[Laparoscopic transperitoneal replacement of the abdominal aorta with left renal artery reimplantation: experimental study on pigs].

Objective: To study the feasibility and the tolerance of a combined laparoscopic transperitoneal aortic and renal restoration performed on animals.

Methods: Six pigs (mean weight: 79.5 kg, range 73-86) underwent laparoscopic replacement of the abdominal aorta using a 6-mm Dacron(R) graft, with direct reimplantation of the left renal artery.

[Cardioversion by external electric shock for atrial fibrillation: does patient age affect immediate results?].

The restoration of sinus rhythm by external electric shock in patients with persistent atrial fibrillation is a well established treatment. However, in current practice this treatment is generally indicated less in the elderly subject although this attitude is not factual. The objective of this work was to evaluate the immediate results of cardioversion by external electric shock, comparing the success rates in four age groups: under 60 years, between 60 and 69 years, between 70 and 79 years, and over 80 years.

[Epidemiology and natural history of cholelithiasis].

Gallstone disease is relatively common, affecting approximately 15% of the population in Europe and North America, but it is benign since its natural history remains asymptomatic in nearly 80% of cases. The stones are predominantly cholesterol derived in 80% and pigmentary in 20% of cases. Recent epidemiologic studies using ultrasound examination have determined the factors favouring lithogenesis, in addition to those that are already wellknown, such as age, obesity, female gender, high blood triglyceride levels and multiparity, the risk is correlated with high, frequent variations in weight, with intake of certain drugs and with alimentary habits.

Interelectrode (Accufix) lead fracture.

An interelectrode fracture was diagnosed 7 years after the implantation of an Accufix lead. The lead body separated from the tip with the helix screwed into the atrial wall. The retention wire was intact and may have contributed to the lead rupture.

Pocket infection complicating inadvertent transarterial permanent pacing. Successful percutaneous explantation.

This report describes a patient admitted for the treatment of a pocket infection occurring 5 months after a dual chamber pacemaker implantation. The ventricular lead had been inadvertently placed into the left ventricle through the arterial system. After careful examination using transesophageal echocardiography and left heart angiogram, successful percutaneous extraction was performed without complication.

Electromagnetic interference of external pacemakers by walkie-talkies and digital cellular phones: experimental study.

A number of experimental and clinical studies have documented the risk potential of interference with implanted pacemakers by various types of cellular phones. Radiofrequency susceptibility of external medical equipment has also been reported in experimental studies. The purpose of this experimental study was to evaluate electromagnetic interference of external pacemakers by walkie-talkies and digital cellular telephones.

New trends in the surgical and endovascular reconstructions of large veins for nonmalignant chronic venous occlusive disease.

Considerable advances have been made in reconstructive venous surgery in the past two decades because of an increased recognition of venous disease and because of extensive experimental work. Meaningful evaluation of longterm patency of bypass grafts and midterm patency of stent placement are now available and seem appropriate to provide guidelines. Based on our experience and on the literature, this article highlights the techniques and the respective indications of surgical and endovascular treatment of large vein reconstructions.

Surgical interruption of a left inferior vena cava following the transfemoral implantation of a permanent pacing lead.

This report describes the case of a patient in whom, after an unsuccessful attempt through the subclavian vein, a permanent pacing lead was inserted through the femoral vein and a left inferior vena cava with azygos continuation. The procedure was followed 4 months later by a pulmonary embolism complicating a right femoroiliac thrombosis. The patient was successfully treated by a percutaneous lead extraction procedure combined with an inferior vena caval surgical interruption.

Cirrhosis: a new, but expected cause of biliary sludge.

Background/aims: Biliary sludge is increasingly recognized as a natural stage in gallstone formation. Logically, cirrhosis, a well-documented cause of black pigment cholelithiasis, should be another condition predisposing to the development of sludge. The aim of this study was to assess the prevalence of biliary sludge in an unselected population and to test the hypothesis that cirrhosis could be one of the causes of sludge.

Use of an experimental model of chlamydial salpingitis in mice for the evaluation of activity of antibiotics and anti-inflammatory drugs on fertility.

An experimental animal model has been used to study the separate and combined use of antibiotics and anti-inflammatories in the treatment of salpingitis. The addition of an anti-inflammatory did not seem to help preserve fertility.

Indications for surgery in so-called "regular" thoracic and thoracolumbar kyphosis.

Idiopathic thoracic, thoracolumbar, and Scheuermann's kyphosis do not figure in the same global entity. We propose a classification for so-called "regular" kyphosis. This classification is based on the location of the most rigid curvature segment.

Incidence of perforation and other mechanical complications during dual active fixation.

The intraoperative and early postoperative mechanical complications of a procedure combining an atrial screw-in lead and a ventricular screw-in lead insertion were prospectively evaluated. The procedure was performed in 119 consecutive patients (mean age 69 +/- 8 years), at first implant in 100 patients and at reoperation in 19. Nine patients had previously undergone cardiac surgery and three underwent transvenous ventricular defibrillator implantation.

Lead explantation late after atrial perforation.

This report describes the case of a patient in whom atrial perforation with penetration of the thoracic wall was diagnosed 2 years after the implantation of an Accufix lead. Despite this complication, atrial detection in the bipolar mode and ventricular pacing were normal. Digital fluoroscopy detected a fracture with extrusion of a short segment of the retention wire.

[Ambulatory ultrasound-guided puncture in abdominal tumoral pathology. Study of 131 cases].

Objectives And Methods: Outpatient ultrasound guided liver biopsy is usually reserved for diffuse pathologies. The aim of this study was to assess the feasibility and results of 131 ultrasound guided biopsies of 128 abdominal lesions in 104 patients (69 men and 35 women, mean age: 59). Twenty four cysts were punctured (18 pancreatic cysts, 4 liver cysts and 2 unspecified abdominal cysts) and 104 solid tumors were biopsied (80 liver tumors, 9 pancreatic tumors, 5 portal vein obstructions, 4 unspecified abdominal tumors, 3 stomach tumors and 3 lymphadenopathies).

[Subtalar dislocations. Apropos of 35 cases].

Purpose Of The Study: The subtalar dislocation is a rare injury. The authors appreciate the difference of frequency between medial and lateral displacement, the factors likely to increase a classical favorable prognosis and the therapeutic attitude to suggest.

Material And Methods: 35 observations were included of which two bilateral, 26 had a medial displacement, 9 a lateral displacement.

[Endoscopic treatment of a pancreatic-pleural fistula. Apropos of a case].

Pancreaticopleural fistula is a rare complication of pancreatic diseases. It results from communication between a pancreatic duct and the pleural space, either directly, or through a pseudocyst. The treatment is medical or surgical.

[Portal thrombosis and liver cirrhosis. Value of ultrasound-guided puncture-biopsy of the thrombus].

Objectives And Methods: Portal vein thrombosis which occurs in the course of cirrhosis, associated or not with hepatocellular carcinoma, can be either cruoric or neoplastic. The aim of this study was to assess the feasibility and the results of ultrasound guided biopsy of portal vein thrombosis in 21 patients with cirrhosis (20 men and 1 woman; mean age 66 +/- 9 years), who were hospitalized between May 1989 and November 1993. Ultrasound guided biopsies of the cirrhotic liver, of the portal vein thrombosis and, when present, of a hepatic nodular lesion were performed.

[Noma or cancrum oris: etiopathogenic and nosologic aspects].

Noma is a gangrenous disease that usually begins in the mouth and is characterized by rapid necrotizing destruction of soft tissue and underlying bone. The disease, which is associated with a strong putrid odor suggestive of mixed bacterial infection, develops only in predisposed persons, especially children whose natural defenses have been weakened by poor socio-economic living conditions. However a few atypical cases have recently been reported in adults in whom the main risk factor seemed to be immunodepression.

Fibrotic stricture of the extrapancreatic biliary tract: a new complication of acute pancreatitis. Two cases.

Two cases of fibrotic stricture of the extrapancreatic common bile duct were observed 3 and 5.5 months after severe acute alcoholic pancreatitis. The diagnosis was made by endoscopic retrograde cholangiography in both cases.

Fine-needle aspiration of thyroid follicular neoplasm: diagnostic use of thyroid peroxidase immunocytochemistry with monoclonal antibody 47.

Background: We previously demonstrated that thyroid peroxidase (TPO) immunocytochemistry with monoclonal antibody 47 can help to differentiate benign (staining score, 80% or more) from malignant (staining score, less than 80%) thyroid nodules on fine-needle aspiration (FNA) samples. In the present study we assessed the use of TPO immunocytochemistry in the cytologic diagnosis of thyroid follicular neoplasms.

Methods: A total of 109 histologically proven follicular tumors were studied.

A long-acting repeatable form of bromocriptine as long-term treatment of prolactin-secreting macroadenomas: a multicenter study.

Objective: To assess the efficacy and tolerability of monthly injections of the long-acting repeatable bromocriptine in patients with macroprolactinomas.

Design: Open and prospective trial.

Setting: This multicenter trial was carried out in seven university hospitals.

Prolactinomas and resistance to dopamine agonists.

Among 288 patients with prolactinoma (aged 12-62 years; 242 women), 27 were diagnosed as resistant to bromocriptine as their plasma prolactin (PRL) levels remained elevated despite long-term (3 months or more) treatment at high doses (> or = 15 mg daily). These 18 women and 9 men, aged 29 +/- 9 years (mean +/- SD, range 13-50), followed-up for 8 +/- 4 years, had microadenomas (n = 6) or macroadenomas. They were treated by dopamine agonists alone (n = 6) or associated with surgical or radiation therapy.

[Oral propranolol in Wolff-Parkinson-White syndrome. Electrophysiological data].

The effects of oral propranolol were studied in 24 patients with the WPW syndrome. The average daily dose of propranolol was 130 +/- 24 mg administered in 3 doses over a period of 48 to 72 hours. Endocavitary electrophysiological study was performed 2 to 4 hours after the last dose.