[False traumatic aneurysm of the ulnar artery in a teenager]. / Faux anévrysme traumatique de l'artère ulnaire chez un adolescent.

Most aneurysms of hand arteries are traumatic. It is a generally rare unrecognized pathology. Complications are serious (embolism and thromboses of interdigital arteries). Two main causes can be recalled: acute trauma, with development of a false aneurysm; repeated microtrauma (hand hammer syndrome), with occurrence of an arterial dysplasic aneurysm. The diagnosis is based on the presence of a pulsatile mass, with finger dysesthesia, unilateral Raynaud's phenomenon. It is confirmed by duplex Doppler. Arteriography is necessary but can be replaced by an angio-MR. We report a case of false traumatic aneurysm of the ulnar artery in a teenager. This case illustrates this rare condition and opens discussion on therapeutic options.

[Axillary artery pseudo-aneurysm secondary to shoulder dislocation in children]. / Pseudo-anévrisme de l'artère axillaire secondaire à une luxation de l'épaule chez l'enfant.

Axillary artery injury following anterior dislocation of the shoulder in children is a rare complication often considered as iatrogenic. We report the case of a pseudo-aneurysm of the axillary artery in a 5-year-old boy that appeared four months after a shoulder dislocation that was reduced in an ambulatory setting. Although this is an uncommon vascular complication, we emphasize the need for short-term and long-term follow-up in these children to avoid missing a pseudo-aneurysm of the axillary artery.

[An unusual cause of dysphagia: esophageal tuberculosis]. / Une cause inhabituelle de dysphagie: la tuberculose oesophagienne.

Esophageal tuberculosis is a rare etiology of dysphagia. Such a location is also rare in comparison with other digestive tract sites of the disease (3.2%). Esophageal involvement may be secondary or primary. Diagnosis is particularly difficult in the latter situation. At any event, the diagnosis can only be histological by examination of endoscopic biopsy material. Treatment is essentially medical and leads to recovery in most patients.

Evaluation of somatostatin biosynthesis, somatostatin receptors and tumor growth in murine medullary thyroid carcinoma.

Spontaneous medullary thyroid carcinomas (MTCs) of old rat thyroids were analyzed for the expression of somatostatin and somatostatin binding sites in tumoral C cells in relation to the stage of tumor development, the mitotic activity of tumoral tissue and calcitonin biosynthesis as a marker of C cell differentiation. High levels of both immunoreactive somatostatin and its mRNA were detected in a subpopulation of tumoral C cells, gathered in areas suggesting a clonal proliferation and located preferentially at the periphery of the tumor. These cells also displayed high levels of calcitonin and its mRNA. However, many calcitonin immunoreactive cells showed no sign of somatostatin synthesis. The proliferative activity of the somatostatin-containing areas was low and slow compared to the areas lacking somatostatin production. However, it increased during the course of tumor growth. Somatostatin binding sites, measured with in vitro receptor autoradiography using 125I-[Tyr3]-octreotide or 125I-[Leu8, dTrp22, Tyr25]SS-28, were not detected in any of the MTCs tested. In rat MTC cells, somatostatin was associated with differentiation and slow proliferation, two parameters inversely correlated with the progression of malignancy. As expected, owing to the highly regulated secretion of the differentiated endocrine cell type, its presence was correlated with low basal calcitonin levels. However, the absence of somatostatin binding sites on any type of MTC cells does not favor a direct autocrine regulation of this peptide in this murine model of human MTC.

[Severe forms of hemorrhagic rectocolitis. Predisposing role of the amebic graft?]. / Les formes graves de la rectocolite hémorragique. Rôle favorisant de la greffe amibienne?

Severe forms of ulcerative colitis are somewhat rare but have a severe prognosis. Apart from the usual predisposing factors, the amebic graft must be especially emphasized, at least in those countries where the parasite is endemic. Entamoeba histolytica was consistently identified in 19 cases of the severe form that we found out of a total of 126 cases of ulcerative colitis. Usually the parasite was found in the shape of massive infestation and in most cases it proved to be resistant to the amebicides currently available. The clinical picture shown by the 19 patients was identical to that given in the literature for severe forms of ulcerative colitis. Therapeutically, it was essential to combine one (or, if necessary, several) course(s) of treatment with amebicides with the usual therapeutic measures until the parasite was destroyed in the intestine. This work suggests that any attack on ulcerative colitis must automatically include an anti-amebic course of treatment, and this should strictly precede any corticosteroid therapy, even administered as enemas.

[Diagnostic and therapeutic aspects of peritoneal tuberculosis in Morocco. Apropos of 300 cases]. / Aspects diagnostiques et thérapeutiques au Maroc des tuberculoses péritonéales. A propos de 300 cas.

We describe 300 cases of peritoneal tuberculosis observed in the space of 11 years in Morocco. The most usual terrain presented is the young woman in precarious socio-economic conditions. The febrile ascitic form was observed in 229 cases. The ulcero-caseous was observed in 51 cases, and the fibro-adhesive form in 14 cases. Diagnostic was based on laparoscopy with peritoneal biopsy. A controlled prospective study done randomly on 100 patients showed that corticotherapy associated with tuberculous antibiotherapy did not speed up clinical recovery but tended, rather, to slow down the disappearance of granulations and indeed facilitate the constitution of peritoneal adherence phenomena.