[Place of automatic oxytocin perfusion devices in the artificial induction of labor]. / Place des perfuseurs automatiques d'oxytocine dans le déclenchement artificiel du travail.

Automatic and self-regulated ocytocin perfusion sets, currently available, are able to precisely analyze the uterine activity in 15 minutes and automatically reduce the ocytocin output when a stable and effective uterine activity is obtained. The authors report the results of 41 inducements with the Autosoma pump and compare them with 358 inducements with manually controlled pumps. The duration and the amount of ocytocin perfused with Autosoma are comparable to the results obtained with manually controlled pumps. The frequent release of Autosoma alarms at the beginning of the experiment partially explains the lack of advantages of the automatic perfusion set.

Endocrine cells in ectocervical epithelium. An immunohistochemical and ultrastructural analysis.

A systematic study of endocrine cells in the ectocervix was carried out using histochemical, immunohistochemical and ultrastructural techniques. Serotonin and calcitonin immunoreactive cells were demonstrated in this site. Serotonin and calcitonin immunoreactivities were coexpressed in the same endocrine cell. These distinctive cells were encountered in two main morphological varieties of ectocervical epithelium. Normal-appearing stratified squamous epithelium contained only very rare serotonin and calcitonin cells. In contrast, endocrine cells were fairly abundant in a specific epithelium termed "transitional-like". This type of epithelium was not only confined to the transformation zone but could also extend onto the portio as far as the vaginal cut margin. In some cases, transitional-like epithelium bore morphological resemblance to urothelium. In other cases, it could be regarded as basal cell hyperplasia or immature squamous metaplasia. Of interest, serotonin and calcitonin cells have been well-documented as normal inhabitants of some other non-squamous epithelia, such as urothelium or pseudostratified columnar epithelium. Therefore, it is suggested that certain ectocervical epithelia show some similarities to urothelium, in respect of their morphological appearance and endocrine profile. Further investigations using more objective and specific markers of urothelial cells are needed to assess the exact degree of homology connecting all these types of epithelium.

[One hundred cases of highly selective vagotomy without pyloroplasty for duodenal ulcer, with a follow-up of 4 to 8 years (author's transl)]. / Cent cas de vagotomie supersélective sans pyloroplastie pour ulcère duodénal suivis pendant quatre à huit ans.

The authors relate about a pilot series of 100 controlled cases of duodenal ulcer, operated by means of a highly selective vagotomy without pyloroplasty. These patients, all followed during a mean period of 5 1/2 years, showed a recurrent ulcer rate of 5%. Literature studies indicate that, when one wants to improve the results of this operation, it is necessary to avoid a pyloroduodenal stenosis and to clear completely the esophagus over the distal 5 to 7 cm. The pH-measurements during operation seem to be of accessory importance. The duodenal ulcers with and without hypersecretion can be operated by means of a highly selective vagotomy with equal chances of healing.

[Duodenal ulcers. Vagotomy-antrectomy or vagotomy-pyloroplasty. Comparison after ten years (author's transl)]. / Ulcère duodénal. Vagotomie-antrectomie ou vagotomie pyloroplastie. Comparaison après 10 ans.

Follow-up results of two series of patients, one group of 50 vagotomy-antrectomies and another of 100 vagotomy-pyloroplastie, were compared after an average of 2,5, and 10 years. Nutrition, the capacity for work, and resistance to fatigue were better after pyloroplasty. After antrectomy there is a progressive decrease in nutrition, body weight varying by 2.730 kg. Digestive discomfort occurs after pyloroplasty, however, and does not improve with time : about half of the patients complain of post-prandial heaviness. Anastomotic ulcers are observed in 6 p. cent of patients after pyloroplasty, and 4 p. cent after antrectomy. Relapses after pytoroplasty occur at an early stage and are mainly due to failure of the vagotomy ; in this series their level remained stable. Phytobezoar is an elective complication of pyloroplasty and was noted in 4 p. cent of cases. The need for repeat operations (4 p. cent of cases) was identical in both groups.

[Preoperative intravenous cholangiography and residual common bile duct calculi. 600 cases reviewed 2 to 15 years after operation]. / Cholangiographie intraveineuse pré-opératoire et calcul résiduel du cholédoque. 600 cas revus 2 à 15 ans après opération.

The authors have carried out as a routine since 1960 before operation a good intravenous cholangiography, i.e. showing up satisfactorily the bile ducts from the bifurcation of the common bile duct to the duodenum and have abandoned routine per-operative radiography. Satisfactory cholangiography was obtained in 96% of cases of simple cholecystitis and in 80% of complicated cases. 600 cases were questionned 2 to 15 years after operation (average 7 years). The 567 controllable cases were all questionned or seen again. The reliability of pre-operative cholangiography is excellent: no common bile duct declared normal on X-ray was found to contain a gall stone either during or after operation and the negative choledocotomies were only 0.17%. The operative simplification permitted us to reduce the operative mortality of simple cholecystectomy to 0.4%. The number of controlled residual calculi was 5.8%. With routine per-operative radiomanometry, the average level without control at the Lille Colloquium in 1968 was 7%. But with late control according to the estimation of the authors it should be about 10%.