[Comparative study of mechanical and manual suture of bronchial stumps in pneumonectomy (author's transl)]. / Suture mécanique et manuelle des moignons bronchiques dans la pneumonectomie. Etude comparative.

The incidence and time of onset of bronchial fistulae were retrospectively studied in 306 patients who underwent pneumonectomy at the Saint-Joseph Hospital, Paris, between 1975 and 1979. The bronchial suture was performed mechanically in 145 cases and manually in 161 cases. Patients in both groups were of comparable age, lung disease, side operated upon, nature of the bronchial division, post-operative course and surgeon's ability. From the results of the study, the authors have endeavoured to determine the advantages of mechanical suture as opposed to manual suture with regard to both operatory technique and quality of results.

[Pericardiac tamponade revealing a lympho-epithelial thymoma (author's transl)]. / Tamponnade péricardique révélatrice d'un thymome lympho-épithélial.

An inaugural pericardiac tamponade performed on a 39 years old man, reveals a lympho-epithelial thymoma. The anatomic diagnosis first suggested by the radiography after evacuation of the effusion, is confirmed by the swab taken during the retroxiphoidal drainage. A 57 Gray cobaltotherapy was then performed. 18 months later, a satisfactory general state, allowed the patient to return to his professional activity. The evaluation of a tumourous residue by a tomodensitometry, is discussed at the light of a comparable observation confirming the efficiency of cobaltotherapy but, at the same time, its agressivity for such an important target volume. A previous surgical reduction, whenever possible, is then considered; an unthinkable eventuality in the reported observation.

[Right heart haemodynamics in bullous emphysema associated or not with diffuse emphysema. Interest in surgical indication (author's transl)]. / Hémodynamique du coeur droit dans l'emphysème bulleux associé ou non a un emphysème diffus. intérêt dans l'indication opératoire.

A right heart haemodynamic study brings us closer to answering the following question: Would surgical intervention allow the re-expansion of a compressed lung area in the case of bullous emphysematous lesions more or less associated with a localized or generalized diffuse bullous dystrophy? It is difficult to know if a positive pressure exists at the level of the lesions to be treated. Furthermore, the consequences involving the neighboring lung parenchyna, mediastinal organs, and right-heart circulation also raise several problems.

[Treatment of mitral insufficiency by Wooler-Reed annuloplasty. Remote results]. / Traitement de l'insuffisance mitrale par annuloplastie de Wooler-Reed. Résultats lointains.

The outcome of 67 patients operated on between 1963 and 1971 for pure mitral regurgitation due to dilatation of the mitral ring (group I: 25 cases), papillary muscle dysfunction (group II: 11 cases) and valvular and/or subvalvular lesions (group III: 31 cases) was analysed with an average follow up of 9.1 years (range 4 to 12 years). Eleven patients (16 p. 100) died in the late post-operative period (average 4 years). The main cause of death was cardiac failure related to the valvulopathy (8 cases). 11 patients were reoperated (16 p. 100) (on average 5 years after operation). The opeartive findings, besides early technical errors (2 cases), showed deterioration to be less often related to secondary dilatation of the mitral ring (1 case) than to progression of the valvular and subvalvular disease (7 cases). The patients followed up at present have shown symptomatic improvement (39 out of 40 cases) although the cardiothoracic ratio has generally remained unchanged. Average pulmonary capillary and arterial pressures were lower than the preoperative findings in 9 control cardiac catheterisations. Thromboembolism (2.6 p. 100), infection (2.6 p. 100) and haemolysis (0 p. 100) were less frequent than in patients with prosthetic valves. The survival curve is also better in patients having undergone reconstructive surgery. This study showed the best results in the group with pure mitral regurgitation secondary to mitral ring dilatation. The results were less favourable in groups II and III. This surgical technique would seem best reserved for young people, when anticoagulant therapy carries unacceptable risks, and when the following anatomical conditions are respected: pure mitral regurgitation with a normal valvular and subvalvular apparatus.

[Subvalvular aortic stenosis, dysmorphic familial syndrome and peripheral muscular disease]. / Rétrécissement aortique sous-valvulaire, syndrome familial dysmorphique et maladie musculaire périphérique

Two related cases are reported, those of two sisters aged 7 and 13, who had an aortic subvalvular stenosis in the form of a fibro-muscular channel, associated with mitral incompetence, a triangular facies with a pointed chin, pinched lips, a divergent squint, hypertelorism, a mask-like face, normal intelligence, and a peripheral muscular disorder with arthrogriposis. The description of such a combination of malformations is original, and this is discussed.

[Angiofollicular lymphoid hyperplasia (Castelman's tumor) in the mediastinum. Apropos of 2 cases]. / Hyperplasie lymphoïde angiofolliculaire (tumeur de Castelman) de localisation médiastinale. A propos de 2 observations

The authors report two new cases of angiofollicular hyperplasia of the mediastinum (Castelman's tumour). The only clinical peculiarity was a rapid increase in volume. The authors then review about 200 published cases. Emphasising the existence of 3 different histological types (plasma cell form, vascular hyaline form and intermediate form) and on the association in certain cases of hematological disorders such as anemia and hypergamma globulinemia. The significance of this lesion is discussed. An inflammatory theory with reactional hyperplasia of the beta-lymphocytes is proposed. It was supported by a direct immunofluorescent study of two cases (first study of this type carried out on such lesions) which showed polyclonal plasma cell hyperplasia predominating on the IgG.

[Aneurysm of the superior vena cava, Apropos of 1 case]. / Anévrysme de la vein cave supérieure. A propos d'une observation

Report of the case of a seventeen-year-old man in whom was discovered in the course of a systematic X-ray examination of the thorax a shadow of the right upper mediastinum. The variability of the pictures in relation with the upward or supine position, suggest the diagnosis of a vascular tumour, which was confirmed by angiocardiography. Towards the end of this examination there was a cardiac arrest with coma, which was suggestive of the probable diagnosis of thrombo-embolic accident, and the operation was undertaken under extracorporeal circulation. It made it possible to extract various recent clots and to perform a reconstitutive endo-aneurysmorrhaphy. The post-operative period was favourable, both from the neurological and haemodynamic points of view.