[Deafness in typhoid fever].
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Biomedical subjects
Publications and source records attributed to A Mehdi.
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HL-60 cells were sequentially labeled with the thymidine analogues iododeoxyuridine (IUdR) and bromodeoxyuridine (BrdU). The labeling index (LI), the duration of S-phase (Ts) and the total cell cycle time (Tc) were measured immediately. It was therefore possible to predict the next time when the single versus double labeled cells would re-enter the S-phase. In our study, the Tc was calculated to be 20 hours. The third label, tritiated thymidine (3HTdR), was introduced at the predicted time of 20 hours to confirm the validity of the previously calculated Tc. The actual percentage of cells which were labeled by (3HTdR) was very similar to the predicted value. We conclude, therefore, that the calculated cell cycle time correlated well with the actual cell cycle time, at least in a controlled in vitro culture system. This novel triple label method validates our double-label technique developed for cell cycle measurements.
The authors report the complications noted in the course of 120 cases of typhoid fever. Intestinal hemorrhages and ileal perforations were the most frequent complications observed, respectively, among 12.5% and 3.3% of patients. Neuropsychiatric manifestations were also frequent: 6.7% of cases. Only one death was noted (0.8%). According to this high rate of complications, typhoid fever must be managed under hospital conditions.
Duodenal diverticula are frequent, they are present in 22% of the cases at autopsy. However, radiological assessment demonstrates duodenal diverticula in 1 to 5% of the patients only. Perforation, the main complication, is very rare. Preoperative diagnosis is exceptional. In a 69-year patient admitted for diffuse abdominal pain, a computerized abdominal tomography, completed by opacification of the gastroduodenal transit allowed diagnosis. In the second case, diagnosis was made peroperatively. Based on these two observations, the authors review the elements of diagnosis and management in complicated duodenal diverticula.
Diaphragmatic rupture occurs in 25% of the thoracic and abdominal blunt injuries. It may be discovered immediately or sometimes several months or even years after the trauma. The diagnosis can be made easily on the basis of a standard chest X-ray. Barium swallow examination, computerized tomography Scan and especially Magnetic resonance imaging can be helpful for differential diagnosis. Surgical treatment is always necessary.
A 47-year-old female presented with intestinal occlusion and a lower abdominal mass. On laparotomy, a 10 cm diameter mass was discovered involving the ileum, jejunum, vagina and the bladder. Pathological studies conclusion was a primary adenocarcinoma of the ileum involving the jejunum. Small bowel carcinoma is rare. It occurs between sixty- and seventy-year-old equally in male and female. It presents most frequently in the duodenum, sometimes in the jejunum, and occasionally in the ileum. The symptoms are not specific and do not point to the diagnosis which must be made radiologically and endoscopically. Currently, for a minority of patients, surgical resection remains the only hope of cure. Palliative resections and bypass procedures can prevent occlusion or subocclusion.
BACKGROUND/AIMS: The place of endoscopic retrograde cholangiopancreatography (ERCP) before open or laparoscopic cholecystectomy remains controversial. Most of the reports study highly selected series of patients and therefore do not give a survey of the actual situation in a general population. We describe here the therapeutic impact of preoperative ERCP in a continuous cohort of patients needing a cholecystectomy. MATERIAL AND METHODS: Data concerning a 2-year continuous and unselected series of 452 patients undergoing cholecystectomy were evaluated. RESULTS: Two hundred ninety-three patients (65%) presented with a chronic symptomatic biliary lithiasis and 159 patients (35%) with a complicated biliary lithiasis. A preoperative ERCP was performed in 206 patients, all presenting with a suspicion of associated lithiasis of the common bile duct (CBD). An endoscopic sphincterotomy was performed in 106 patients: 44 patients presented with CBD stones (9.7%), all successfully cleared by endoscopy. Laparoscopic cholecystectomy has been attempted in 367 patients (81%) and successfully performed in 333 patients (74%). Laparotomy as a first-choice procedure was performed in 85 patients (19%). Surgical choledochotomy was never performed. Postoperative ERCP was needed in 4 patients (0.88%) and in only 1 of them for a retained CBD stone (0.22%). CONCLUSIONS: In a continuous series of patients needing a cholecystectomy, preoperative ERCP was performed on the basis of suspected CBD disorders. It allows CBD stone detection and extraction in almost 10% of the patients and avoids peroperative CBD exploration, with a very low rate of retained stones after surgery. The association of preoperative ERCP with subsequent laparoscopic cholecystectomy (when feasible) offers the patient a quick recovery and a short hospital stay.