Because reoperative thyroid surgery can lead to potential complications, especially permanent RLN palsy or hypoparathyroidism, it should be reserved for patients who need it. The importance of respecting specific technical rules should be emphasized.

No abstract

The blood schizogonic cycle of human malaria parasites has thus far been the most exhaustively studied phase of parasite development. However, before entering red blood cells (RBCs), the parasite undergoes its first multiplication not in blood, but in hepatic cells. These hepatic stages were the last to be discovered and only a few studies have been performed in humans and other primates. Despite recent advances, in vivo studies have limitations and other approaches such as cultures of these liver forms may be necessary to investigate their chemosensitivity and their biochemical or immunological properties. Recently, sporozoites of species of rodent malaria have been made to infect cultured cell lines or primary hepatocyte cultures. We report here that the complete cycle of the human malaria parasite Plasmodium vivax can be obtained in primary cultures of human hepatocytes up to release of merozoites able to penetrate RBCs.

Small bowel stomas can be closed in selected healthy patients on postoperative day 10 without major complications.

We report a series of 30 patients with pancreatic insulinoma treated from 1967 to 1990. Twenty-nine patients underwent surgery. In 24 patients, the lesion was a benign adenoma. The pancreatic lesion was localized preoperatively in 59% of cases (94% since 1980), and all lesions that were identifiable histologically were palpable intraoperatively. Endoscopic pancreatic ultrasonography, performed twice, appeared to be a very promising method of investigation. In the 24 patients with adenoma, 14 enucleations and 10 pancreatic resections were performed, with the enucleation rate increasing over time. One patient died during the postoperative period. Pancreatic fistulas (43%) were the most common cause of morbidity and were more common after enucleation (57% versus 29% after pancreatectomy). The mean follow-up period was 7 years. Excluding the patients with adenocarcinomas, the recovery rate was 92% (23 of 25 among whom 2 patients had transitory recurrent hypoglycemia), 2 patients who underwent corporeo-caudal pancreatectomy being diabetic (8%).