Pseudotumor form of pulmonary nocardia infection (Nocardia nova) in a renal transplant patient

The authors report a case of pulmonary nocardiosis due to Nocardia nova occurring in a smoker who had a renal transplant. A pseudo-tumour was found on a standard X-ray and computerised tomography did not suggest the diagnosis. Needle aspiration under computerised tomographic control enabled a diagnosis to be made.     

Arterial radio-anatomy of the extrahepatic biliary system (author's transl)

The uni-arterial vascularisation of the lateral bilary duct makes it impossible to systematise the arteries which supply the common bile duct. Only the cystic artery is seen at coelio-mesenteric catheterization. The techniques essential for visualisation of the cystic artery are discussed, on the basis of one hundred coelio-mesenteric arteriograms: frequency of demonstration, origin, course, termination, calibre and length. The frequent finding of opacification of the wall of the gall bladder under normal conditions is stressed.     

Abdominal tomometry. 1st results in exploration of the liver and pancreas

Over a two month period, 120 patients were explored using an Acta Scanner tomometer for various hepatic disorders. In parallel, comparison was made of anatomical slices and computed tomography findings in cadavers and isolated livers. This made it possible to recognise normal structures seen at computed tompgraphy and to identify certain hepatic images which might be sources of error. Serial transverse axial sections were used to reconstruct the whole liver in space, thereby making it possible to eliminate certain cases of pseudotumoral hepatomegaly. Systematic densitometry was carried out using hepatic radio-anatomical and pathological studies. This new type of analysis led to a quantified diagnosis in certain diffuse hepatic disorders and a histological approach to tumour lesions. Hepatography using special contrast agents in very low dosage was used in liver computed tomography after animal experiments. This method, free of untoward effects, makes possible the diagnosis of hepatosplenic tumour lesions less than one centimetre in diameter.     

Palliative percutaneous treatment under x-ray computed tomographic control of inoperable pulmonary aspergilloma. Apropos of 30 cases

The authors report 30 cases of the percutaneous treatment of symptomatic pulmonary aspergilloma by injection of amphotericine paste in patients who were not considered to be operable. The treated aspergillomas had developed as a sequel to bacilliary infection and pulmonary fibrosis. Surgery was contraindicated in these patients on account of severe respiratory failure. The authors specify the technique for the preparation of the paste and for the type of percutaneous injection, the aim being to obtain complete filling of the cavity and creating an anaerobic environment for the aspergillus. The contribution of this technique for the non-surgical treatment of patients appears interesting but should be carried on a larger series to identify the exact indications and the interaction with other new treatments which have just appeared.     

Endovascular management of traumatic infrarenal abdominal aortic dissection

Dissection is a recognized finding after blunt trauma to the abdominal aorta. Immediate and long-term prognosis is poor without surgical treatment especially since most patients present severe associated injuries. On the basis of encouraging results using endovascular techniques to treat experimental dissection of the descending thoracic aorta, we treated three patients with traumatic infrarenal abdominal aortic dissection by percutaneous stent placement. There were two men 34 and 41 years of age and one 89-year-old woman. In all patients, dissection began in the infrarenal portion of the aorta and extended into the iliac arteries. All patients had multiple associated injuries. The main symptoms were acute abdominal pain (two patients) and ischemia of the lower extremities (two patients). Diagnosis was missed in one patient despite exploratory laparotomy for an associated injury. Two patients were treated in the acute phase by placement of a self-expanding endovascular prosthesis at the aortoiliac level. The third patient was treated in the chronic phase by placement of a balloon-expandable endovascular stent. All procedures were performed uneventfully by femoral route. Success of treatment was confirmed by arteriography and computed tomography (CT) scan demonstrating obliteration of the dissection. Upon late follow-up examination, all patients were in satisfactory condition, with normal Doppler ultrasound findings. These findings confirm experimental studies using endovascular treatment for dissection of the descending thoracic aorta and are promising for future clinical management.     

Modeling logical and temporal synchronization in hypermedia systems

The paper introduces a unified formal model for the complete and accurate specification of both temporal and logical (i.e., link) synchronization within hypermedia distributed and weakly synchronous systems. This new model extends time Petri nets with hierarchical design capabilities and new firing rules. These new firing rules enlighten the notion of hypermedia synchronization through powerful combinations of temporal and logical synchronization. Moreover, the proposed model offers an easy and concise modeling technique of asynchronous events in hypermedia systems