The percutaneous treatment of stenosis and thrombosis in haemodialysis access achieves patency rates similar to those reported in the surgical literature and confirms that grafts must be avoided as much as possible given their poorer outcome, especially after the first thrombosis. Poorer outcome is also demonstrated in accesses of less than 1 year's duration.

Over 54 months, 70 short stenoses of 63 shunts (32 Brescia-Cimino fistulas, 31 grafts) in 59 patients necessitated a first percutaneous transluminal angioplasty (PTA). Restenosis led to 63 redilations in 38 lesions. Nine stents were inserted in seven grafts and two proximal veins in seven patients, the indication being that stenosis had recurred twice in 6 months. In three of these stenoses, five delayed intrastent redilations were necessary. Three previously dilated occluded grafts were recovered with local thrombolysis. Morbidity was 4.08%, with one immediate rupture, four delayed pseudoaneurysms (1-28 months), and two periprocedural bacteremias. Half (15 of 29) of graft stenoses and only 14% (four of 27) of Brescia-Cimino fistula stenoses had a mean restenosis interval of less than 6 months. The mean restenosis interval increased from 3.6 months +/- 0.5 (standard deviation) before stent placement to 15.2 months +/- 0.4 after stent placement (P < .001). Insertion of a stent can be advised when stenoses of graft venous anastomoses have recurred twice in less than 6 months. The combination of all interventional radiologic procedures allowed a significant improvement in secondary patency rates after PTA, with 82% at 1 year, 79% at 2 years, and 71% at 3 years.

Death after withdrawing from dialysis was the most common cause of death in ESRD patients in our French population cohort. The patients who died after discontinuation of treatment were more often in a poor general condition, near the end of life, and most often the physician decided to stop dialysis treatment.

No abstract

Washed suspensions of mixed rumen protozoa readily hydrogenated fatty acids in cottonseed, soya bean and corn oils in addition to free oleic and linoleic acids. Protozoa belonging to the family Ophryoscolecidae appeared to account for almost all the activity of mixed protozoa, protozoa of the family Isotrichidae possessing little or no ability to hydrogenate the added substrates. The hydrogenation of oleic acid was markedly increased by Fe and Mn. The addition of starch cellulose, urea and sodium formate greatly stimulated hydrogenation of oleic acid by rumen protozoa. Glucose, casein, ammonium sulphate, i-cysteine and n-valeric acid had no or little effect on extent of hydrogenation.When suspensions of mixed protozoa were incubated in a buffer solution, an increase in iodine value was observed. The desaturation in the protozoal cells was appreciably increased by DL-methionine and was not influenced by L-cysteine. No desaturation activity by the pure suspensions of Ophryoscolecidae or Isotrichidae was observed.The presence of protozoa in the rumen of sheep greatly increased the levels of saturated fatty acids over those in the ciliate-free animals. The concentrations of saturated fatty acids in the plasma of faunated sheep were significantly higher than those in the same animals after the removal of rumen ciliate protozoa.TNTRODTirTTOV present investigation was therefore, undertaken in order to study the lipid metabolism of rumen proThe ciliates of the rumen are of two families: the tozoa in fairly pure preparation and almost free of highly complex family Ophryoscolecidae (Oligo-bacteria, trichs) of which there are many species and the family Isotrichidae (holotrichs), consisting of the MATERIALS AND METHODS Isotricha prostoma, Isotricha intestinalis and Dasytricha ruminantium (Abou Akkada, Bartley & In vitro studies Fina, 1969) . Considerable interest has been shownPreparation of protozoal suspension. Two fistuduring the last few years in the carbohydrate and lated sheep which had been fed a diet composed of nitrogen metabolism of these organisms (Abou 50% Berseem (Trifolium Alexandrinum); 24% Akkada, 1965). Furthermore, the contribution of undecorticated cottonseed cake; 24% rice bran; the rumen protozoa to the metabolism and growth 1-5 % calcium carbonate; and 0-5 % common salt, of the host animal has been recognized by a num-served as the source of protozoa.