Actinomycosis of the gallbladder due to Actinomyces naeslundii.

We report two cases of actinomycosis of the gallbladder due to Actinomyces naeslundii. Both patients presented with acute cholecystitis. After cholecystectomy with the removal of gallstones each patient made an uneventful recovery. The literature on cholecystitis due to Actinomyces is reviewed.

[Ventricular rhythms with normal heart rate in the acute stage of myocardial infarction]. / Rythmes ventriculaires á fréquence normale au stade aigu de l'infarctus du myocarde

In relation with 25 personal cases, a general review of ventricular rhythms with normal rate observed during the acute stage of myocardial infarction is undertaken. More commonly called "slow VT", this transient and benign arrhythmia occurs within the first 48 hours of infarction. Presence of numerous fusion beats and His potential recordings make it possible to demonstrate its ventricular origin. Its mechanism is variable: in most cases it results from the discharge of an automatic, non-parasystolic, intermittently active focus, more rarely from the discharge of a parasytolic focus and in many cases, the focus is not apparent. Treatment of this arrhythmia should be careful: its benign character often justifies therapeutic abstention.

[Study of the association between aortic coarctation and congenital mitral insufficiency (excluding atrioventricular canals)]. / Etude de l'association coarctation de l'aorte-insuffisance mitrale congénitale (à l'exclusion des canaux atrio-ventriculaires)

Coarctation of the aorta is accompanied by congenital mitral incompetence in 3% of cases, and this combination worsens the prognosis. A series of 23 cases is reported, and the treatment analysed. In 6 cases only medical treatment was used, either because death was rapid or, on the contrary, satisfactory progress made it possible to wait for the normal age for resection and suture of the coarctation. In one case the severity of the mitral incompetence required early valvular replacement, while the minimal coarctation was ignored. Usually (16 cases) a Crafoord operation is carried out as a first stage, and of the 13 children still alive, 8 had their mitral incompetence improved or stabilised; but in 5 it became worse, requiring mitral valve surgery from 1 to 7 years later. Post mortem study showed the multiplicity of mitral lesions present, and explains the difficulty of mitral 'plasty' operations, which are the best solution in children.

[Myocardial biopsy in congestive myocardiopathies of apparently primary origin]. / La biopsie myocardique dans les myocardiopathies congestives en apparence primitives

38 patients with congestive cardiomyopathy of apparantly primary origin had a myocardial biopsy. The histology of the fragment of myocardium was studied both by light microscopy and electron microscopy. The results were compared with those from 3 "control" cases and with 16 cases of congestive asystole secondary to a known cause. The non-specific patternss which were observed were of 3 types: patterns of degeneration, pattern of hypertrophy, and interstitial fibrosis. Chronic alcholism had no modifying effect on the ultrastructure. Finally, the group in which the morphology was altered had a higher mortality, but the prognostic significance of the degree of severity of the morphological change must be treated with caution in each individual case.

[Phonomechanograms of patients with the Bjork aortic valve prosthesis]. / Etude des phonomécanogrammes chez les malades porteurs d'une prothèse de Björk en position aortique

A survey, with consecutive phonocardiograms, of the function of 75 Björk aortic valve prostheses has enabled us to examine the basic components of the opening and closure sounds of this type of replacement; these are usually made up of multiple components in varying combinations. This diversity underlies the importance of an early postoperative recording to act as a baseline. In addition, 2 cases of malfunction presented with only the classical phonocardiographic changes.

[Endomyocardial biopsy. Innocuousness and clinical value. A 5-year experience]. / La biopsie endomyocardique innocuité et intérêt clinique. Une expérience de cinq ans

The authors present their experience of the endomyocardaial biopsy procedure by Konno's technique; they have carried out 180 biopsies in 94 subjects. When the person taking the biopsy is experienced, the procedure is trouble-free, and yields tissue fragments of good quality which are suitable both for histological study and for study of ultrastructure. Biopsies from 47 cases of primary congestive cardiomyopathy have formed the basis of a precise histological study, and have been compared with the findings of a control group comprising various cardiac defects and three normal hearts. The diagnostic and prognostic value of the method are discussed.

[Injuries of the abdominal aorta. General review apropos of a late discovered case]. / Traumatismes de l'aorte abdominale. Revue générale à propos d'un cas à révélation tardive

The authors present a case of acute ischemia of one lower limb with a an uncommon etiology. The cause of embolism was an incomplete thrombosis of the abdominal aorta; this followed a blunt trauma occured three months before. Some similar cases, reported in the litterature, are resumed. This observation permits the authors to review other cases of rupture and post-traumatic thrombosis of the abdominal aorta.

[Meckel's diverticulum. Is it necessary to search for it? Is it necessary to remove it? Apropos of 116 cases]. / Le diverticule de Meckel. Faut-il le rechercher? Faut-il l'enlever? A propos de 116 observations.

Of 116 Meckel's diverticula operated upon over a period of 13 years, 35 had provoked severe disorders and 80 p. cent of the cases concerned patients under 30 years of age. Occlusions represented half of the lesions involved, perforations, hemorrhages, and diverticulitis being less frequently involved. Mucosal heterotopia was a relatively frequent finding: 13 p. cent of cases, and was often the origin of hemorrhagic accidents. Asymptomatic diverticula can be potentially pathologic, as 2 carcinoid tumors and 2 cases of gastric heterotopia were discovered during routine examinations, suggesting that prophylactic excision of apparently healthy diverticula should be performed in young subjects.

[Common bile duct stone formation on migrating ligature threads. A report on three cases (author's transl)]. / Calcul cholédocien sur fil migrateru. A propos de 3 observations.

Common bile duct stones developed around non-absorbable suture threads that had migrated into the common bile duct in three patients. Two cases were typical in that they involved migration of the gallbladder stump ligature thread, associated in one cases with that of the arterial ligature. the third, rather more unusual case, involved the formation of stone on a nylon thread fifteen years after removal of the head and body of the pancreas following an injury, without any intervention on the biliary tract. The only explanation possible for the presence of a thread in the biliary tract is that it migrated through the Wirsung's duct. The published literature on the particular subject of common bile duct stone formation on non-absorbable suture material is reviewed.