[The efficacy of topical application of bionect (hialuronic acid) in wound treatment after cesarean section].

UNLABELLED: Hyaluronic acid is an important component of the extracellular matrix and has a crucial role in wound healing by stimulation of neutrophil migration, fibroblast proliferation and neoangiogenesis. OBJECTIVE: To study the efficacy of topical application of Bionect (Hialuronic Acid Sodium Sal 0.2%t) in wound treatment after cesarean section. RESULTS: The incidence of edema, infiltration, exudation and superficial blood collections was significantly lower in cases of Bionect application. The results in patients, treated with Bionect makes it a reasonable wound treatment option.

[Ganglioneuroblastoma in the adult]. / Ganglioneuroblastome de l'adulte.

BACKGROUND: Ganglioneuroblastoma is commonly observed in children but rarely in adults. Therapy and prognosis are not well defined in adults. CASE REPORT: We report the case of a female adult who developed a ganglioneuroblastoma of the left adrenal gland with liver metastasis. Surgical treatment combined with radio and chemotherapy led to complete remission. DISCUSSION: The outcome in our patient and data reported in the literature suggest that a multidisciplinary approach is necessary and that initial surgical resection should be performed whenever possible. Adjuvant radiotherapy or chemotherapy have been shown to be somewhat effective in children but their true impact in adults remains to be ascertained. Follow-up after resection should include physical examination, assay of adrenal derivatives in plasma and urine and imaging.

[Preoperative evaluation of respiratory function in thoracic surgery. Do reliable predictive criteria exist in that type of surgery?]. / Evaluation fonctionnelle ventilatoire pré-opératoire en chirurgie thoracique. Existe-t-il des critères de prédiction fiables dans ce type de chirurgie?

A cautions analysis of the respiratory preoperative study may decrease morbidity and mortality after pulmonary surgery. To search for predictive criteria of respiratory complications following this kind of surgery, 454 patients have been studied retrospectively. Morbidity was defined as the need for postoperative ventilation. Preoperative criteria were divided in clinical (age, obesity, history of pulmonary disease, dyspnea, score of Karnofsky), laboratory (blood gases, spirometry) and surgical (kind of procedure). Three criteria were significant for morbidity (15 ventilated patients) and mortality (27 deaths): age (> 65 years), obesity, hypocapnia (pCO2 < 4.1 kPa-31 mmHg). Analysed spirometric values were no significant.

[Amikacin concentrations in lung and serum after single intratracheal administration in men]. / Concentrations d'amikacine dans le poumon et dans le sérum après administration unique intratrachéale chez l'homme.

This study was designed to assess the diffusion into lung tissue and systemic circulation of amikacin administered endotracheally. Eleven consecutive patients, suffering from lung carcinoma and scheduled for elective pneumonectomy or lobectomy, were included in the study. After induction of anaesthesia and before tracheal intubation, a single 500 mg amikacin dose was administered endotracheally through a catheter whose tip was located 5 cm below the vocal cords. Blood was then collected every 15 min for serum assays, until pulmonary resection had been carried out. Pulmonary concentrations were assessed in a healthy area. Measurements were carried out in duplicate using fluorescence polarizing immunoassay and microbiological methods. Serum peak concentrations were found 105 min after administration (7.97 +/- 5.62 micrograms.ml-1). Six and 12 h after administration, serum concentrations were 3.19 +/- 1.87 and 1.20 +/- 0.67 micrograms.ml-1 respectively. Mean lung concentrations were 1.85 +/- 2.12 micrograms.g-1, with a corresponding serum level of 7.22 +/- 4.36 micrograms.ml-1. However, endotracheal instillation of amikacin provided serum concentrations which, were not high enough for treatment of gram negative pneumonia. Lung concentrations are lower than both serum levels and MIC90 for gram negative bacilli. Moreover, there was a major heterogeneity in serum and lung levels, which seemed to be unpredictable. This was probably due to heterogenous tracheal, bronchial and alveolar absorption. The results obtained in this study with a single dose administration should be reassessed in the light of data obtained with long-term amikacin administration.