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Y Janin

Publications and source records attributed to Y Janin.

10 recordsLinked to original sources
PubMed1985

The "lead-induced colic" syndrome in lead intoxication.

Lead has a multiplicity of biologic effects. The universal occurrence of lead accounts for the continuous appearance of new instances of human lead poisoning. The most common and one of the earliest manifestations of lead intoxication in the adult is so-called lead-induced colic, which is a syndrome with a multiplicity of clinical patterns and at least three possible different pathogenic mechanisms. It may be caused by changes in the visceral smooth muscle tone secondary to the action of lead on the visceral autonomic nervous system, lead-induced alterations in sodium transport in the small-intestinal mucosa, and lead-induced interstitial pancreatitis. It should be considered in the differential diagnosis of abdominal pain of obscure etiology and whenever a disparity is observed between the symptoms and the abdominal findings in a patient with abdominal pain, especially in the presence of a history of occupational exposure to lead.

Abdominal Muscles↗
PubMed1983

Bitemporal palsy of the pupillary sphincters. A sign of diffuse circulatory insufficiency.

Two patients with generalized arteriosclerotic changes presented with oval-shaped pupils in both eyes. Sectorial palsy of the iris sphincters, essentially in the lower temporal segments, was demonstrated. Paralyzed sectors did not react to 2% pilocarpine. There was no dilator weakness, and the iris did not exhibit atrophy or synechia. We consider the sectorial palsy of the sphincters in these patients to be due to circulatory insufficiency of the iris. We reviewed previously published cases of diffuse or multifocal circulatory insufficiency with ischemic iris changes, and analyzed the accompanying photographs. We found that temporal segments of the iris are predominantly involved in these patients. Predisposition to this sectorial palsy, especially in the pupillary temporal region, might be explained by several anatomical particularities of the vascular network in the iris. Bitemporal palsy of the pupillary sphincters may be a sign of generalized circulatory insufficiency.

Aged↗
PubMed1983

Superior vena cava syndrome in childhood: report of ten cases and review of the literature.

Experience with ten children with superior vena cava obstruction is reported. Five patients had non-Hodgkin's lymphoma, two had Hodgkin's disease, two had benign lesions, and one patient was suspected on clinical and radiologic basis to have a lymphoma. The clinical situation at presentation was often critical and required rapid treatment. Radiotherapy and/or chemotherapy were used initially as lymphoma was the most frequent cause of obstruction. Urgent thoracotomy was resorted to when treatment failed. Survival with no evidence of disease for more than 5 years was observed in three children: one had a cystic lymphangioma, another had a mediastinal abscess, and the third had a Hodgkin's lymphoma. Review of the literature from 1951 to 1976 revealed that only 24/150 children reported with superior vena cava obstruction syndrome had mediastinal tumors; the remainder developed the obstruction after surgical procedures on the heart or vena cava.

Adolescent↗
PubMed1982

A comparative study of the treatment of cervical spondylotic myeloradiculopathy. Experience with 50 cases treated by means of extensive laminectomy, foraminotomy, and excision of osteophytes during the past 10 years.

This paper reviews management by means of the posterior approach of 50 patients with cervical myeloradiculopathy caused by spondylosis and stenosis of the spinal canal seen in the past 10 years. Careful selection of patients is an absolute necessity since a primary cause of failure occurred in individuals who subsequently proved to have motor neurone disease. Older individuals with long-standing neurological deficits, especially long tract signs indicative of fixed lesions, were benefited primarily by a lack of further progression of their disorder and occasional improvement in hand function and gait. Diagnostic evaluation should include electromyography, nerve conduction studies, and sensory evoked cortical potentials. With the introduction of the fourth generation CAT scanning equipment, additional diagnostic information is available regarding the internal configuration of the spinal canal, its contents, and the amount of available space at various levels. Supplementary myelography remains of basic importance. Laminectomy includes two levels above and below the areas of significant canal encroachment. Foraminal decompression with removal of only the innermost third of the foramen permits mobilization of the nerve roots, removal of osteophytes and untethering of the dural sac. A great deal of importance is attached to the preservation of the cervical lordotic curve since, with an adequate decompression and an intact dura, the cord moves dorsally into an expanded canal, rising above the ventrally situated osteophytes. In those patients with reversal of the cervical curve and swan neck deformities, posterior decompression has not been of value. Recent more radical procedures in such cases, such as vertebrectomy, remain to be evaluated. Any procedure which will permit further kyphotic deformity, such as laminectomy, is contraindicated. Eighty-five percent of the patients operated upon by the recommended surgical approach improved.

Adult↗
PubMed1982

Superior vena cava syndrome in childhood and adolescence: a review of the literature and report of three cases.

Obstruction of the superior vena cava is rare in childhood and adolescence. Its etiology is now mainly iatrogenic. Mediastinal tumors are the main primary causes of the superior vena cava syndrome (SVCS) in childhood and adolescence. The most common mediastinal tumors presenting with the SVCS are the lymph node tumors and especially the lymphosarcomas. About 50% of the mediastinal tumors are primary in the mediastinum. Early treatment is designed to cause a rapid shrinking of the tumor and should not be delayed by an overly diligent pursuit of the diagnosis. Treatment should consist of a combination of radiation therapy, chemotherapy, and steroids. Surgery should be limited to obtaining tissue for diagnosis, except when the tumor is localized to the mediastinum and is completely resectable. One hundred and seventy two children and adolescents with the SVCS are reviewed and three patients are added.

Adolescent↗
PubMed1981

Osteoid osteomas and osteoblastomas of the spine.

Benign osteoblastic lesions are rare bone tumors and they are usually divided into osteoid osteomas and benign osteoblastomas based on their biological behavior. Both lesions are prevalent in the spine, with the lamina and pedicle being involved frequently. Long diagnostic delays are frequent. Pain, the most prominent symptom, is often nocturnal and is relieved by aspirin in 30 to 40% of patients. Radicular pain occurs in 50% of the patients. The most common physical finding is tenderness in the vicinity of the lesion. Neurological abnormalities are more frequent in patients with osteoblastomas, which frequently extend into the neural canal. Tomograms are invaluable in most patients in whom plain films are normal. The bone scan is one of the most important diagnostic studies and provides an excellent means of accurately demonstrates the location and extent of the tumor. Permanent relief of pain and neurological recovery is dependent primarily on total removal of the lesion.

Adolescent↗
PubMed1981

Splenic pseudocyst associated with hypersplenism.

A patient with hypersplenism, who was found to have a splenic pseudocyst containing an organized hematoma, is described. There are only two patients with splenic pseudocyst and hypersplenism and an additional two patients with splenic cysts and hypersplenism reported in the world literature. The hypersplenism associated with splenic cysts and pseudocysts is explained on the basis of an expansion of the plasma volume and the total blood volume, an increased destruction of red blood cells and a pooling of blood in the enlarged spleen. The combined use of ultrasonography and computerized tomography has increased the accuracy of noninvasive diagnosis and made more invasive examinations unnecessary. When the ultrasound is technically unsuccessful or when it shows a mixed echo pattern, one should resort to computerized tomography with which it is possible, almost invariably, to differentiate between cysts and neoplasms.

Adult↗
PubMed1980

Mesenteric hernia.

Acute intestinal obstruction secondary to an idiopathic mesenteric hernia has been reviewed by collecting 139 reports from the literature and studying them from the standpoint of incidence, etiology, pathogenesis, clinical manifestations, diagnosis, treatment and mortality. An acute intestinal obstruction with strangulation in the absence of an external hernia and with no history of previous surgical procedures must suggest the possibility of an internal hernia, especially if the patient has a history of chronic intermittent abdominal distress and a palpable abdominal mass if found on examination.

Adolescent↗