Chronic inflammatory demyelinating polyradiculoneuropathy in childhood: outcomes after methylprednisolone pulse therapy

INTRODUCTION: Chronic inflammatory demyelinating polyneuropathy (CIDP) in children is relatively rare and treatment is based primarily on intravenous immunoglobulins or oral corticosteroids. Boluses of methylprednisolone (MP) are a seldom used alternative. CASE REPORT: We report the case of an 8-year-old child, first presented at the age of 3 years, with recurring episodes of functional impotence of both lower limbs and walking impairment, partially reversible without treatment. Clinical, progressive, and electrophysiological data and the analysis of the cerebrospinal fluid were compatible with CIDP. MP boluses were administered: after a total eight monthly boluses, very satisfactory progression on the clinical and electrophysiological fronts was noted after 24 months. CONCLUSION: Childhood CIDP presents clinical, electrophysiological, progressive, and prognostic particularities, they recur readily and the outcome is good. Boluses of methylprednisolone are an alternative to the treatment of these neuropathies in childhood.     

Prevalence of hepatitis C, hepatitis B and HIV infection among haemodialysis patients in Ibn-Rochd university hospital, Casablanca

The viral infections are frequent in haemodialysis patients, notably those due to the hepatitis C virus (HCV), the hepatitis B virus (HBV) and the human immunodeficiency virus (HIV). The objective of this study is to determine the prevalence of the hepatitis C, the hepatitis B, the HIV infection in haemodialysis patients and the main risk factors for hepatitis C in the chronic haemodialysis patients treated in haemodialysis unit of Ibn Rochd University Hospital in Casablanca. This retrospective study was performed in 186 chronic haemodialysis patients and showed a high prevalence of HVC infection (76%), the prevalence of HBV infection was at 2%, none of the patients had detectable antibodies of HIV. Among the patients infected by the HCV, the mean duration of dialysis was 8,7 years. The mean number of blood units transfused was 16,5. Seventeen patients (11%) had no history of blood transfusion. In conclusion, the blood transfusion is not considered to be a like a major risk factor of the HCV infection in haemodialysis patients and this since the systematic detection of the anti-HCV antibodies in the blood donors. The nosocomial transmission of HCV seems to be the main risk factor HCV infection in the haemodialysis units requiring a strict adherence to infection control procedures for prevention of HVC infection in haemodialysis patients.     

Clinical and electrophysiological aspects of acute organophosphate intoxication]

INTRODUCTION: Acute organophosphate (OP) intoxications, accidental or voluntary, are responsible for a high mortality. They cause extensive muscular paralysis by acetyl cholinesterase activity inhibition at the neuromuscular junction level. AIM: To underline the rarity and the characteristic electrophysiological pattern during cholinergic crisis. OBSERVATION: A 28-year-old woman was admitted to the medical intensive care unit for Malathion acute intoxication with signs of glandular hypersecretion, complicated tetraparesis, and respiratory distress. The cholinesterase activity was 17%. The electroneuromyography showed multiple motor responses to the same stimulation, which is characteristic of the cholinergic crisis. Other electrophysiological parameters, in particular low-frequency repetitive stimulations, were normal. The evolution was favourable after symptomatic treatment and respiratory assistance. DISCUSSION AND CONCLUSIONS: Organophosphate intoxications evolve in three phases: acute cholinergic crisis, intermediate syndrome, and delayed neuropathy. While the electrophysiological aspects of delayed neuropathy are best characterized, those of crisis and intermediate syndrome remain very little studied. The persistence of acetylcholine in the synaptic slit would explain the multiple motor responses to single stimulation during the crisis.     

多层螺旋CT成像技术在急腹症中的应用

影像学检查是诊断急腹症的重要手段．电子计算机断层(computed tomography,CT)对腹部解剖和病变的准确显示,越来越体现出其优越性,而多层螺旋CT具有快速螺旋扫描和三维后处理能力,显著提高了图象质量和显示细微结构的能力,尤其是其新的成像技术:多平面重建、最大密度投影、曲面重组法等的出现,在急腹症的诊断上体现了巨大的优势．     

L’actinomycose abdomino-pelvienne: difficultés diagnostiques et thérapeuthiques

Acta Endoscopica - L’actinomycose est une maladie chronique suppurative granulomateuse responsable d’un syndrome tumoral d’origine infectieuse. Nous rapportons deux observations...     

缺氧对海马神经元培养的影响及巴曲酶的保护作用—HSP70的表达及细胞形态学的研究

本文采用新生大鼠海马神经元培养技术，以细胞形态学及ＨＳＰ７０免疫阳性细胞表达为指标，首次观察了巴曲酶对缺氧海马神经元损伤的直接保护作用。结果发现：在缺氧前０．５ｈ给予巴曲酶（０．５ＢＵ／ｍｌ），海马神经细胞存活率以及ＨＳＰ７０免疫阳性细胞率均明显高于缺氧对照组（Ｐ＜０．０１），而在缺氧前２４ｈ给予巴曲酶后，二者与缺氧对照组均无明显差别。表明：巴曲酶对缺氧海马神经细胞损伤有直接的保护作用，而且其作用与给药的时机有关。     

Lymph vascular invasion in invasive mammary carcinomas identified by the endothelial lymphatic marker D2-40 is associated with other indicators of poor prognosis

Background  

Immunohistochemical studies of lymphatic vessels have been limited by a lack of specific markers. Recently, the novel D2-40 antibody, which selectively marks endothelium of lymphatic vessels, was released. The aim of our study is to compare lymphatic and blood vessel invasion detected by hematoxylin and eosin (H&E) versus that detected by immunohistochemistry, relating them with morphologic and molecular prognostic factors.