Scanographic features of gastrointestinal stromal tumors.

PURPOSE: To present the scanographic features of gastrointestinal stromal tumor (GIST) and to discuss their differential diagnosis. PATIENTS AND METHODS: A retrospective study of 45 patients who underwent surgery for GIST between January 1990 and March 2006 was performed. RESULTS: Patient age was 64 years on average. The most common symptoms were abdominal pain and gastrointestinal bleeding. Tumors were located in the stomach in 28 patients (body: 19, antrum: 5, fundus: 4), the small intestine in 13 (jejunum: 6, duodenum: 4, ileum: 3), the rectum in two and the small bowel mesentery in two. Computed tomography showed a large (average size: 9.2 cm, range 3.3-30 cm) exophytic extragastric lobulated mass with an associated wall thickening in 35 cases (78%). The pattern was an endoluminal polyp (average size: 3.2 cm, range 2.2-5.5 cm) in eight cases (18%). The two mesenteric stromal tumors (4%) were seen as well-delimited lobulated large masses (3 and 12 cm). The enhancement was peripheral with central hemorrhagic, necrotic and cystic areas in 37 cases (82%). Mucosal ulceration was seen in 18 cases (40%) and ascites in five (11%). Peritoneal spread and liver metastasis were demonstrated in three patients (7%). Calcification, metastatic lymphadenopthy, venous thrombosis or vascular invasion were not seen. CONCLUSION: Scanographic features of GIST can suggest the diagnosis of GIST before surgery.

[A new method for radio-carpal joint injection]. / Une nouvelle technique de ponction de l'articulation radio-carpienne.

OBJECTIVE: Previous techniques for radiocarpal joint injection introduce the needle directly between the navicular and the radius. We propose here a new technique using the same puncture site for midcarpal and radiocarpal arthrograms without need for needle reinsertion. MATERIALS AND METHODS: A prospective study of 85 radiocarpal injections for arthrography was performed. For each case, the needle tip was positioned at the medial part of the proximal scaphoid, under the mid carpal joint, and directed obliquely with a 45 degrees angle to the joint space to reach the radiocarpal joint. In case of midcarpal and radiocarpal arthrograms, a single puncture site was always used. RESULTS: Injection of the radiocarpal joint was successful in 82 of the 82 cases. CONCLUSION: The method proposed here is simple, efficient and uses a single site of puncture in cases requiring bi-compartmental injections.

Efficacy of Arthrotec in the treatment of rheumatoid arthritis.

In a double-blind study, 346 patients with active rheumatoid arthritis were randomly assigned to receive Arthrotec, a combination of 50 mg of diclofenac and 200 *g of misoprostol, or 50 mg of diclofenac; the drugs were given two or three times daily for 12 weeks. At weeks 4, 8, and 12 of treatment, no clinically significant differences between the two treatment groups were noted on measures of joint tenderness, pain, and swelling or on physicians' and patients' assessments of disease severity.

[Hepatitis secondary to current non-steroidal anti-inflammatory agents]. / Les hépatites secondaires aux anti-inflammatoires non stéroïdiens récents.

The authors report 83 cases of acute hepatitis secondary to non steroid anti-inflammatory drugs (NSAID), published in the literature. The NSAID in question are: niflumic acid, tolfenamic acid, diclofenac, fenoprofen, ibuprofen, indomethacin, naproxen, piroxicam, pirprofen and sulindac. Six deaths are directly ascribed to NSAID: although rare, these forms of hepatitis deserve therefore to be reported. They are usually mixed immuno-allergic forms of hepatitis (cytolytic as well as cholestatic). They often affect elderly women taking multiple medications. Monitoring of the liver function tests is necessary, during prolonged treatment with NSAID, especially during the first six months.