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Biomedical subjects

G Hidden

Publications and source records attributed to G Hidden.

At least 19 recordsLinked to original sources

Anatomic basis of lymphatic spread of lung carcinoma to the mediastinum: anatomo-clinical correlations.

Correlation of the anatomic and surgical features in 360 cadavers and in 260 patients operated for bronchial carcinoma reveals that the lymphatics of the lung reach the ipsilateral mediastinum, sometimes directly and sometimes by sites which do not correspond to the anatomic site of the injection or of the pulmonary lesion. This implies the need for systematic eradication of all the lymph nodes of the ipsilateral mediastinum during surgery for bronchial carcinoma. In cases of tumoral lesions (N2), the prognosis is better when only one site is involved, whether the nodal disease is microscopic, uni- or multiglandular, with or without rupture of the capsule and whatever treatment is carried out, even when resection seems macroscopically complete to the surgeon. This is explicable in the light of the anatomic study, which shows that the lymph node chain is a functional entity which channels the lymph into the systemic circulation, either at the venous confluence of the neck or into the thoracic duct in the mediastinum. When only a single chain is affected, there is a greater than 70% chance that systemic metastases are already present, 90% when N2 affects 2 chains, while in N3 cases (lymph passage to contralateral chains) the incidence reaches virtually 100%. However, macroscopically satisfactory excision allows management of the local problem, and involvement of the mediastinal nodes, even with capsular rupture, cannot be considered as a contraindication in the absence of clinically detectable systemic metastases.

Adult

[The lymphatic drainage of the esophagus].

The study was carried on 65 cadavers: 50 adults and 15 newborns. The esophagus was injected at the level to the neck 16 times, in the thorax at the superior level 18 times, middle level 30 times and inferior level 21 times. The lymphatic pathways were named short when joining the nodes at the same level, half long when joining the nodes of the neighbouring level, long when joining third level, and very long. At the level of the neck were injected 24 lymph nodes chains: in 12.5% of the cases the pathways were long, joining the nodes of the arch of the Azygos vein. At the superior thorax level were injected 27 chains: half of the pathways were half-long: 7.5% long (-joining the pharynx once and the cardia once). At the middle thorax level were injected 37 chains: 27% were long and very long. At the inferior thoracic level were injected 21 chains: The pathways were half long in half cases and very long in 15% of the cases joining the cervical nodes. These results compare with experience in oncology and justify the need for total esophagectomies and nodes resection of all levels in surgical treatment of carcinomas of the esophagus.

Adult

Routes of lymphatic drainage from the pancreas: a suggested segmentation.

The peripancreatic lymphatics were dissected after intrapancreatic injections of different colorants by territory. The aim of this study was partly to determine the lymphatic drainage routes specific to each pancreatic segment, and partly to define the nodal relay stations for each territory. Whatever the site of injection in the segment of the body and tail, the dye followed the splenic and inferior pancreatic pathways before reaching a left intercelio-mesenteric node (ICMN) and then the supra- and infrarenal nodal groups. However, three distinct drainage routes emerged for the head of the pancreas. The lymphatics of the uncus (anterior and posterior aspects) follow the superior mesenteric route to reach a right ICMN and then the supra- and infrarenal relays bilaterally. Rarely, the lymphatics of the posterior uncus may pass directly to the supra- and infrarenal relays. The anterosuperior segment of the head drains by the gastroduodenal route. This route crosses the superior border of the pancreas and joins the right ICMN. There is an inferior route for this segment which turns back along the inferior border of the isthmus. After injection into the posterosuperior segment of the head, the dye frequently refluxes along the common bile duct and hepatic artery and stains the pericholedochal and hepatic pedicular nodes. When the dye is not entirely collected by these large nodal stations, it goes to join the right ICMN. The right ICMN is the principle relay station for the head of the pancreas. The dye flows only from the pericholedochal relays towards the right ICMN, never in the opposite direction (right ICMN to pericholedochal relays).(ABSTRACT TRUNCATED AT 250 WORDS)

Humans

[The bronchial arteries and their anastomoses with the coronary arteries].

We studied bronchial arteries (BA) and their anastomoses with coronary arteries in 53 adult subjects (30 female and 23 male, mean age 82) and one 2 month old child. Each subject had 1 to 4 BAs, born from an area on the anterior side of the descending aorta measuring less than 2 cm in diameter in 62 percent of the cases and never exceeding 4 cm in the other cases. In 6 cases BAs vascularize the left auricle; more than half of all cases had an anastomose with the coronary arteries: 11 with the right coronary artery and 9 with the left one. These anastomoses preserve the vascularization of the carina after a cardio-pulmonary transplantation. The may have a function of vascular supply in some coronarian patients and the study of associated coronary pathology gives confirmation of it in one fourth of the cases.

Aged

[Lymphatic drainage of the heart].

The study was carried out on 91 adult cadavers to point out clearly the lymphatic drainages of the heart into the blood circulation. 45 right and 63 left ventricles and 9 right and 5 left atria were injected by means of a green modified gerota medium. A right collecting trunk received its afferents from 29 right and 5 left ventricles, ran upwards in front of the ascending aorta, involved the left brachiocephalic nodes and opened into the left subclavicular veins but also in 1 case in 5 into thoracic duct. A left collecting trunk received its afferents from 59 left and 23 right ventricles, ascended along the pulmonary trunk, involved the right paratracheal nodes and opened into the right subclavicular veins. From the right paratracheal nodes were also injected the left tracheobronchial nodes in 14 cases, and then the left brachiocephalic nodes twice, the left paratracheal nodes in 3 cases until the thoracic duct once and directly the thoracic duct in the mediastinum in one case. Afferents from the right atria ran upwards the superior vena cava and involved the right brachiocephalic nodes but connected also with the right paratracheal nodes as did the afferents of the left atria too. The connections with the thoracic duct must be emphasized.

Adult

[Pericardial fatty fringes: preoperative anatomo-radiographic value of their use in the protection of bronchial sutures].

Bronchial sutures grafts by epiplooplasty is a method used to allow a better vascularisation of the bronchial sutures. The authors purpose an other method using the pericardial fatty fringes (P.F.F.). The vascularisation of P.F.F. was studied on 30 fresh cadavers and 8 patients before surgery. Angiography of the internal thoracic artery was done in the first group and M.R.I. in the second group. M.R.I. is better than angiography because numerous parietal vessels project in the angiogram, and they overlap pericardial fat fringes vessels.

Aged

[Parameters of the facial bones in the fetus. Anthropology and medico-legal application for the determination of the fetal age].

From 93 skulls and 23 foeto-skeletals we give a glimpse of the rhythme of the human foetuse's facial bones growth and the main variations for facial measurements rating during foetal period. The best correlation between foetal age and facial measurements was obtained with facial height (correlation coefficient: 0.96). Evolution of cranio-facial rating, during foetal stages shows essentially: the increase of the height/width facial rating, the same rhythme of growth for frontal and facial width, the rapidly growth of biparietal diameter up to 30 amenorrhea weeks comparatively to the facial and frontal growth in width.

Age Determination by Skeleton