Retrospective endoscopic analysis of gastric xanthelasma in the non-operated stomach

To investigate the significance of gastric xanthelasma, a retrospective review of 109 cases with an endoscopic diagnosis of this lesion was undertaken. A predominance in older patients was noted, with a similar distribution in antrum and fornix. In 15 cases (16.6%) they were multiple. They were occasionally associated with gastric erosions. In particular they were associated with chronic gastritis and intestinal metaplasia (48.9%). It is therefore concluded that gastric xanthelasma is not a rare lesion and that it is frequently associated with senile degenerative changes in the gastric mucosa.     

Diagnostic yield and endoscopic patterns of laparoscopy in the diagnosis of granulomatous hepatitis

In reviewing 54 cases of granulomatous hepatitis (GH) diagnosed among 2,620 laparoscopies, we have been able to classify the capsular GH changes into five patterns: Macular, exudative, pinpoint, granular and cord-like. The exudative pattern was the most frequent one, and predominated in brucellosis. The granular pattern was most common in tuberculosis. Furthermore, 35 additional cases, in whom a laparoscopic diagnosis of GH was not confirmed by liver biopsy, showed a trend to a final diagnosis consistent with multifocal diseases, whenever laparoscopic pictures were similar to the patterns described herein. We speculate with the limits associated with the use of only a single biopsy sample. We conclude that laparoscopy permits the establishment of a tentative diagnosis of GH, which could provide us with valuable information about the usefulness of obtaining multiple hepatic biopsies.     

French-language adaptation of an evaluation test of knowledge meant for insulin-dependent children: methodology and value for research in clinical practice]

A measure of knowledge level of diabetic patients is useful in evaluating their educational needs as well as the impact of the educational programs specifically designed for them. The lack of such scales in French, led us to translate and validate an existing knowledge scale for diabetic children, the Test of Diabetes Knowledge (TDK) (Johnson et al.). After several translations and back translations, the 33 item scale was submitted to the staff members of a pediatric diabetology unit, to establish its content validity. An assessment the questionnaire was performed in a group of 49 children, aged 7.9 to 12.8 years. The mean duration of diabetes was 4.6 +/- 2.9 years and their scholastic level varied from 1st to 6th grades. Time spent in filling out the questionnaires was 12 to 25 minutes. Few missing values were noted. The reliability of the scale was excellent as shown by Cronbach's alpha coefficient: 0.83 for the overall scale, 0.72 for the general knowledge subscale (20 items) and 0.70 for the problem solving subscale (13 items). The level of correct responses was correlated with age and scholastic level (p < 0.0001), but not with sex, duration of diabetes, or HbA1c levels. This study shows that the French version of the TDK is a valid and reliable tool for measuring the level of knowledge in children and adolescents with diabetes. This scale provides the researcher and clinician with a tool that facilitates the performance of an educational diagnosis and the evaluation of educational programs based on the transmission knowledge.     

The anatomy of the inferolateral trunk (ILT) of the internal carotid artery

Summary The authors of the paper present the results of 20 anatomical dissections of the cavernous sinus area, correlated to 90 angiographies and to basic embryological knowledge; they emphasize the role played by the inferolateral trunk in the arterial blood supply of the cavernous area and its complex and the value of the internal maxillary angiogram for its visualization.Research Grants of Paris South University     

COBB syndrome treated by staged intravascular embolisation and surgery

A 28-year old Malay man with evidence of an upper motor neuron cord lesion was diagnosed to have a C7 to T2 spinal arterio-venous malformation and associated cutaneous vascular lesion. He finally agreed for treatment after 5 years of progressive spastic right lower limb weakness leading to inability to mobilize. A two staged intravascular procedure was done followed by surgery with recovery of ASIA impairment scale grade B.