[Pulmonary and bronchial kinetics of cefuroxime after a single 500 mg intramuscular injection]. / Cinétique pulmonaire et bronchique de la céfuroxime après dose unique de 500 mg par voie intramusculaire.

Thirty-two patients (28 males; mean age 56 +/- 10 years) who were undergoing bronchopulmonary exeresis surgery were included in this study of the pulmonary (pulm), bronchial (br), and plasma (pl) kinetics of cefuroxime after a single 500 mg intramuscular injection. Twenty-nine bronchial specimens and 38 pulmonary and plasma specimens were taken on average at the following times after the cefuroxime injection: 1 h, 2 h, 3 h, 4 h, 6 h, 8 h, and 10 h. Cefuroxime was assayed using HPLC on ground tissues, with a correction for contamination by blood. Peak concentrations (C) were found after one hour (Cpl = 11.6 +/- 0.8 micrograms/ml; Cpulm = 7.3 +/- 3.3 micrograms/g; Cbr = 3.7 +/- 1.5 micrograms/g) with the following residual values after 8 hours: Cpl = 0.94 +/- 1.04 micrograms/ml, Cpulm = 0.49 +/- 0.45 micrograms/g, Cbr = 0.15 +/- 0.07 micrograms/g (means +/- 1 SD). Elimination kinetics were monoexponential and similar in plasma, lung tissue and bronchial tissue (elimination half-lives: 1.74 h, 1.66 h, and 1.56 h, respectively), suggesting that all three elements belong to the same pharmacokinetic compartment. Mean intrapolated area-under-the-curve values (AUC) were 33.58 micrograms.ml-1.h (plasma), 20.08 micrograms.g-1.h (lung), and 10.22 micrograms/g-1.h (bronchus). The AUCpulm/AUCpl and AUCbr/AUCpl ratios were 0.60 and 0.30, respectively, in agreement with mean values of tissue level/simultaneous plasma level ratios (lung: 0.59; bronchus: 0.33).

[Esophageal perforation during tracheal intubation. Report on 6 cases. (author's transl)]. / Perforation de l'oesophage au cours d'intubations trachéales. A propos de 6 cas.

Perforation of the esophagus and hypopharynx followed tracheal intubation for general anesthesia or during intensive care in 6 patients. Circumstances favorable to the production of these lesions, and diagnostic features enabling early diagnosis are discussed. Simple surgical procedures and intensive postoperative care resulted in recovery in 5 of the 6 cases.

[Penetrating thoracic and abdominothoracic wounds. Results of treatment in 221 cases (author's transl)]. / Plaies thoraciques et plaies thoraco-abdominales. Etude de 221 plaies récentes.

Overall mortality after treatment of 221 thoracic or abdominothoracic wounds was 5 p. cent in a recent series, mortality from bullet wounds being the double of that from other weapons. Isolated thoracic wounds without cardiac lesions have a good prognosis, whereas mortality after heart or abdominothoracic wounds remains high (12.5 p. and 14 p. cent respectively). Apart from those with severe hepatic injuries or wounds of the suprahepatic veins, most of the injured patients that died were in cardiac arrest on arrival. Different therapeutic attitudes are necessary for pure thoracic wounds and those involving the abdominothoracic region. It is essential to gain as much time as possible at all stages, particularly during transport of the injured and when deciding the course of treatment, to avoid losing patients with curable lesions.

[Laryngeal trauma and laryngo-tracheal rupture during road accidents. Current concepts (author's transl)]. / Fracas du larynx et désinsertion laryngo-trachéale au cours des accidents de la voie publique. Aspects actuels.

The authors review 6 cases of laryngeal trauma and 2 cases of laryngotracheal rupture which were seen after road accidents. They note that increasingly, as a result of the intervention of emergency medical ambulance teams, such injured patients are intubated at the site of the accident. Closed laryngo-tracheal rupture corresponds completely with cases described in the literature, forming a clinical picture which is a source of grave error by virtue of its latent nature. The management at the time of admission of the patient obviously is altered if intubation has already been performed, since the tube should never be removed for the purposes of clinical assessment before tracheotomy has been performed. If the patient is not intubated, the presence of respiratory distress necessitating emergency therapy reflect major lesions which therefore require surgical exploration. Rather than primary tracheotomy, the authors prefer intubation using a rigid bronchoscope which facilitates subsequent tracheotomy.

[Cervical esophagus injuries (author's transl)]. / Traumatismes de l'oesophage cervical.

The authors report 16 cases of cervical esophagus injuries. In two patients, they followed a closed injury to the neck, in six cases, wounds from firearms or other weapons. In five cases, tracheal intubation, and in three cases, perforations of various origins. All patients required operative treatment, and in six cases surgery was performed between the 3rd and 25th day following the injury. Only one of the 8 patients operated upon within 12 hours following injury developed cervicomediastinal complications, while seven of the 8 cases operated upon after this period developed mediastinitis or a fistula. Radiological examination with an opaque medium and urgent operation combining drainage and suture are essential when injury to the esophagus is suspected, in order to obtain early diagnosis and good results.

[Rupture of an atheromatous plaque in a non-ectatic sub-renal aorta without evidence of an infectious process (author's transl)]. / Rupture d'une plaque d'athérome en dehors de toute infection sur une aorte sous-rénale non ectasique.

The authors report a case of rupture of an atheromatous plaque in a non-ectatic sub-renal aorta without signs of aneurysm or evidence of an infectious process. Similar cases do not appear to have been reported.