Urological complications after renal transplantation using ureteroureteral anastomosis in children.

Purpose: Ureterovesical reimplantation is most often performed for renal transplantation in children. We reviewed our experience to evaluate the safety and efficacy of ureteroureteral reimplantation in pediatric renal transplantation.

Materials And Methods: We retrospectively evaluated the charts of 92 boys and 72 girls who underwent a total of 166 ureteroureteral anastomoses for renal transplantation from January 1990 to December 1999.

CC chemokines and interleukin-5 in bronchial lavage fluid from patients with status asthmaticus. Potential implication in eosinophil recruitment.

In status asthmaticus (SA), severe bronchial inflammation is associated with acute respiratory failure. Neutrophils are the prominent cells found in bronchi from SA patients, but eosinophils are also recruited within the first 48 h after the beginning of mechanical ventilation (MV). Interleukin (IL)-5 and CC chemokines have been directly implicated in the pathophysiology of allergic asthma.

Matrix metalloproteinases and tissue inhibitors of metalloproteinases in bronchial squamous preinvasive lesions.

Metalloproteinases and their inhibitors are known to play an important role in the extracellular matrix remodeling associated with preinvasive lesions and invasive carcinomas; however, little is known about their role in early lung carcinoma. Immunohistochemical studies were made of the reactivity of bronchial squamous preneoplastic lesions from cigarette smokers, including basal cell hyperplasia, squamous metaplasia, dysplasia, carcinoma in situ, and invasive squamous cell carcinoma for matrix metalloproteinases (MMPs), their tissue inhibitors (TIMPs), and type IV collagen in 13 patients. Staining for type IV collagen disclosed discontinuities in basement membranes from basal cell hyperplasia to dysplasia, progressing to destruction in carcinoma in situ and invasive carcinoma.

Management of childhood fractures in Anjouan Island, Comoros.

Limb fractures were reviewed in 489 children, 390 boys and 99 girls whose ages ranged between 2 days and 14 years (mean 8 yrs). Only 54 (11%) were caused by road traffic accidents; 435 (89%) were due to other causes. Fractures of the arm were seen in 332 (68%) children and there were leg fractures in 157 (32%), of which 155 (32%) were undisplaced and were treated by first aid.

Endoscopic bilateral metal stent placement for malignant hilar stenoses: identification of optimal technique.

Background: The aim of this study was to identify factors that facilitate bilateral insertion of metal stents in malignant hilar stenoses, for which plastic stents often result in incomplete drainage and subsequent cholangitis.

Methods: Between January 1994 and April 1998, we collected 45 cases of advanced (Bismuth stage II or higher) hilar malignant stenoses. The insertion technique was progressively modified and the success rate in the early period (1994 to 1995) was compared with that of a later period (1996) and the most recent period (1997 to 1998).

PCR detection of aminoglycoside resistance genes: a rapid molecular typing method for Acinetobacter baumannii.

Aminoglycoside resistance is common among strains of Acinetobacter baumannii responsible for nosocomial infections, and inactivation of these antibiotics by enzymatic modification is the main mechanism. Different types of aminoglycoside acetyltransferases (AAC), nucleotidyltransferases (ANT), and phosphotransferases (APH) are synthesized by clinical isolates, and several enzymes can be produced by a single strain. Using a multiplex PCR procedure carried out on bacterial thermolysates, we analyzed the aminoglycoside resistance gene content of strains belonging to eight clusters identified by pulsed-field gel electrophoresis.

Obstructive sleep apnea syndrome: hooked appearance of the soft palate in awake patients--cephalometric and CT findings.

Purpose: To determine whether a hooked appearance of the soft palate can be seen in awake patients with snoring with or without obstructive sleep apnea syndrome (OSAS) on cephalometric radiographs and computed tomographic (CT) scans.

Materials And Methods: One hundred thirty-one patients with snoring underwent cephalometric radiography, with which the posterior airway space, soft palate length and width, and distance between the hyoid bone and mandibular plane were measured, and/or pharyngeal CT, with which the luminal areas of the airway at the naso-, oro-, and hypopharyngeal levels were measured.

Results: Of the 131 patients, 96 had OSAS, and 35 had snoring.

Sphincter preservation in rectal cancer. Endocavitary radiation therapy.

Endocavitary radiation therapy (Endo RT) is performed mainly with a contact x-ray tube. Interstitial brachytherapy is a supplementary method to boost the tumor bed. Only strictly selected patients can be treated for cure by Endo RT.

Vulvovaginal sequelae in toxic epidermal necrolysis.

Objective: To evaluate the incidence of vulvar lesions during the acute and healing periods in toxic epidermal necrolysis (TEN), to describe the clinical aspects and functional consequences, and to evaluate surgical treatment.

Study Design: During the acute period in 40 patients, cutaneous and mucous lesions were described on the day of hospitalization and daily thereafter. To evaluate the healing period, a questionnaire was sent to the same 40 patients to obtain information on symptomatology after the acute period, anatomic modifications, and the quality of sexual and other genital activity.

Embolic thrombus on mitral anulus calcification.

Embolic thrombus on mitral anulus calcification (MAC) was demonstrated in an 83-year-old woman with retinal embolism. Mitral anulus calcification has been associated with a significant increase of stroke in elderly people. Atrial fibrillation and calcific emboli have been reported, and embolic thrombus by MAC may be another potential cause.

Dobutamine stress echocardiography in orthotopic heart transplant recipients. VACOMED Research Group.

Objectives: This study sought to determine whether dobutamine stress echocardiography could accurately identify coronary artery disease after heart transplantation.

Background: After heart transplantation, coronary artery disease is related to either diffuse concentric intimal thickening or focal stenosis and may be underdiagnosed by coronary angiography.

Methods: We enrolled 41 patients, a mean (+/- SD) of 40 +/- 20 months after heart transplantation, at the time of their routine control coronary angiogram.

[Prenatal prevention of infant respiratory distress syndrome. 2nd part: clinical applications and indications].

Two types of sometimes complementary therapeutic strategies can be developed to prevent infant respiratory distress syndrome antenatally. The first is to administer a treatment aimed at accelerating the maturation process of fetal lung tissue in women at risk of premature birth. This is the only strategy with a goal of antenatal treatment.

Hepatitis C virus RNA in serum of blood donors with or without elevated transaminase levels.

The pattern of hepatitis C virus (HCV) viremia in blood donors who are positive for antibody to HCV (anti-HCV) according to the level of transaminase activity is unclear. A polymerase chain reaction-based HCV RNA detection method was used to study two clearly defined groups of anti-HCV-positive blood donors with repeatedly normal (n = 27) and elevated (n = 17) alanine aminotransferase (ALT) levels. HCV RNA was detected in only 4 of 27 blood donors with normal ALT values and 15 of 17 with elevated ALT values.

Carboxyl-terminal and central regions of human immunodeficiency virus-1 NEF recognized by cytotoxic T lymphocytes from lymphoid organs. An in vitro limiting dilution analysis.

Cytotoxic T lymphocytes (CTL) specific for human immunodeficiency virus (HIV) proteins have been analyzed in lymphoid organs from seropositive patients. Indeed, an active HIV replication coexists with a major CD8+ lymphocytic infiltration in these organs. We have shown in a previous report that HIV-seropositive patients lungs were infiltrated by HIV specific CD8+ lymphocytes.

Age-related changes in glucocorticoid receptor binding and mRNA levels in the rat brain and pituitary.

Hypothalamic-pituitary-adrenal (HPA) activity under both basal and poststress conditions is often increased in the aged rat. This change has been associated with the loss of corticosteroid receptors in specific regions that mediate glucocorticoid negative feedback. In order to study the cellular basis for the loss of receptors, we measured glucocorticoid (type II corticosteroid) receptor binding and mRNA levels in pituitary and selected brain regions in rats at 6, 12, and 24 months of age.

A case of myelodysplastic syndrome with abnormal megakaryocytes and ins(8;3)(q24;q21q26).

We report a 56-year-old male patient with refractory anemia with excess of blasts in transformation (RAEB-T) who had an ins(8;3)(q24;q21q26) as the sole chromosome abnormality in bone marrow (BM) cells. The findings of disturbed thrombocytopoiesis with numerous micromegakaryocytes suggest that it could be a variant of the classic ins(3;3)(q26;q21q26) described in hematologic malignancies with abnormal thrombopoiesis.

Immunological heterogeneity of autoreactive T lymphocytes against the nicotinic acetylcholine receptor in myasthenic patients.

The response of human T lymphocytes against the nicotinic acetylcholine receptor (AChR) was studied in five patients with myasthenia gravis (MG) and in six healthy donors using either native Torpedo AChR or recombinant protein derived from the mammalian AChR alpha subunit (X4, residues 6-216 of mouse AChR alpha subunit). The present study demonstrates that (a) AChR-specific T helper cell lines can be generated from MG patients [either from peripheral blood lymphocytes (PBL) or from thymocytes] as well as from PBL of normal controls, (b) lymphocytes from MG patients, but not from controls, recognize the mammalian AChR but not the Torpedo receptor, (c) in humans, the HLA-DR2-associated T cell epitope is probably located in the region of residues 162-216 of the AChR alpha subunit and (d) there is a considerable heterogeneity of autoreactive T cell responses: (i) T cell lines from different HLA-type donors have distinct epitope profiles; (ii) the epitope specificity of the PBL-derived T cell line is different from that of the thymocyte-derived line; (iii) the epitope specificities of patient-derived T cell lines are different from those generated from normal controls who share the same HLA phenotype.

Chromosomal analysis of colonic adenomatous polyps.

Chromosomal analysis of 25 colonic adenomatous polyps was performed by a direct method similar to that used in prenatal diagnosis of chromosomal aberration on chorionic villi. Fourteen lesions showed an abnormal karyotype. Two changes were recurrent: trisomy 7 (observed in eight cases) and trisomy 13 (observed in seven cases).

Antibiotic prophylaxis with cefotaxime in endoscopic extraction of upper urinary tract stones: a randomized study. The Cefotaxime Cooperative Group.

This French multicentre, placebo-controlled, double-blind study investigated the efficacy of a single dose of cefotaxime 1 g iv in the prophylaxis of patients undergoing endoscopic extraction of urinary tract stones. Postoperative fever occurred in 12 patients in the placebo group and in nine in the cefotaxime group (no significant difference). The incidence of postoperative bacteriuria, between the first and third postoperative day, was significantly higher in the placebo group (15/60, 25%) than in the cefotaxime group (5/60, 8.

Crossover study of thalidomide vs placebo in severe recurrent aphthous stomatitis.

A multicentric crossover randomized trial of 100 mg of thalidomide vs placebo each for 2 months was conducted in patients with severe aphthous stomatitis of more than 6 months' duration. Seventy-three patients were included. Complete remission was obtained in 32 patients who received thalidomide and in 6 patients who received placebo.

[Skin expansion in plastic surgery. (University Hospital Center of Treichville-Abidjan)].

The skin expansion by inflatable prosthesis is a recent method to resolve insufficient tissue a short series of 7 cases. But the authors think that despite these inconveniences this technique needs to be largely diffused and used judiciously.