[Responsibility of the left renal vein and inferior vena cava in certain cases of myelitis and syringomyelia. Value of ligation of the venous reno-spinal trunk. Apropos of 30 cases]. / Responsabilité de la veine rénale gauche et de la veine cave inférieure dans certains cas de myélites et de syringomyélie. Intérêt de la ligature du tronc veineux réno-rachidien. A propos de trente cas.

Certain diffuse forms of myelitis may be due to raised intra-spinal venous pressure resulting in veritable "varicose veins of the spinal cord". The origin of this increased pressure is often multifactorial, but may be due to venous reflux of blood from the left kidney into the intraspinal plexuses via the reno-spinal trunk. Ligation of this trunk results in a considerable and often complete improvement in the neurological syndrome. This operation was performed for the first time by our team in 1973 and since then has been successfully performed on 30 occasions for 21 cases of myelopathy and 9 cases of syringomyelia.

Renal immunopathology in renal cell carcinoma.

Signs of glomerulopathy, especially a nephrotic syndrome can occur in cancer patients, but the exact frequency of glomerular lesions is not well known in these patients. To define this frequency in a given type of malignancy we have studied the nephrectomy kidneys in 40 patients with renal cell carcinoma. Proteinuria, which was present in 7 cases, ranged from 0.15 to 1.5 g per 24 h. Reduction of the creatinine clearance greater than 50% was observed in 5 patients. Circulating immune complexes were detected in 11 of the 15 patients studied. Carcinoembryonic antigens were noted in 2 of 9 patients investigated. Research of alpha 1 foetoprotein carried out in 12 patients was always negative. HBs antigen or Hbs antibodies were detected in 6 of 29 patients studied. Light microscopic examination of the normal uninvolved kidney tissue showed obvious glomerular lesions (mesangial hypertrophy with or without deposits, with or without cell proliferation) in 7 patients (17.5%). Amyloid deposits were never observed. Immunofluorescence study revealed mesangial deposits in 35% of patients versus 5.4% of control subjects (P less than 0.0001). These deposits included C3 and/or IgM in 13 cases, IgA and C3 in one case. No fixation was observed, neither on tubules of normal tissue nor on carcinoma lesions. This report demonstrates that glomerular deposits are usually found in approximately one third of patients with renal cell carcinoma and that these deposits are located in the mesangial areas and not in the subepithelial space as it is often observed when glomerulonephritis is expressed by clinical symptoms.

[Torsion of the spermatic cord: diagnosis by Doppler ultrasonography?]. / Torsion du cordon spermatique: diagnostic par ultrasonographie Doppler?

The Döppler ultrasonic examination proposed for the diagnosis of acute painful scrotal syndromes has been used during 4 months. The presence of false negative results in the literature and in the series reported here throws some doubt on the reliability of the method and confirms that systematic surgical exploration remains imperative at the slightest doubt.

Immunofluorescence study of the distribution of A, B and H cell surface antigens in bladder tumors.

The distribution of A, B and H cell surface antigens was studied in 30 patients with bladder tumors using indirect immunofluorescence. These antigens, normally present at the surface of the healthy urothelium, disappear in various degrees in a large number of bladder tumors. Nevertheless, no close correlation exists between this loss of antigens, and the grade and stage of the vesical tumor, although when A, B and H antigens persist the prognosis generally seems better.