[Comparative study of the LIFT and the TVT procedure in the surgical treatment of female stress urinary incontinence]. / Etude comparative du LIFT et du TVT dans le traitement chirurgical de l'incontinence urinaire chez la femme.

AIMS: The purpose of the study was to compare a polyester mesh coated with silicone (LIFT, Cousin) to a polypropylene mesh (TVT, Gynecare), in terms of results, and short and middle term complications. MATERIAL AND METHODS: We have performed a retrospective study concerning 140 patients between 2000 and 2002 (71 LIFT and 69 TVT operated for stress incontinence with or without vaginal surgery (prolapse surgery or hysterectomy). We noticed per- and postoperative complications. The patients were contacted by phone to evaluate the middle and long-term results. RESULTS: The mean age of the patients were of 58.8+/-11.3 years in LIFT group and 57.2+/-7.5 years in TVT group. More intraoperative complications arose in the TVT group (six bladder injuries and three haemorrhages versus two in LIFT group, p<0.05). There was no difference for the postoperative time. The mean follow-up was 16.6+/-5.7 months for the LIFT and 32.2+/-11.3 months for the TVT. 80% of the patients were dry in the LIFT and 75.8% in the TVT group. There was no significant difference concerning the rate of de novo urge incontinence (18.3 versus 17.7%) and voiding difficulties (10 versus 16%). On the other hand, 6.7% of the patients of the group LIFT presented bad healing with prosthesis exposure, in every case a partial resection of the mesh was performed. We did not observe any case of exposure in the TVT group. CONCLUSION: The LIFT seems as effective as the TVT with a rate of de novo urge incontinence and voiding difficulties similar to the TVT and to the literature's data. However the rate of 6.7% of exposure leads us to prefer polypropylene meshes.

Improvement of the activity measurement method for solid dosimeters emitting X-rays.

Today, there is growing interest for neutrons in the intermediate energy range between 100keV and 1MeV, which are responsible for damaging materials in reactor. To improve this deficiency, we use rhodium and niobium which, through the inelastic neutron scattering reaction, leads to the formation of 103mRh and 93mNb low-energy X-emitters. This paper describes the improvements and validation made on this type of complex measurement by X spectrometry: self-attenuation, fluorescence correction, and emission intensity were poorly known previously.

Efficacy and complications in the surgical treatment of stress urinary incontinence by insertion of a silicone-coated polyester tape (Lift).

OBJECTIVES: To evaluate the efficacy and safety of a surgical treatment for stress urinary incontinence by implantation of a silicone-coated polyester tape (Lift). MATERIALS AND METHODS: This retrospective study included 72 female patients having had a suburethral silicone-coated polyester tape inserted as treatment for stress urinary incontinence, combined or not with pelvic surgery. We recorded the patient's characteristics, the surgical procedure, the short and long-term results and complications. RESULTS: Seventy-two patients were operated, 60 of whom were fully evaluated. The average follow-up was 17 months. On 48 patients (80%) the treatment was successful, 3 (5%) were improved, and 9 (15%) were regarded as a failure. Dysuria occurred in six (10%) patients, five were de novo, and one was persistent. Ten patients (16.6%) presented de novo urge incontinence. The main complication was a higher rate of severe infections, accompanied by defective healing (4, i.e. 6.7%). CONCLUSION: The procedure using a silicone-coated polyester tape seems to be efficient, but insufficiently secure. This higher rejection rate leads us to prefer other synthetic materials proved to be better tolerated.

A Case Report: Pseudoangiomatous Stromal Hyperplasia Tumor Presenting as a Palpable Mass.

We report a case of woman with a palpable lump on her left breast. On mammography, a huge mass located between the inner and the outer inferior breast quadrants of the left breast was found. The ultrasound examination realized later revealed a heterogeneous mass with smooth and lobulated borders. An MRI was also performed, showing an oval mass with heterogeneous areas of enhancement. Finally, a core biopsy under sonographic guidance revealed a pseudoangiomatous stromal hyperplasia of the breast.

Traumatic neuroprotection with inhibitors of nitric oxide and ADP-ribosylation.

N-Methyl-D-aspartate (NMDA) receptor activation is known to contribute to neuronal damage from head trauma. Additionally, NMDA neurotoxicity occurs in part through the generation of nitric oxide (NO), and injury from NO has been shown to be mediated by ADP-ribosylation. Therefore, we investigated whether inhibitors of NO and ADP-ribosylation would protect against acute CA1 traumatic neuronal injury in hippocampal slices subjected to fluid percussion. Treatment with the nitric oxide synthase (NOS) inhibitor, methyl-L-arginine 170 microM for 35 min after trauma injury, improved CA1 antidromic population spike (PS) recovery to 91 +/- 2%, compared to unmediated slices which recovered to only a mean of 20 +/- 4%, 90 min after trauma. Similarly, hemoglobin 50 microM, which directly binds NO, protected against traumatic neuronal injury and yielded a mean CA1 PS recovery of 92 +/- 1%. Treatment with inhibitors of poly-ADP-ribosylation was also strongly protective, with the vitamin nicotinamide 10 mM and 3-aminobenzamide 1 mM yielding PS recoveries of 98 +/- 2% and 90 +/- 3%, respectively. Protection was also seen with inhibitors of mono-ADP-ribosylation, including novobiocin 500 microM and meta-iodobenzylguanidine 20 microM which yielded recoveries of 89 +/- 6% and 96 +/- 26%. Novobiocin also protected against direct application of NO and NMDA. These findings suggest that NO and ADP-ribosylation are mediators of acute traumatic neuronal injury.

[Magnetic resonance imaging in fractures caused by fatigue and by insufficiency]. / Imagerie par résonance magnétique dans les fractures de fatigue et par insuffisance.

The only important complication of a stress fracture is the true fracture. For this reason, a diagnostic should be made as fast as possible. 30 patients with stress fractures, whose 10 with magnetic resonance imaging are presented and the different radiological technics are compared. The magnetic resonance imaging, showing the first modifications inside the medullary cavity, allows a quick diagnosis in very difficult cases, when the other technics have not given the answer.

[Value of gradient echo MRI in patellar chondromalacia]. / Intérêt de l'IRM en écho de gradient dans la chondromalacie rotulienne.

The use of MRI in the evaluation of cartilaginous lesions is now well established. Thirty patients suspected of presenting such lesions were investigated by MRI with gradient echo sequences. Twelve patients had an arthroscopy either before or after the MRI. The sequences have allowed characterisation of the lesions of chondromalacia and have showed early lesions not visible at arthroscopy, without need for intraarticular contrast injection.

[Prevention of preeclampsia]. / Prévention de la prééclampsie.

Aspirin has shown efficacy in preventing PE with a 10 % incidence reduction. The treatment must be started between the 12(th) and 14(th) week of amenorrhea with a dose of 75 to 160 mg once daily. This treatment is all the more effective as it is given to a high risk population. The supplementation with 1,5 g of calcium per day appears effective as well in the prevention of PE, especially in the malnourished and young patents. Insufficient data is currently available to recommend antioxidant supplementation. Low molecular weight heparin is potentially beneficial in the prevention of PE, however its efficacy remains to be demonstrated and indications determined. Nitric oxide (NO) or NO releasers are not effective and can cause headaches. Diuretics reduce the birth weight without improving the incidence of PE.

[Prevention and treatment of the secondary effects of oral contraceptives using Citro B-6]. / Prevention et traitement des effects secondaires des contraceptifs oraux par citro B6.

PIP: The treatment of hepato-digestive side effects of combined oral contraceptives using Citro B6 (an association of monopyridoxine citrate, betaine, and citric acid) in 50 women aged 16-62 years is reported. Citro B6 was administered in 1 or 2 courses of 20 days, 3 ampules per day. Therapeutic results were considered good or excellent in 43 patients, with disappearance of nausea and digestive disturbances, and improvement of mastodynia, headache, leg pain, and serum lipid levels. The author recommends the routine use of Citro B6 in association with oral contraceptives.^ieng

Selective enrichment of Th1 CD45RBlow CD4+ T cells in autoimmune infiltrates in experimental allergic encephalomyelitis.

The cytokine effector status of CD4+ T cells from lymph nodes (LN) and the central nervous system (CNS) of SJL/J mice immunized with autoantigen in adjuvant for the induction of experimental allergic encephalomyelitis (EAE) was compared. CD4+ T cells were FACS sorted based on the levels of expression of the activation marker CD45RB. Low levels of expression of this surface marker are induced by antigen recognition and are associated with 'effector' T cell function. Reverse transcriptase polymerase chain reaction (PCR) was used to analyze the expression of different T cell cytokine genes in the sorted populations. CD45RBlow cells constituted a minority of CD4+ cells in the LN and expressed elevated levels of IL-2, IFN-gamma, and IL-4 mRNA, whereas the CD45RBlow CD4+ population did not express detectable message for these cytokines under linear PCR conditions. By contrast to the LN, CD4+ cells from the CNS were predominantly CD45RBlow and expressed readily detectable levels of IL-2 and IFN-gamma mRNA, but almost no IL-4 transcription could be detected. IL-4 mRNA levels in CNS were 100- to 250-fold lower than in LN. Also, IL-4 message could not be detected in the CNS 1 week after remission. A cytokine-specific immunocytochemical single cell staining technique was used to enumerate cytokine-producing cells in LN cell populations and in CNS infiltrates. Between 1 and 5% cells in isolated LN cells produced detectable IL-2 and IFN-gamma. By contrast, the frequency of cytokine-producing cells stained in perivascular infiltrates in frozen sections from the brains of animals with active EAE was 10-fold higher.(ABSTRACT TRUNCATED AT 250 WORDS)