[Pheochromocytoma of the organ of Zuckerkandl]. / Phéochromocytome de l'organe de Zuckerkandl.

The authors report the case of a pheochromocytoma of the organ of Zuckerkandl in a 46 year old man. The clinical presentation was severe paroxysmal hypertension; the tumour was located by arteriography, CT scanning, and by scintigraphy with iodine labelled benzylguanidine. The blood pressure returned to normal after surgery. The embryological, anatomical and physiological features of the organ of Zuckerkandl are reviewed: the authors discuss briefly the modern methods of diagnosis and localisation of the tumour.

[Peripheral arterial recanalization using a Kensey catheter]. / Désobstruction artérielle périphérique par cathéter de Kensey.

Between June 6 1988 and September 30 1989, 46 superficial femoral obliterations in 44 patients were treated by rotary atherectomy, completed by conventional dilatation in 40 patients. The 44 patients (27 males and 17 females), mean age over 66.5 years (45 to 90), presented symptomatic superficial femoral obliterations (17 tight stage, two occlusions, 5 stage III, and 10 stage IV occlusions), with mean length of 9.8 cm (2 to 24 cm). Vascular echography was performed systematically before the procedure, to assess the extent of intraluminal calcification. Moreover, a control venous angiography was performed on the third day. Of the 46 treated arteries, the occlusions which had remained impermeable with a traditional guidewire were traversed successfully and without incident in 40 cases (87%). In case 20, the massively calcified obliteration could not be traversed, and perforation occurred in four cases, but without clinical consequences. In five other cases (11%), precocious reocclusion occurred before the 48th hour. It should be pointed out that, in 2 of these 5 cases, no additional conventional dilatation had been performed at the beginning of the trial. In 35 cases (76%), satisfactory permeability with residual stenosis less than 30% was thus obtained upon discharge from the hospital. For these patients, the lower limb/upper limb Doppler index rose from 0.44 to a mean 0.89 after treatment. 2 embolism were observed: one popliteal treated by embolectomy. The mid term permeability at 6 months is 80% among the 25 primary successes.

[The barium meal in chronical mesenteric ischemia. A report of a case with malabsorption (author's transl)]. / Le transit du grêle dans l'ischémie mésentérique chronique. A propos d'une observation avec malabsorption.

A 50 years old man with clinical manifestations of intestinal ischemia associated with malabsorption. On abdominal angiography an obstruction of the 3rd jejunal artery is seen. Barium meal revealed a diffuse jejunopathy with disappearance of mucosal folds and intestinal biopsy showed a complete loss of villi.

[Control of massive hematuria after nephropyelotomy by selective intra-arterial injections of noradrenaline (author's transl)]. / Contrôle d'une hématurie massive aprés néphropyélotomie par injection intra-artérielle sélective de noradrénaline.

Severe hematuria after pyelonephrotomy was controlled by the selective injection of noradrenaline into the renal artery. The indications for this conservative therapeutic technique are defined as well as its place in relation to hemostatic surgical procedures.

[Local fibrinolytic treatment in occlusions of the central retinal artery]. / Traitement fibrinolytique local dans les occlusions de l'artère centrale de la rétine.

The effectiveness of thrombolytic agents used in local infusion has been demonstrated in the treatment of acute myocardial infarctions by several randomized trials. Thrombolytic therapy seems also to improve the prognosis of certain acute life-threatening brain stem strokes. Two cases of central retinal artery occlusion were treated with intracarotid urokinase injections. Visual acuity was improved in both cases in less than 24 hours, repermeation of the occluded vessels was observed 48 hours after the beginning of treatment. The limits of this kind of therapy are emphasized: there must be no contra-indication to the fibrinolytic agents, a delay shorter than 6 hours after the beginning of symptoms, a lack of arguments in favour of an embolism, and integrity of the carotid bifurcation. Surveillance in an intensive cares unit during the first days is required.

[Axial osteomalacia. Comparative analysis with fibrogenesis imperfecta ossium (author's transl)]. / L'ostéomalacie axiale. Analyse comparée avec la fibrogénèse imparfaite.

Axial osteomalacia is an infrequent osseous disease, etiopathogeny of which is yet unknown. The authors report three cases of such affection and two cases of fibrogenesis imperfecta ossium. They stress the clinical, biological and radiological specific signs of these diseases. Biopsy is necessary for diagnose some doubtful cases, especially in order to exclude other causes of osteomalacia as fibrogenesis imperfecta ossium. The latter osteopathy which frequency may be underestimated has often similar radiological data.

[Arteriovenous fistula of the spleen revealed by ascites and profuse diarrhea. A case report including ultrasonography and arteriography findings (author's transl)]. / Ascite et diarrhées profuses révélatrices d'une fistule artério-veineuse splénique. Evaluation échographique et artériographique.

Abdominal pain, ascites and diarrhea revealed acute portal hypertension in a young woman. Ultrasonography and angiography demonstrated the causative congenital arterio-venous fistula of the splenic vessels. Surgery was successfully performed.

[Wilms' tumor in adults. Apropos of a case]. / Tumeur de Wilms de l'adulte. A propos d'une observation.

Nephroblastoma is a rare tumor in adult. We report here one case in which all the radiological examination were performed. The diagnosis was made by histological study. As a rule, except if some signs are present, it's impossible to suggest diagnosis on X-rays.

[Study by radioactive microspheres of bone microcirculation in aseptic osteonecrosis of the femoral head]. / Etude par microsphères radioactives de la microcirculation osseuse dans l'ostéonécrose aseptique de la tête fémorale.

Thirty-two hips affected by aseptic necrosis, four of them post-traumatic and 12 contralateral hips thought to be healthy have been studied by combining superselective arteriography with the injection of radioactive microspheres. It has been possible to show that aseptic necrosis begins with a global ischaemia and is followed by an incomplete revascularisation leaving a necrotic area. On the border between the two areas hypervascularity produces a zone of fragility where microfractures develop with detachment of a sequestrum. The presumed opposite hip is almost always, even in traumatic lesions, the site of a hypovascularity which seems to suggest a predisposition to the lesion. There is a correlation between radiological and clinical worsening and the development of revascularisation in the femoral head.

[Radiological exploration of the inferior vena cava in nephroepithelioma]. / L'exploration radiologique de la veine cave inférieure dans les néphroépithéliomes.

The development of non-invasive procedures, namely ultrasonography and computed tomography, has modified the strategy for evaluating the spread of a nephroepithelioma to the inferior vena cava. When a complete study can be performed, ultrasonography is the most informative method. Angiographic studies are only performed as the second choice.

[Post-cholecystectomy pseudo-aneurysm. Spontaneous regression demonstrated by angiography]. / Pseudo-anévrisme post-cholécystectomie. Régression spontanée démontrée à l'angiographie

The authors report the case of a pseudo-aneurysm of the right hepatic artery following a difficult cholecystectomy in a patient with sub-acute pancreatitis. Angiography, two years later, showed spontaneous regression of the pseudo-aneurysm and the development of chronic pancreatitis.

[Postoperative thyroidal arteriovenous fistula of late manifestation or disclosed 14 years after thyroidectomy]. / Fistule artério-veineuse thyroïdienne post-opératoire de révélation tardive ou révélée 14 ans après une thyroïdectomie.

A postoperative arteriovenous fistula of the upper thyroidal pedicle was detected 14 years after thyroidectomy. Treatment in this rare case was by elective surgical excision of the fistula.

Effects of L-dopa on myocardial contractile force: a reappraisal.

The apparent decrease in myocardial force of contraction observed after L-dopa, 10 mg/kg i.v., is artifactual since the maximum rate of left venticular isovolumic pressure rise (dP/dt) remains elevated. The apparent decrease is due to shrinkage in heart size secondary to venous "pooling". The decrease in contractile force parallels a decrease in cardiac output. A peripheral decarboxylase inhibitor and L-dopa produce a decrease in both contractile force and dP/dt. Strain gauge arch recordings may produce false-positive data during marked venous pooling.

The cardiovascular pharmacology of the antibiotic ionophore Ro 2-2985 (X537A).

Ro 2-2985 increased mean arterial blood pressure in both the venous bypass preparation and the intact animal; however, total peripheral resistance increased in the venous bypass preparation with a constant cardiac output but decreased in the intact animal with an increase in cardiac output. These observations indicate a drug-related increase in the distensibility of the aorta at the same arterial pressure. In vivo ventricular function curves were shifted to the left indicating enhanced myocardial performance with the translocation of large volumes of blood to the central circulation since total body venous compliance was significantly decreased. Beta adrenergic blocking doses of propranolol blocked the positive inotropic effect of Ro 2-2985 while myocardial depression produced by toxic doses of propranolol was reversed. This observation suggests several mechanisms for the Ro 2-2985 metabolic mediation of myocardial muscle contraction. The cardiovascular effects produced by Ro 2-2985 were accompanied by a marked polycythemia and a decrease in plasma volume without a change in total circulating blood volume, while blood glucose values showed a nonsignificant increase. Ro 2-2985 produced a marked increase in cardiac output. The increase in myocardial performance appears to be complex since myocardial force of contraction, dT/dt, dP/dt:P40 and Vmax were all increased. RO 2-2985 increased coronary flow without an increase in resistance. There were no significant increases in myocardial arteriovenous glucose, lactate, K+, Ca++, Na+ or Cl.