[Polyarthritis associated with hydatid cyst of the liver].
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Biomedical subjects
Publications and source records attributed to B Delaitre.
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The pharmacokinetics of albendazole was evaluated in 11 patients with hydatid disease who underwent surgery 12 h after the last dose of drug. Albendazole and its main metabolite, albendazole-sulphoxide, were assayed in the serum from peripheral and portal blood, the liver, bile, lungs, and hydatid cyst walls and fluid. After a 10-14 mg/kg daily oral dose of albendazole, concentrations of 1844 +/- 904 ng/g wet tissue of albendazole-sulphoxide were found in the liver and 749 +/- 34 ng/g wet tissue in the lungs. The level in hydatid cyst fluid was 921 +/- 314 ng/ml. The drug was also excreted through the bile. The same daily oral dose produced very stable blood levels after 2 to 4 days of treatment (600-1000 ng/ml). In another part of the study 3 patients with liver cysts, 2 with peritoneal cysts, and 5 with bone cysts received 7 mg/kg twice a day prophylactically and/or therapeutically for 30 days. In all cases the treatment was repeated several times after intervals of 2 weeks. The 3 patients with liver cysts were cured (probably due to treatment); there was no recurrence in the 2 patients with peritoneal cysts and very slight improvement in the 5 cases with bone cysts. The drug was clinically and biologically extremely well tolerated.
The authors report three cases of splenic abscess. The condition developed twice during a salmonella infection associated in one case with sickle cell disease. In two patients, the spleen was the site of a suppurated infarction. One patient died shortly after operation. Study of the 79 cases of splenic abscess treated surgically published since 1960 reveals a mortality of 16%. This rare condition is seen essentially during typhoid and septicaemias (endocarditis). Such pathology in also now seen in drug addicts. The diagnosis and, hence, the prognosis should be improved by the use of echography which seems to be the most reliable investigation before peritonitis by rupture which remains a complication associated with a heavy mortality.
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Africa, and in particular North Africa, is a site of high prevalence of carcinoma of the nasopharynx in the young subject. There is a marked male predominance and a clear peak of incidence between 15 and 25 years. The presenting feature is usually rapidly growing cervical lymphadenopathy. The diagnosis is based upon histological examination of these nodes. It is a squamous carcinoma, usually highly undifferentiated and difficult to identify. However, for the experienced observer, the special appearance of tumour proliferation makes it possible to localise the primary tumour in the epi-pharyngeal region. Current work is aimed at research into a possible genetic predisposition and the relationship which the carcinoma may have with the Epstein-Barr virus.
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The authors report a clinical study of 101 cases of continuous digestive suture and an experiment comparing intestinal healing after continuous and interrupted sutures. A certain discrepancy exists between the excellent clinical results and the pathological and microscopic findings with continuous sutures, and in particular the presence of pseudo-diverticular pouches in 20% of cases developing at the expense of a mucosal evagination within the suture. If carefully performed, continuous suture seems excellent, preventing by its watertightness, the onset of early fistula.
The authors report a case of complex traumatic carotid-jugular fistula, and insist on the interest of strict identification of vascular injuries and their haemodynamic consequences, by angiographic study from upper thoracic aorta. Further, the post-operative examination permist verification of the vascular reconstitution.
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The authors analyse retrospectively 284 case records of perforation of gastric and duodenal ulcers treated between 1961 and 1972 and, from a study of the literature, the authors attempt to draw up prognostic factors which permit one to apply to this complication of ulcer disease, the most efficient short and long-term treatment.