Myospherulosis as a complication of functional endoscopic sinus surgery: a double case report.

INTRODUCTION: Paraffinomas (also known as 'sclerosing lipogranulomas' or 'myospherulosis') are a widely acknowledged complication of cosmetic paraffin injections but they are rare following functional endoscopic sinus surgery. CASE PRESENTATIONS: Our first case features a 45-year-old woman presenting with a peri-ocular swelling two weeks after functional endoscopic sinus surgery. The procedure was complicated by a fractured lamina papyracea. A nasal packing with antibiotic ointment was left in situ. Initially, the inflammation was controlled successfully with corticosteroids but the swelling persists to this day. Our second case is a 45-year-old man who suffered from a recurrent swelling of the right eyelid after endoscopic sinus surgery. Multiple treatments with oral antibiotics and corticosteroids brought about no improvement. Debulking surgery was performed and a PDS film was placed between the peri-orbita and the bony orbital floor but the swelling recurred. The patient finally consulted a plastic surgeon as a last resort, but the reconstructive procedure only exacerbated the clinical picture. In both cases a biopsy was performed which established the foreign body reaction typical of a paraffinoma. At present, both patients still suffer from this condition. CONCLUSION: The complete resection of a paraffinoma is seldom possible because of diffuse infiltration and recurrence is very likely. We therefore conclude that paraffin-based ointments should not be used with nasal packing after sinus surgery, especially when there has been a lesion involving the orbital wall.

Definition of the data for comprehensiveness in scenario analysis of near-surface nuclear waste repositories.

This article provides data on the near-surface repository for nuclear waste in the associated Research article "Comprehensiveness of scenarios in the safety assessment of nuclear waste repositories" [1].We illustrate i) the parameters of the COMSOL Multiphysics model for calculating the radiological impact of the repository, ii) the set of scenarios analyzed following a pluralistic approach, and iii) nodes, experts' beliefs and prior probabilities for the scenario analysis based on Bayesian networks.

Analysis of the receptor specificity of tolerance induction in stress versus opioid-related prolactin secretion in rats.

The effects of restraint stress and opiates on prolactin secretion in male rats have been measured. Both induced a short-lived increase in prolactinaemia. Experimental evidence indicates that both opioids and restraint stress bring about their actions by the activation of opioid receptors. When restraint stress was followed by administration of the specific kappa-agonist bremazocine, a second prolactin peak was observed. In contrast, morphine (predominantly a mu-agonist) lost its prolactin-stimulating capacity when given after a period of restraint stress. This indicates cross-tolerance between restraint stress and morphine. Tolerance was overcome when the dose of morphine was doubled, and an increase in prolactin secretion could again be obtained. The cross-tolerance phenomenon argues that a common opioid receptor is involved in morphine- and restraint stress-stimulated prolactin release. In another set of experiments, in which morphine administration replaced restraint stress as a means of inducing tolerance, a second rise in prolactinaemia was seen only with bremazocine and not with a further administration of morphine. This suggests a morphine (mu) receptor-specific development of tolerance. Two consecutive administrations of bremazocine also produced tolerance, in this case for the kappa-receptor. This illustrates the rapid and receptor-specific development of tolerance for the prolactin-releasing capacity of opioid compounds.

The effect of bombesin on basal, alpha-methyl-p-tyrosine, haloperidol, morphine, bremazocine and stress-induced prolactin secretion.

Intravenously administered bombesin lowered basal PRL levels in conscious male rats and prevented the morphine, bremazocine and stress-induced PRL secretion. The same dose of bombesin had no effect on PRL levels in alpha-methyl-p-tyrosine pretreated rats and did not affect haloperidol-stimulated PRL release. These results show that bombesin given intravenously acts as an inhibitor of PRL secretion and suggests that it does not act on the lactotrope itself but rather by an increase of the inhibitory dopaminergic tone.

Inhibition of gastric acid secretion by intravenous cholecystokinin extract.

The rapid single intravenous injection of the cholecystokinin preparation Cecekin (Vitrum) was found to inhibit the responses of Heidenhain pouch dogs to stimulation by gastrin extract or synthetic gastrin-like penta-peptide at both submaximal and supramaximal dose rates, to histamine, to the stable cholinergic drug Amechol, and to feeding a meat meal. The pattern of inhibition suggested that the inhibitor effect was exerted in the region of the acid secreting cell. Pure cholecystokinin was capable of inhibiting the acid response of the Heidenhain pouch dogs to histamine. Although both pure secretin and pure cholecystokinin have now been demonstrated to be possible inhibitor agents arising from duodenal mucosa, it is likely that endogenous duodenal acidification releases a further as yet unidentified humoral inhibitor agent, or that secretin and/or cholecystokinin may act in collaboration with each other or a further inhibitor agent. In dogs with both a Heidenhain pouch and a simple fistula into the normally vagally innervated gastric remnant and in which antrectomy had been performed, a single rapid intravenous injection of the Cecekin had no effect on the Heidenhain pouch responses to the continuous intravenous infusion of histamine. The acid output from the main gastric remnant, however, was increased by the Cecekin injection. Several hypotheses to account for the difference in behaviour in the two preparations are discussed. The possibility is raised that Cecekin contains some gastrin-like activity.

[Parenteral feeding after total gastrectomy (author's transl)]. / Alimentation parentérale après gastrectomie totale

The authors report on 2 cases of radical gastrectomy for cancer. Parenteral feeding composed of amino acids, solutions of lipids and carbon hydrats insures an intake of 2,500 to 4,000 calories per day in the immediate postoperative phase. Daily nitrogen and measurement of the different blood and urine parameters make it possible to estimate the daily needs of these patients and to provide for a smooth recovery.

[Activities of the emergency department of a suburban hospital in 1984]. / Activité du service de garde d'un hôpital de Faubourg en 1984.

This is a review of the population coming to the outpatients department along June 1984. Most of the people are coming between noon and midnight. 20% of the patients are driven by ambulance and 59% of them are admitted, while only 23% of the total population and 11% of surgical cases are hospitalized. 56% of the patients are living in the neighbourhood of the hospital and 38% in the other suburbs of Brussels' urban area. Only 26% of the patients are referred by the family physician and 86% of them are admitted, while only 14% are requesting for a specific examination.

[Parenteral nutrition in gastro-intestinal surgery (author's transl)]. / Alimentation parentérale en chirurgie digestive.

Forty-two postoperative patients received by parenteral route on 24 hours a total of 2,610 calories by means of a simultaneous infusion of 1,500 ml Trivé 1000 and 1,500 ml 10% invert sugar through a central venous line. Of those 42 cases 12 had peritonitis with 7 of them an enteric fistula, 18 underwent an extensive bowel resection and 12 suffered malnutrition secondary to their primary pathology. The average duration of parenteral nutrition was 13 days and the average hospital stay 27 days. No major metabolic derangement was noted except for a temporary transient elevation of SGOT and AF. A systematic bacteriological study of the perfusion lines disclosed an associated morbidity of about 6%. We are convinced that with the used solutions the postoperative catabolism can be managed successfully and that the association of aminoacids, lipids and glucides as used by us facilitates, nursing care.

[Ulcer perforating into the free peritoneum. Review of 70 cases]. / Ulcère perforé en péritoine libre. Revue de 70 cas.

We retrospectively studied a series of 70 patients admitted between 1977 and 1982 with an acute perforated ulcer. As compared to available data our patient's population is characterized by elevated mean age and by important delay between onset of symptoms and admission. Clinical diagnosis supported by plain X-rays and laboratory was confirmed in 91%. In one patient only, treatment was purely conservative; nine vagotomies, four gastrectomies and fifty-six suture plication were performed. Hospital stage was short (mean: 13,5 days) despite 37% morbidity. Mortality (10%) was close correlated with age and delay between onset of symptoms and treatment.

Subpubic cartilaginous cyst: a rare cause of dysuria.

A subpubic cartilaginous cyst is a rare lesion that may present as a vulvar mass or rarely with dysuria. This condition occurs predominantly in multiparous postmenopausal women and is believed to be secondary to degenerative changes in the fibrocartilaginous disc of the symphysis pubis. The midline location, close relationship with the undersurface of the symphysis pubis and the cystic nature are the clues to the correct diagnosis.

Exergy analysis of the Chartherm process for energy valorization and material recuperation of chromated copper arsenate (CCA) treated wood waste.

The Chartherm process (Thermya, Bordeaux, France) is a thermochemical conversion process to treat chromated copper arsenate (CCA) impregnated wood waste. The process aims at maximum energy valorization and material recuperation by combining the principles of low-temperature slow pyrolysis and distillation in a smart way. The main objective of the exergy analysis presented in this paper is to find the critical points in the Chartherm process where it is necessary to apply some measures in order to reduce exergy consumption and to make energy use more economic and efficient. It is found that the process efficiency can be increased with 2.3-4.2% by using the heat lost by the reactor, implementing a combined heat and power (CHP) system, or recuperating the waste heat from the exhaust gases to preheat the product gas. Furthermore, a comparison between the exergetic performances of a 'chartherisation' reactor and an idealized gasification reactor shows that both reactors destroy about the same amount of exergy (i.e. 3500kWkg(wood)(-1)) during thermochemical conversion of CCA-treated wood. However, the Chartherm process possesses additional capabilities with respect to arsenic and tar treatment, as well as the extra benefit of recuperating materials.