branched, was always found, an intermesenteric arcade was sometimes present (20%). Straight arteries became more numerous with function and age. Histologic study showed two types of muscular penetration by these arteries.
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