Flexor tendon injury of hand at zone II. Early or delayed suture?

The healing of a sutured tendon in the hand usually occur with an unwanted amount of scarring that defeat good results. Many variables have been studied over many decades; timing of repair was a matter of debate. Zone II is the area where those variables mostly affect the results of treatment. To-study and evaluate the results of early or delayed repair under the effects of our local variables. Prospective study of 85 patients, which had flexor tendon repair at zone II by primary repair, delayed primary repair and tendon graft. Results showed a primary repair ended with better functional results than those with delayed repair and than those with tendon graft. Excellent and good results were 83.7% in the early repaired group versus 43.8% in the delayed groups; these results were statically significant; P=<0.0002. We conclude that early suture is better than delayed suture and call on casualty doctors to refer patients to hand surgery units to have better end results in this difficult area of treatment

[Rare causes of low digestive hemorrhage]

The lesions responsible for low digestive hemorrhage [LDH] are located at the lower part of the angle of Treitz. They are of origin colic in 90% of the cases. The lesions of hail are less frequent, with more difficult diagnosis and management. We report 2 observations of rare causes of LDH 47 and 44 years old respectively admitted both because of an anaemia with low digestive hemorrhage related to a stromal jejunal tumor in the first case and on a cavernous hemangioma of hail in the other case. The diagnosis is confirmed by the histologic study of the exeresis product

Study of angiogenesis and inflammation patterns in ductal carcinoma in-situ of the breast

This study aimed to determine the pattern of microvessels and inflammation around DCIS and assess their relationship to each other and to the histopathological types of DCIS. Two distinct vascular patterns were observed, a diffuse increase of stromal vascularity between duct lesions [Pattern I] in 52% and a dense rim of microvessels adjacent to the basement membrane of individual ducts [Pattern II] in 28% and both patterns in 19%. Pattern I was seen with high grade [Comedo carcinoma]. Two patterns of inflammation were studied in 23/42 cases of DCIS. Clusters of inflammatory cells situated either adjacent to involved duct or in the interductal stroma [17/23]. A less prominent pattern was a diffuse stromal infiltrate of inflammatory cells [6/23]. There was no significant correlation between patterns of angiogenesis and patterns of inflammation. Thus, different patterns of inflammation were associated with different patterns of vessels. The clusters of inflammatory cells may be recruited via high endothelial venules induced by the DCIS. Cytokines released by the DCIS and/or inflammatory cells [clusters or diffuse] may stimulate the two patterns of new vessels formation. This study suggested that distinct patterns of vascularity in DCIS might be useful for identifying patients who are at high risk