[Colonic transit time in healthy Ivorian subjects]. / Détermination du temps de transit colique de sujets ivoiriens sains.

Colonic transit time (CTT) values obtained from healthy Western populations cannot be applied to the population of the Cote d'Ivoire, whose diet is very different. We report the first study of CTT among healthy Ivorian volunteers. This study included 20 healthy Ivorian volunteers (16 men, 4 women, mean age: 25). None was constipated, and all had at least three stools a week. They took no medication and presented no diseases that might affect their digestion. Vegetable fiber was not added to their diet. CTT was assessed according to the method described by Chaussade and al. in 1986: Subjects ingested three types of radiopaque markers in soluble medication capsules at fixed hours for three successive days; plain abdominal radiography was performed on days four, seven, and, if markers remained in the colon on day seven, again on day ten. The plain abdominal radiographs were divided into three parts, representing the right, left and rectosigmoid colons, and radiopaque markers were counted in each segment. CTT was calculated according to Arhan's formula. Mean values (m+/-SD) for CTT were 8.94+/-5.76 hours in the right colon, 12.6+/-8.29 hours in the left, 14.4+/-5.45 hours in the rectosigmoid and 34.94+/-15.09 hours for the entire colon. The corresponding upper limits (M + 2DS) for each segment were 20, 29, 25, and 65 hours. These results suggest the specificity of CTT in healthy Ivorian subjects. CTT norms obtained from healthy Caucasian subjects must not be used to assess CTT in Ivorian patients with constipation.

[Hepatocellular carcinoma (HCC) observed in Abidjan: aspects and role of ultrasonography]. / Carcinomes hépatocellulaires (CHC) observés a Abidjan: aspects et place de l'échographie.

In this retrospective study, we define the localization and ultrasound appearances of hepatocellular carcinomas observed in Abidjan. The study included 31 inpatients (23 males and 8 females), aged from 24 to 76 years (mean, 47.4). All patients had serum alphafetoprotein dosage and 21 patients had cytologic examination. Diagnosis was based on a high level of serum alpha-fetoprotein (> 500 ng/ml), with or without cytological proof. Tumor characteristics (size, number, echogenicity, nodular or diffuse form) and associated extratumoral signs were noted. Ultrasound identified 19 cases of small tumors (size < 5 cm), and 12 large tumors (size > or = 5 cm). The tumor forms were mostly nodular and multiple (24 cases), solitary nodule (3 cases), diffuse or infiltrative (4 cases). The liver was heterogeneous with hyperechoic tumoral nodules (16 cases), hypoechoic tumoral nodules (5 cases), hyperechoic and diffuse form (4 cases), and 2 cases of mixed form. We have noted a particular form in 4 cases represented by a heterogeneous liquid-like mass simulating tropical abscesses. Ascites (12 patient) was the most common extratumoral sign. Portal vein invasion or thrombus was rare (3 patients). Of the 31 patients, ultrasound was abnormal in all cases, alpha-fetoprotein test was positive in 12 cases (57.14%) and negative in 9 cases (42.8%). Cytological test was positive in 17 cases (80.95%), and negative in 4 cases (19.04%). Alphafetoprotein and cytologic tests were both positive in 8 cases and, nonconcordant in 13 cases; in 4 cases alphafetoprotein was positive while cytological tests were negative and, in 9 cases alphafetoprotein was negative while cytological tests were positive. Two negative tests were never observed. In Abidjan, hepatocellular carcinomas are commonly small or large, multinodular and hyperechoic tumors contrasting with the small nodular and hypoechoic tumors usually reported in western series. Ultrasound associated with cytologic examination, appears to us to be more usefulness than alphafetoprotein dosage in the diagnosis of hepatocellular carcinoma.

[Significance of the presence of Australia antigen in liver diseases seen in a department of internal medicine in Abidjan]. / Réflexions sur la signification de la présence de l'antigène Australia dans les hépatopathies observées dans un service de médecine interne à Abidjan.

The exact responsibility of the hepatitis B virus in hepatic diseases seen in Ivory Coast is difficult to specify for several reasons, particularly technical ones. Nevertheless, we have tried to determine the prevalence of the HB virus in hospital practice and in patients hospitalized for liver diseases (viral hepatitis, cirrhosis, primary liver cancer). Comparison of the results to the prevalence of the virus in the ivorian population and statistical processing has led us to moderate the influence of HB virus in the different hepatic disorders. In primary liver cancer, the role of aflatoxine whose carcinogenic potential is now well established has not been disproved.