[SMILE: refractive lenticule extraction for myopic correction]. / SMILE : correction de la myopie par ablation réfractive par laser femtoseconde d'un lenticule intracornéen.

PURPOSE: It is currently possible to obtain refractive correction without using an excimer laser; the technique is called ReLEx(®) (Refractive Lenticule extraction) and uses the femtosecond laser VisuMax(®) (Carl Zeiss Meditec, Jena, Germany). We present initial clinical experience with small-incision (4mm) lenticule extraction (SMILE) for the treatment of moderate to high myopia via a retrospective study of 106 myopic and astigmatic eyes. MATERIALS AND METHODS: This retrospective study of 106 eyes measures postoperative visual acuity to determine the safety, efficacy and predictability of the technique. For SMILE, an intrastromal lenticule is cut with the VisuMax(®) femtosecond laser; it is then dissected and detached from the anterior and posterior stromal planes and finally removed through a 4mm incision. This procedure does not require the creation of a flap. The study is based on 106 eyes of 54 patients who underwent the surgery for moderate to high myopia, with or without associated astigmatism. Patient selection was the same as for LASIK. RESULTS: The average age of the patients was 33 ± 9 (20-54). The mean preoperative spherical equivalent was -6.22 ± 1.6 (-3; -9.75 D). The mean preoperative sphere was -5.88 D ± 1.52 (-3; -9.75 D) with a mean cylinder of -0.68 D ± 0.58 (0.00; -2.25). Postoperatively, 95% of patients had distance vision greater than or equal to 8/10. No loss of BCVA was noted. The mean postoperative spherical equivalent was -0.16 ± 0.35 D (-1.38; +0.88) with a mean sphere of 0.00 ± 0.34 D (-1,25; +1) and a mean cylinder of -0.31 ± 0.37 D (0; -1.5). One eye was converted to PRK because the incision site was covered by conjunctiva during the last 5 seconds of the laser phase. CONCLUSION: SMILE is a predictable and safe technique for the surgical correction of moderate to high myopia.

[Transfusion of platelet concentrates]. / Transfusion de concentrés plaquettaires.

Although a number of research have been realized in the aim of decreasing the use of platelet concentrates, these blood products remain absolutely necessary for patients with therapeutic aplasia and for some surgical patients. After the description of the main rules of platelet transfusion procedures, we will discuss some controversial issues: threshold value for platelet transfusion, platelet doses, place of curative and prophylactic strategies, refractoriness to platelet transfusion, HLA alloimmunization. Then we will focus our review on the future alternatives for platelet transfusion.

Serum concentrations of cytokines in patients with Hodgkin's disease.

Serum concentrations of interleukin (IL)-1 alpha, IL-2, IL-4, IL-6 and tumour necrosis factor (TNF) were measured in 24 untreated patients with Hodgkin's disease and in 24 healthy volunteers matched for age and sex. Serum levels of IL-1 alpha were significantly higher in patients with Hodgkin's disease. The number of patients with detectable serum IL-2 or IL-6 levels was significantly higher in patients with Hodgkin's disease as compared to the control group. No difference was observed for TNF. IL-4 was undetectable in all patients. Serum cytokine levels were not significantly different in patients with and without systemic "B" symptoms (weight loss or fever and night sweats) in the different histological subtypes and clinical stages. Serum concentrations of IL-1 alpha, IL-2, IL-6 and TNF were not correlated to the erythrocyte sedimentation rate, fibrinogenaemia or thrombocyte number. These results indicate that subsets of patients with Hodgkin's disease have detectable serum IL-1 alpha, IL-2 and IL-6 levels, but that other mediators are likely to be involved in the associated clinical and biological inflammatory syndrome.

[Role of x-ray computed tomography in the follow-up of the course of Hodgkin's disease]. / Rôle de la tomodensitométrie dans le suivi évolutif de la maladie de Hodgkin.

Fourteen files of patients having had Hodgkin's disease have been analyzed retrospectively to assess the justification of systematic surveillance after complete remission has been achieved. The data of successive CT exams, compared with the findings of clinical and biological studies performed on the same dates, confirm the primordial role of imaging, since computed tomography was predictive for 7 of 18 events (14 relapses and 4 second progressions). The occurrence of subphrenic recurrence in 3 cases for which the initial site was mediastinal leads to discussing the merits of a yearly thoraco-abdomino-pelvic examination during the two years following complete remission.

Clinical and biological analysis of peripheral T-cell lymphomas: a single institution study.

Peripheral T-cell lymphoma (PTCL) accounts for 15-20% of non-Hodgkin's lymphoma in the Western World. Clinical, histopathologic, phenotypic and genotypic data were received from 33 cases of PTCL referred to our institution. The median age order was 50 years, 78% were males, and 18% had a history of a preceding disorder of the lymphoid system. 60% had stage 4 at diagnosis and B symptoms were also present in 60%. The most frequent sites of extranodal involvement were bone marrow (54%), liver (45%) and skin (33%). Twenty-eight of 33 cases were histologically classified according to the Working Formulation (most in the diffuse mixed and large-cell subgroups) and the Kiel updated system. Phenotypic and genotypic studies of malignant cells showed a considerable heterogeneity with respect to the expression of either T-cell receptor (TCR) alpha beta and gamma delta and pan-T differentiation molecules. Of the studied cases 63% expressed TCR-alpha beta. All five patients with PTCL of the TCR-gamma delta subtype had a peculiar extra-nodal presentation. The vast majority of cases expressed an abnormal T-cell phenotype with respect to the expression of pan-T antigens, including the lack of expression of the TCR-associated CD3 molecule in 2 cases. Rearrangements of the TCR beta and/or delta-chain genes showed clonality in 21 of the 23 studied cases. Twenty-five patients were treated with a multiagent chemotherapy regimen with curative intent and the remainder received a less intensive palliative regimen. Only 9 patients achieved CR (8 of whom had received an anthracycline-containing regimen) and the 4-year survival rate was 25%.(ABSTRACT TRUNCATED AT 250 WORDS)