[The Alzheimer's disease or the fall of the neocortical empire at the age of nonsense].

ERMAInternational audienceIf we observe the evolution of the Alzheimer's disease of a premature entorhinal stage at an evolved stage of the neocortex, the succession of the confusions of the simple mnesic complaint in the aphasia, praxia, gnosia, visual, psychological and comportemental difficulties testify of the extension of the lesions in the neocortical structures. This neocortical regression seems to take the inverse road of the phylo- and ontogenetic evolution, where this hegemonic neocerebral cortex - which had grown again on the borders of the archeocortical and paleocortical barbarian empire - sees itself dispossessed of its conquests and gives free rein to these ancestral structures. We could compare the Alzheimer's disease with the fall of the neocortical empire at the age of nonsense

Dystrophie kystique sur pancréas aberrant duodénal (à propos de deux cas et revue de la littérature)

LIMOGES-BU Médecine pharmacie (870852108) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Platelet-activating factor in cirrhotic liver and hepatocellular carcinoma.

http://www.wjgnet.com/1007-9327/12/2773.aspAIM: Platelet-activating factor (PAF) is a pro-inflammatory and angiogenic lipid mediator. Here we aimed to investigate levels of PAF, lyso-PAF (the PAF precursor), phospholipase A(2) (PLA(2), the enzymatic activity generating lyso-PAF), acetylhydrolase activity (AHA, the PAF degrading enzyme) and PAF receptor (PAF-R) transcripts in cirrhotic liver and hepatocellular carcinoma (HCC). METHODS: Twenty-nine patients with HCC were enrolled in this study. Cirrhosis was present in fourteen patients and seven had no liver disease. Tissue PAF levels were investigated by a platelet-aggregation assay. Lyso-PAF was assessed after its chemical acetylation into PAF. AHA was determined by degradation of [(3)H]-PAF. PLA(2) levels were assessed by EIA. PAF-R transcripts were investigated using RT-PCR. RESULTS: Elevated amounts of PAF and PAF-R transcripts 1 (leukocyte-type) were found in cirrhotic tissues as compared with non-cirrhotic ones. Higher amounts of PAF and PAF-R transcripts 1 and 2 (tissue-type) were found in HCC tissues as compared with non-tumor tissues. PLA(2), lyso-PAF and AHA levels were not changed in cirrhotic tissues and HCC. CONCLUSION: While the role of PAF is currently unknown in liver physiology, this study suggests its potential involvement in the inflammatory network found in the cirrhotic liver and in the angiogenic response during HCC

Chapitre 5. Changements structuraux dans le cerveau vieillissant

ERM

Long-term results of mesocaval shunts with polytetrafluoroethylene grafts.

ERMAInternational audienceDespite the introduction of new procedures such as pharmacologic reduction of portal pressure and endoscopic sclerotherapy, the role of surgery in portal hypertension must be reconsidered. The aim of this retrospective study was to evaluate the long-term results of mesocaval interposition shunting in the treatment of recurrent variceal bleeding after sclerotherapy failure or in patients with intractable ascites in whom optimal medical treatments failed. Over a 20-year period, 85 patients (66 men and 19 women; mean age, 53.96 +/- 11.57 years) underwent a mesocaval interposition shunt procedure. Sixty-six patients had recurrent variceal bleeding, and 19 patients had refractory ascites. The underlying etiology of portal hypertension was alcoholic cirrhosis (n = 69), posthepatitis cirrhosis (n = 10), cryptogenic cirrhosis (n = 3), primary biliary cirrhosis (n = 2), and Budd-Chiari syndrome (n = 1). Thirty-one patients were in Child-Pugh grade A, 34 were in grade B, and 20 were in grade C. The mean diameter of the graft was 11.85 +/- 1.53 mm (range, 10-14 mm). Overall, in-hospital mortality was 10.5% (9 of 85 patients). There were 3 postoperative recurrences of variceal hemorrhage and 5 recurrent bleeds during the follow-up. The overall incidence of shunt thrombosis of this series was 10.5%. The total incidence of encephalopathy was 10.5%. Intraoperative gradient pressure measurements before and after shunt showed satisfactory pressure reduction (16.90 +/- 5.32 to 5.12 +/- 2.50/ mmHg; P < 0.0001). The mean follow-up period was 26.09 +/- 25.3 (range, 1-90) months. Nine patients (10.5%) later received liver transplants, with time intervals ranging from 2 months to 5 years. The actuarial survival rate was 92% at 1 year and 75% at 5 years. In our series, the interposition mesocaval shunt seems to be an effective procedure for the control of complications of portal hypertension in cirrhotic patients with good long-term results. Moreover, the procedure can be considered as a solution of choice in patients who are current liver transplant candidates, leaving the hepatic hilus intact

The anterior intermeniscal ligament of the knee: an anatomic and MR study.

ERMAInternational audienceBACKGROUND: The purposes of this study were to identify the presence of the anterior intermeniscal ligament of the knee (AIL), to study its attachment patterns and relationships to other anatomic structures within the knee and to evaluate the potential association of its rupture with other pathology of the knee. METHODS: Ten human cadaver knees were dissected excluding knees with surgical scars. Fifty-one MR examinations were performed in symptomatic patients. Arthroscopic observations were carried out on ten patients. RESULTS: AIL was found in nine dissected knees with type I insertion in six cases, type II insertion in three cases. The average length was 31.2 mm (25-45 mm). The average distance between AIL and insertion of the anterior cruciate ligament was 12 mm (11-15 mm). Concerning MR study, AIL was found in 34 cases (82.9%). Four (9.75%) ruptures of the AIL were encountered. Where AIL was intact, 14 patients presented meniscal lesions (46.6%). Where AIL was ruptured, three patients presented meniscal lesions (75%). CONCLUSION: The present study demonstrates through anatomical and MR studies that AIL is present in more than 80% of the cases with predominant type I insertion. The association of meniscal and AIL lesions was highlighted demonstrating that AIL is not only an anatomical point of interest but also a clinical and surgical reality