[Anatomical radiology of the descending colon in the left pararenal space: about 1084 cases]. / Radio-anatomie du côlon descendant dans l'espace pararénal gauche : à propos de 1084 sujets.

AIMS: Due to the severity of colonic injuries and their frequency on the left side, we study relationships between the left kidney and the descending colon to identify subjects at risk of colonic perforation during percutaneous surgery of the left kidney. MATERIAL AND METHODS: Over a period of 3 years we exploited abdominal CT scans for 1084 patients in both sexes without any visceral or parietal lesions. We studied the situation and relationships of the lumbar part of the descending colon in the left pararenal space using a conventional grid technique. RESULTS: The preferential site of the colon in both sexes was laterorenal in 55.8% of cases. We also found the descending colon in a posterolateral situation in 21.1% of cases, and in an anterolateral situation in 14.8% of cases. In women, the posterolateral situation was twice more common than in men, but we did not observe any post-renal situation. Laterorenal and posterolateral situations were the most frequent in patients less than 50 years; while beyond this age 70.1% of subjects had a laterorenal type. CONCLUSION: Sex and age affect topographic variations of the lumbar part of the descending colon in the left pararenal space. Although they are rare or aberrant, some locations exist and should not be ignored by the operator. These locations are risk factors of colonic lesion during percutaneous approach of the left kidney.

[Complement and serum immunoglobulins in homozygous and heterozygous sickle cell anemia in Senegal]. / Complément et immunoglobulines sériques chez des drépanocytaires homozygotes (SS) et héterozygotes (AS) au Sénégal.

Sickle cell disease is an hereditary hemoglobinopathy syndrome which provokes deglobulization crisis and infectious complications. These infectious diseases may be due to a permanent activation of the immune system. The aim of our study was to explore alternative pathway by measuring C3 complement and the classical pathway by C4 complement. The level of immunoglobulins IgA, IgG and IgM was also measured in the subjects sera. Thirty homozygous sickle cell anemia (SS), 25 heterozygous (AS) and 34 controls subjects (AA) were recruited in the Hôpital d'Enfants Albert Royer (HEAR), Fann hospital and Centre National de Transfusion Sanguine (CNTS). Radial Immunodiffusion (RID) technics using specific antisera for C3c, C4c, IgA, IgG and IgM were used in our study. Homozygous SS proved an increase level of IgA (50%, p < 0.003) and IgG (47%, p < 0.003), unlike of IgM level. The C3c complement decrease significantly in (27%) of homozygous SS patients (p < 0.0005) unlike of C4c level. This low level of C3 and IgG in sickle cell homozygous patients can explain the higher susceptibility to infection in these patients. Normal level of C4 and low level of C3 show activation of alternative pathway. Heterozygous AS showed a normal level of C4, C3 and immunoglobulins. Our results suggests a direct involvement of the complement system in sickle cell disease and the depletion of C3 registered was a possible cause of increased susceptibility to infections in patients with homozygous sickle cell anemia.

[Antithrombin ii in eclampsia: estimation of predictive value]. / Antithrombine III dans l'éclampsie: estimation d'un seuil prédictionnel.

We have observed in our study that antithrombin III activity decreases very significatively in eclampsia (p < 0.0001). A level of 90% was defined as a threshold. All the rates which are under or equal to 90% have 78.3% as a positive predictive value and those over 90% have a 98.7% as a negative predictive value for the overcoming of eclampsia. We have concluded that the 90% antithrombin III activity represents the alarm level for over coming eclamptic crises. The determination of the antithrombin III activity must be systematically done in every hypertensive pregnancy with proteinuria.

[Endemic parasitic epidemiology in the anti-salt dam area of Bignona (Senegal)]. / Epimédiologie des endémies parasitaires dans la zone du barrage anti-sel de Bignona (Sénégal).

During the study in the anti-salt dam area in Bignona, we noted that malaria was mesoendemic (IP = 45.2%), with a high transmission during the rainy season. Prevalence rate of schistosomiasis was low. Intestinal parasites were frequent (74.4%). It is to be feared with the putting salt out, the prevalence rate of the parasitic diseases would increase, so it is important to create an unity of follow up.

[Factors of humoral and cellular immunity in onchocercosis (results of studies conducted in Senegal)]. / Les facteurs humoraux et cellulaires de l'immunité au cours de l'onchocercose (résultats d'études effectuées au Sénégal).

In the course of Onchocerca volvulus infection in subjects with from light to heavy microfilarial count in skin snips occurred important alterations concerning both humoral and cell-mediated immunity. Serum examination for immunoglobulins showed high synthesis of IgG, IgM and IgE. The level of IgM was found to be correlated to the intensity of the infection, an important reduction of T4 cells was observed and is associated with hyporeactivity to in vitro stimulation to phytohemagglutinin A (PHA). The considerable loss seen in T4 cells function could lead to a reducing of cell-mediated immune mechanisms and humoral response needed in the acquisition of resistance.

[T-cell subpopulations during acute attacks of pernicious malaria]. / Les sous-populations T au cours des accès aigus et pernicieux palustres.

The distribution of T-cell subsets in acute and cerebral malaria have been studied using two monoclonal antibodies. In the course of the disease both in acute and cerebral malaria in persons living in senegalese hypoendemic area occurred important alterations of circulating T-cell subsets. A significant loss of OKT4 positive cells is observed; OKT8 positive lymphocytes are also affected but to a lesser extent. The reversal of the OKT4/OKT8 ratio found in this disease is associated with decrease responsiveness of lymphocytes to PHA. The considerable loss seen in OKT4 cells fonction could be of great importance in reducing cell mediated immune mechanisms and humoral response needed to eradicate the malaria parasite.