[Extra-nodal NK/T-cell lymphoma, nasal-type, revealed by cutaneous and ocular involvement].

Background: Extra-nodal NK/T-cell lymphoma (ENKTL) is a form of highly malignant non-Hodgkin's lymphoma. There are two types: nasal forms primarily affecting the oropharyngeal sphere and so-called nasal-type extra-nasal forms in which primary skin involvement is the most common feature enabling diagnosis. Herein, we report a case of systemic nasal-type ENKTL (ENKTL-NT) that was diagnosed based on skin involvement associated with ocular involvement.

Comparison of 20-gauge Procore® and 22-gauge Acquire® needles for EUS-FNB of solid pancreatic masses: an observational study.

Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) has been proposed to obtain high-quality tissue samples for pancreatic tumors. We performed an observational study to compare EUS-FNB with a 20-gauge Procore® needle versus a 22-gauge Acquire® needle. Our primary endpoint was the quantity of the obtained tissue, as defined by the mean cumulative length of tissue core biopsies per needle pass.

[Extensive digital necrosis during dermatomyositis associated with MDA-5 antibodies].

Background: Dermatomyositis (DM) is an inflammatory disease associated with auto-antibodies in 50 to 70% of cases. A new antibody, anti MDA-5, has been described in association with a specific type of DM involving severe interstitial lung disease and minimal muscle disease. We report the first case of DM with MDA-5 antibodies and with interstitial lung disease and rapidly extensive digital necrosis.

[History of surgery of the parathyroid glands].

In 1850 Sir Richard Owen discovered the parathyroid glands in rhinoceros. After they have been discovered in man in 1880 their history spread all along the 20th century. The history started from the descriptive anatomy and the clinical pictures of their illness to the trouble of their functioning.

[Lymph nodes and rectal cancer].

Nodal invasion is a major prognostic factor of rectal cancer. Lymphatic extension of rectal cancer usually involves the mesorectal nodes then the inferior mesenteric chain but in 14% of patients, particularly with cancer of the lower rectum, metastasic nodes can be observed in the internal or lumboaortic chains situated beyond the usual territory of nodal dissection. On average, 30 nodes are examined on a proctectomy specimen, but with wide interindividual variation.

[Role of surgery in closed abdominal trauma].

Over the past twenty years, nonoperative management has increasingly been recommended for the care of patients with blunt abdominal trauma. Emergency laparotomy remains the rule in patients with hemodynamic instability or in those with peritonitis due to intestinal perforation. Surgical treatment of liver and splenic lesions tends to be more conservative.

Extracorporeal lithotripsy of ureteric calculi using the Dornier HM-3 lithotriptor.

Over a 5-year period (November 1984-November 1989), we treated 356 patients with ureteric calculi; 170 were treated by extracorporeal shock wave lithotripsy (ESWL) on a Dornier HM-3 lithotriptor. The calculi (n = 176) were uniformly distributed along the length of the ureter: 44 were just below the pelviureteric junction, 59 were lumbo-iliac, 42 were in the upper bony pelvis and 32 in the lower bony pelvis. The mean diameter of the upper ureteric calculi was 10 mm and for the others it was 8 mm.

Tumors of the upper urinary tract: 10 years of experience.

We reviewed 108 patients with upper urinary tract tumors who underwent surgical treatment during a 10-year period (87 men and 21 women with a mean age of 63.5 years). Of the tumors 97% were unilateral and only 3 patients had bilateral tumors.

[Do posterior urethral valves alter the results of renal transplantation in children?].

The authors conducted a retrospective study based on a series of 715 renal transplantations in children performed between January 1973 and December 1989 at the Hôpital Necker-Enfants Malades in order to determine whether the long-term result of renal transplantation was as good in children with posterior urethral valves (PUV) as in children with a normal lower urinary tract. Group 1 consisted of 50 renal transplantations performed in 41 children in whom the primary urological disease was PUV. The bladder was able to be used without modification in 36 cases and had to be enlarged in 5 cases.

Expression of the human nephron differentiation molecules in renal cell carcinomas.

The authors tested frozen sections from 28 renal cell carcinomas (RCC)--21 clear, 1 eosinophilic, 4 basophilic, and 2 spindle-shaped cell type--with monoclonal antibodies (MAb) reacting against cytokeratin, vimentin, CD24, CALLA/CD10, villin, CD26, and HLA class I and class II molecules. These molecules are markers of specific segments of the mature kidney, and their loss or acquisition reflects the different steps of human nephrogenesis. KI67 MAb was used to evaluate cell-proliferating activity.

[Relationships between posterior urethral valves, vesico-renal reflux and renal dysplasia].

Children with valves of the posterior urethra show asymmetric involvement of the upper urinary system with a nonfunctional kidney in 10 to 15% of cases. In a study of 12 nephrectomy patients and 14 reflux patients, the authors reached the conclusion that valvular obstruction, vesico-renal reflux and dysplasia are coexisting anomalies with little relationship between each other.

[5-year treatment results of urethral stenosis using internal urethrotomy in adults].

The authors reviewed the records of 69 patients with a mean age of 51 years treated for single (81%) or multiple (19%) urethral strictures, in whom the first operation to be performed was endoscopic internal urethrotomy with a follow-up of at least 5 years. The mean follow-up was 71 months. The actuarial rate of good results was 27.

[Anomaly of the pyelo-ureteral junction and antenatal ultrasonic diagnosis].

Over a period of five years, 40 cases of anomaly of the pyelo-ureteral junction were diagnosed ante-natally which subsequently required surgical intervention during the first year of life. The indication for the therapy was based on the degree of obstruction (IVU, DTPA scanning, Whitaker test), the thickness of the renal parenchyma (IVU, ultrasound) and, to a lesser extent, on calyceal dilatation. After a period of follow up ranging from 3 to 48 months (mean 16.

[Extracorporeal shockwave lithotripsy in children].

Upper urinary tract lithiasis is a rare condition in children in comparison to its incidence in the adult population. The distribution of lithiasis in children has been reported to be 56% for idiopathic lithiasis, 20% for metabolic lithiasis, and 25% for lithiasis associated with uropathy. Extracorporeal shock wave lithotripsy (ESWL) has become the treatment of choice for upper urinary tract calculi in the adult patient as well as in children after minor changes and complementary material had permitted the utilization of the Dornier HM-3 lithotripter in these small patients.

[Value of extracorporeal shockwave lithotripsy in the treatment of urinary lithiasis in children].

We report our experience with extracorporeal lithotripsy (Dornier HM3) in a series of 26 children with a mean age of 11.6 years, treated for 3 1/2 years. 12 children (46%) had a previous history of calculi and 7 (27%) had already undergone surgery on the same side.

[Tumors of the upper excretory urinary tract. A homogeneous series of 108 patients].

In their study of a homogeneous series of 108 patients operated for a transitional cell tumor of the upper urinary tract, the authors emphasize the following points: --every third tumor has several foci, and it is very difficult to make a complete inventory of all tumoral foci before surgery; --the great majority of these tumors are unilateral. Bilateral recurrence following radical unilateral excision is quite exceptional; --low-grade superficial tumors virtually never invade the lymph nodes, and their prognosis is excellent as a rule; --grade III carcinomas area almost always infiltrating and present high risks of lymph node invasion. Lymph node involvement means that the evolution will be lethal in all cases.

[Superficial bladder tumors. Results of preventive treatment of recurrence by intravesical instillation of BCG].

Two-thirds of newly diagnosed bladder tumors are superficial transitional cell carcinomas. Local relapses occur in more than 2/3 of the patients after transurethral resection of the initial tumor, with a risk of muscle invasion in 1/3 of them. A retrospective study of 100 consecutive patients was performed to assess the role of intravesical BCG-therapy as a prophylaxis against the recurrence of superficial bladder cancer; the treatment protocol is described.

[Surgical correction of intermittent vesico-ureteral reflux without radiologically detectable reflux].

On the basis of a series of 62 children with no radiological evidence of reflux but with an abnormality of a ureterovesical implantation similar to that seen in children with radiologically detected reflux, the authors attempt to show that under certain precise conditions (presence of cortico-papillary renal lesions, recurrent episodes of acute pyelonephritis, even in the absence of renal lesions), the absence of radiologically detectable reflux is not sufficient to confirm the primary nature of pyelonephritis. The sub-mucosal course of the ureters was found to be short in all of these children, and anti-reflux surgery was carried out on one or both sides according to whether the abnormality of uretero-vesical implantation was uni or bilateral. In this small selected group, clinical and bacteriological results were similar to those obtained by anti-reflux surgery in children with radiologically detected vesico-renal reflux.

[Ureterosigmoidostomy with antireflux in children. Apropos of a short series].

Ureterosigmoidostomy with anti-reflux technique (Petit-Leadbetter procedure) was performed in 12 children, mainly after failure to repair an exstrophy. After a mean follow up of 45 months, results were assessed as good from clinical and urographic points of view, although there were 3 possible cases of reflux, one of anastomotic stenosis (operated upon with success) and one of moderate continence only. An anastomotic tumor was not detected, but follow up is of moderate duration only.