[Management system for patients requiring stereotactic macrobiopsies of the breast: report on 100 patients]. / Mise en place de la prise en charge des macrobiopsies stéréotaxiques mammaires: évaluation sur 100 patientes.

PURPOSE: The authors describe and evaluate the management system for patients requiring large core vacuum-assisted biopsies at a dedicated breast center. This process includes mandatory review of all requests by a multidisciplinary team. MATERIAL: and method. Patients were provided questionnaires to evaluate their degree of satisfaction with the management process. Results from biopsy and surgery were retrospectively reviewed. RESULTS: From the 100 patients included in the study (106 macrobiopsies), 95,28% of biopsies were informative. The degree of correlation between the histological diagnosis from biopsy and surgery was 86,95% for the 46 operated cases. The degree of acceptability by patients as well as medical and non-medical staff was satisfactory. CONCLUSION: The original feature of this process is the retrospective review of all charts after the histological results becomes available for final validation of the biopsy results and management. The results of the biopsy and the post biopsy management are provided by the initial referring physician, allowing optimal patient care and follow-up.

Phylogeographical evidence of gene flow among common crossbill (Loxia curvirostra, aves, fringillidae) populations at the continental level

Common Crossbill subspecies have been described according to morphological traits, vocalizations and geographical distribution. In this study, we have tried to determine whether the subspecies correspond to clear-cut mitochondrial DNA lineages, by sequencing 717 bp of the control region from individuals taken at several sampling locations in North America and the Western Palaearctic. We find 22 haplotypes from the 37 sampled individuals with a mean divergence of 0.0118 +/- 0.0069 (mean +/- SD). We find a mixing of the mitochondrial haplotypes at the continental level among the different types or subspecies previously described. Morphological differentiation (in bill size and shape essentially) shows the possibility of rapid local adaptation to fluctuating resources (coniferous seeds), without necessarily promoting the development of reproductive barriers between morphs.

Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases.

We described the sonographic, computed tomographic (CT), and magnetic resonance (MR) imaging features of one atypical case of nodular regenerative hyperplasia of the liver. The presence of multiple hepatic nodules suggested the diagnosis of metastatic disease to the liver because of a peripheral rim of enhancement on CT obtained after intravenous administration of contrast material and a halo sign on T2-weighted spin-echo MR imaging. Examination of the pathologic specimen obtained after surgical biopsy showed that the nodules were made of hepatocytes, with a nodular arrangement surrounded by peliosis, without fibrosis or cirrhosis. These findings suggested that peliosis may cause peripheral rim of enhancement on CT and halo sign on MR imaging. In light of this case, nodular regenerative hyperplasia of the liver should be considered in the differential diagnosis of hepatic metastases.

[Mandibular reconstruction by free transfer of the fibula after cancer excision]. / Reconstruction mandibulaire par transfert libre du péroné après exérèse carcinologique.

The authors present five cases of mandibular reconstruction using a vascularised fibula free transfer in cases of mandibulectomy for cancer. After giving a short account on the anatomy, they describe the technical details of fibula preparation and its transfer at the recipient site. The clinical observations are described. This recent technique seems to be developing, taking in account the qualities of the fibula: available bone length, possibility of performing osteotomies with preservation of the vascular supply, low morbidity at the level of the donor site, and satisfactory cosmetic and functional results. Despite of one recent failure, this short series seems to confirm the great interest in this type of bone reconstruction.

[Lessons of the socioeconomic structure of a cohort of 50 drug addicts infected with HIV and followed up over a year]. / Enseignements d'ordre socio-économique à partir d'une cohorte de 50 toxicomanes infectés par le VIH et suivis pendant un an.

Fifty drug addicts, users of intravenous heroin and infected by HIV, with an average age of 28 years, were followed for a period of one year. The purpose was to analyze, as precisely as possible, the medical and social cost of their illness as a function of the stage of the infection to which they belonged. The costs vary significantly according to the age and sex of the patients, and are higher in those patients with stage IV (confirmed clinical AIDS) than with stage II and stage III HIV infection. Although the population of drug addicts infected by HIV is likely to stabilize, the medical and social cost of caring for HIV-infected drug addicts is very heavy, and can be estimated at about 4 to 5 billion french francs by year.

[Treatment of buccal mucosa lesions with the carbon dioxide laser]. / Traitement des affections de la muqueuse buccale par le laser à gaz carbonique.

The authors report their experience of the use of the CO2 laser in oral pathology, based on 109 patients treated in 136 sessions. The indications of this type of therapy are reviewed and details of the technic and results are given. The CO2 laser is specially useful in cases of dysplasia and cavernous hemangiomas; it guarantees the quality of the intervention, and avoids post-operative discomfort for the patients. Future prospects of this method are promising.

The reconstruction of cranial defects involving scalp, bone and dura following electrical injury: report of two cases treated by homograft, free groin flap and cranioplasty.

The authors present two cases of extensive and very deep electrical burns of the skull, involving the dura and producing neurological complications. In both cases the surgical excision and repair was carried out in four stages. This paper sets out the clinical justification for this approach.

[Cryptogenetic osteolysis of the mandible (author's transl)]. / Ostéolyse cryptogénétique de la mandibule.

A case of "cryptogenetic osteolysis of the mandible" is reported. This is a rare affection as only 13 cases of "phantom mandible" are known, but other sites exist (91 cases of phantom bone are known). The diagnosis is suspected after radiography, and confirmed by anatomopathological examination. No treatment for this affection has been described.

[Cervical and cervicodorsal flaps. Vascularisation. Surgical applications (author's transl)]. / Lambeaux cervicaux et cervico-dorsaux. Vascularisation. Applications chirurgicales.

The authors used injected anatomical specimens to analyse the cutaneous vascular distribution of the cervical and cervicodorsal regions. The arrangement of the arterial network does not make it possible to define flaps with a vascular pedicle. Only the jugular vein may be used as the axis for such a flap. The most valuable flaps, in everyday practice, are transverse flaps, a vertical flap pediculated on the external jugular and the cervicodorsal flap used without autonomisation. The combined musculocutaneous flap, including the sternocleidomastoid, is used in the treatment of extensive loss of laterofacial substance.

[Stomatitis and antimitotics (author's transl)]. / Stomatite et antimitotiques.

The authors report a case of stomatitis, in a patient receiving antimitotic therapy, which was found to be due to an acute leukosis. They feel that patients on antimitotics who develop stomatitis should have a white cell count to exclude leukosis, which is not a very rare finding today.

[LLL plasty in reparative surgery of the face (author's transl)]. / La plastie en LLL dans la chirurgie réparatrice de la face.

The problem of the repair of loss of cutaneous substance from the face is extensively studied in works on plastic surgery. The so-called LLL lozenge plasty of Dufourmentet no longer has the place of which it is worthy, when it is not ignored altogether. The authors here stress the advantages: simplicity, minimal separation of the skin from underlying structures, ease of application using local anaesthetic, minimal scarring, aesthetic quality. The limitations of this autoplasty are also described, in particular with regard to the extent of the repair and the problem of malignancy.

[Calification of the dental system in dialized patients]. / Calcification du système dentaire sous dialyse.

The authors present the case of an eight-years-old child, dialysed since the age of two following a bilateral nephrectomy. The chronological appearance of the teeth was not disturbed. By contrast, there was a delay in mineralisation of the dental organ, and in particular the root. There was lysis of the alveolar bone, resulting in a parodontopathy. The authors distinguish two ages in the effects of dialysis: the first period is that of the construction of the dental system and the second is the adult age at which the dental system is constituted.

[The mandible in labio-maxillary clefts]. / La mandibule des fentes labio-maxillaires.

The writers have studied mandibular anomalies in a series of 20 surgically treated clefts. Anomalies of shape occur in one case out of two and are in the form of a mandible which is too long. Anomalies of position most often show a mandible in front of the maxillary and to the rear in comparison to the base of the skull.

[Mesiodens and heredity]. / Mésiodens et hérédité.

The authors describe the case of mesiodens in two non-identical twins and in their grandfather. They recall that, although no investigation confirmed the hereditary nature of the mesiodens, it is quite undeniable in view of the frequency of familial cases. They think there is a recessive gene on an autosome and a gene on the inhibiting chromosome X. They discount the theory of mutation.

[Recurrence factors in the surgical treatment of prognathism of the mandible]. / Facteurs de récidive dans le traitement chirurgical des prognathies de la mandibule.

With regard to recurrences following surgery for prognathia of the mandible, the authors draw the distinction between immediate and secondary recurrences caused by errors in surgical indication or technique. They then review late recurrences, which they classify as being alveolar, basal or by forward sliding. They then study the role played in recurrences by growth of the condyle, neuromuscular balance and the hyoid suspensor system. Finally they stress the action of the tongue and the age factor (over 17 years being, in their view, desirable).

[Total reconstruction of the mandible with an endoprosthesis]. / Reconstruction totale de la mandibule par endoprothèse.

The authors present a reconstruction after total mandibulectomy, using a Kirschner wire, modelled and adjusted at the time of insertion. They emphasis the simplicity of the technique and the quality of the result.