[Laser-assisted endoscopic resection: a new surgical technique for the treatment of benign prostatic hypertrophy. Preliminary results of a study involving 100 patients]. / Resezione endoscopica laser assistita: nuova tecnica chirurgica per il trattamento dell'ipertofia prostatica benigna. Risultati preliminari di uno studio riguardante 100 pazienti.

This study was designed to assess the efficiency of 2 kind of laser prostatectomy devices in the treatment of Benign Prostatic Hyperplasia: a non contact technique versus a contact technique versus a contact one. From January 1994 to September 1994, 100 patients were included in a randomized comparison of 2 laser prostatectomy devices with right angle firing laser fibers: a non contact technique with Urolase fiber (Bard) (50 patients) versus a contact technique with Fibertom fiber (Dornier) (50 patients). The Urolase fiber was used at 60 Watts power setting for 60 seconds and administered to each lobe at 2, 4, 8 and 10 o'clock positions. The Fibertom fiber was used by dragging or the so called "painting" technique at 3 and 6 months with 3 parameters: Madsen symptom scores, peak urinary flow rates and post-void residual urine volumes. Operative morbidity rate was 9%. No difference in morbidity between both fibers. No blood transfusion was required in any case. Statistical analysis of the aforementioned parameters shows a p-value of < 0.001 for all parameters. Comparing the 2 different fibers, there was no statistical difference in outcome for any of these parameters. From this study we conclude that the preliminary results achieved, using the Urolase and the Fibertom fiber, are equivocal and interesting. However, a long term follow-up is necessary to evaluate the definitive efficiency of laser prostatectomy and to determine the optimal procedure.

[Multiple pancreatic metastases of small-cell bronchogenic carcinoma]. / Métastases pancréatiques multiples d'un carcinome bronchique à petites cellules.

Multiple pancreatic metastasis of small cell lung cancer. Pancreatic metastasis of small cell lung cancer are unusual, in spite of their fast evolution. The authors describe a case of small cell lung cancer with multiple pancreatic metastasis showed by echography and confirmed by ultrasonic guided biopsy.

[Needle puncture biopsy: the contribution of extemporaneous examination of samples in the diagnosis of malignant liver tumors]. / Ponction-biopsie à l'aiguille: apport de la lecture extemporanée des prélèvements dans le diagnostic des tumeurs malignes hépatiques.

In this retrospective study, the authors compared the sensitivity and specificity, in terms of the diagnosis of malignancy, of two techniques of ultrasound-guided biopsy of liver tumours. The first technique involving fine needle biopsy with cytological and histological analysis of the specimen was carried out in 39 patients. A technique using a wide calibre needle with frozen section examination of the fragment obtained was performed in 27 patients. All patients had one or more malignant liver tumours. Sensitivity and specificity of the technique with frozen section histology were both 100 per cent, while figures for the technique with delayed histological study were 84.6 and 87.4 per cent. This study suggests that frozen section histology might be associated with greater sensitivity than delayed histology.

[Evaluation of ultrasonography in the diagnosis of cirrhosis. Retrospective studies of 100 consecutive tests]. / Evaluation de l'ultrasonographie dans le diagnostic des cirrhoses. Etude rétrospective de 100 examens consécutifs.

This study was carried out in order to assess the value of ultrasonography in the diagnosis of cirrhosis. One hundred patients were studied within 2 weeks of the histological diagnosis of the liver disease (cirrhosis 49, acute or chronic hepatitis: 23, fatty liver: 16, normal liver: 12). Ultrasonic patterns were classified by a second examiner according to 5 hepatic criteria (volume, outline, echogenicity, attenuation of the ultrasound beam, enlargement of caudate lobe) and 3 extrahepatic criteria (dilatation of the portal vein, ascites, splenomegaly), leading to a ultrasonic diagnosis. Cirrhosis was diagnosed in 36 out of 49 patients (73 p. 100) by the echographist whereas clinical and biological data lead to diagnosis in only 27 out of these 49 patients (P = 0.057). Hepatocellular carcinoma was diagnosed only in 2 out of 5 patients. Splenomegaly (0.60) and caudate lobe enlargement (0.59) were the signs whose predictive value was the best for this group of patients. The ratio thickness of caudate lobe/global hepatic thickness (as measured on a sagittal cut through the inferior vena cava) allowed for easy assessment of caudate lobe size. The mean value of this ratio was significantly different (P less than 0.001) in the cirrhotic group (0.38 +/- 0.07) when compared to the non-cirrhotic one (0.28 +/- 0.06). Ratios greater than 0.35 were not seen in subjects with normal livers, nor were ratios greater than 0.40 seen in non-cirrhotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pelvic hydatid cyst: atypical ultrasonographic findings in one case (author's transl)]. / Aspect échographique particulier d'un kyste hydatique pelvien.

The authors present one case of pelvic hydatid cyst scanned by ultrasound. This recent localisation of the hydatid disease permits the description of particular semeiological data. This aspect is not described in the literature concerning the cystic pathology of the pelvis, and can be evocative of an parasitic etiology.

[Study of the Wirsung duct by echography (author's transl)]. / Etude du canal de Wirsung par échotomographie.

With the usual echographic technics, the Wirsung duct, when dilated can be only episodically seen: the seesaw motion of the transducer produces some undesirable echoes, which rub out the lumen of the Wirsung duct. In order to obtain steadily pictures of the dilated Wirsung duct, the transducer must be used with a sweep motion in only one direction, while a positive pressure is exerted on the epigastrium. When transversally intersected, the Wirsung duct appears spindle shaped; it can be displayed on a rather good length. When sagittaly intersected, it presents, itself like a curved shaped picture, 4 mm to 2 cm in diameter, empty of echoes, in the center of the pancreatic section. The Wirsung duct, with the former technics, had been displayed 20 times in 140 cases of chronic pancreatitis; whe have found it in 4 cases in our 10 last cases of chronic pancreatitis. These case have been verified by endoscopic Wirsungography.

[Abdominal echotomography in a pneumology department]. / Place de l'echotomographie abdominale dans un service de pneumologie.

In the last years, echotomography has become an essential element in the diagnosis of a number of diseases. In pleuro-pulmonary pathology, echotomography is also valuable for diagnosing pleural diseases and in some pathological conditions affecting at the same time thorax and abdomen. Echotomography of the abdomen is advised in a number of cases. The diaphragm and regions above and below it should be tested when there are deformations of the cupolae and radiological images in the pulmonary bases. Liver is investigated to trace any possible hepatic localization of broncho-pulmonary cancers or any chest hydatidosis. Echographic investigation of pancreas is advisable when a tumour of glandular origin is diagnosed. For patients with mesotheliomas, it should be associated to a retro-peritoneal investigation.

[Echotomography of the liver with three-dimensional representation of the organ]. / Echotomographie du foie avec représentation tridimensionnelle de l'organe

Three-dimensional representation facilitates the reading of ultrasonic seriographs of the liver. It uses a conducing wire to provide a correspondence between the xipho-umbilical line and the information collected on the seriographic polaroids. Proceeding from image to image, a more thorough interpretation is possible. This analytical study provides a synthetic representation of the organ. When present lesions are seen on these diagrams and their location and dimensions clearly defined. A precise indication of the height, breadth and thickness of the organ is given, which makes it possible to obtain an accurate approximation of the hepatic volume, taking the morphotype into consideration.

[Value of echotomography in pleuro-pulmonary pathology]. / Intérêt de l'échotomographie en pathologie pleuro-pulmonaire

Echotomography based on the use of ultrasound as a diagnostic tool, little used until now in pleuropulmonary pathology, seems interesting and valuable and diserves to be counted amongst the various paraclinical examinations. Out of a hundred patients, we obtained the following results: -- 91.7% success in the needle biopsies done after echotomography. -- 84.4% success in exploring peripheral pulmonary tumor. -- 100% success in plotting: pleural thickening in which figures obtained with ultrasounds are very close to those obtained directly by needle. Echotomography in pleuropulmonary pathology has the following indications: -- for pleura effusions, pleural thickening and tumors; -- for pulmonary parenchyma: evolving or stable, solid or liquid masses, that are close enough to the thoracic wall; -- for mediastinum: lesions localized in the anterior mediastinum and related to the sternocostal wall. In all these cases echotomography brings valuable complementary information, sometimes allowing the location of fibrohyalin pleural plaques of asbestosis invisible on X rays. By combining a wider experience and the perfectioning of the equipment, this method could become a common practice in pleural pathology and thoracic oncology.