WIND-PVPA: Water/Ion NMR Detected PVPA to assess lipid barrier integrity in vitro through quantification of passive water- and ion transport.

Water/Ion NMR Detected - Phospholipid Vesicle Permeability Assay (WIND-PVPA), is presented as a novel, straightforward and automatable method to assess lipid barrier integrity in vitro. The apparent permeability constants of water- and ions across the PVPA barriers are determined in a one-pot experiment under the influence of membrane-active guest molecules. NMR spectroscopy is used to quantify the water directly (D2O) and the ions indirectly (complexed with EDTA) as a function of time. WIND-PVPA is demonstrated using four anti-microbial peptides, to show that membrane active molecules can be differentiated by their disruptive influence on the PVPA system. The results obtained are compared with explicit molecular dynamics simulations of lipid bilayers, AMPs, water and salt, where the motions of all individual water molecules relative to the lipid bilayer are monitored over the course of the simulations, allowing the calculation of theoretical apparent permeability constants of the corresponding single bilayer systems. Proof-of-principle is presented that WIND-PVPA can be used to evaluate the lipid barrier destabilizing effect of active guest molecules by measuring changes in passive water- and ion permeabilities upon exposure. The method is highly flexible in terms of barrier composition, choice of probes and membrane active compounds.

[Epidemiological, therapeutic and prognostic aspects of breast cancer: about 473 cases collected in Hopital Principal de Dakar]. / Aspects epidémiologique, thérapeutique et pronostique des cancers du sein: a propos de 473 cas colligés a l'Hôpital Principal de Dakar.

INTRODUCTION: The aims of this study were to appreciate the epidemiological, therapeutic and pronostic aspects of breast cancer. This retrospective study was carried out in gynecology service in Hopital Principal of Dakar. We collected 473 cases of breast cancer over a period of 15 years, from January 1986 to December 2001. MATERIALS AND METHODS: Only the patients having a histological diagnosis were involued. The identification of patients, their medical history, their present complaints and the different treatment performed, were registred. The actuarial method of survival was used. RESULTS: The mean age of patients was 42.5 years; the average of parity was 4.7. The patients live in Dakar in 245 cases (51.7%). We had observed 279 cases (59.1%) diagnosed between six months and twelve months. Only 74 cases (15.8%) were diagnosed less than three months. In 282 cases (60%) the disease stage was T4N1Mx in TNM classification. In 425 cases (89.89) the histological type was infiltrate canal carcinoma. The surgery had concerned 441 patients (93.2%). And 52 of them (11%) underwent conservative treatment and 309 out of them (65.2%) underwent total mastectomy associated to axillary cleaning out like Patey method. Chemotherapy had been done in 426 cases (90%), hormonotherapy in 92 cases (19.4%) radiotherapy in 83 cases (17. 5%) and surgical costiation had been performed in 42 cases (8.8%). The overall survival at 15 years was (8.5%). CONCLUSION: According to the issues of other african series we found out that our patients were young at the time of the diagnosis, We think that early diagnosis and appropriated treatment must improve the prognosis of breast cancer. The mass screening politics must be involved.

[Continent esoduodenal intubation after total gastrectomy for cancer. An African experience apropos of an initial series of 17 cases]. / L'intubation oeso-duodénale continente après gastrectomie totale pour cancer. Expérience africaine à propos d'une série préliminaire de 17 cas.

On the basis of a series of 17 cases in which GI continuity was restored by a containing esoduodenal intubation, the authors describe the technique, which consists in the approximation of the duodenum opposite the diaphragm. Esophageal intubation in the duodenum, the margins of which have been everted, allows preserving the physiological circuit, producing a new container within 3 months and ensuring an effective protection against reflux. The 17 patients had undergone total gastrectomy for advanced cancer, Gutman's stage II in 80% of all cases and stage III or more in the other 20%. 88% of the tumors were adenocarcinomas. There were no clinical or radiological signs of reflux, and no esophagitis was noted on repeated endoscopies. The postoperative mortality rate was 5.8%. The shortest time lapse is 1 year.

[Restoration of continuity after rectosigmoidectomy by colorectal intubation and transproctoanal anastomosis. An African experience with 10 cases]. / Rétablissement de continuité après rectosigmoïdectomie par intubation colorectale et anastomose transproctoanale. Expérience africaine de dix cas.

On the basis of 10 cases (8 cases of rectosigmoid cancer and 2 of sigmoid volvulus), the authors report about their experience in the restoration of GI tract continuity using colorectal intubation into the rectal lumen and a transproctoanal anastomosis. This technique helps avoiding subperitoneal sutures, which are a cause of fistulae and shrinkage. It is simple enough to be performed by younger surgeons. This technique was initially developed for anterior resections for rectosigmoid cancer, and it can be utilized as an emergency procedure with single-piece resection without untwisting the sphacelous sigmoid loops, so that neither a temporary left iliostomy nor a second operation are needed.

[Right ileocolonic intubation after resection of the terminal ileum for generalized peritonitis caused by ileal perforation. An African experience with 33 cases]. / Intubation iléo-colique droite après résection de l'iléon terminal pour péritonite généralisée par perforation iléale. Expérience africaine de 33 cas.

Generalized peritonitis due to ileal perforation is common in Africa, and is caused by typhoid fever in most cases. For various reasons, the patients arrive at hospital in a poor general condition. In spite of combined intensive care and surgery, the general evolution of the disease resulted in a high mortality rate. All surgical techniques requiring sutures on a poor-quality ileon, ie. excision and suture, limited segmental resection or extensive ileal resection, most often lead to the breakdown of suture lines, so that the patient enters the vicious circle of repeated peritonitis and hazardous re-operations. Even exteriorized suture lines turn into fistulae, and temporary terminal ileostomy requires an amount of maintenance that is sometimes difficult to ensure in Africa. The technique proposed by the authors was developed in the department of surgery of the Dakar Main Hospital and has several advantages: It is a simple and quick procedure, which does not require the surgeon to be very experienced and can be performed in underequipped hospitals. There is no procedure-associated mortality. Morbidity decreases as the surgeon's experience increases. GI continuity can be established even in a septic environment. No second-look operation is necessary, so that the stay at hospital becomes shorter and the costs of treatment lower. Lastly, this type of restoration can be applied to other indications such as right colectomy and ileocolic or transverse ileal intubation.