[Surgery and the acquired inhibitor of factor VIII coagulant]. / Chirurgie et inhibiteur acquis du facteur VIII coagulant.

A case is reported of an 80 year old woman with old sarcoidosis and acquired factor VIIIc inhibitor undergoing orthopaedic surgery. This was successfully carried out after she had been given a total of 48,420 units of factor VIII concentrate: there were no haemorrhagic complications. The main pathological states in which acquired factor VIIIc inhibitor may be found are related: principal treatments available nowadays are discussed: immunosuppressors, human factor VIII, animal factor VIII, prothrombin complex concentrate, plasma exchange.

[Determination of methylmethacrylate in expired gases after hip prosthesis cementing]. / Dosage du méthacrylate de méthyle dans les gaz expirés après scellement des prothèses de hanche.

Total hip replacement using methylmethacrylate can induce early intraoperative hypoxaemia caused, according to some authors, by alveolar gas dilution by acrylic monomer vapour. In order to test this hypothesis, expired monomer was measured in ten patients undergoing total hip replacement carried out under narconeuroleptanalgesia. Methylmethacrylate was collected by adsorption on activated charcoal and measured by gas chromatography. The quality of expired monomer was 25 +/- 10 micrograms after cotyloid sealing. It is of 264 +/- 396 micrograms after femoral sealing; the most important excretion took place in the first three minutes, and its total duration may exceed 18 min. A simple calculation showed quite convincingly that the volume of expired monomer vapour was not sufficient to explain the hypoxaemia: impaired arterial oxygenation associated with the use of methylmethacrylate is not due to a dilution technique.

[Potentiation of a vitamin K antagonist by a pefloxacin-rifampicin combination]. / Potentialisation d'une antivitamine K par l'association péfloxacine-rifampicine.

The combination of a new quinolone, pefloxacin, with rifampicin seemed of interest in the treatment of staphylococcal osteitis. Interactions of a coumarin anticoagulant (acenocoumarol) and several antibiotics were well known, mostly resulting in a decrease of the anticoagulant activity. A new interaction of this anticoagulant drug with the pefloxacin-rifampicin combination is described which gave an increase in the anticoagulant activity.

[Pharyngolaryngeal fistula and hypopharyngeal perforation resulting from difficult tracheal intubation]. / Fistule pharyngo-laryngée et perforation hypopharyngienne après une intubation trachéale difficile.

The authors report a case of lesions of the pharyngo-oesophagolaryngeal junction following difficult intubation. On the basis of the small number of cases published in recent years, they attempt to determine those factors which may permit early diagnosis before the development of complications in order that any medical or surgical therapeutic measures applied may be fully effective.