Impact of Olfactory Priming on Food Intake in an Alzheimer's Disease Unit.

Alzheimer's disease (AD) is often associated with feeding difficulties and changes in eating behavior with may lead to malnutrition. In French nursing homes, AD patients may live in special care units that better meet dementia residents' needs. However, meals are often delivered to AD patients by using meal trays coming from central kitchens.

[Lymphatic malformation and chyluria: presentation of a treated case without relapse].

Chyluria is a consequence of the aperture of one or more perirenal lymphatic vessels to the renal pelvis, and is characterized by milky urine, rich in protein, lipids, cholesterol and triglycerides. Where there is chyluria there is malformation of the chyliferous vessels of the small intestine associated to hypoplasia of Pecquet's cistern. A 22 year old patient who had had persistent chyluria since the age of 16 is presented with a test of induced hyperlipidemia typical of intestinal lymphatic malformation.

Congenital malformation of the lymphatics of the small intestine.

Of 300 congenital malformations of the lymphatics of the small intestine investigated, 120 were operated upon. Intestinal lymphography shows no injection of the cisterna chyli and histology proves that the mesenteric lymph nodes are abnormal. The induced hyperlipidemia test permits a biochemical diagnosis.

Surgical treatment of lymphedema: a report on 652 cases.

We performed the world's first lymphography, and 2 years later we focused our surgical methods on total superficial lymphangiectomy for the treatment of lymphedema. In the course of 40 years, we have studied the results of this treatment for edemas of lymphatic origin. We surgically treated 600 cases of lymphedema of the lower limb, 48 of the genital organs, and four of the upper limb and have had very promising results.

Klippel and Trénaunay's syndrome. 768 operated cases.

Since 1945, we have operated on 786 patients with Klippel and Trénaunay's syndrome. Elongation of the impaired limb was invariably found while edema was present in 84%, varicose veins in 36%, and flat angiomata in 32%. Venography and surgical exploration have demonstrated malformation of the deep veins involving the popliteal vein in 51%; superficial femoral vein, 16%; both popliteal and superficial femoral veins; 29%; iliac veins, three per cent; and lower vena cava, one per cent.

[Lymphoedema of penis and scrotum: two observations (author's transl)].

Two cases of lymphoedema of penis and scrotum are reported: lymphanogiography is useful to distinguish between primary or secondary lymphoedema. In the first case, this is a primary tarda lymphoedema of penis and scrotum with hypoplastic lymphatics of the right leg. In the second case the lymphoedema follows repeated infection and paraphimosis.

Spontaneous, post-operative and traumatic chylothorax.

Study of the malformation of the chyliferous vessels, malformations of Pecquet's cistern or of the thoracic duct has brought out the nature of the physiopathology of spontaneous chylothorax: it is the result of a rupture of a lymphatic of the diaphragm, mediastinum, or lung. Post-operative chylothorax is due to a lesion of the thoracic duct or of one of its branches.

[Diagnosis of chyliferous blockage by the hyperlipidemia test (author's transl)].

In our hyperlipidemia test, the total lipids curve, a plateau without a postprandial peak, allows an easy diagnosis of the chyliferous blockage. The malformation of chyliferous vessels produces the congenital forms: exsudative enteropathy, chyloperitoneum, spontaneous chylothorax, chylous cyst of the mediastinum, reflux of chyle in the pulmonary lymphatics, lymphoedema with chyle reflux in the lymphatics of the leg and chyluria. The acquired forms comprise the post-infectious sclerosis of the intestinal lymphatics and the neoplastic invasions of the mesenteric lymph nodes.

[Malformations of the lacteals].

For the diagnosis of malformations of the lymphatics is made by the hyperlipidaemia test, which shows a flat total lipids curve without a post-prandial peak. Malformation of the lymphatics of the small intestine is responsible for exudative enteropathy, chyloperitoneum, chyluria, lymphoedema with reflux of lymph in the lymphatics of the legs and its complications (chylorrhagia, chylarthrosis), chylothorax, chylopericardium and reflux of lymph in the pulmonary lymphatics. This malformation can also be associated with other disorders : such as the syndrome of Klippel and Trenaunay, and simple lymphoedema of the limbs or genital organs.

[Deep vein malformations in the Klippel-Trenaunay syndrome].

Klippel's syndrome is due to a malformation of the deep veins. From 1944 to 1978 we have operated on 614 cases. In 51 % of these cases the malformation concerned the popliteal vein, in 16 % it concerned the superficial femoral vein, and in 25 % both veins were affected.

[The induced hyperlipemia test. 10 years of experience].

The induced hyperlipemia test, which is easly to administer, yields very interesting information for the study of lipidic metabolism in arteriosclerosis patients. Its use, in both the pre- and post-operative phases, has brought out the valuable effect of ligature of the intestinal lymphatics in treating arteritis. It may also enable us to determine whether there is a hereditary factor or family predisposition to arteriosclerosis.

[Interventricular communication caused by nonpenetrating injury of the thorax].

Previously fatal in the majority of cases, traumatic interventricular communications are now curable by surgery. This is illustrated by the case described here of a 20 year old man. 62 other cases were found in the literature.

[Chyloperitoneum causing intestinal obstruction].

The two cases reported here show intestinal obstruction may occur by coagulation of lymph around the loops. They permit us to better understand the physiopathology of blockage of the lymph vessels whether congenital as in the first case or traumatic as in the second case. Traumatic rupture of the cisterns chyli is exceptional.

[Ligation of lymphatic ducts in treatment of arteriosclerosis. 550 operated cases reported over a period of 9 years].

In all diseases where there is an important loss of lymph, e.g. chylothorax, chyloperitoneum, exsudative enteropathy chyloduodenal fistula, we observed not only a fall in the serum proteins and calcium, but also a fall in lipids and cholesterol.

Hematuria and rectal bleeding in the child with Klippel and Trenaunay syndrome.

We have operated upon 588 patients with Klippel and Trenaunay syndrome. The underlying factor is a congenital malformation of the deep veins: agenesis, atresia or compression by fibrovascular bands of the popliteal, femoral or iliac veins. Of these 588 patients, 6 children between 15 months and 4 years of age had severe rectal bleeding and hematuria.

[Sclerosis of the intestinal lymphatic vessels].

Fibrosis of the intestinal lymphatic vessels, produced in one case by tuberculosis and, in the other, by appendicitis and peritonitis, caused blockage of the main lymphatic vessels causing, clinically, a protein-losing enteropathy similar to that noted in congenital lymphatic diseases of childhood. In the laboratory, there was noted a fall in serum protein, lipid and cholesterol. A fat absorption test was very abnormal showing a flat curve.