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Peripheral airway smooth muscle (ASM) mass is increased in severe equine asthma, but no information is available on age related changes in ASM. In this study, peripheral ASM dimensions were determined in healthy horses of different ages. The thickness of the peripheral ASM layer was constant in horses of different ages, but ASM occupied a greater proportion of the inner wall area in young horses compared to older horses. This finding suggests that equine airways experience a decrease in the relative abundance of ASM with age.

Recurrent hepatitis C virus (HCV) in liver transplant patients is a major cause of graft loss, liver failure, and need for retransplantation. The results available to date with the use of interferon alfa (IFN-alpha) in the treatment of recurrent HCV in liver transplant patients have been disappointing. The aim of this study was to evaluate the efficacy and clinical utility of post-transplant combination therapy with IFNalpha2b (3 million units 3 times weekly) and oral ribavirin (1,200 mg/d) for a duration of 6 months, followed by maintenance with ribavirin alone for an additional 6 months. Twenty-one liver transplant recipients with recurrent hepatitis C infection (HCV-RNA-positive; active hepatitis without rejection on biopsy) were enrolled in this study. Pretreatment serum alanine transaminase (ALT) levels were at least two times the upper limit of normal. Before treatment, all patients were HCV-RNA-positive and mean HCV-RNA titers were 125 million genome-equivalents/mL. Mean pretreatment histological score was 6.3 +/- 2. After 6 months of combination therapy, all 21 patients had normal ALTs. Ten patients (48%) cleared HCV-RNA from their serum, as assessed by polymerase chain reaction (PCR), and HCV-RNA levels decreased significantly in the others (P = .0001). Improvement in histological score was seen in all patients after combination therapy (P = .0013). During maintenance ribavirin monotherapy, ALT remained normal in all but 1 of the 18 patients who tolerated therapy. HCV-RNA reappeared in 5 patients, but HCV-RNA levels did not return to pretreatment levels (P = .0004). Comparison of pretreatment and postribavirin monotherapy liver biopsies revealed improvement in all but 1 of the 18 patients who tolerated ribavirin (P = .0002). Side effects were restricted to anemia, which necessitated cessation of ribavirin therapy in 3 patients. No patient experienced graft rejection during the study period. These results are significantly better than those reported with IFN-alpha monotherapy. Most importantly, there was a complete absence of graft rejection. These results suggest that the combination of IFN-alpha and ribavirin is effective in reducing HCV-RNA levels and ameliorating hepatocellular injury in recurrent HCV after liver transplantation, and that maintenance therapy with ribavirin monotherapy can maintain the biochemical and histological response.

International audience; A bench test for differential radar cross-section (ΔRCS) measurement is described. The principle is to measure the power difference between the low and high modulation state of the tag and calculate the ratio with the received power. To do this, devices such as an arbitrary generator that replaces the reader, and a real-time spectrum analyser to receive and analyse the signal backscattered by the tag, are used; both devices can be configured in frequency and power. The first measurements are performed manually and the results demonstrate the validity of the proposed method. The automation of the system is carried out in order to make the measurement faster, less hardwork, more precise and more repeatable.

Measurement methodology and theoretical equations to RCS and ΔRCS determination are recalled and the measurement uncertainties are evaluated in this paper. Even if measurement uncertainties are generally not required for RFID, it is important to understand and to be able to determine the measurement uncertainty. Currently, manufacturers and testing laboratories present some results of RFID measurements but never show the associated uncertainty. Yet, seeing the values of the uncertainties, it is clear that they are not negligible.

Evaluation of a new pig liver transplantation technique for survival and hypertrophy of a small-sized graft by providing adapted and controlled venous portal flow.[corrected] Twenty Large-White pigs underwent heterotopic liver transplantation after a mesocaval shunt and ligation of the superior mesenteric vein downstream from the shunt. The donor-to-recipient weight ratio was below 30%. Furthermore, recipient's biliary duct and portal vein into the hilum were tied. In a control group, no mesocaval shunt was performed and the graft received the entire splanchnic venous flow.The mesocaval shunt provided diversion of 60% of the splanchnic blood flow. The median survival of study pigs was 39 days (range: 8-98). Median serum bilirubin levels at 1 week were 12 micromol/L (range: 4-59). At autopsy, graft weight was increased to 2.7 times the initial weight and histological findings were normal. In the control group, all pigs died quickly from acute splanchnic congestion.In a model of heterotopic liver transplantation using small-sized grafts, complete diversion of mesenteric blood flow through a mesocaval shunt resulted in hemodynamic tolerance and hypertrophy of a graft corresponding to less than 30% of the ideal mass.

A model of heterotopic liver transplantation had been studied. The graft was laid under the recipient liver and the portal blood flow was supplied by anastomosis with the distal part of the splenic vein. Both liver can then receive portal blood through two parallel portal circulation. Liver function of transplant was satisfactory at three months after transplantation. Their had been no alteration of the recipient liver during the same period.

Repeated hepatic resection (RHR) for recurrent colorectal metastases remains uncommon and controversial. We report our experience in order to assess the feasibility and the potential oncologic benefit of such an aggressive management. From 1981 to 1991, 13 patients underwent a RHR. The first hepatic resection had been an anatomic hepatectomy removing between two and six segments in 10 patients and a wedge resection in three. The RHR was performed after a mean delay of 16 +/- 10 months (5-35) from the first liver procedure. The RHR was an anatomic hepatectomy in eight patients (including a right hepatectomy in three) and a minor resection (tumorectomy or segmentectomy) in five. Three patients underwent a third liver resection for recurrence. There was no post-operative mortality. Eleven patients died from recurrence after a mean survival of 17 +/- 13 months from the second hepatic procedure (range: 6-47). One patient died from unrelated disease after 12 months and one was alive free of recurrence 22, 53 and 84 months after third, second and first hepatectomy respectively. The median survivals from the second and first hepatic resections were 17 and 31 months, respectively. It is concluded that in the well-trained team, RHR is feasible and safe even after major primary hepatectomy. However the oncologic benefit remains questionable.

Epithelioid hemangioendothelioma (HEE) is an unusual malignant neoplasm of vasculo-endothelial origin, arising in soft tissues, lung and liver. One case of hepatic HEE is reported in a 32 year-old man wit an isolated multinodular hepatomegaly. The diagnosis was made by the histologic examination of biopsy specimens. At the time of diagnosis, there was evidence of pulmonary metastasis. However, an orthotopic liver transplantation was performed. The tumor cells were immunoreactive with factor VIII-related antigen, BNH9 and vimentin. There was no expression of cytokeratin and epithelial membrane antigen. The patient is alive and well 24 months after. The thoracic X-ray are unchanged. This case is compared with the 84 others cases of the literature. Fourteen experienced a favorable outcome after transplantation. Extra-hepatic dissemination doesn't contra-indicate the graft. But hilar vascular involvement may be correlated with worse prognosis.

Forty-eight hours after a women was poisoned by ingesting Amanita phalloides mushrooms, she developed fulminant hepatic failure with collapse, pH 7.24, lactic acidosis 7.6 mmol/l, hypoglycaemia 3.5 mmol/l, anuria and stage IV coma requiring tracheal intubation and mechanical ventilation. Transaminase level was up to 8,000 UI/l. Prothrombin and factor V levels were below 10 percent, with an APT time of 86 s versus a 29 s control time. Twenty-four hours after her admission, the patient underwent orthotopic liver transplantation. The postoperative period was uneventful, with return to consciousness and rapid normalization of hepatic biochemistry values, without signs of acute rejection. This 10th published case of orthotopic liver transplantation for Amanita phalloides poisoning with acute hepatic necrosis confirms that this type of treatment must be systematically envisaged in all such cases.

Two patients with severe hepatic and renal failure underwent emergency hepatic retransplantation (2nd and 6th day after transplantation). Continuous arteriovenous haemodialysis was begun before surgery and successfully performed, without any incident, during the retransplantation with a biospal (SCU/CAVH AN 69 S) device, without pump. Vascular access was obtained with femoral catheters. Such a continuous dialysis and ultrafiltration allowed us to infuse massive amounts of blood products before and during surgery and to maintain pH, potassium and lactate at levels compatible with survival in anuric patients. Standard haemodialysis replaced CAVHD when haemodynamic stability was restored.

36 patients with peptic strictures were operated between 1981 and 1987. 40 operations performed because 4 recurrences after a first intervention obliged to a re-operation. The conservative procedure was used in 29 cases (72.5%). A resection had to be done in 11 cases (27.5%), with 3 re-operations after a first conservative treatment. 1 patient died in hospital. The follow up concerns all patient after a minimum of 2 years. 31 patients (88%) remained symptom free, but 4 patients required further surgery. No mortality and a low morbidity with conservative surgical method were observed. The rate of success was 76% with 24% of recurrence. For us, the best conservative method is total fundoplicatio if possible (sometimes on a gastric cone in case of reflux stricture with shortening of the esophagus). The duodenal diversion is recommended if approach of hiatus is too difficult (re-operation) and in case of alkaline reflux.

Ten patients undergoing resection for esophageal cancer were randomized postoperatively into two groups. In group 1, five patients were supported with positive pressure inspiratory aid (PPIA); whereas, in group 2, five patients were managed with conventional assisted mechanical ventilation (AMV). Both groups had ventilatory support for 18 hours and then were extubated subject to defined criteria. Compared to AMV, PPIA patients felt comfortable, used less sedation, and the PaO 2 , was higher, with PaC0 2 and pHa close to normal values. These favorable results were obtained despite a decrease in respiratory rate and expired minute volume. No adverse effects in terms of hemodynamic alterations, weaning difficulties, or pulmonary complications were seen. PPIA differs from other pressure support modes by providing a virtually unlimited inspiratory flow and an expiratory trigger that ends the inspiretory phase. These features provide a zero end inspiratory flow phase, thereby allowing patients to control inspiratory time and vary or modulate their own inspiratory effort. In the context of routine postoperative ventilatory support for esophageal resection patients, PPIA offers advantages over AMV.

A modification of a split Hopkinson pressure bar is presented. The experimental data, obtained with this testing apparatus, are treated by means of a graphic microcomputer. The behaviour relationship sigma =f( epsilon ) for high rates of strain is rapidly achieved and then can be used for modelisation.

Intra operative radiation therapy is a new look at an old idea (Rich). In relation with the first experience at the Croix-Rousse Hospital with orthovoltage, a review of technical choices, surgical problems, and biological questions is presented. The analysis of literature about accumulated clinical results suggest that local control in recurrence, residual, or inoperable tumor can be obtained by combined surgery IOR, and external beam irradiation. This short experience demonstrate the feasibility of the treatment as a routine and emphasizes the need for continued study.

The authors report a series of 72 cases of Crohn's disease, and discuss the clinical and pathological aspects, the surgical treatment and results. A critical study of the operations in view of the requirements of the disease showed that incomplete resection was mainly responsible for the recurrences. In most cases, the word relapse was more suitable to describe the poor results noted. Immediate radical removal gives such good results that these outweigh the functional disadvantages.

In the period between 15/12/1987 and 15/08/1989, ten patients with either fulminating or subfulminating hepatitis have been treated by orthotopic liver transplantation (O.L.T.). Six patients are doing well in the post-operative period with a mean follow-up of 12 months (7-23 months). No evidence of neurological sequelae has been observed and recurrence of HB virus infection was absent from the three cases who survived hepatitis B transplantation. Four out these ten patients died after initial successful O.L.T... One patient succumbed 7 days after O.L.T. from sepsis or early super-acute rejection, the second 21 days after O.L.T. from neuromeningeal listeria, the third 43 days post O.L.T. from acute rejection, while the fourth developed cytomegalovirus pneumonia and died 61 days after O.L.T. Orthotopic liver transplantation has become the treatment of fulminating hepatitis. It is an emergency which is usually accompanied by successive difficulties in decision making: indication criteria, then acceptance or refusal of ABO incompatible grafts (5/10) and of suboptimal donors. Orthotopic liver transplantation for fulminating hepatitis is technically easy to perform, but usually requires the use of extra-corporal veno-venous circulation. Accompanying intensive medical care is essential and usually includes one or multiple plasmaphereses to correct existing coagulopathy without any fluid or sodium overload to the circulation.

Between 1981 and 1985, 39 patients had hepatic resection for colorectal cancer liver metastases 44 operations (5 iteratives resections) were performed with 33 major hepatectomy. There was no mortality. Long term results showed: a one year 53% survival, a two years 23% survival, a three years 11% survival. 28 patients had recurrences; 15 of these 28 had hepatic recurrences. According to recent literature the high level of hepatic recurrence suggest that surgical resection should be accompanied with regional chemotherapy.