[Treatment of leprotic neuritis. Exclusive medical treatment or combined with decompression]. / Evolution du traitement des nevrites hanséniennes. Traitement médical exclusif ou associé à la décompression.

The authors consider the evolution of the treatment of leprotic neuritis based on homogenous series of numerous observations (a minimum of 250-300). These observations are well registered and documented with some results dimensioned by the classical A. L. E. R. T. tests carried out at intervals of time and verified by comparison between series only medical treatment and series of medico-surgical treatment. Considering some remote results and some comparative series, the indications of the exclusive medical treatment have been well defined, and the ones of the surgical decompression have been reduced. The early case finding of a leprotic neuritis by the mean of easy methods as well as its monitoring during its early specific treatment is essential. By this way we get an important proportion of functional results: satisfactory (50 p.c.) or interesting (20 p.c.). In the case of painful hypertrophia, the complementary decompression secure not only the functional recovery of mortricity, but also the epicritic sensibility.

[Abdominal forms of Castleman's disease]. / Formes abdominales de la maladie de Castleman.

Two cases of Castleman's disease (angiofollicular lymphoid hyperplasia) with abdominal localisation are reported. The first case was a mesenteric localisation with compressive symptoms in a sixty year-old patient; its histological type was hyalino-vascular; the evolution was favorable one year later following cobaltherapy; but ultimately pathological examination of a peripheral lymph node led to the discovery of a malignant nodular lymphoma of the follicular center cell type. The second case involved the retroperitoneal space with multiple lymph nodes and IgA dysglobulinemia in a 49 year-old patient; its evolution was favorable as judged six months after surgical resection. Twenty cases of mesenteric and thirty one of retroperitoneal involvement of Castleman's diseases have been previously reported. The nosology and pathogenesis of this disease remain unclear.

[Surgical approach to the so-called infectious perforations of the small intestine in Africa south of the Sahara (author's transl)]. / Attitude thérapeutique devant les perforations dites infectieuses de l'intestin grêle en Afrique noire.

Non traumatic perforations are frequent in Africa South of the Sahara and most often due to salmonellosis. From 50 cases recorded in Dakar, the authors study the main problems raised by diagnosis (specially in non reactive peritonitis requiring iterative controls), surgical tactic and procedure, and intensive care. In 86 p. 100 of the case they report on, the authors performed a suture completed by passive drainage. However, and in spite of the risk of leaking, resection had to be done either immediately or because suture failure. As patients were presented generaly in very bad condition, intensive cares were complex but essential. Death rate ranged between 25 p. 100 and 50 p. 100.

[Drepanocytic osseous infections (osteitis and osteomyelitis) (author's transl)]. / Les infections osseuses drepanocytaires (ostéites et ostéomyélites).

Osseous infections have a special importance among the various polymorphic osteoarticular troubles of drepanocytemia. From 92 cases, the authors emphasize 4 points: --Osteitis and osteomyelitis are frequent, specially in the homozygotic form. --Salmonellae are the prevailing pathogenic bacterias. --Osteomyelitis caused by staphylococcus have, in drepanocytic patients, a more serious and more expanding evolution than in other patients. --Anatomic and radiologic features as well as evolution are different in the staphylococcal forms and in the salmonellal ones in which, most often, surgery may be discarded.

[Drepanocytic osseous complications: dystrophia and osteonecrosis (author's transl)]. / Les complications osseuses de la drépanocytose. (Dystrophies et osteonécroses).

Osseous troubles are the most frequent and earliest signs of drepanocytemia. They are due to the bone dystrophia observed in any chronic hemolytic anemia, to aseptic infarcts and to bacterial infections. These syndromes are described according to age and localizations, and proper surgical tactics are proposed.