Pathophysiologie, évaluation et traitement médical de l’incontinence fécale

L’incontinence fécale est un problème fréquent en pratique médicale mais souvent sous-estimé et mal traité. Cet artiele revoit l’épidémiologie, les mécanismes pathophysiologiques et les approaches diagnostiques des patients souffrant d’incontinence fécale. De plus, je ferai une synthèse des traitements médicaux de l’incontinence fécale. Une anamnèse systématique et une étude de la morphologie et de la physiologie anorectales permet souvent de mettre en évidence les mécanismes pathogéniques sous-jacents et d’orienter le traitement.     

Chronic ethanol intake may delay the onset of gossypol-induced infertility in the male rat

Summary. Parameters were obtained from the reproductive organs of ethanol-fed, gossypol-treated Sprague Dawley rats. The experimental animals were fed either on a normal (15.17%) or low protein (8.00%) diet. Measurements included reproductive organ weights, seminal characteristics, serum concentration of testosterone and histological, stereological and histomorphometric evaluation of the testis. The testis size, length and diameter of the seminiferous tubule had the least values in the protein-malnourished, gossy-pol-treated rats (3.01±0.26 g, 0.56 ± 0.03 m, 281.34±11.30 μn), in comparison to corresponding animals which had received ethanol simultaneously with gossypol (3.40 ± 0.25, 0.71±0.06m, 314.42 ± 11.61 μn). As gossypol and ethanol are both associated with reduced reproductive capacity, this unexpected but interesting finding lends support to the hypothesis that either a normal dietary protein or ethanol consumption may modify the action of gossypol on body tissues, including the testis. This effect, presumably mediated through changes caused to the bioavailability of gossypol, modifies its antifertility activity. The present observation further highlights the need to consider the concurrent administration of other drugs, such as alcohol, and the nutritional status in the evaluation of gossypol for various potential uses.     

Inhibition of spontaneous testicular Leydig cell tumor development in F-344 rats by dehydroepiandrosterone.

The incidence of spontaneous Leydig cell tumors of testis is very high in old F-344 rats. We have examined the effect of dehydroepiandrosterone (DHEA), a steroid hormone with antimitotic and anticarcinogenic properties, on spontaneous Leydig cell tumorigenesis. Fifteen-week-old male F-344 rats were fed a diet containing DHEA (0.45% w/w) for 84 weeks. At the termination of experiment none of the 13 rats had Leydig cell hyperplasia or Leydig cell tumors. All the eight control rats of comparable age had Leydig cell tumors. These findings suggest that DHEA is a potent inhibitor of spontaneous Leydig cell tumors of testis in aged rats.     

Dengue fever presenting with acute colitis.

Gastrointestinal manifestations of dengue fever are mainly in the form of bleeding or liver function abnormalities. Dengue fever presenting as acute colitis-like picture is not reported to date. We report a 50-year-old man with dengue fever presenting with lower gastrointestinal bleeding and colonoscopic features of acute inflammatory colitis.     

Tannic acid-induced nucleolar changes in hepatocytes transplanted into syngeneic or xenogeneic host and in hepatocytes maintained in primary culture

In this study we have investigated the effect of a single dose of tannic acid, administered s.c., on the nucleolar ultrastructure of hepatocytes transplanted into a syngeneic or xenogeneic host in order to evaluate the validity of our hepatocyte transplantation system as an in vivo alternative to the use of whole animals to test for species and strain differences to the effects of hepatotoxins. Within 4-6 h following tannic acid injection, rat hepatocytes transplanted into the anterior chamber of eye and inguinal fat pads of rat and athymic nude mouse, showed changes of nucleolar components, with separation of ribonucleoprotein containing granules into discrete dark zones. These dark areas were surrounded by light areas consisting of granular and fibrillar components of the nucleolus. These changes were identical to tannic acid-induced nucleolar alterations in the homotopic liver. Hamster and rat hepatocytes xenotransplanted into athymic nude mice also displayed prominent nucleolar alterations in response to tannic acid. The similarity and extent of nucleolar alterations observed in transplanted hepatocytes and the in situ homotopic liver cells attest to the usefulness of the hepatocyte transplantation system for the evaluation of species differences in biological response to toxic/carcinogenic effects of xenobiotics.     

The popularization and application of cold storage red blood cells or whole blood at −80 °C of the Rh(D) negative patients in surgical operation

Summary The efficiency of cold storage red blood cells (CSRBC) or whole blood at −80 °C used in 27 Rh(D) negative patients during surgical operation was reported. The Rh(D) negative patients received the transfusion of CSRBC or whole blood stored at −80 °C for 180 to 360 days. The changes in the indexes, such as blood TB, DB, K⁺, Na⁺, BUN, Cr, urine protein (URPO), UOB, Hb, HCT, serum total protein, relative to hemolytic reaction and blood volume before and after transfusion were observed. The results showed that after transfusion of CSRBC or whole blood 27 cases were negative for urine protein and UOB, and the levels of BUN and Cr were normal (P>0.05). Blood TB, DB, Hb, and HCT were increased, while pH, blood K⁺ and blood Na⁺ was normal with the difference being not significant before and after operation (P>0.05). Plasma protein was decreased, but there was no significant difference before and after operation (P>0.05). It was suggested that CSRBC or whole blood at −80 °C could be safely infused to the Rh(D) negative patients without side effects during the surgical operation. YU Zhongqing, male, born in 1957, Technician in Charge     

Benign synovioma causing internal derangement of the knee. A report of nine cases

Nine pedunculated benign synoviomata causing mechanical symptoms similar to those of a torn meniscus are described. The average age of the patients was 34.4 years. During the period of study, 2254 meniscal lesions causing mechanical symptoms were identified, giving an incidence of one benign synovioma for every 250 meniscal lesions. All the lesions were removed arthroscopically with relief of symptoms.     

十二指肠乳头括约肌切开胆总管取石术前静注咪唑安定对麻醉及手术效果的影响

目的　探讨在十二指肠乳头括约肌切开 (EST)胆总管取石术前静注咪唑安定的可行性及价值。方法　将 71例拟行 EST胆总管取石患者随机分为咪唑安定组 (试验组 ) 5 1例和对照组 (2 0例 ) ,两组术前均给予 6 5 4 -2 (10 mg)静脉注射 ,试验组同时静脉注射咪唑安定 (3～ 5 mg)。观察两组患者的进镜时间、麻醉程度 ,患者的反应与配合程度、自身感受程度 ,同时监测患者的血压、心率、血氧饱和度。结果　试验组进镜时间缩短、镇静程度适中、患者自身感受好 ,与对照组比较 ,差异有显著性 (P<0 .0 1) ;患者心血管及呼吸参数无明显变化。结论　EST胆总管取石术前静脉注射咪唑安定可提高麻醉效果 ,有利于提高患者配合的依从性 ,对血压、心率、血氧饱和度无明显影响