Neurologic signs of ciguatera disease: evidence of their persistence.

Ciguatoxins exert their effect on the voltage-sensitive sodium channels of the cellular membranes of all excitable tissues. This effect confers to ciguatera disease (CD) its neurologic hallmarks. A prospective study among French Polynesian adults over a two-month period was conducted to characterize and determine the persistence of neurologic symptoms of CD. We compared 47 patients with CD with 125 controls. In the acute phase of the disease, patients had mainly sensory disturbances as detected by an hypoesthesia on the palm of the hand and poorer sway performance compared with controls. Follow-up two months showed improvement of sway performance that eventually reaching control levels. However, for light-touch threshold, even if we observed a decrease threshold towards normal values, more than 50% of patients did not reach normal values 60 days after disease onset. Our results support the existence of neurologic impairments of CD and suggest their persistence for at least two months after onset.

[Chronic cor pulmonale after embolism, antiphospholipid syndrome, Horton disease: therapeutic approach apropos of a case]. / Coeur pulmonaire chronique post-embolique, syndrome des antiphospholipides, maladie de Horton: approach thérapeutique à propos d'un cas.

Chronic thromboembolic cor pulmonale is a rave evolutive complication of acute pulmonary embolism, responsible for a sometimes severe dysprea. The etiological research and the therapeutic possibilities are studied. The association with a Horton's disease bad us to consider the links between this pathology, the existence of antiphospholipid antibodies and the thromboembolic complications.

[Ewing's sarcoma and peripheral neuroectodermal tumors. Report of a case with laterothoracic localization]. / Sarcomes d'Ewing et tumeurs neuroectodermiques périphériques. A propos d'un cas de localisation latéro-thoracique.

The authors report the case of a 20-year old male patient presenting with a lateral thoracic tumour which at pathological examination looked like an extra-osseous Ewing's sarcoma. Strongly positive NSE immunolabeling suggested a recently described variant of this lesion: Askin's tumour. In 1979, F. B. Askin described a tumour made of round small cells, located on the side of the thorax and possibly derived from differentiated neuroectodermal tissue. Since that time, the ever wider use of electron microscopy and immunohistochemical methods has made it possible to demonstrate the existence of peripheral neuroectodermal tumours (PNETs) distinct from neuroblastomas. Askin's tumour being only, as it turned out, one of their clinical forms. Following a brief presentation of the clinical, pathological and therapeutic features of PNETs, the authors underline the great similarity between these tumours and Ewing's sarcoma. Owing to the successive discoveries of a cytogenetic abnormality common to these tumour--t(11;22)(q24;q12)--, of a similar expression of proto-oncogens and of identical neuroenzymatic characteristics, Ewing's syndrome can now be regarded as the most undifferentiated of all PNETs, probably arising from the postganglionic neuron of the parasympathetic system.

[Laterosternal mediastinoscopy. Technic and indications. Apropos of 23 cases]. / La médiastinoscopie latéro-sternale. Technique et indications. A propos de 23 observations.

Parasternal (or anterior) mediastinostomy--a thoracic diagnosis surgery--is a simple, safe and rapid procedure which can be used either to gain access to the anterior or superior mediastinum and to the pulmonary pedicles ("hiloscopy" for exploration and biopsy, or to perform a wide lung biopsy without true thoracotomy.

[2 cases of sarcoidosis in Yaounde (Cameroon)]. / Deux cas de sarcoidose à Yaoundé (Cameroun).

Two new cases of sarcoidosis are reported from Cameroon. The first one concerned a man, 53 years old, who presented multiple dermal nodules of the face, polyadenopathy , splenomegaly, exertional dyspnea, reticular and micronodular aspect of lungs X-ray. Diagnosis was confirmed by histology of skin, ganglions and bronchus biopsies. Patient was treated by corticotherapy. The other one concerned a woman, 28 years old, who presented successively mediastinal adenopathies, then, 9 months later, reticular and micronodular aspect of lungs X-ray. During this period, a treatment against tuberculosis had been established. Bronchus biopsies confirmed the diagnosis. The patient was also treated by corticosteroids. The authors wonder whether sarcoidosis is actually or apparently rare in Negro-Africans, owing to the fact of frequent failure to recognize this affection, or confusion with tuberculosis. Correct incidence of sarcoidosis in Negro-Africans should be defined.