Efficacy of 1% geraniol (Fulltec) as a tick repellent.

A field trial on the efficacy of 1% geraniol (Fulltec) spray against ticks has been carried out in two farms near Rabat (Morocco). Results clearly revealed that 1% geraniol has a preventive effect against Hyalomma ticks. Comparison of geraniol sprayed cows with control herd showed a reduction of mean number of ticks per animal of 98.4%, 97.3% and 91.3% at respectively day 7, 14 and 21 post-spraying. These data give evidence that the geraniol, natural product extracted from plants, could be an alternative to limit use of chemical acaricides, which efficacy is compromised by development of resistance.

Radiology of colorectal cancer.

In the past 20 years, the radiology of colorectal cancer has evolved from the barium enema to advanced imaging modalities like phased array magnetic resonance imaging (MRI), virtual colonoscopy and positron emission tomography (PET). Nowadays, primary rectal cancers are preferably imaged with transrectal ultrasound or MRI, while barium enema is still the most often used technique for imaging of colonic cancers. Virtual colonoscopy is rapidly evolving and might considerably change the imaging of colorectal cancer in the near future. The use of virtual colonoscopy for screening purposes and imaging of the colon in occlusive cancer or incomplete colonoscopies is currently under evaluation. The main role of PET is in detecting tumour recurrences, both locally and distantly. Techniques to fuse cross-sectional anatomical (computer tomography (CT) and MRI) and functional (PET) images are being developed. Apart from diagnostic imaging, the radiologists has added image-guided minimally invasive treatments of colorectal liver metastases to their arsenal. The radio-frequency ablation technique is now widely available, and can be used during laparotomy or percutaneously in selected cases.

Incidence of adrenal masses in patients referred for renal artery stenosis screening MR.

RATIONALE AND OBJECTIVES: Prior work has shown the efficacy of magnetic resonance (MR) in renal artery stenosis evaluation. The increasing role of renal artery stenosis in the differential diagnostic evaluation of hypertension raises the question of whether MR should be used as a screening modality. This project evaluated the additional potential benefits of MR by determining the incidence of adrenal masses in this selected population. METHODS: A 2-year retrospective study analysis of patients who failed to respond to antihypertensive medical management and were referred for renal MR for hypertension amassed 77 subjects ranging in age from 18 to 88 years. A masked analysis for adrenal masses was performed on this data set. Magnetic resonance techniques included T2-weighted turbo spin-echo (repetition time [TR] 2000-4000 ms, echo time [TE] 80-100 ms, turbo factor 2-16), T1-weighted spin-echo (TR 200-500 ms, TE 10-30 ms), gradient-echo time-of-flight (TR 26 ms, TE 6.9 ms, 40 degrees flip angle, 2 excitations), and dynamic gadopentetate dimeglumine-enhanced MR angiography (three-dimensional gradient recalled echo, TR 10 ms, TE 3 ms, 40 degrees flip angle, 1 excitation). RESULTS: Thirty-three patients had renal artery disease, 44 had normal renal arteries, and 7 had adrenal masses. Forty-three percent of patients who underwent renal MR had disease of the renal arteries detected, and 9% of patients referred for MR had adrenal masses that would have been missed with scintigraphy and/or angiography, of which 57% were responsible for hypertension. CONCLUSIONS: The ability to evaluate renal artery and adrenal anatomy globally can be useful, as exemplified in the current series, and the adrenals should be examined carefully in any renal MR in a hypertensive patient.

Standardized measurement of the future liver remnant prior to extended liver resection: methodology and clinical associations.

BACKGROUND: There is no agreement regarding the preoperative measurement of liver volumes and the minimal safe size of the liver remnant after extended hepatectomy. METHODS: In 20 patients with hepatobiliary malignancy and no underlying chronic liver disease, volumetric measurements of the liver remnant (segments 2 and 3 +/- 1) were obtained before extended right lobectomy (right trisegmentectomy). The ratios of future liver remnant to total liver volume were calculated by using a formula based on body surface area. In 12 patients, response to preoperative right trisectoral portal vein embolization was evaluated. In 15 patients who underwent the planned resection, preoperative volumes were correlated with biochemical and clinical outcome parameters. RESULTS: The future liver remnants increased after portal vein embolization (26% versus 36%, P < .01). Smaller size liver remnants were associated with an increase in postoperative liver function tests (P < .05) and longer lengths of hospital stay (P < .02). Preliminary data indicates an increase in major complications for liver volumes < or = 25% (P = .02). CONCLUSIONS: A simple method of measurement provides an assessment of the liver remnant before resection. It is useful in evaluating response to portal vein embolization and in predicating the outcome before extended liver resections.

Impact of nitrate intake in drinking water on the thyroid gland activity in male rat.

The purpose of this study was to determine the effects of nitrate on both the activity of the thyroid gland and other biological parameters. After 5-month treatment, nitrate 150 and 500 mg/l induced a significant decrease in the serum level of thyroid hormone T3. For T4, the 500 mg/l dose only reduced its plasma level. On the other hand, nitrate induced a dose-dependent increase in the weight of the thyroid gland. The histological study of the thyroid gland shows vacuolisation and an increase in the size of the follicles accompanied by a flatness of follicular epithelium with nitrate 150 and 500 mg/l. We concluded that the presence of high concentrations of nitrate in drinking water influence the growth, induce morpho-functional modifications of the thyroid gland and might be considered as a goitrigenic factor.

MRI isolation of infected renal cyst in autosomal dominant polycystic kidney disease.

The use of gadolinium-enhanced magnetic resonance (MR) to isolate an infected renal cyst in the setting of autosomal dominant polycystic kidney disease (ADPKD) has not been previously described. A case in which T1- and T2-weighted and gadolinium-enhanced MR images were used to identify a single purulent cyst in a patient with ADPKD is herein presented. We suggest that gadolinium-enhanced MR be considered useful in the evaluation of ADPKD patients with suspected infected cyst.

Pharmacological activity, blood and tissue levels of indomethacin after single oral administration of two long-acting forms in the rat.

The duration of pharmacological action in the rat (carrageenin edema inhibition) of a long-acting indomethacin form (Dolcidium PL) was compared to that of a reference long-acting indomethacin form after a single oral dose (3 mg/kg) considered as the ED50 value and compatible with clinical use. Kinetic comparison of both forms was achieved in the blood and at the level of the inflammatory site. There was an identical bioavailability, but the rate of indomethacin release from the test preparation was significantly slower than that of the reference form. Greater pharmacological potency and significantly longer duration of action were also demonstrated for the former, indicating that this novel formulation exhibited better sustained release characteristics than the reference form, and thus exerted an optimal pharmacological effect (over 24 hr). Since there is a high degree of correlation of clinical efficacy with potency in the rat foot edema test, better effectiveness of Dolcidium PL should be expected in man. The reduction in peak plasma level of indomethacin should improve its tolerability as well.

Preliminary note: effect of microtubule inhibitors with acrylophenone structure on Triton WR 1339 induced hyperlipidemia in rats.

Acrylophenone derivatives having in vitro antimicrotubular activity very similar to that of Colchicine were tested on Triton WR 1339 induced hyperlipidemia in rats. By inducing a disorganization of the microtubular system these compounds decreased the movement of very low density lipoproteins (VLDL) to the extracellular space and consequently decreased hypertriglyceridemia. On the other hand, contrary to Colchicine, these derivatives decreased cholesterolemia more significantly and this could be explained by a second action mechanism.

[Gestational trophoblastic diseases. Apropos of 105 cases]. / Les maladies gestationnelles trophoblastiques. A propos de 105 cas.

The authors report a retrospective study of 105 observations of gestational trophoblastic diseases managed at the university clinic of obstetric gynecology I (Pr Chaoui). Of this study, one listed 72 cases of complete mole hydatiforme with 5 cases of sacrofetal pregnancy. The invasive mole is found in 4 cases and the choriocarcinoma in 24 cases. The general frequency of this pathology is of 1/770 pregnancies. The age of our patients varies from 15 to 52 years with an average age 27 years and the multiparity is found in 50% of the cases. 103 patients (95.5%) consulted for metrorrhagia associated pelvic pains in 31 cases (30%). The toxic syndrome was present in 20 patients (12%) with a preeclampsy in 6 cases (5.71%). The physical examination showed a very increased uterus of size in 92 cases (87.5%) associated adnexal mass in 37 cases (35.2%). The diagnosis was especially echographic in the totality of the cases associated or not with a proportioning of plasmatic beta HCG or prolans urinary. The treatment of the trophoblastic disease varies simple endo-uterine aspiration (85%) until the chemotherapy treatment (32.4%), the hysterectomy was indicated in a third of the cases. The evolution of the non complicated mole hydatiforme was good in 100% of the cases, it quasi totality of the invasive moles presented a complete remission. Among the 24 choriocarcinoma, we deplore 4 deaths in a table of pulmonary, hepatic and cerebral metastases. In order to improve the forecast of these diseases, the diagnosis must be early with an adequate treatment and a rigorous monitoring.

[Bilateral breast cancer. Incidence and risk factors]. / Cancer du sein bilatéral. Incidence et facteurs de risque.

OBJECTIVE: To clarify, thanks to a retrospective study of 24 bilateral breast cancer cases, the frequency, the risk factors and the prognosis of bilateral breast cancers. PATIENTS AND METHOD: Between 1984 and 1999, out of 506 patients treated for unilateral non-metastatic breast cancer at Gynecologic and Obstetric ward, at Maternity Souissi of Rabat, 24 cases of bilateral breast cancers were diagnosed. Our results were compared to those of the literature. RESULTS: The frequency of bilateral breast cancers was 4.7% (24/506). In 87.5% of cases, these were metachronous cancers with a mean interval of 45 months (12-144 months). Patients under 40 at first cancer ran a fivefold superior risk than women more than 40 (P < 0.05). In cases of T3 or T4 tumors, the risk was 10-fold superior to that in smaller ones (P < 0.05). DISCUSSION AND CONCLUSION: Significantly more first metachronous tumors were invasive adenocarcinoma cancers. Histologic type of first and second tumor was the same in all cases. The prognosis depends at once on the first and second cancer staging and the treatment must be done according to the same rules as in the first cancer.

[Angiosarcoma of the breast: a case report]. / L'angiosarcome du sein: à propos d'un cas.

We report a breast's angiosarcoma case admitted at the maternity hospital Souissi of Rabat in 1997. We discussed epidemiologic, diagnostic and therapeutic aspects of this type of tumor insisting on the difficulties of diagnosis.

[Hydatidiform mole and its complicated development]. / La môle hydatiforme et ses évolutions perturbées.

The authors report a series of 260 cases of trophoblastic disease, followed up over a period of 18 years. Supervision was based on clinical findings, biological development, radiology and ultrasound. The outcome was favourable in 80% of cases with 2.7% requiring prophylactic hysterectomy for classifical hydatiform mole. In the other cases (20%) the following was the way the disease developed: 12 cases of persistent trophoblastic activity, 13 cases of invasive mole, 24 cases of choriocarcinoma. Initially the treatment was with chemotherapy and surgery was used as an extra treatment in 14% of cases, which gave encouraging results. The authors regret three deaths in this series following choriocarcinoma. Two of these were after chemotherapy as a sole treatment and one after treatment with chemotherapy and surgery.

[Multiple cancers. Apropos of a quadruple cancer]. / Les cancers multiples. A propos d'un cancer quadruple.

A woman of 48 years of age presented over a period of twelve years with, successively, a cancer of the rectum, a cancer of the breast, cancer of the scalp and finally of the endometrium without metastases. Her general condition stayed good. We have looked into the nosological, statistical, pathogenic and prognostic features of multiple cancers. It does seem that the hormone state may be the trigger for this polycancerous condition (hyperoestrogenaemia). This was linked to an alimentary factor (obesity) and to a family history of a predisposition to cancer, as our patient was the tissue of a blood-related marriage and a member of a family where the incidence of cancer was 40%. Multiple cancers are 2.42% of all cancers but are mainly double or triple cancers. There are only 20 cases of quadruple cancers in the literature. One can divide these into: Cancers with a short interval between each appearance of simultaneous appearances, which usually occur at an advanced age, due to simple chance and often with a bad prognosis. Cancers that occur at longer intervals in younger people, which are rarer and show a family predisposition or endogenous factors. Their prognosis is as a whole better.

[Hypertrophic tuberculosis of the cervix. Three cases]. / La tuberculose hypertrophique du col. A propos de trois cas.

Tuberculosis of the cervix of the uterus is a rare form of genital tuberculosis. The epidemiology does not have any particular specific feature; but the macroscopic appearance gives a first impression of a cancer. Only by carrying out a biopsy of the cervix, followed by study of the histology can the problem be solved so that longterm anti-tuberculous treatment can be started. There is rarely any need for surgery, that only in cases resistant to medical treatment. The authors report three cases of tuberculosis of uterine cervix, found in the university clinic of obstetrics and gynaecology I (Professor Chaoui) during the years 1986-90. The incidence of this condition is 8.5% of genital tuberculosis. The outlook is good with full healing if the treatment is carried out properly.

[Complete non-obstetrical uterine inversion]. / Inversion utérine complète non obstétricale.

A rare case of a gynaecologic uterine inversion is reported emphasizing on the exceptional character of the gynecologic uterine inversion and the pathogenic problems which are tackled. Gynaecologic inversion results from a tumor implanted on fundus of the uterus or from the essential atrophy of suspension ligaments of the uterus. Treatment depends on the anatomic type and the stage.

[Malignant schwannoma of the breast. A case report]. / Schwannome malin du sein. A propos d'un cas.

Malignant schwannoma is a very rare sarcomatous tumor of unknown etiology. Primary mammary localization is exceptional. Clinically, the tumor manifests as an isolated painless nodule visualized as a benign nodule on standard radiogram. Positive diagnosis is provided by pathology. Treatment is surgical. The risk of local recurrence imposes a radical treatment. We report one case and review the literature, underlining the difficulties encountered in diagnosis and emphasizing the recurrent nature of this tumor after conservative treatment.

[Primary malignant melanoma of the cervix]. / Mélanome malin primitif du col utérin.

INTRODUCTION: Primary malignant melanoma of the cervix is an extremely rare histological variety of cervical tumor, with only 54 cases reported. OBSERVATION: A 70 year-old woman consulted for metrorrhagia and pelvic pain. Clinical examination revealed a tumefaction on the anterior labium of the cervix. The anatomo-pathological examination of the biopsy led to diagnosis of a malignant melanoma of the cervix. Despite enlarged Wertheim-type colpohysterectomy associated with pelvic lymphadenectomy, pulmonary metastases developed and the patient died six months later. COMMENT: This is a typical case of malignant melanoma of the cervix. All the authors underline the poor prognosis when visceral metastases occur early, as was the case in our patient.

Effect of natural starters used for sourdough bread in Morocco on phytate biodegradation.

Phytase activity was studied in natural sourdough bread starters to determine physicochemical characteristics (phytic acid hydrolysis, dough rising capacity and pH) in the flour and during sourdough fermentation. Fermentation microorganisms (yeasts and lactic acid bacteria) were also characterized. Results showed a decrease of phytic acid in sourdoughs started with traditional starters, and wide variation in phytase activity. Microorganism counts were high at the end of fermentation, indicating higher fermenting activity of the starters. Yeast populations showed wide variation and lactic acid bacteria had high counts in the fermentation. Phytase activity was demonstrated in starter cultures made of lactic acid bacteria and yeast isolates, the most interesting of which were Saccharomyces cerevisiae combined with Lactobacillus plantarum and Leuconostoc mesenteroides.

[Renal transplantation and pregnancy. Report of a case]. / Transplantation rénale et grossesse. A propos d'un cas.

The authors report a case, the first in Morocco, of a kidney transplanted woman pregnancy. The pregnancy occurred eleven months after the kidney transplantation. The renal function has not been modified. Treatment immunosuppressor has been maintained. The pregnancy evolution has been marked by a moderate hypertension arterial without child reverberation. To shortcoming this observation and to the lights of data of the literature, authors recalls factors that condition the stability of the renal function and the good progress of pregnancy and insist on the necessity of the scheduling of pregnancy and a multidisciplinary surveillance.

[Breast tuberculosis]. / Tuberculose mammaire.

Tuberculosis rarely affects the breast. The authors report the case of a 50 years-old woman with breast tuberculosis. The main purpose of this case report is to remind clinicians of the unusual presentations of extrapulmonary tuberculosis that can easily be forgotten. Mammary tuberculosis presents a number of diagnostic pitfalls. Diagnosis is based on identification of the tubercle bacillus in cultures or demonstration of typical histological lesions. Antibacillary drugs are the mainstay of therapy. Surgery is used only is cases that fail to respond to medical treatment and/or involve extensive tissue damage. Although rare, tuberculosis of the breast should be considered as a possible diagnosis, particularly in countries where tuberculosis is endemic.