Obstetric dislocation of the thoracic spine: case report and review of the literature.

A fracture dislocation of the upper thoracic spine with spinal cord injury is reported in a neonate. This rare injury is associated with attendant predisposing obstetric circumstances (breech transverse presentations, large baby size) that can alert clinicians of potential problems and aid in the diagnosis of neonatal hypotonia and paralysis.

Two distinct endothelial lineages in ontogeny, one of them related to hemopoiesis.

We have shown previously by means of quail/chick transplantations that external and visceral organs, i.e., somatopleural and splanchnopleural derivatives, acquire their endothelial network through different mechanisms, namely immigration (termed angiogenesis) versus in situ emergence of precursors (or vasculogenesis). We have traced the distribution of QH1-positive cells in chick hosts after replacement of the last somites by quail somites (orthotopic grafts) or lateral plate mesoderm (heterotopic grafts). The results lead to the conclusion that the embryo becomes vascularized by endothelial precursors from two distinct regions, splanchnopleural mesoderm and paraxial mesoderm. The territories respectively vascularized are complementary, precursors from the paraxial mesoderm occupy the body wall and kidney, i.e., they settle along with the other paraxial mesoderm derivatives and colonize the somatopleure. The precursors from the two origins have distinct recognition and potentialities properties: endothelial precursors of paraxial origin are barred from vascularizing visceral organs and from integrating into the floor of the aorta, and are never associated with hemopoiesis; splanchnopleural mesoderm grafted in the place of somites, gives off endothelial cells to body wall and kidney but also visceral organs. It gives rise to hemopoietic precursors in addition to endothelial cells.

[Therapeutic problems caused by rupture of large hepatic adenoma with central location. Apropos of 3 cases]. / Problèmes thérapeutiques liés aux ruptures de volumineux adénomes hépatiques de siège central. A propos de 3 observations.

We report three cases of young female patients (26, 30, 36 years) with intraperitoneal hemorrhage associated with a rupture of a liver cell adenoma. Their topography was central or with central extension. Three patients had taken oral contraceptives, for a period of 10 years, before diagnosis in two cases and for only three weeks in the remaining patient. The diagnosis of hemoperitoneum from a liver tumor was established on initial symptoms and ultra sonographic examination. Angiography and CT were the most valuable investigations. The control of hemorrhage was obtained by hepatic artery ligation (2 cases) and angiographic embolization (1 case). We observed one patient with liver adenomatosis, uncommon lesion consisting of numerous adenomas in an otherwise normal hepatic parenchyma. In emergency major hepatic resection for an adenoma, in central localization, is too a high risk procedure for a benign tumor. Control of hemorrhage should be the aim of treatment, best achieved by alternative treatment, such as hepatic artery ligation of angiographic embolization, highly effective in our experience. Resection may be delayed for a residual tumor.