Glass transition by gelation in a phase separating binary alloy.

We use molecular dynamics simulations to show that glass transition in a model phase separating amorphous alloy, Cu(50)Nb(50), occurs by gelation. At the glass transition, a mechanically stiff, percolating network of atoms with icosahedral local packing forms at the interfaces between compositionally enriched regions. This low-energy network halts coarsening of the phase-separated structure and imparts shear resistance. These features of glass transition are remarkably similar to gelation processes in polymeric and colloidal gels.

A transmission electron microscopy study of the effect of interfaces on bubble formation in He-implanted Cu-Nb multilayers.

Magnetron sputtered thin films of Cu, Nb, and Cu-Nb multilayers with 2.5 and 5 nm nominal layer thickness were deposited on Si and implanted with 4He+ and 3He+ ions. Secondary ion mass spectroscopy and nuclear reaction analysis, respectively, were used to measure the 4He+ and 3He+ concentration profile with depth inside the films. Cross-sectional transmission electron microscopy was used to characterize the helium bubbles. Analysis of the contrast from helium bubbles in defocused transmission electron microscope images showed a minimum bubble diameter of 1.25 nm. While pure Cu and Nb films showed bubble contrast over the entire range of helium implantation, the multilayers exhibited bubbles only above a critical He concentration that increased almost linearly with decreasing layer thickness. The work shows that large amounts of helium can be trapped at incoherent interfaces in the form of stable, nanometer-size bubbles.

[Digestive manifestations of periarteritis nodosa in a series of 120 cases]. / Les manifestations digestives de la périartérite noueuse dans une série de 120 cas.

In a series of 120 patients with periarteritis nodosa (PAN), 50 had gastrointestinal manifestations; 34 had transient abdominal pain which regressed spontaneously or in response to corticosteroid therapy and required no further investigation. Thirty one more serious episodes occurred in the remaining 26 patients. Eight of these were in fact the initial signs of PAN and 13 required laparotomy. There were 20 episodes of abdominal pain (peritonitis: 9, pancreatitis: 4, acute cholecystitis: 2, duodenal ulcer: 3, intestinal infarction: 1, unexplained pain without diagnosis at laparotomy: 1) and 11 of gastrointestinal hemorrhage (melaena or hematemesis: 4; hematochezia: 5). Clinical and biological features of patients with and without gastrointestinal manifestation were not significantly different except for cardiac involvement which was significantly more frequent (p less than 0.05) in the second group. Corrected survival rates were significantly lower (p less than 0.05) in patients with gastrointestinal manifestations. These results show that, in patients with PAN, digestive manifestations, particularly perforations, carried a poor prognosis. Nevertheless exploratory laparotomy and surgery unrelated to PAN (eg appendicectomy) were well tolerated.

[Hepatic metastases. Value of chemotherapy by the intra-arterial route]. / Métastases hépatiques. Intérêt de la chimiothérapie par voie intra-artérielle.

Forty-three patients with metastatic liver cancer were treated with multiple chemotherapy by the intra-arterial route. Metastases originated from primary cancer of the breast (16) or colon (10), melanoma (7) and miscellaneous tumours (10). In 35 patients chemotherapy was administered by selective catheterization of the hepatic artery via the axillary artery; it usually (31 cases) consisted of doxorubicin (60 mg/m2) and mitomycin (10 mg/m2) injections, and continuous infusion of 5-fluorouracil (1 g/24 or 72 hours). In 14 patients (10 responders to the above method and 4 new cases), a catheter with subcutaneous chamber was implanted surgically so that chemotherapy could be continued through the chamber. Blood toxicity was usually moderate. The main complication of injections through the catheter (114) or through the chamber (60) was thrombosis. However, except for 1 lethal cerebral thrombosis, the others (axillary artery 3, hepatic artery 5) were unattended by functional symptoms. Transient biochemical signs of hepatic cytolysis were frequent after each course. Hepatic insufficiency was severely aggravated in 2 cases. Painful digestive disorders were relieved by symptomatic treatments. Four complete responses, 16 partial responses, 8 stabilizations and 10 failures were observed; 5 patients died soon after one single course of intra-arterial therapy. The high response rates (greater than 50%) in metastases from cancer of the breast and colon, and chiefly the 3 complete responses obtained in patients with mammary carcinoma were most encouraging, bearing in mind that one of these 3 patients had not responded to intravenous chemotherapy.

[Cystadenoma and cystadenocarcinoma of the pancreas. Apropos of 7 new cases]. / Les cystadénomes et cystadénocarcinomes du pancréas. A propos de 7 nouvelles observations.

Cystadenomas and cystadenocarcinomas of the pancreas are tumours which remain poorly known because of their relative rarity. They are seen essentially in women aged between 40 and 60 and involve the left half of the pancreas more often than the right. The symptomatology remains latent for a fairly long time, which explains the fact that they are most often discovered only at the stage of a palpable tumour. Recent methods of investigation--echotomography and computed tomography--are of very great value in preoperative diagnosis. It is extremely important to draw the distinction within the group of benign cystadenomas between microcystic forms and macrocystic forms or mucinous cystadenomas, the latter having a definite potential for malignant change, possibly explaining the link with certain cystadenocarcinomas. As a result, excision surgery is always preferable, when possible, to bypass surgery, at least in caudal or corporeo-caudal lesions, since excision surgery is usually easy. For cephalic lesions, if excision surgery seems difficult, it may be conceivable, using modern techniques of investigation, to adopt a conservative attitude when there are no features suggestive of potential malignant change.

Counseling Army reservists and their families during Operation Desert Shield/Storm.

The hardships of war affect all members of society. Those most acutely affected are service members and their families. Civilian service personnel mobilized within an active reserve component experience a disruption of life style which can cause stress. Service members are trained to be effective soldiers, but very little training is provided to service members or their families on the wartime stresses they face. The psychiatric army reserve unit based in Minneapolis developed a family support program for three phases of wartime stress: (1) pre-deployment, (2) deployment, and (3) reunification and sustainment. Recommendations are provided for family support in future wartime situations.

[Leiomyosarcoma of inferior vena cava. A new case. Surgical management (author's transl)]. / Les léiomyosarcopes de la veine cave inférieure. A propos d'un cas ayant bénéficié d'une exérèse chirurgicale.

The authors report on a new case of leiomyosarcoma of the inferior vena cava, to add to the sixty five cases already mentioned in the literature. The patient had been suffering from subcostal pains for 12 years, and an adenomyoma of the gall bladder was diagnosed. The tumor was discovered in the course of a cholecystectomy. The vena cava was resected and ligated below the renal veins. After describing the case, the authors go on to review the literature and stress the fact that the prognosis, which is often severe, could be improved by earlier diagnosis.

[Corticotherapy and surgery. Apropos of 73 cases]. / Corticothérapie et chirurgie. A propos de 73 observations.

The authors reviewed the outcome of 73 operations performed on 60 patients on long-term steroid therapy: Eighteen operations were carried out for gastro-intestinal perforation but the causal role of steroid therapy was only established in 6 cases (4 gastric and 2 colonic perforations). In the other 12 cases there was intercurrent pathology or a recrudescence of the underlying disease process. More selective indications for steroid therapy and the protective action of new drugs on the gastro-intestinal mucosa are probably responsible for the low incidence of iatrogenic complications compared with previously published series. However, steroid therapy did affect the postoperative course: the risk of infection was 20 to 30 p. 100 higher than normal, very common after emergency surgery (75 p. 100) and a major cause of mortality (60 p. 100); the risk seems to be high when the steroid dose exceeds 0.5 mg/kg/day, the disunion of an anastomosis was observed in 6 cases, including 5 "dirty" operations with a mortality of 60 p. 100, healing was slow: 2 cases of evisceration and 2 of abdominal hernia were observed. It was not possible to assess the threshold dose of steroids with regards to this complication, metabolic complications, especially adrenal failure were much less common. Of the diseases requiring steroid therapy the problem of angiitis seemed particularly prominent. Although the prognosis of the intercurrent surgical condition was not aggravated; mortality from a relapse of the angiitis was nearly 100 p. 100. Therefore, medical control of the relapse would seem to be the first priority and should be taken into account when assessing the surgical indications.

[Intra-arterial chemotherapy for hepatic metastases. Experience of the Pitié-Salpêtrière Hospital Group]. / Chimiothérapie par voie intra-artérielle des métastases hépatiques. Expérience du Groupe Hospitalier Pitié-Salpêtrière.

Intra-arterial chemotherapy of hepatic metastases is theoretically interesting because of the essentially arterial blood supply of these metastases in contrast with the healthy tissue and because of the theoretical pharmacokinetic advantage for certain drugs, depending on their quotient of hepatic extraction and the wole body clearance. We have treated 43 patients with this technique. The primary cancer was a cancer of the colon in 10 patients, a breast cancer in 16 patients, a melanoma in 7 patients and cancers of other sites in 10 patients. The chemotherapy was initially administered by selective catheterisation of the hepatic artery via an axillary approach and usually consisted of a bolus injection of adriamycin 40 mg/m2 and mitomycin 10 mg/m2 and an infusion of 5 FU 1 g/m2 for 24 to 72 hours. In 15 patients, we surgically implanted a subcutaneous reservoir and catheter. To date, we have performed 114 arterial injections via the catheter and 60 injections into sub-cutaneous reservoirs. We have observed few complications, apart from thrombosis of the axillary artery (3 cases) and of the hepatic artery (5 cases). We have obtained 4 complete responses, 16 partial responses, 8 stabilisations, 10 failures and, unfortunately, 5 patients died rapidly after a single course of chemotherapy and could not be evaluated. The response rate was particularly high for the breast cancers (about 60 percent) and the cancers of the colon (more than 50 percent). We have also observed 3 complete responses in patients treated by intravenous chemotherapy with the same protocol.