[The best of 2001. Valve diseases].

The publications in 2001 regarding valvulopathies have concerned all sectors of this pathology. Aortic valvulopathies are the object of new work supporting the relationship between aortic sclerosis or stenosis and cardiovascular risk factors. They confirm the analogy between lesions of inflammatory origin observed on calcified valves and atherosclerotic plaques (Mohlner).

Sepsis due to Clostridium perfringens after pregnancy termination with feticide by cordocentesis: a case report.

We report a case of sepsis due to Clostridium perfringens after termination of pregnancy at 22 weeks with feticide by cordocentesis. Three weeks earlier, the 41-year-old patient had undergone an amniocentesis and a full trisomy 13 karyotype had been discovered. Feticide was performed by injection of thiopental and potassium chloride after percutaneous umbilical foetal blood sampling through the same needle.

[Anticoagulant therapy during pregnancy in patients with mechanical valvular prostheses].

Anticoagulant therapy (heparin or oral anticoagulants) during pregnancy in patients with mechanical valvular prostheses should take into consideration the respective risks of the usage of these two products: thromboembolic for the mother, congenital malformations for the children and haemorrhagic for them both. Basically, heparin therapy is useful by limiting the risk of foetal complication, but it increases maternal risk, especially related to thromboembolism. The risks of oral anticoagulants are concentrated in the second half of the first trimester (coumarin-related embryopathies) and in the peri-partum period (maternal and foetal haemorrhage).

[Unfavorable effects induced by mandibular surgery in Class II malocclusions].

The sagittal split ramus osteotomy is probably the most frequently used procedure for correction of mandibular skeletal dento-facial deformities. In the 30 years since the procedure was introduced, a number of complications has been reported: unfavorable fracture during surgery, paresthesia or anesthesia and relapse. The literature seems to be very poor concerning the esthetical and morphological complications of the sagittal split ramus osteotomy; especially when treating Class II dento-facial deformity frequently associated with a genioplasty.

[The best in 2000 on valve diseases].

During the year 2000, publications on valvular heart disease have concerned all aspects of this field of cardiology at a time when old and dated therapeutic procedures are being reassessed. The ageing population of the developed world has led to aortic stenosis playing a large part, and the study of its natural history has provided two keynote publications. Aortic valve replacement, increasingly involving older patients, led to the evaluation of this surgery in this age group in which bioprostheses are often associated with coronary bypass surgery.

[Peroperative use of a silicone occlusal block for palatal and lingual support in orthognathic surgery].

We present an alternative to acrylic occlusal wafers in orthognatic surgery. We propose using a silicone wafer that is easier to position preoperatively.

[Valvular prostheses and their follow-up].

In use since 1961, valvular prostheses allow the correction of the severe valvular diseases when conservative procedures are not possible. Current prostheses have outstanding haemodynamic features. Mechanical prostheses have a supposedly unlimited life span but require anticoagulant treatment.

[MALT lymphoma of the lacrimal apparatus (mucosa-associated lymphoid tissue)].

Mucosa-associated lymphoid tissue lymphoma can occur in various localizations. We describe the case of a patient presenting bilateral MALT lymphoma involving a lacrimal gland and a lacrimal duct. Biopsy specimens are required for histologic diagnosis.

Pudendal nerve terminal sensitive latency: technique and normal values.

Purpose: We evaluated a new technique to study the terminal sensory branches of the pudendal nerve in 30 normal men.

Materials And Methods: To elicit response endorectal stimulation of the pudendal nerve was delivered just to the left then right of the ischiatic spine using an electrode. The sensory potential was recorded in the balanopreputial zone with ring contact electrodes wrapped around the shaft of the penis.

Arthroscopy of the hip: 12 years of experience.

The purpose of this study was to evaluate the results of and temporal trends in hip arthroscopy by reviewing 413 procedures performed over a 12-year period. The two anatomic areas of the hip can be examined separately, the periphery without distraction and the iliofemoral joint per se with distraction. Combined use of both these techniques should be decided preoperatively.

[Malaria in airports and their neighborhoods].

Though very rare compared to imported malaria, airport malaria should not be disregarded considering its very special gravity often due to late diagnosis. In most cases, it could be avoided if airlines and airports applied disinsecting measures vigilantly.

[Quality of life of women with stress urinary incontinence with or without pollakiuria].

Objectives: Assess improvement in quality of life using a validated scale in women with urge incontinence or pollakiuria treated with oxybutynine.

Patients And Methods: A prospective open multicentric trial was conducted in 1701 women aged 20 to 60 years (mean 47.6) with the last 2 months.

[Sagittal osteotomy of the ascending ramus. Technic and value of transcutaneous basilar osteotomy].

Dalpont II sagittal osteotomy is the procedure of choice for prognathism. The surface for bone consolidation can be significantly increased by an anterior extension of the section, favored in cases with major skeletal imbalance. Neurosensorial or bone complications often compromise sagittal surgery.

[Rectus abdominis free flap breast reconstruction. A series of 23 cases].

Free TRAM flap breast reconstruction was performed in 23 patients from july 1993 through november 1995 at the Saint-Louis Hospital in Paris. The surgical team was composed of eight different surgeons. In all cases a delayed breast reconstruction procedure was performed.

Pitfalls in the diagnosis of airport malaria. Seven cases observed in the Paris area in 1994.

Clinical and biological pitfalls that lead to incorrect or delayed diagnoses of airport malaria are described based on 7 cases reported from the Paris region in the summer of 1994. We also report the outcome and the epidemiological features of these patients.

[Penile neuropathy: clinical and electrophysiologic study. Report of 186 cases].

Penile neuropathy is a common disease due to lesion of the sensory branch of the pudendal nerve, ie, the dorsal nerve of the penis. Sexual disorders (deterioration of erection) and sensory signs (hypoesthesia or paresthesia of the penis) are noted in patients with penile neuropathy. Electrophysiological recordings help guide the diagnosis (reduction of the sensory velocity of the dorsal nerve of the penis).

[Superficial pediculated temporal fascia flap in the reconstruction of the oropharynx].

The authors emphasize the interest of using the fascial temporal superficial flap for the reconstruction of an oropharynx after tumoral removal. The intrinsic qualities of this aponevrotic flap (rich vascularization, plasticity, finness, absence of after effects for the doner) have made it a particularly innovative instrument in this field. They expose their experience through nine patients and specify the place of this mean of reconstruction.

[Intraductal pancreatic adenomatosis. Apropos of a new case].

A 49-year-old diabetic patient with abdominal pain was found upon ultrasonography and computed tomography to have a cystic mass in the head of the pancreas with dilation of the main pancreatic duct. The head of the pancreas and duodenum were removed surgically. Examination of the operative specimen showed chronic pancreatitis, dilation of the main pancreatic duct, and impacted mucus in the secondary ducts with villous proliferation of the ductal epithelium, establishing the diagnosis of intraductal adenomatosis.

[Human diffusion of arthropod disease vectors throughout the world].

The present distribution of animals and plants throughout the world is the result of an evolutionary process involving tectonic, climatic and biotic factors. Humans, since their appearance, have contributed to the spreading of many species including disease vectors and pests. When humans left their native African home, they brought with them ectoparasites such as lice and acarids.

[Vesico-sphincter disorders of nervous origin].

Neurogenic bladder is a common feature in many neurological disorders such as stroke, multiple sclerosis, paraplegia, Parkinson disease, peripheral neuropathy. Specific treatment is always necessary to improve quality of life and decrease renal potential risk. Urodynamic investigations (cystometry, pelvic floor electromyography) are very useful to determine physiopathologic mechanisms of bladder dysfunction.

[Persistence of the bulbocavernosus reflex during micturition in bladder hyperactivity of central neurological origin].

The bulbocavernosus reflex (BCR) was evaluated before, during and after micturition in 35 patients. All the 19 patients with upper motor neuron lesions had a positive BCR during micturition. By comparison, 11/16 of the patients with a lower motor neuron lesion or with urogynecologic diseases did not have a BCR during micturition.