[Protein assay by the modified Dumas method applied to preparations of plasma proteins]. / Dosage des protéines par la méthode de dumas modifiée appliqué aux préparations de protéines plasmatiques.

Quantify protein according Pharmacopoeia method, based on Kjeldahl method, needs a long time to do. The development of an automaton which used the modified Dumas method divide the analysis time by 15 (6 minutes versus over 90 minutes). The results show no statistical differences between official method and this one.

[Detection of heterogeneous Staphylococci by the Autobac system using a nafcillin disk]. / Détection des staphylocoques hétérogènes par le système Autobac en utilisant un disque de nafcilline.

Detection of Methicillin Resistant Staphylococcus aureus (MRSA) is still a problem for automated system users. Forty-nine strains were studied--two kinds of tests were performed: the first by using a 1.0 microgram nafcillin disk with the Autobac system, the second by testing an oxacillin disk by diffusion on Mueller-Hinton agar base complemented with natrium chloride incubated at 37 degrees C. Between the two tests, we observed a concordance for 87.8% of the strains. Six strains showed a discrepancy with the reference method. But for five of them, the Light Scattering Index (LSI) showed a decreasing sensibility near for the cut off. Whereas, only one strain is considered as susceptible. The 1.0 micrograms nafcillin disk allow better results than the 5.0 micrograms oxacillin disk in the automated system, Autobac.

[Value of bead-type cassettes for antibiograms of Streptococci in Autobac units]. / Intérêt des cassettes "à billes" pour l'antibiogramme des streptocoques sur Autobac.

Antimicrobial susceptibility testing of Streptococci in automated units (Autobac) is not always satisfactory: aggregates formed spontaneously by Streptococci in the medium used can reduce the reliability of tests by interfering with correct reading, and, in many cases, bacterial growth is very slow, necessitating long periods for analysis (up to 6 hours). Owing to the fact that use of "bead type" cassettes for antifungal susceptibility testing in the Autobac improved results, and in particular prevented the formation of aggregates, we decided to adopt the same system for tests of streptococci. Each compartment in these cassettes contains glass microbeads which prevent aggregate formation thanks to an agitation mechanism. Rapid sedimentation of these beads allows normal reading with the Autobac. A comparative study of 66 strains of streptococci with various antibiotics was performed. Three techniques were used: classical diffusion technique, susceptibility testing with the standard cassette in the Autobac, and test with the bead type cassette in the Autobac. Parameters evaluated included the effective duration of each test, and comparison of the results (Autobac with and without beads, diffusion method). Results are detailed and discussed.

[Reno-ureteral prosthetic by-pass operations : experimental results (author's transl)]. / Le pontage réno-urétéral prothetique. Résultats expérimentaux.

Results of experiments conducted in dogs are reported, in which the first few centimetres of the ureter were replaced by a prosthesis in silicone elastomer, the upper extremity being intubated by a trans-renal approach into the lower calyx and the upper extremity into the iliolumbar ureter. The one case of failure among the 6 dogs studied was due to a pyonephrosis from a technical error. In the 5 surviving dogs, the by-pass has remained permeable and there is no sign of incrustation. Control I.V.U. examinations after periods ranging from 26 months to 3 years showed normal function. This procedure has now been used in two human cases with good results.

Renoureteral bypass in obstructions and losses of substance of the initial ureter.

When the renal pelvis and the proximal ureter are destroyed, surgical repair is always difficult. In case of a loss of substance of the upper ureter, it is possible to replace the obstructed (or destroyed) segment and to preserve the healthy iliopelvic ureter. The 'renoureteric bypass' consists of the insertion of an intermediate segment between the lower calyx of the kidney and the lumboiliac ureter. A prosthesis or an intestinal loop may be used to restore the continuity of the urinary tract. The results obtained in dogs being excellent, the technique was applied successfully in man in 2 cases.

[Increase of anaerobic infections. Prevalence of Bacteroides. Apropos of 17 cases in abdominal surgery]. / Recrudescence des infections à germes anaérobies. Prédominance des bactéroïdes. A propos de 17 cas en chirurgie abdominale.

Seventeen cases of anaerobic infections in abdominal surgery are reported. Predominance of bacteroides is evident (9/17), especially bacteroides fragilis. The clinical manifestations of bacteroides infections are severe: 7 septicemias and 2 parietal infections, being the cause of the death in four patients. Bacteroides infection develops preferently in an old patient, with severe disease, in colic surgery especially in emergency. Bacteroides are characterized by their polyresistance to antibiotics: beta-lactamins, except carbenicillin, and aminosids. Metronidazole is a powerful bactericidal agent with a very low toxicity, particularly active in the treatment of these affections, as well as clindamycin. If oral route is impossible, chloramphenicol, I.V. tetracyclin, and above all carbenicillin are able to be used with success.

[Wirsung's duct and chronic pancreatitis. Changes in the morphology of the pancreatic ducts after pancreatic duct shunts. 23 cases followed-up]. / Canal de Wirsung et pancréatite chronique. evolution de la morphologie des voies canalaires aprés dérivations wirsungo-digestives

The authors study in chronic pancreatitis the morphology of Wirsung's duct in 31 patients who had undergone repeated operations, 23 of them were submitted in a first stage to an anastomosis between the pancreatic duct and the digestive tract. The main causes of failure were obstructions of the anastomosis, biliary complications and continuation of the pancreatic disease. The difference in prognosis between pancreatitis with a dilated pancreatic duct, and those with a filiform duct, is perhaps due to lesions of different histological appearance and course. The best results were obtained in patients able to give up alcohol and in whom it was possible to carry out a broader anastomosis on a dilated and unobstructed pancreatic duct.

The prosthetic replacement of the ureter: experimental and clinical results.

The authors present their experience over several years in replacement of the ureter by a silicone prosthesis. This includes experimental work in dogs and clinical application performed in three different ways: (1) A uretero-vesical or pelvo-vesical bridge. Trials were started in 1967 and on the whole the results have been good, although in some cases deterioration was noted after a few months (18-20). The quality of the results obtained experimentally, encouraged clinical application and the authors employed ten prostheses in patients with advanced carcinoma and obstruction. The results have been excellent and a cutaneous fistula or diversion has been avoided. (2) Segmental replacement of the lumbo-iliac ureter. In experiments in 15 dogs, there were nine successful results, with survival periods of from 19 to 25 months. One patient has been treated with an immediate good result. (3) A renal-ureteric bridge. By implanting the top end of the prosthesis in the lower calyx and at the lower end in the lumbo-iliac ureter, the pelvis and proximal ureter are by-passed. This procedure has been applied in one patient. He has been followed up for only 4 months, but the results appear to be excellent.