Laser-induced fluorescence spectroscopy of the (0, 0) Schumann-Runge band of O(2).

We report laser-induced fluorescence recording and identification of the R and P branches (J = 1-21) of the (0, 0) Schumann-Runge band of molecular oxygen, excited near 202 nm by a tunable pulsed laser beam (3-MW/cm(2) maximum intensity). The intensity of the excitation spectrum varies linearly with the density of the laser power. In the conditions of the experiment, the detection limit of ground-state O(2) molecules deduced from the R(5) line is ~10(15) cm(-3).

[Direct re-instillation through endotracheal intubation tubes during enteral nutrition for short bowel syndrome]. / Réinstillation directe par connexion de sondes d'intubation endotrachéales lors d'une nutrition entérale pour grêle court.

Case report of a 65-year-old man, operated on for small bowel infarction. Only the initial 40 cm of the jejunum, and the last 10 cm of the ileum were vital and could be kept. The ileo-caecal valve and the colon were not resected. Two stomas were carried out: a left-sided jejunostomy, and a right-sided ileostomy. Enteral nutrition was attempted, but jejunal outflow increased. It was therefore decided to attempt re-instillation of jejunal juices directly to the ileum using two 33 CH endotracheal tubes connected with soft chest drain tubing. A bag was placed over the jejunal tube to collect any leakage. Semi-elemental enteral nutrition could then be successfully carried out, and parenteral feeding stopped. With this simple appliance, the patient was able to lead as normal a life as possible. After 42 days of such feeding, the patient had only lost 2 kg in body weight, and intestinal continuity was re-established.

[Gazeous necrosis of the liver due to hepatic artery thrombosis after liver transplantation]. / Nécrose gazeuse du foie par thrombose de l'artère hépatique après transplantation hépatique.

An emergency liver transplantation was performed in a 22 year-old female for fulminant hepatitis. The donor had had splenectomy with portal vein thrombosis which was diagnosed and removed during portoscopy. Nineteen days later, abdominal pain with shock and hepatic failure occurred. X-rays showed pneumoperitoneum and aeric images in the liver area. Laparotomy disclosed massive liver necrosis with gaz under the Glisson's capsula. The hepatic artery was thrombosed. In spite of emergency retransplantation, the patient died 8 days later, due to systemic aspergillosis. Thrombosis of hepatic artery was particular by the importance of gaz-forming infection, and emphasizes the role of rejection. The discovery of portal thrombosis allows to outline the precautions necessary in case of splenectomized donors. The severeness of aspergillosis is underscored.

[Study of the intraperitoneal penetration of imipenem/cilastatin in acute peritonitis with perforation]. / Etude de la pénétration intrapéritonéale de l'imipénème/cilastatine au cours de péritonites aiguës avec perforation.

A study was performed to investigate the intraperitoneal penetration of Imipenem/cilastatin into inflammatory peritoneal fluid. Six patients undergoing abdominal surgery (acute peritonitis), were treated with Imipenem/cilastatin (4 perfusions of 0.5 g/day) during 5 days after the intervention. Plasma samples were obtained on day 1 and 4 at the pic and at the valley; peritoneal samples were obtained every days for 4 days, 1, 3 and 6 hours after the end of a perfusion. The samples were immediately stabilised following the manufacturer instructions and quick freezed at -80 degrees C. Dosages were performed using a microbiological assay. The mean peritoneal levels are above the MIC 90 of the more frequent bacteria which cause infection in abdominal surgery. Moreover none of the patients showed relapse of infection or complication during this treatment.

[Infectious complications after surgery of esophageal pathology. Apropos of 60 cases]. / Complications infectieuses après chirurgie pour pathologie oesophagienne. A propos de soixante cas.

Infections after oesophageal surgery are studied on sixty patients who received perioperatively two antibiotics (cefoxitin and amikacin). Postoperative infection rate is 62% (pneumopathies: 27%, leakage of cervical anastomoses: 17%). Different parameters which can induce postoperative infection are analyzed. The only significative data are the duration of total parenteral nutrition and of intensive care stay. The commonest isolated organisms are gram negative bacilli (61%) and streptococci (30%). Yeasts infections are frequent, and significantly correlated with antibiotic treatment duration.

[Block of the cervical plexus for the unipolar exclusion of a gastroplasty after bronchial fistula]. / Bloc du plexus cervical pour exclusion unipolaire d'une gastroplastie après fistule bronchique.

A 46 year old man was operated on for an oesophageal carcinoma. Total oesophagectomy and gastroplasty were carried out. Postoperatively, a fistula developed between the gastroplasty and the right main bronchus. This led to respiratory impairment, with pulmonary infection, pleural effusion and hypoxia; the patient could not remain supine. A cervical oesophagostomy was decided on; to carry it out, a cervical plexus block was preferred to a cervical epidural anaesthesia because of the lesser respiratory and haemodynamic effects of the former technique. The procedure was well supported by the patient, and no significant hypoxia was detected by continuous pulse oximetry. Artificial ventilation of this patient was therefore successfully avoided.

[The value of monitoring arterial oxygenation saturation by pulse oximetry in neuroleptanalgesia]. / Intérêt de la surveillance de la saturation artérielle en oxygène par oxymétrie de pouls au cours de la neuroleptanalgésie.

Anaesthesia can induce hypoxaemia. Pulse oximetry gives continuous non invasive monitoring of arterial oxygen saturation. No arterial puncture is needed. Ninety-four patients were monitored by pulse oximetry during neuroleptanalgesia for colonoscopy. Eighteen patients showed desaturation episodes of less than 90%, eight linked to opioid-induced respiratory depression. In all patients, pulse oximetry gave clinicians an immediate awareness of the incident. Treatment was facilitated. Pulse oximetry made anaesthesia safer.