Aerodynamic and acoustic parameters in CO2 laser posterior transverse cordotomy for bilateral vocal fold paralysis.

The aim of this prospective study was to analyse airway improvement and acoustic and aerodynamic parameters after CO2 laser posterior transverse cordotomy (LPTC) in bilateral vocal fold paralysis (BVFP). Four patients (2 males, 2 females) were recorded pre- and post-operatively at 1, 3, 6, 12 and 24 months. Forced inspiratory volume during the first second (FIV), vital capacity, peakflow, and forced expiratory volume during the first second (FEV) were measured with the Gould II spirometer.

Supracricoid partial laryngectomy for non-squamous cell carcinoma of the larynx.

The objective of this paper was to evaluate the potential utility of supracricoid partial laryngectomies (SCPLS) for non-squamous cell carcinoma of the larynx. To illustrate our management of such tumours we present a case series based on six patients. Local control was achieved in five patients, with the sixth being salvaged by total laryngectomy and post-operative radiation therapy.

Hyperpigmentation of the distal phalanx in healthy Caucasian neonates.

Transient alterations in pigmentation are frequently observed in black neonates, but to our knowledge, have not previously been reported in Caucasian infants. In 54 Caucasian newborns, we found at least mild periungual hyperpigmentation similar to the variation in coloration in the periungual region of many black newborns. This pigmentation should be added to the transient benign dermatoses of Caucasian infants.

Laryngeal stenosis after supracricoid partial laryngectomy.

The purpose of this study was to review the incidence, risks, management, and outcomes of nontumoral laryngeal stenosis after supracricoid partial laryngectomy (SCPL) in a case series of 376 consecutive SCPLs performed at 1 institution from 1975 to 1995 with a minimum of 3 years of follow-up. Post-SCPL nontumoral symptomatic laryngeal stenosis was defined as an inability to decannulate patients before the 60th postoperative day (group 1) or the development of dyspnea (in patients without local recurrence) after an initial period of prolonged, successful decannulation (group 2). Of 376 SCPLs performed, nontumoral symptomatic laryngeal stenosis developed in 14 (3.

Intraoperative enteroscopy for diagnosis and management of unexplained gastrointestinal bleeding.

Background: The aim of this study was to evaluate the diagnostic and therapeutic yield of intraoperative enteroscopy in patients with obscure gastrointestinal (GI) bleeding.

Methods: Complete intraoperative enteroscopy was performed in 25 patients with GI bleeding (overt hemorrhage 21, occult blood loss 4). The cause of GI bleeding was unknown before intraoperative enteroscopy in 20 patients and presumed in 5 (colon 4, duodenum 1).

Vertical partial laryngectomy versus supracricoid partial laryngectomy for selected carcinomas of the true vocal cord classified as T2N0.

From an inception cohort of 204 patients with squamous cell carcinoma of the true vocal cord classified as T2N0 and a minimum of 3 years of follow-up, the authors compare the oncological and functional outcomes following vertical partial laryngectomy (group 1; 85 patients) and supracricoid partial laryngectomy (group 2; 119 patients). The 10-year actuarial survival estimate was 46.2% for group 1 and 66.

HIV protease inhibitors restore impaired T-cell proliferative response in vivo and in vitro: a viral-suppression-independent mechanism.

In 99 adults infected with human immunodeficiency virus type 1 (HIV-1) who received highly active antiretroviral therapy (HAART) (including 2 nucleoside analogues and 1 or 2 protease inhibitors) for 1 year, CD4(+) and CD8(+) T cells (including memory and naive subsets) increased similarly among patients with sustained plasma viral load decrease, transient decrease, or no decrease. A linear correlation was observed between the decrease in serum beta(2)-microglobulin concentration (an independent surrogate marker of HIV disease) and the increase in peripheral blood T-cells (CD4(+) and CD8(+)) counts. In vitro, HIV protease inhibitors indinavir and saquinavir (but not nucleoside analogues) enhanced the survival of patients' peripheral blood T cells at doses that are at least 30-fold lower than those required for achieving 90% viral inhibition in the same cultures.

Markers of hemostatic system activation in pulmonary embolism. Changes during and after cessation of anticoagulant treatment.

Plasma levels of prothrombin fragment 1+2 (Fl+2), thrombin-antithrombin complexes (TAT) and D-dimers were measured in 15 patients with pulmonary embolism during heparin therapy, oral anticoagulation, and after cessation of warfarin therapy. Each patient had a favorable outcome during anticoagulant therapy (3 months), but late venous thromboembolism occurred in six cases. The mean levels of the three markers were significantly increased on day 4 after the thrombotic event, and normalized during warfarin therapy.

Oxaliplatin, 5-fluorouracil, and folinic acid (Folfox) in patients with metastatic renal cell carcinoma: results of a pilot study.

We report the results of a chemotherapy regimen combining oxaliplatin, 5-fluorouracil, and folinic acid in patients with metastatic renal cell carcinoma. The objective of this pilot study was to define the potential efficacy of this second-line combination in patients previously treated with interleukin-2 alone or in combination with interferon alpha. Fourteen patients with metastatic renal cell carcinoma in failure after immunotherapy were included in this trial.

Total pancreatico-duodenal transplantation with portal venous drainage: metabolic assessments in diabetic rats.

A perfect metabolic correction of diabetes is essential to completely eradicate long-term chronic complications. Only a total pancreatic graft with portal venous drainage enables such an achievement. Isogenic Lewis rats were used for donors, recipients and controls.

Supracricoid partial laryngectomy for severe laryngeal stenosis.

We report 2 cases in which supracricoid partial laryngectomy and cricohyoidoepiglottopexy were used to restore the airway in cases of severe associated glottic and supraglottic laryngeal stenosis.

Complications of postoperative radiation therapy after partial laryngectomy in supraglottic cancer: A long-term evaluation.

This retrospective study, based on a series of 90 patients with invasive squamous cell carcinoma of the supraglottis, was designed to document the functional outcome and complications after postoperative radiation therapy following partial laryngeal surgery. The surgical procedure was a standard supraglottic laryngectomy in 62 patients and a supracricoid partial laryngectomy in 28 patients. All of the patients had an unremarkable postoperative course and achieved locoregional control.

Experience in the treatment of synchronous and metachronous carcinoma of the oesophagus and the head and neck.

Background And Objectives: Treatment of multiple primary squamous cell carcinomas of the head and neck and oesophagus is controversial. The poor prognosis of these 2 types of carcinoma taken individually and their anatomic proximity complicate the therapeutic strategy and limit the treatment choices for each location.

Methods: From 1986 to 1998, 43 patients received curative treatment for multiple synchronous (n = 30) or metachronous (n = 13) primary neoplasms of the oesophagus and head and neck.

Inflammatory bowel disease.

This article reviews important papers on inflammatory bowel disease published between May 1998 and June 1999. It does not review every aspect of treatment, but focuses on the effects of anti-tumor necrosis factor antibodies on the inflammatory lesions. The new information summarized includes: the role of bacteria and the modulating effects of probiotics; the frequency of appendiceal orifice inflammation in ulcerative colitis; progress in imaging based on endoscopic ultrasonography, magnetic resonance imaging, and leukocyte scintigraphy; frequency and treatment of massive hemorrhage, viral superinfection, and persistent perineal sinus; and the pathogenesis, detection, and treatment of dysplasia and cancer.

Outcome after surgical resection of intraductal papillary and mucinous tumors of the pancreas.

Objective: Treatment of intraductal papillary and mucinous tumors of pancreas (IPMT) usually requires surgery. The objective of this study was to evaluate the risk of recurrence in patients after surgery according to the histological nature of the neoplasm and the type of surgery.

Methods: The outcome of 45 patients who underwent partial pancreatectomy (n = 35) or total pancreatectomy (n = 10) for IPMT was studied according to the nature of the neoplasm (invasive carcinoma or noninvasive neoplasm), type of surgery (partial or total pancreatectomy), and lymph nodes status.

Hepatic and splenic involvement in cat-scratch disease: imaging features.

Hepatosplenic involvement in cat-scratch disease, probably underdiagnosed, is characterized by multinodular lesions throughout the liver and spleen. Radiologic features of ultrasound, computed tomography, and magnetic resonance imaging are not specific. The key of the diagnosis relies on a history of cat or kitten contact.

Rhombencephalosynapsis diagnosed in childhood: clinical and MRI findings.

Rhombencephalosynapsis is an unfrequent malformation of the posterior fossa essentially characterized by vermian agenesis or hypogenesis, fusion of the cerebellar hemispheres and fusion of the dentate nuclei. Supratentorial abnormalities are usually associated. No specific clinical syndrome can be described in relation with this disorder.

Metastatic jejunal VIPoma: beneficial effect of combination therapy with interferon-alpha and 5-fluorouracil.

The VIPoma syndrome is rare. It is usually caused by a neuroendocrine tumor located in the pancreas. Somatostatin analogs and interferon-a can be helpful in the symptomatic control of the disease, but the efficacy of chemotherapy in metastatic disease is limited.

Comparative, open, randomized trial of the efficacy and tolerance of slow-release 5-ASA suppositories once daily versus conventional 5-ASA suppositories twice daily in the treatment of active cryptogenic proctitis: French Pentasa Study Group.

Objective: The efficacy and tolerance of slow-release 5-ASA suppositories (Pentasa 1 g/day) were compared with those of conventional 5-ASA suppositories (Rowasa 0.5 g b.i.

Tricuspid insufficiency after blunt chest trauma in a nine-year-old child.

The case of a traumatic tricuspid insufficiency in a child, due to an anterior and septal leaflet rupture at the annulus level is reported for the first time. The early diagnosis 2 months after the trauma enabled a rapid and simple tricuspid valvuloplasty by laeflet reinsertion on the annulus associated with annuloplasty with a good result 6 months after the repair.

Endosonographic features predictive of benign and malignant gastrointestinal stromal cell tumours.

Background/aim: Some endoscopic ultrasonographic (EUS) features have been reported to be suggestive of malignancy in gastrointestinal stromal cell tumours (SCTs). The aim of this study was to assess the predictive value of these features for malignancy.

Methods: A total of 56 histologically proven cases of SCT studied by EUS between 1989 and 1996 were reviewed.

Intracordal autologous fat injection for aspiration after recurrent laryngeal nerve paralysis.

The present prospective study was designed to analyze the results achieved with intracordal autologous fat injection for aspiration in a series of 20 patients with recurrent laryngeal nerve paralysis. Swallowing was documented by having each patient swallow puréed food colored with methylene blue during nasofibroscopy. No laryngeal adverse effects were associated with the intracordal injection of fat.

Push enteroscopy in celiac sprue and refractory sprue.

Background: The aim of this study was to determine in patients with sprue whether jejunal endoscopy improves the diagnostic yield or provides information that may modify management, when compared with evaluation limited to the duodenum.

Methods: From January 1994 to June 1998, a total of 31 patients (6 men, 25 women, mean age 41 years) were prospectively evaluated by push enteroscopy. They were divided into two groups: (1) celiac disease at different stages of activity (n = 23) and (2) refractory sprue (n = 8).