[Primary colonic intussusception protruding from the anus in adults. Two cases]. / Invagination colique primitive de l'adulte, procidente à l'anus. Deux observations.

The authors report two cases of colonic intussusception in the adult protruding from the anus--or colon-anal intussusception--, not due to a tumor. The first case was a chronic ileo-caeco-colique intussusception, the second case was an acute colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than twenty cases have been described since 1925 in adults. The absence of a tumor origin in our cases represents a special feature, as only three other similar cases have been described. The surgical treatment in both cases was primary colonic resection without colostomy. The surgical treatment of the first case was subtotal colectomy with ileo-rectal anastomosis. The second case was primarily reduced by barium enema which allowed optimal secondary surgical resection of a prepared colon.

[Primary colonic intussusception protruding from the anus in adults. Two cases]. / Invagination colique primitive de l'adulte, procidente à l'anus. Deux observations.

The authors report two cases of colonic intussusception in the adult protruding from the anus--or colo-anal intussusception--, not due to a tumor. The first case was a chronic ileo-caeco-colique intussusception, the second case was an acute colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than twenty cases have been described since 1925 in adults. The absence of a tumor origin in our cases represents a special feature, as only three other similar cases have been described. The surgical treatment in both cases was primary colonic resection without colostomy. The surgical treatment of the first case was subtotal colectomy with ileo-rectal anastomosis. The second case was primarily reduced by barium enema which allowed optimal secondary surgical resection of a prepared colon.

[Mucus-secreting tumors of the appendix: a preoperative diagnosis is possible. Apropos of 2 cases]. / Tumeurs muco-sécrétantes de l'appendice: un diagnostic pré-opératoire est possible. A propos de deux observations.

The authors present two cases of pseudo tumoral type Mucus Secreting Tumours (MST) of the appendix. In this type (32% of the cases), the clinical presentation, barium enema, ultrasonography and most importantly CT scan generally confirm the preoperative diagnosis. We found three advantages this preoperative diagnosis. 1) Primarily it allow selection of a large surgical approach that permits full exploration of the abdominal cavity especially the ovaries (2-18% associated lesions); 2) also it allows a histopathological examination (frozen section) of the appendix to be performed during the operation; 3) and finally the surgical treatment will depend on the operative findings and the result of the histopathological examination: in the benign forms simple appendicectomy will be sufficient but the malignant forms (12% of the cases) should be treated by right hemicolectomy.

[Mucus-secreting tumors of the appendix: a preoperative diagnosis is possible. Apropos of 2 cases]. / Tumeurs muco-sécrétantes de l'appendice: un diagnostic pré-opératoire est possible. A propos de deux observations.

The authors present two cases of pseudo tumoral type Mucus Secreting Tumours (MST) of the appendix. In this type (32% of the cases), the clinical presentation, barium enema, ultrasonography and most importantly CT scan generally confirm the preoperative diagnosis. We found three advantages this preoperative diagnosis. 1) Primarily it allows selection of a large surgical approach that permits full exploration of the abdominal cavity especially the ovaries (2-18% associated lesions); 2) also it allows a histopathological examination (frozen section) of the appendix to be performed during the operation; 3) and finally the surgical treatment will depend on the operative findings and the result of the histopathological examination: in the benign forms simple appendicectomy will be sufficient but the malignant forms (12% of the cases) should be treated by right hemicolectomy.

Testosterone metabolism by homogenates of human prostates with benign hyperplasia: effects of zinc, cadmium and other bivalent cations.

The effects of various quantities of Ba, Be, Ca, Cd, Co, Cu, Mg, Mn, Sr, Zn and EDTA on the formation of 5 alpha-reduced metabolites of testosterone (T) substrate and of 3 alpha-/3 beta-reduced metabolites of 5 alpha-dihydrotestosterone substrates by homogenates of 6 human hyperplastic prostate glands were studied in incubations at pH 7.4 with NADPH-generating system. Effects of these cations and EDTA on the VM and KM of the 5 alpha-reductase and 3 alpha-/3 beta-hydroxysteroid dehydrogenases (-HSD) were also measured. Quantities of 5 alpha-reduced T metabolites were significantly increased by Cd, Cu and Zn supplementations. These increments were shown to result from significant augmentations of the VM but no change in KM of the NADPH-dependent 5 alpha-reductase. Quantities of 3 alpha-reduced DHT metabolites were significantly decreased by Cd and Cu supplementations and resulted from an increase of the KM of the NADPH-dependent 3 alpha-HSD by Cd and both an increase of KM and a decrease of VM by Cu. Quantities of 3 beta-reduced DHT metabolites were significantly decreased by Cd and Cu supplementations. Increase of the KM of the NADPH-dependent 3 beta-HSD by Cd was found significant while Cu both increased the KM and decreased the VM of the enzyme. EDTA-related changes in 5 alpha-reductase activity were shown to result from the EDTA-induced decrease of the pH of the medium. No effect of EDTA was observed on the activities of both 3 alpha/3 beta-HSD.

Correlative study of the morphology and C19-steroid metabolism of benign and cancerous human prostatic tissue.

Perineal punch biopsy specimens of human prostate with benign hyperplasia (BPH), well- and poorly-differentiated adenocarcinoma and transitional-cell carcinoma were incubated with testosterone-1,2-3H and 5alpha-dihydrotestosterone-1,2-3H. Incubations were carried out using a single tissue-radiosubstrate ratio and time point. Resulting radiosteroid patterns were related to histologic and ultrastructural features of these tissues. Well differentiated neoplasms had ultrastructural characteristics closely resembling hyperplastic epithelia. Both in BPH and in well differentiated carcinomas the C19-steroids were mainly metabolized by the 17beta-hydroxysteroid pathway. In contrast, cells in poorly-differentiated adenocarcinoma and transitional-cell carcinoma lacked the cytoplasmic organelles responsible for secretion; formation of 5alpha-reduced 17beta-hydroxysteroids was decreased in these carcinomas, while conversion to 17-oxosteroid radiometabolites remained unchanged or was greatly increased. These results indicate that loss of prostatic differentiation is attended by a trend from reductive toward oxidative radiotestosterone metabolism. Even in NAPDH-supplemented preparations of the majority of poorly-differentiated tumors, there was diminished transformation to 5alpha-dihydrotestosterone, the key intracellular hormone in the expression of androgenic activity in the prostate. These findings may explain why poorly-differentiated prostatic neoplasms are frequently unresponsive to anti-androgenic therapy.

Continuous low rate enteral feeding.

The original method of continuous low rate enteral feeding is used in cases of nutritious deficiencies and is found to be of value in view of its scientific and technical advantages. Its value is demonstrated by 95% satisfactory results. Furthermore, its low cost, handiness and ease of operation make it accessible to any medical or surgical center where it may have a preferential if not exclusive place.