[Changes in the pressure borne by the hip during the phase of unilateral support in locomotion. II]. / Variation des pressions subies par la hanche durant la phase d'appui monopodal de la marche.

Adopting the methodology that we have just described, our study completes that of Pauwels in that we take into consideration the pressures sustained by the hip not only in the frontal plane but also in the horizontal and sagittal planes during the phase of unilateral weightbearing when walking. Thanks to the work of Braune and Fischer (1) the forces exerted on the hip are now well known and are represented by the weight of the body, the muscular forces and the dynamic forces generated by walking. From these data, we have been able to quantify the pressures sustained by the hip in each plane during the different phases of unilateral weightbearing when walking (weightbearing on heel, sole and toes).

[Non-Hodgkin's large B cell malignant lymphoma localized in the anterior mediastinum. Apropos of 2 cases]. / Lymphome malin non Hodgkinien à grandes cellules de type B localisé dans le médiastin antérieur. A propos de deux cas.

The authors present two cases of a specific variety of malignant non Hodgkin's lymphoma large B cell, characterised by an initial localisation in the anterior mediastinum where the tumors were adhesive and infiltrating, by the fact they appear, most of the time, in young women, by their usual resistance to treatment and by the presence of severe fibrosis on histological examination.

[Isolated rupture of the left main-stem bronchus during intubation with a Carlens tube]. / Rupture isolée de la bronche souche gauche lors d'une intubation par sonde de Carlens.

A case is reported of bronchial rupture due to a Carlens double-lumen tube. A 73 year old male patient was to undergo a double right lower and middle lobectomy for carcinoma. All went well and as expected until 20 min after the start of left-sided unilateral ventilation by way of the double-lumen tube. A sudden increase in the inspiratory pressures led to the discovery, first, of a leak around the cuff, and then, air bubbles in the mediastinum. Surgical exploration showed up the 4 cm long rupture in the pars membrana of the left main bronchus through which the cuff was herniating. The patient was reintubated and the rupture surgically repaired. The right upper lobe had not been ventilated for 45 min and there were signs of micro-atelectasia. The immediate postoperative course was rather stormy, with severe cardiac failure, recurring right upper lobe atelectasia and bilateral pulmonary infection. The patient was only definitely weaned from the respirator 40 days after the surgical incident. Although such complications with double-lumen tubes are rare, they must be recognized and surgically repaired very rapidly. A few simple rules to prevent these complications are discussed.

[A new case of cyst of the common bile duct with an anomaly of the bilio-pancreatic convergence]. / Une nouvelle observation de kyste du cholédoque avec anomalie de la convergence bilio-pancréatique.

A case of common bile duct cyst operated upon in a 2 1/2 year old girl is used as a basic for discussing the forms associated with anomaly of convergence of common bile and wirsung's ducts. The latter, of dysembryoplastic origin, appears to be the cause of this type of cyst. These forms are atypical in that no mass is palpable and they are frequently complicated by a pancreatitis. They constitute the majority of Japanese cases when the anomaly is investigated. Its detection is possible by retrograde catheterization or more rarely during perioperative cholangiography, the only possibility in the very young infant. Different operative technics are outlined, taking into account principally the risk of secondary malignant changes and the possible performance of a hepatico-duodenal anastomosis without increasing the risk of an ascending angiocholitis.