[Postexercise duplex ultrasound to diagnose external iliac endofibrosis]. / Endofibrose de l'artère iliaque externe diagnostiquée par écho-doppler post-effort.

Arterial endofibrosis is a disease of recent discovery which concerns high-performance athletes, predominantly competitive cyclists. The preferential location is the external iliac artery. The symptoms are diverse (pain, edema, paresthesia), always linked to an effort. The diagnosis may be delayed due to atypical symptoms in athletes. Complementary tests are measure of the systolic pressure index after exercise, duplex ultrasound, CT angiography, MR angiography and arteriography. We report a case of endofibrosis where late diagnosis was established with postexercise duplex ultrasound, while CT angiography and arteriography failed to reveal characteristic abnormalities.

[Prevention of deep venous thrombosis of the leg by a very low molecular weight heparin fraction (CY 222) in patients with hemiplegia following cerebral infarction: a randomized pilot study (30 patients)]. / Prévention des thromboses veineuses profondes des membres inférieurs par une fraction d'héparine de très bas poids moléculaire (CY 222) chez des patients porteurs d'une hémiplégie secondaire à un infarctus cérébral: étude pilote randomisée (30 patients).

The effectiveness and safety of a very low molecular weight heparin fraction were evaluated in the prevention of deep-vein thrombosis in patients confined to bed due to hemiplegia consecutive to a recent cerebral infarction. CY 222 was administered within 48 hours of the stroke by one single daily subcutaneous injection of 0.6 ml (= 15,000 U AXa IC) during 14 days. This randomized pilot study involved 30 patients. The effects of CY 222 were assessed in a group of 15 patients compared with a control group of 15 untreated patients. No deep-vein thrombosis was detected by the labelled fibrinogen test in the treated group, as against 12 patients in the control group. Six patients (3 in each group) died during the study. One case of lethal pulmonary embolism was observed and confirmed at autopsy in the control group. In the remaining 5 patients, no systematic autopsy which would have asserted the absence of pulmonary embolism or drug-induced haemorrhage was performed. Numerous standard laboratory tests confirmed that CY 222 was well tolerated.

[Value and place of real-time ultrasonic diagnosis combined with continuous-wave Doppler in the diagnosis and follow-up of thromboembolic disease]. / Valeur et place de L'échographie temps réel couplée au Doppler continu dans le diagnostic et la surveillance de la maladie thrombo-embolique.

The authors compared the results of real time ultrasound imaging and continuous wave Doppler (Echography-Doppler with bilateral venography and ilio-cavography in the diagnosis and the follow-up of deep venous thrombosis (D.V.T.). Diagnosis of D.V.T. The value of echography-Doppler (ED) compared to venography is studied on 297 patients (590 legs) suspected of D.V.T. (221) or pulmonary emboli (76). The two methods give concording results in 95% (563/590). Discrepancies (27) are more often located in distal veins. If we refer to venography as the gold standard, sensitivity of ED is 98% (236/242) and specificity is 95% (327/344). Other diagnosis are possible: hematoma (9), extrinsic compression (15), Baker's cyst (4), muscular problems (3)... Topographic value Sensitivity in isolated calf vein thrombosis is 90% (54/60 are detected, 22 are bilateral). 4/6 false negatives are located in the presumable healthy legs. Sensitivity in proximal D.V.T. is excellent 100% (182 D.V.T. with 28 bilateral). The upper extremity of the thrombus is located exactly by ED whatever the topography (35 in the inferior vena cava, three of them beyond the renal veins), the degree of obstruction (partially occluded veins: 32), and even if it's extended or not (27). Follow-up of D.V.T. Assessment of the results in 80 patients under treatment is identical with the two methods, whatever the topography, the degree of obstruction and the evolution of thrombosis. E.D. predictive value in therapeutic efficiency is discussed according to the evolution data in 260 patients. Screening of D.V.T. ED is compared to venography (13) and/or Fibrinogen test (15), in 23 patients (46 legs) with high risk of thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Phase I clinical trial and pharmacology of 2,4-diamino-5-(3',4'-dichlorophenyl)-6-methylpyrimidine (metoprine) (DDMP) and folinic acid (CF).

Escalating doses of DDMP (metoprine) (15-280 mg/m2) were administered as single oral doses 24 h before a fixed leucovorin (CF) rescue (15 mg IM every 6 h for 72 h). CNS toxicity was dose-limiting and cumulative when the drug was given more frequently than at 3-week intervals. DDMP has a very long half-life (150 h) and is extensively bound to serum proteins (88%). It diffuses into the CSF and concentrates in brain tumours and normal brain tissue (brainserum ratio 3.8-5.3). DDMP is a potentially useful drug against brain tumors. Tumor regressions were seen in two patients with epidermoid carcinomas.