[Imaging of vasospasm].

Neuroimaging is of paramount importance in the evaluation and management of cerebral vasospasm. Arteriographic demonstration of concentric arterial constriction between 4 and 12 days after subarachnoid hemorrhage is the definition of vasospasm. Assessment of angiographic vasospasm is subjective.

Treatment of experimental osteosarcoma tumors in rat by herpes simplex thymidine kinase gene transfer and ganciclovir.

Previous results have demonstrated the efficiency of Herpes simplex type 1 thymidine kinase (HSV1-TK) retroviral gene transfer and ganciclovir (GCV) treatment of a human osteosarcoma cell line resulting in the death of the cell population and a proximal bystander effect; therefore, we investigated gene therapy on an in vivo osteosarcoma rat model. For in vivo experiments, small fragments of tumor were grafted onto rats in a paratibial position. Seven days after the graft, packaging cells (psi CRIP-TK and psi CRIP-LLZ) were inoculated into tumor mass, followed by GCV administration.

[Benign prostatic hypertrophy: mini-invasive treatments (interstitial laser-transurethral needle ablation-thermotherapy)].

Endoscopic resection is the "gold standard" to treat benign prostatic hyperplasia refractory to medical treatments, because it is effective and only relatively aggressive. In young patients or debilitated elderly patients, there is a place for so-called minimally invasive surgical treatments, consisting of three possibilities: interstitial laser, TUNA (transurethral needle ablation), and thermotherapy. The results of these last two techniques are very similar o those obtained by endoscopic resection, with virtually no complications.

Is treatment with hydroxyurea leukemogenic in patients with essential thrombocythemia? An analysis of three new cases of leukaemic transformation and review of the literature.

From 1981 to 1995, we diagnosed, followed and treated at our institution fifty-eight cases of essential thrombocythemia (ET), using hydroxyurea (HU) as first-line therapy in these patients. Three patients who were continuously receiving HU had a leukemic transformation after a chronic phase of respectively 47, 81 and 90 months. One patient developed an acute leukemia with minimal myeloid differentiation (AML MO) and soon died of refractory disease; the second developed a refractory anemia with excess blasts in transformation (t-RAEB) and survived one year; the third patient developed a chronic myelomonocytic leukemia (CMML) and is alive at 21 months.

Postoperative interstitial radiotherapy of keloids by iridium 192: a retrospective study of 46 treated scars.

Background: Keloids are clinically vexacious scars characterized by a high recurrence rate after excision alone (50-100%). Many adjuvant techniques have been used with more or less convincing results.

Objective: The aim of this study is to show the efficiency of keloidectomy and postoperative interstitial radiotherapy by an iridium 192 wire.

Macrophage colony stimulating factor involvement in uremic patients.

The immunodeficiency of patients with chronic renal failure (CRF) is related to multiple and complex alterations of the cytokine network and of its target cells such as T or B lymphocytes, monocytes, fibroblasts or endothelial cells. Chronic activation of monocytic functions is recognized as a key factor in these immunological disorders. Since macrophage colony stimulating factor (M-CSF) is essential for the activation of several functions of monocytes and macrophages and their production of cytokines such as interleukin-1, interleukin-6, and tumor necrosis factor alpha, we investigated its involvement in patients with CRF.

[Ligamentoplasty using the peroneus tertius in the correction of lateral laxity of the ankle. Surgical technique].

Introduction: The authors present an original procedure for lateral ankle ligamentoplasty using peroneus tertius.

Material And Methods: This muscle inconstantly present (90 p. cent), lies from the distal third of the anterior aspect of the fibula to the base of the fifth metatarsal with a caracteristic "hockey stick" shaped insertion.

[Primary adenocarcinoma of the duodenum. Study of three cases and review of the literature].

The authors report three cases of primary adenocarcinoma, two concerning the duodenum and the third concerning the duodenojejunal junction. These rare tumours are characterized by polymorphic and non specific clinical signs. Diagnosis is suspected by upper gastrointestinal fibroscopy and barium swallow, and confirmed by biopsies.

Sodium naproxen: concentration and effect on inflammatory response mediators in human rheumatoid synovial fluid.

Twelve patients suffering from rheumatoid arthritis and having swollen knees were treated with 1.1 g/day of sodium naproxen administered in one dose, daily for 5 days. The 72-h wash-out period was verified by the absence of any nonsteroidal anti-inflammatory drug using a HPLC screening.

[Ultrasonographic aspect of the rectal wall in liver cirrhosis].

The aim of this study was to assess the ultrasonographic abnormalities of the rectal wall and surrounding structures in patients with cirrhosis and to correlate these findings with endoscopy. From November 1992 to May 1993, 53 cirrhotic patients and 30 control subjects were examined by transrectal ultrasonography and rectoscopy. In addition to rectoscopy and transrectal ultrasonography, patients with cirrhosis underwent an upper gastrointestinal endoscopy.

[Diprivan and electroconvulsive therapy].

Anaesthesia for Electroconvulsive Therapy (ECT) is characterized by short repeat anaesthetic procedures, performed outside an operating theatre. The efficacy of ECT relies upon the occurrence of tonoclonic convulsions. Propofol seems to be the intravenous induction agent of choice for ECT.

[Orbital decompression by the Olivari technique].

Orbital decompression using Olivari's method is described: extraconal fat is removed surgically from the orbit. Intraconal fat is also removed with the help of a microscope. Removal of at least 5 cc of orbital fat is necessary to reduce exophthalmos.

Non-union of a midshaft anterior tibial stress fracture: a frequent complication.

We report a case of non-union of a midshaft anterior cortex tibial stress fracture and review the literature concerning this pathological entity. This is a relatively rare clinical form of tibial stress fracture which often results in delayed union, non-union or complete fracture. Initial management is as for a conventional stress fracture, associated in some cases, according to certain authors, with pulsing electromagnetic field physiotherapy.

A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. The French Study Group on Selective Decontamination of the Digestive Tract.

Background: Selective decontamination of the digestive tract with topical nonabsorbable antibiotics has been reported to prevent nosocomial infections in patients receiving mechanical ventilation, and the procedure is used widely in Europe. However, it is unclear whether selective decontamination improves survival.

Methods: We conducted a randomized, double-blind multicenter study in which 445 patients receiving mechanical ventilation in 15 intensive care units were given either prophylactic nonabsorbable antibiotics (n = 220) or a placebo (n = 225).

[Prognosis in surgical treatment of cancer of extra-hepatic biliary ducts].

This work reports a retrospective multicenter study of the treatment and prognosis of 746 patients with gall bladder cancers and 684 patients with extrahepatic biliary duct cancers. Gallbladder cancers: Adenocarcinoma was encountered in 92.6% of cases, 107 were limited to the gallbladder.

[Diagnosis and urologic development of urinary lithiasis. Revealing manifestations, radiologic diagnosis, course complications].

The presence and migration of stones in the urinary tract are the consequences of lithiasis, a pathological process whose evolutive potential determines the frequency of recurrence. The stones produce haematuria and above all obstruction which manifests itself by pain and may be complicated by infection. The most suggestive type of pain is renal colic, but other revealing manifestations may occur.

[Techniques of autologous transfusion in hip surgery: a retrospective study].

A retrospective study was carried out on 99 patients undergoing hip surgery to evaluate the efficacy of three autotransfusion techniques on sparing of homologous blood. Preoperative normovolemic hemodilution (HDN), delayed autotransfusion (ATD) and recuperation of blood lost during surgery (RSPO) were studied. Patients were divided into 5 groups: group HDN, group ATD, group ATD + HDN, group RSPO, and the control group.

[Closed-circuit anesthesia].

Closed circuit anesthesia answers the objections to open and semi-closed systems that are related to high delivery flow rates: pollution, cost, efficiency and the hydration of inhaled gases. But closed circuit anesthesia requires a good understanding of the amount of anesthetic agenda needed, and a convenient method of administering it. It is necessary use a reliable oxygen analyser, a carbon dioxide monitor and a circuit volatile agent analyzer.