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The authors report a 38 years old patient in whom an intravenous pyelogram was performed for moderate arterial hypertension. This showed a large filling defect in the right lower part of the bladder without renal function on that side. Endoscopic separation of the jet coming from the right half of the trigone showed a liquid containing numerous spermatozoa. A cystogram opacified by reflux a cavity in the genital system via this, the right ureter. With the diagnosis of ectopic ureter ending in the genital system, a nephro-ureterectomy demonstrated the attachment of the ureter into a pouch which communicated with the bladder and the seminal vesicle. A view of the normal embryology insists on the fact that contrary to the classic view, the pronephros disappears entirely and that the metanephros is at the origin of the Woffian canal which opens on the posterior wall of the urogenital sinus at the 28th day when the ureter springs from a ureteral bud. Since 1960 this would be the 34th case in the literature, seminal ectopia (24%) coming after ectopia in the prostatic urethra (54%). Epididymitis is a frequent presenting symptom (44%). The workup shows: absence of renal function (100%), raising of the ipsilateral trigone by a cystic swelling (76%), absence of the meatus on that side on endoscopy, presence of an ipsilateral mass above the prostate on rectal examination (30%). The diagnosis is confirmed by vasography where the ureter is opacified by the seminal vesicle or by systography after endoscopic incision of the mass. Excision of the seminal vesicle was done in conjunction with total nephroureterectomy in 17% of cases.

This is a report of a 26-year-old woman who died of a massive intestinal infarction caused by occlusion of the celiac axis and the superior and inferior mesenteric arteries. Autopsy showed intimal hyperplasia and an overlying thrombus that obstructed the lumen of the vessel. As shown by Irey et al., exogenous or endogenous female reproductive steroids can act on the vascular system as a target organ and induce intimal hyperplasia and thrombus formation. The effects of contraceptive estrogens and progestogens are discussed, but the catalytic effect of heavy cigarette smoking appears to be the factor that induces, in predisposed women with hyperplasia, thrombosis of visceral arteries. In this case report we want to emphasize that the association between smoking and oral contraceptives can cause cardiovascular disease in young women. Failure to recognize this fact could result in delayed diagnosis and worsen the prognosis.To further understand the pathophysiology of arterial diseases induced by oral contraceptives (OCs), a case report is presented of a young woman who died of extensive visceral artery thrombosis. The possible role of estrogens and progestogens and of cigarette smoking as the predisposing factors in this patient are discussed. A 26-year-old woman, who complained of progressive abdominal pain and whose past medical and surgical history was negative, was admitted to the general surgery service. She was the mother of 1 child and had had 2 previous spontaneous abortions. She had received ethinyl estradiol 35 mcg with norethindrone 500 mcg and 1000 mcg for 3 months, but because of a problem with breakthrough bleeding the medication was changed to mestranol 50 mcg with norethindrone 1000 mcg. She had been taking Ortho-Novum 1/50 for 2 1/2 years. She had smoked 25-35 cigarettes daily for about 10 years but denied use of alcohol or other drugs. She was not known to be diabetic, hypertensive, or dyslipidemic, and had no history of atherosclerosis in her family. For 7 months prior to her admission, the patient complained of abdominal pain, which progressively increased in intensity and duration, interrupted by periods of well-being. The patient reported 2 recent, isolated episodes of mild proctalgia but no tenesmus or melena. There had been no fever, but the patient had been anorexic for the past 2 weeks and reported losing 10 kg in the past month. She had no complaints apart from those related to the gastrointestinal system. At an emergency laparotomy, gangrenous acalculous cholecystitis and infarction of the terminal ileum were discovered. A cholecystectomy with resection of the terminal ileum and the right colon was performed. An end-to-end primary anastomosis was performed. On exploration of the superior mesenteric artery, a thrombus was discovered at its origin. As a transverse arteriotomy showed a good retrograde flow, a thrombectomy was performed. There appeared to be an unsatisfactory antegrade flow. The superior mesenteric artery then was transposed in an end-to-end fashion on the abdominal aorta. An immediate postoperative arteriogram showed thrombosis of the celiac axis at its origin. Revascularization failed to improve the condition of the intestine. The patient died. The intent of this case report is to emphasize that the association between smoking and oral contraceptives can cause cardiovascular disease in young women, and a failure to recognize this association can result in delayed diagnosis and worsen the prognosis.

The dust particle fluences measured aboard the Vega (SP-1 and SP-2 impact sensors) and Giotto probes DIDSY impact sensors) are analyzed to obtain the differential size distribution function of the dust in the coma of comet Halley. The brightness integral is then calculated for perfectly spherical (Mie scattering) and rough grains of various compositions. It is shown that the photopolarimetric observations rule out the dominating presence of weakly absorbing silicates such as olivine but are compatible with rough moderately absorbing silicate grains having a density decreasing with radius and with rough graphite grains. A mixture of the two types gives in fact the best agreement with the observations.

An experimental device, of the nephelometer type, to study the scattering properties of dust particles is presented. A fluidized bed generator produces a continuously flowing aerosol which is illuminated by either a He-Ne laser or a Xenon are lamp with interference filters. The size of the dust particles ranges between 1 and 30 μm. The scattering properties of dust particles are measured in the two directions of polarization. The first results are presented.

A continuing program aimed at improving the determination of the charge of interplanetary as well as cosmic grains is presented. Recent data have been combined to generate two high—resolution solar spectra corresponding to the maximum & minimum of activity. The energy distribution of photoelectrons emitted by quartz grains under solar irradiation is calculated using the new laboratory measurements of Quemerais et al. (this volume). Finally, the method of Lafon, Millet and Lamy (Astron. Astrophys., 95,295, 1981) is used to find the electrostatic potential of these grains.

Plasma thromboxane B2 (TXB2) and 6-ketoprostaglandin F1α (6-keto-PGF1α) were measured in 84 patients at risk of developing adult respiratory distress syndrome (ARDS) (44 patients following multiple trauma, 29 patients following abdominal surgery and 11 patients with acute pancreatitis). Forty-nine of these 84 patients developed an ARDS. High (>140 pg/ml plasma) TXB2 values were found in 52/84 patients. The median values of TXB2 were: 360 pg/ml in multiple injured, 250 pg/ml in abdominal surgery and 410 pg/ml in acute pancreatitis patients. The median TXB2 value was 575 pg/ml in patients developing ARDS and 140 pg/ml in those without this complication: this difference was statistically significant (p

Recent work on the light scattering by large rough particles has led us to propose a model based on the high-energy approximation, the laws of geometrical optics and a mathematical description of the properties of the particle roughness. The influence of the various parameters of the model including those characterizing the roughness on the total intensity and the polarization is presented.

The adult respiratory distress syndrome (ARDS) is the clinical manifestation of a pathophysiological process of rapid onset, characterized by severe dyspnoea, hypoxaemia, increased lung stiffness and diffuse bilateral pulmonary infiltrates. It results from direct or non-specific pulmonary damage to previously normal lungs. The mechanism of acute lung injury in ARDS remains unknown, but different mediator systems are likely to play a role in the pathogenesis of this syndrome. Two recent papers (Deby-Dupont et al. 1984; Nicod et al. 1985) have pointed to a potential role for pancreatic enzymes in the pathogenesis of ARDS, particularly in patients with sepsis, where highly abnormal plasma levels of immunoreactive trypsin have been found. When liberated into the systemic circulation trypsin is a potent protease which can induce damage in very different organs, as observed in acute pancreatitis. Furthermore, trypsin may activate all the other proenzymes including the kallikrein-kininogen-kinin system (KKK system). This may lead to the generation of kinins, especially bradykinin, one of the supposed mediators of ARDS (Fig. 5.1).

This review deals with the main properties of the F-corona. Analysis of its morphology and photometry allows to derive a new axisymmetric, non-spherical model. Polarization, color and infra-red properties are further considered. We suggest the existence of a variable “local” component surperimposed on a quasi-stationnary “far” component.

We have studied 45 patients with adult respiratory distress syndrome (ARDS). Pathological studies were performed on 30 open lung biopsies and 15 autopsies. Concomitantly the physiologic characteristics of the hypoxemia in response to different inspired oxygen fraction (FIO2) and Positive End Expiratory Pressure (PEEP) were determined. These studies allowed categorization of ARDS into 3 groups. Group I had the most severe hypoxemia and a severe fixed shunt at all PEEP and FIO2. Pathologically, there was extensive acute edema, hemorrhage, and exudation to the point of consolidation. Group II had less severe hypoxemia which improved moderately but slowly in response to PEEP and shunt increased with decrease in FIO2 indicating diffusion disturbances or severe ventilation-perfusion abnormalities. Pathology showed severe fribrosis. Group III had least hypoxia which rapidly and markedly improved with PEEP. Shunt also increased with decrease in FIO2. Pathology showed acute changes similar to but less severe than group I. Prognosis was best for group III with 10 of 21 long term survivors (one after ECMO or extracorporeal membrane exygenation). In group I only 2 of 11 survived after prolonged periods of ECMO. In group II, 3 of 13 survived (one required ECMO) with satisfactory pulmonary function despite biopsy evidence of severe fibrosis during the acute illness. These pathological and physiologic studies are useful to better understand ARDS, to optimize respiratory care and for prognosis.

The relevance of the bulk density as a physical parameter characterizing interplanetary dust grains is discussed. The various measurements which lead to a determination of this parameter are reviewed. The specific case of the collected interplanetary dust grains is considered.