Association multiple exostoses and ankylosing spondylitis: about one case and a review of the literature

We report the case of a 25-years-old man who had an ankylosing spondylitis associated with multiple exostoses. The patient had hip pain of inflammatory origin and back stiffness with x-ray findings suggestive of bilaterral sacroilitis, coxitis as well as exostosis of the humerus, radius, femor and tibia. This is occurred in Turkey, the association was described as a simple concidence due to the difference in the genetic mechanisms involved. A more detailed genetic study of these two entities well be helpful for a better understanding of this association.     

CT findings in otosclerosis. A series of 11 cases

INTRODUCTION: Our study's aim is to evaluate the reliability of computed tomography in diagnosis, extension and post-surgical follow-up of otosclerosis. PATIENTS AND METHODS: A group of 11 patients was examined during a period of 25 months from 2002 to 2004. All of them had clinically and audiometrically suspected otosclerosis with bilateral conductive hear loss in 7 cases (3 had surgical management), unilateral in 2, and mixed earing loss in 2. High resolution CT was performed once in 8 patients and twice in the 3 operated. RESULTS: CT showed otosclerosis foci in all our study's patients, which was bilateral in 9 and unilateral in 2. The extension of the lesions varied from type IA to type 4B according to the otosclerosis staging. CONCLUSION: Computed tomography is, so far, the most efficient imaging modality in otosclerosis, showing otosclerosis foci when the clinical features are doubtful, allowing an accurate extension of the lesions and detecting complications during post-surgical follow-up.     

Biliary abnormalities associated to portal Cavernoma. About 17 cases

Portal biliopathy is a newly introduced term, describing the changes observed in the biliary ducts secondary to extrinsic compression by the portal cavernoma. It's a rare condition that is usually not diagnosed. OBJECTIVE: To explore the principles of diagnosis and treatment of portal biliopathy. METHODS: seventeen patients with extrahepatic portal vein obstruction were reviewed prospectively. RESULTS: symptomatic biliary obstruction was found in 82%. Endoscopic retrograde cholangiography revealed abnormality of the bile duct wall in all cases, with stricture in 11 patients. Endoscopic treatment was necessary in 10 patients, whether portosystemic shunting was done only in 2 cases. CONCLUSION: Portal biliopathy is frequent and must be diagnosed early.     

Results of coronary angioplasty in coronary bifurcation. Report of 61 cases

These are the results of 61 bifurcations treated by percutaneous coronary angioplasty in 50 patients (41 males, 9 females) between 1998 and 2003. Bifurcation stenosis, dominated by type I of bifurcation classification. Global restenosis rate was 20% and didn't concern any case of kissing balloon. Restenosis rate in bifunction angioplasty is similar to that of the other sites; besides, it's twice more important when we stent both of the principal and collateral arteries unless we did kissing balloon. Te interventional treatment of bifurcation stenosis is feasible, with restenosis rate similar to the other types of lesions if we proceed systematicaly to kissing balloon.     

Squamous cell carcinoma and discoid lupus erythematosus. Report of 2 cases

Some cases of skin cancer developping from chronic discoid lupus erythematosus were publied among the world. We make know our experience about two cases suffering with a chronic discoid lupus erythematosus from 16 and 11 years and developped a squamous cell carcinoma from the elbow and the lower lip.     

Biological markers of hepatocellular carcinoma

Hepatocellular carcinoma is a rapidly fatal tumor. The only hope for a cure lies in early diagnosis. It follows that an effective screening strategy should be used in high-risk populations. Screening currently relies on tumor markers such as alfa fetoprotein (AFP) and imaging modalities. Because the AFP assay lacks sensitivity and specificity in patient with small tumors, other serum markers are being evaluated.     

Anatomic repair of transposition of the great arteries or arterial switch operation. Report of 62 cases

Between January 1990 and September 2003, 62 patients underwent anatomic repair of a transposition of the great arteries. Mean operative age is 40 days. Transposition of the great arteries was simple in 38 cases and associated to a large ventricular septal defect in 24 cases. 44 patients have had an atrial septostomy of Rashkind and 45 an infusion of prostaglandin E 1.5 patients with simple transposition of the great arteries have had left ventricular retraining before arteriel switch. In association to arterial switch, were performed closure of ventricular septal defect in 24 cases, cure of coarctation of the aorta in 4 cases and cure of an abnormal partial pulmonary venous return in 1 case. Early mortality was 6,45%. After a mean follow up of 3 years, one patient died suddenly (late mortality is 1.72%) and one patient had to have 2 reoperations. Results of anatomic repair are now excellent. Late mortality is essentially related to coronary complications so that a careful follow-up is mandatory.     

Stratification of cardiac risk in unstable angina: value of troponin measurements

Recent studies have identified patients with unstable angina and increased troponin I or T as a high risk population gaining benefit from adjunctive treatment with glycoprotein IIb/IIIa receptor antagonists and early reperfusion by coronary interventions.     

A programmed autologous transfusion. A study of 47 patients

From December 1994 to January 2002, 44 among the 47 patients proposed have been integrated in the protocol of programed autologous transfusion. 18 patients were belonged to the male sex and 26 others belonged to the female one. The average age was 53.2 years (range 15-82 years old). 39 among the patients admitted in the protocol had an orthopaedic pathology. The protocol has associated the teams of surgery, of anesthesia and of transfusion and has occurred in the respect of the regulation (circular 91/2000). The blood taking have led to a significant modification of the hemoglobin rate (average decrease of 2 g/100 ml), of hematocrit (average decrease of 6.1%) and of the rate of platelets (average increase of 29,324 platelets/mm3). On the other hand, a transfusional complement by the concentrated homologous red corpuscles was necessary for 2 patients (2/40).     

Subcapsular liver hematoma,severe complication of pregnancy toxemia. A case report

Subcapsular liver hematoma is a rare and severe complication of pregnancy. This event is already known to have a poor maternal and foetal prognosis. The authors report a case of spontaneous rupture of subcapsular hematoma of the liver in 40 year old multiparous. Confirmation of diagnosis is obtained by abdominal echotomography or TOM. The surgical treatment of this hematoma joints the traumatic surgery of the liver. In every case foetal extraction by cesarean section constitutes the first therapeutic procedure.