[Relative frequency of malignant and benign tumors in Arlit, Niger. Analysis of data from anatomopathological examinations over a 15-year period]. / Fréquence relative des tumeurs malignes et bénignes à Arlit (Niger): bilan de 15 ans d'examens anatomo-pathologiques.

The purpose of this study was to determine the frequency and distribution of cancer in the uranium-mining region of Arlit, Niger, based on extensive data from all the anatomopathological examinations performed at local hospitals over a 15-year period. The overall annual incidence, i.e., 26 per 100000, was similar to incidences reported elsewhere in Africa. The rate of examinations leading to diagnosis of malignancy decreased between 1991 and 1997 and, for unexplained reasons, varied from one practitioner to another. There was no evidence of a higher rate of any cancer that might result from possible exposure to radiation during mining operations. The distribution of cancer by organ was unremarkable, i.e., in order of frequency, womb and ovaries in women; skin and prostate in men; thyroid and lymphatic tissue in both genders.

Performance of colposcopy in five sub-Saharan African countries.

OBJECTIVE: The performance of colposcopy provided in a screening study in five African countries was evaluated. DESIGN: Cross-sectional study. SETTING: Burkina Faso, Congo Brazzaville, Guinea Conakry, Mali and Niger. POPULATION: Women aged 25-59 years. METHODS: A total of 29 294 women participated in a cervical screening study in the five study sites, and newly trained local doctors performed colposcopy and directed biopsies as indicated. Using meta-analytical tools, four measures of colposcopy performance at different thresholds of colposcopic abnormalities were assessed. Sources of heterogeneity were also assessed. MAIN OUTCOME MEASURES: Proportions of women receiving biopsies, adequate biopsies and women diagnosed with cervical intraepithelial neoplasia (CIN). RESULTS: Among 28 553 women with satisfactory colposcopy, 3101 had a colposcopic diagnosis of probable low-grade or worse lesions and 1128 probable high-grade or worse lesions. Overall, the measures that reached the set standards were proportion of biopsy taken at colposcopy threshold of probable high-grade or worse lesions (95%, 95% CI 90-100%) and proportion of adequate biopsy samples. The set standards were not met for the proportions of women diagnosed with CIN at different colposcopic abnormality thresholds. Detection of CIN2 or worse lesions increased with increasing colposcopic abnormality. CONCLUSIONS: The performance of colposcopy in some of the African sites studied was comparable to that previously observed in other studies. With appropriate training, monitoring, continuing practice and quality assurance, adequate standards of colposcopy can be attained in sub-Saharan Africa.

Les causes des amputations des membres : etude retrospective et prospective de 87 cas d'amputations de membres

Introduction : l'amputation est une chirurgie mutilante qui altere l'image corporelle et qui entraine de severes deficits fonctionnels. But : Le but etait de determiner les causes et les resultats fonctionnels de l'amputation a Niamey. Il s'agissait d'une etude retrospective et prospective; menee de janvier 2007 a juillet 2008 a Niamey. Resultats : au total 87 amputations ont ete colligees. L'age moyen etait de 37;7 ans avec des extremes allant de 1 a 72 ans. Nous avons trouve 62 hommes (72;09) et 24 femmes (27;91). Le sexe ratio etait de 2;48. Il y'avait 63 amputations du membre inferieur; 22 amputations du membre superieur; 01 double amputation (membre superieur plus membre inferieur). La premiere cause d'amputation etait les traumatismes avec 37 cas (42;52) dont 19 cas d'echecs de la medecine traditionnelle. Les autres causes etaient le diabete avec 19 cas (21;83); les infections avec 18 cas (20;68); les tumeurs avec 10 cas (11;49); les pathologies vasculaires peripheriques avec 03 cas (3;48). L'amputation de la jambe et de la cuisse ont ete les plus frequentes avec respectivement 41cas (47;12); et 11 cas (12;64 Conclusion : l'amelioration du plateau technique contribuera a diminuer la frequence des amputations. L'accessibilite de l'appareillage donnera aux amputes un devenir fonctionnel moins sombre

Metastases osseuses de cancer primitif du foie meconnu : deux observations

Deux hommes ages respectivement de 57 et 65 ans ont ete admis en urgence dans le service de Traumatologie pour fracture de femur. Les explorations realisees ont permis de constater qu'il s'est agi de fractures pathologiques petrochanterienne et diaphysaire du femur droit. Lors du traitement par une osteosynthese avec plaque; un curetage avec comblement par ciment; des prelevements ont ete effectue et leur analyse microscopique a mis en evidence une proliferation maligne hepato-cellulaire de structure compacte avec biligenese. De plus des investigations cliniques echographiques et biologiques ont montre l'existence d'une tumeur hepatique primitive. En consequence le tableau de metastases osseuses revelatrices de carcinome primitif du foie a ete finalement retenu

Les cancers du sein masculin à Niamey

Moins frequent que chez la femme; le cancer du sein existe aussi chez l'homme. A partir d'une serie hospitaliere a Niamey au Niger; nous avons entrepris une etude retrospective afin d'en analyser les particularites epidemiologiques cliniques et therapeutiques. Durant la periode d'etudes (1992-2006); nous avons collige 18 cas microscopiquement confirmes. La majorite des malades etaient d'origine rurale. Ils se sont presentes a des stades avances : T3 et T4. Toutes les malades ont ete operees; seules 4 parmi elles ont eu un traitement complementaire adjuvant. Le carcinome canalaire infiltrant a ete le type histologique le plus frequent (55;5). L'evolution n'a pu etre evaluer car tous les malades etaient perdues de vue 6 mois apres l'acte operatoire

[Uro-genital schistosomiasis with S. haematobium and infertility in Niger. Prospective study of 109 cases]. / Bilharziose uro-genitale a S. haematobium et infertilite au Niger. Etude prospective à propos de 109 consultantes.

Schistosomiasis represents the second most endemic diseases following malaria. It is now endemic in 76 countries of the world, and it is estimated that more than 200 million persons are infected. The objective of this work is to help in the improvement of knowledge about Female Genital Schistosomiasis (FSG) effects on the women reproductive. A transversal prospective survey during six months, on women consulting for infertility in the health reproductive center of Niamey. The women included (109 persons) have been asked and consulted in gynecology, cervical smears urine pathology, urine ragent strips test, vesico-renal and gynecologic trans-abdominal ultrasound, hysterosalpingography (HSG) and cervical biopsy on infected patients. The infestation prevalence at S.haematobium was 38,5%. The infected persons have presented more gyneco-obstétrical symptomatology than the non infested ones. The proportion of exocervicite was 31,0% by clinical examination. The cervical biopsy done on 26 bilharziosis patients confirmed the frequence of highs chronic exocervicites (50%) and leucoplasia (11,5%). Echography and HSG noticed that the bilharzios patients can let develop other annexiel pathologies such as: ovary cyst, peri-tuboovary adhesions and wide ovaries. The symptomatology felt by infested women showed the parasitose consequence on women in endemic area. The treatment in o large schaddle by the national program allows to reduce morbidity caused by that infection in Niger.

[Epidemiological and histological aspects of gynecologic and breast cancer in the pathology department of Niamey's Health Faculty, Niger]. / Cancers gynecologiques et mammaires: aspects epidemiologiques et histologiques dans le service d'anatomie et cytologie pathologique de la Faculte des Sciences et de la Sante de Niamey Niger.

INTRODUCTION: The aim of this study is to identify the epidemiological and histological aspects of gynaecologic and breast cancer for a best care of patients. METHODOLOGY: A restropective and descriptive study have been realised in the Histopathologic laboratory of Niamey's Health faculty department, Niger. During 9 years (01 January 1992 to 31 December 2000), we brought up all cases of gynaecological and breast cancer. We analysed epidemiologic characteristics of patients, the histological type of cancer. RESULTS: Gynaecologic and breast cancer reprensented 54.3% of woman cancer and 33.1% of diagnosed cancer of both sex. Patients mean age was 36.5 years (extreme 9 to 79 years). The most frequent site was breast (40.4%) follow by cervix (26%). The distribution according to histoloigical group have detected a neat predominance of epitheliale tumours (87%). Sarcoma represents 7.9% of case and 5.1% for the other histological types. CONCLUSION: Despite the results, suggestions have been formulated for epidemiological and histological follow up of gynecologic and breast cancer in Niger.

[Extra uterine pregnancy associated with a tubal schistosomiasis due to Schistosoma haematobium. A case report from Niger]. / Grossesse extra utérine et schistosomose tubaire due à Schistosoma haematobium. A propos d'un cas au Niger.

We are reporting the case of a 21-year-old woman hospitalized for pelvic pains in a context of secondary amenorrhoea, whose examinations revealed a tubal pregnancy After surgical operation, the examination of the operative part showed a schistosomal tubal obstruction. Schistosomal tubal obstructions are the cause of ectopic pregnancies and infertility not to be forgotten in endemic areas. The implementation of a control programme based on chemotherapy by praziquantel will enable the reduction of their frequency.

Evaluation of glycogen loss in human liver transplants. Histochemical zonation of glycogen loss in cold ischemia and reperfusion.

To find a prognosis model of human liver transplant, we evaluate 62 surgical biopsies for the loss of glycogen and its variations in relation to cold ischemia, reperfusion, lobular zonation and donor's ages. We applied univariate, multivariate and discriminant analysis and logistic regression. There was a clear lobular zonation of glycogen during cold ischemia and at reperfusion. During cold ischemia, the mean loss was 48% in periportal zones and 74% in pericentrilobular zones. At reperfusion, it was in the range of 60% in periportal zones and 95% in pericentrilobular zones. It was observed in 64% of the grafts for an ischemia time less than 10 hr and in 82% of the grafts for an ischemia time of 10 hr or more. It was increased by 90% at reperfusion with pericentral predominance. Donors' age was an aggravating factor of glycogen loss beyond 28 years of age. In conclusion, in periportal zones, mean global glycogen depletion was about 54% during cold ischemia and reperfusion. It decreased by 90% at reperfusion with pericentral predominance. Logistic regression has allowed modelization of cold ischemia and reperfusion.

Hepatitis C virus RNA detection by in situ RT-PCR in formalin-fixed paraffin-embedded liver tissue. Comparison with serum and tissue results.

The purpose of this study was to localize HCV RNA in formalin-fixed paraffin-embedded liver biopsies of 15 patients with chronic hepatitis C using in situ RT-PCR method. The results were compared to serum and tissue extract analysis of HCV RNA. HCV RNA was detected in 80% of the sera tested, in 40% of the corresponding hepatic tissue extract and in 60% of the tissue sections tested by in situ RT-PCR. Compared to the serum positive cases, 67% of the cases were positive with in situ RT-PCR and 41% were positive with tissue extract detection. 50% of the cases in situ RT-PCR positive were also positive with tissue extract detection. These results underlined the complementarity of the different methods of viral detection for the precise diagnosis of hepatitis C.

[Dystocia by excess volume of the fetal abdomen: a case of giant polycystic kidney]. / Dystocie par excès de volume de l'abdomen foetal: un cas de polykystose rénale géante.

We describe a case of dystocia by excess of fetal abdominal part related to giant polycystic renal disease. We list the fetal malformations leading to dystocia and discuss the choice between embryotomy and cesarean section, particularly in countries were no prenatal diagnosis can be made.

[Schistosomiasis of the female genital tract: anatomoclinical and histopathological aspects. Apropos of 26 cases]. / Bilharziose du tractus génital chez la femme: aspects anatomocliniques et histopathologiques. A propos de 26 cas.

The authors report 26 cases of female genital schistosomiasis. This parasitosis is observed in women of ages ranging between 17 and 70 years (mean age = 30 years) and associated with sterility (6 cases), uterine tract cancer (1 case), tubular pregnancy (1 case), benign teratoma (1 case) and serous cystadenoma (1 case). The diagnosis is based on an histological analysis which shows several lesions with schistosomiasis (Schistosoma haematobium) eggs, confirmed by ZIEHL coloration. When coupled with infections these anatomical lesions lead to dysfunctions such as sterility and extra-uterine pregnancy through tubular dysfunction.

[Primary adenocarcinoma of the bladder. Apropos of 2 cases]. / L'adénocarcinome primitif de la vessie. A propos de deux cas.

The authors report two cases of primary adenocarcinoma of the urinary bladder with secretion of mucus, observed over a year period, between 1978 and 1990. The different histologic patterns are encountered: mucinous adenocarcinoma (colloid carcinoma), clear cell adenocarcinoma exhibiting glandular and trabecular or papillary patterns. They are often reminiscent of those seen in gastrointestinal tumors. The colloid carcinoma pattern is associated with intense schistosomiasis of the bladder. Macroscopic studies show budding and necrotic tumors, with infiltration and invasion of the musculosa. We agree with the role played by glandular metaplasia of the vesical urothelium that is accepted by the majority of the authors in the histogenesis of these tumors.

[Association of sarcoidosis and primary biliary cirrhosis. Clinical and anatomopathologic study of a case followed for over 10 years]. / Association de sarcoïdose et de cirrhose biliaire primitive. Etude clinique et anatomopathologique d'un cas suivi pendant 10 ans.

A new case of primary biliary cirrhosis associated with sarcoidosis is reported in a 38 year-old woman. The diagnosis of sarcoidosis was based on the occurrence of cutaneous nodules, mediastinal lymph node enlargement, pulmonary reticular infiltrate, parotitis and diffuse arthritic pain, all disappearing after steroid therapy. Hepatic biopsy showed epithelioid-cell granuloma without necrosis. The diagnosis of primary biliary cirrhosis was made 6 years later as based on intrahepatic cholestasis associated with high titer of antimitochondrial antibodies and chronic destructive cholangitis. This association (5 other cases have already been reported) raises the problem of a possible link between the two diseases which could represent different patterns of a single immunological disorder.

[Ultrastructural study of the liver in Niemann-Pick disease type C]. / Etude ultrastructurale du foie dans la maladie de Niemann-Pick de type C.

The authors report an electron microscopic study of the liver in a case of Niemann-Pick disease type C. The diagnosis was supported by clinical data, moderate increase of phospholipids, total cholesterol, leukocytes and liver sphingomyelin and sphingomyelinase activity. Intrasinusoidal liver foamy histiocytes were filled with lamellar and multivesicular inclusions similar to those observed in sphingomyelinase deficient patients. Hepatocytes contained a few non-specific lamellar inclusions occasionally associated with triglycerides and cholesterol crystals. These results are discussed with reference to the recent biochemical findings supporting the evidence of excessive accumulation of unesterified cholesterol in Niemann-Pick disease type C.

[Comparison of 3 metrifonate dosages in mass chemotherapy of Schistosoma haematobium]. / Comparaison de trois posologies de métrifonate en chimiothérapie de masse contre Schistosoma haematobium.

The metrifonate standard cure consisted of three doses of 7.5 to 10 mg/kg at a fortnight interval. These repeated doses increase the total cost of the treatment and the number of incomplete cures. We wanted to verify whether a reduced cure gets still a good efficacy. 286 people from three villages situated near Niamey (Niger) where treated at random with either 1, 2 or 3 doses of 10 mg/kg metrifonate. Before treatment the mean egg-output was 40 eggs/10 ml; 4 months later the cure rate was different only between the 1 dose trial and the 3 doses one. Moreover, this rate is low (35.3%) and the mean egg-output is also low (40.3%) for one dose. These results are more significant according to the first mean egg-output level. Below 5 eggs/10 ml, the cure rate is good with 2 or 3 doses (62% and 70%, 4 months later treatment), between 6 and 50 eggs/10 ml the results are still acceptable (55 and 53%). On the other hand, above 50 eggs these results are insufficient even with 3 doses. The single dose does not give sufficient result even in low egg-output.