Increased yield of PCR products by addition of T4 gene 32 protein to the SMART PCR cDNA synthesis system.

Under certain conditions, T4 gene 32 protein is known to increase the efficiency of different enzymes, such as Taq DNA polymerase, reverse transcriptase, and telomerase. In this study, we compared the efficiency of the SMART PCR cDNA synthesis kit with and without the T4 gene 32 protein. The use of this cDNA synthesis procedure, in combination with T4 gene 32 protein, increases the yield of RT-PCR products from approximately 90% to 150%. This effect is even observed for long mRNA templates and low concentrations of total RNA (25 ng). Therefore, we suggest the addition of T4 gene 32 protein in the RT-PCR mixture to increase the efficiency of cDNA synthesis, particularly in cases when low amounts of tissue are used.

[Helicobacter pylori and gastroduodenal lesions in 547 symptomatic young adults]. / Helicobacter pylori et lésions gastro-duodénales chez 547 jeunes adultes symptomatiques.

OBJECTIVES: Helicobacter pylori (H. pylori) is involved in the pathogenesis of gastric inflammatory disorders. Both antral chronic gastritis and H. pylori infection prevalence increase with age. The aim of the study was to assess the prevalence of H. pylori infection in young adults and to study the relationship between endoscopical and histological features and H. pylori infection. METHODS: The study concerned 547 young patients (age: 18-25 years), undergoing endoscopy for upper gastrointestinal symptoms. The severity and the activity of chronic gastritis was graded by histological examination of antral biopsies. The diagnosis of H. pylori infection was based on histology and culture or urease test. RESULTS: Fifty-three percent of the patients had a normal endoscopy; 44 ulcers were found: 34 duodenal ulcers and 10 gastric ulcers. H. pylori infection was detected in 34% of cases. The prevalence of H. pylori infection was 29.8% in non-ulcer patients, 50% in gastric ulcers and 91% in duodenal ulcers (P < 0.01). Duodenal ulcer, aspect of antral mosaic mucosa and nodular gastritis, were closely related to the presence of H. pylori. There was a significant relationship between H. pylori infection and both the severity (P < 0.01) and the activity (P < 0.01) of the antral chronic gastritis. The prevalence of follicular gastritis was 22% : it was present in 60% of H. pylori positive patients and 2.4% of H. pylori negative patients. H. pylori infection was more frequent in patients from Africa than in Europeans (P < 0.01). There was no significant association between H. pylori infection and different types of diets, settlements (rural vs urban) or symptoms. CONCLUSION: These results show that in the young population studied, duodenal ulcer, nodular gastritis, antral mosaic mucosa, active chronic gastric and follicular gastritis are closely related to H. pylori infection. They suggest that in the subgroup of non ulcer symptomatic patients, H. pylori prevalence is higher than in the general population.

[Follicular gastritis in adults. Relations with Helicobacter pylori, histological and endoscopic aspects]. / Les gastrites folliculaires de l'adulte. Relations avec Helicobacter pylori, aspects histologiques et endoscopiques.

Follicular gastritis (FG) is characterized by lymphoid follicle hyperplasia in the gastric mucosa. The aim of this prospective study was to determine the prevalence of FG in adults, their relation to Helicobacter pylori infection, and their histological and endoscopic features. Of 445 patients (379 men, 66 women), 36.4 years old (range: 18-86), FG was detected in 63 patients (14.2%). This was highly significantly associated with H. pylori infection: 49/138 infected patients (35.5%) versus 14/307 non infected patients (4.6%) (P < 0.001). None of the histological features of the antral mucosa were correlated with FG. The prevalence of FG in patients less than 20 years old (in 45.4%) and between 20 and 40 years (in 41.3%) was higher than in patients aged from 40 to 60 years (in 33%) and older than 60 years (in 23%) (no significant difference). No one endoscopic feature of the gastric mucosa was predictive of the presence of FG. We conclude that FG is highly correlated with H. pylori infection and represents a local immune response to bacterial antigens. Their occurrence is probably multifactorial and related to age, duration of infection, bacterial strains, host immune status.

[Neumann's tumor or congenital epulis of the newborn]. / Tumeur de Neumann ou épulis congénitale du nouveau-né.

Congenital epulis is a rare benign gingival tumor affecting mainly female neonates. Histology shows characteristic granular cells. Although diagnosis and therapy fail to raise particular problems, this is not the case for histopathogenesis of lesion. Two cases observed recently in West Africa are reported.

[Rectocolonic polyps in Senegal. Results of 1500 lower endoscopies carried out at the Dakar General Hospital]. / Les polypes recto-coliques au Sénegal. Résultat de 1,500 endoscopies basses effectuées à l'Hôpital Principal de Dakar.

57 polyps were discovered during 1,500 low endoscopies, and 24 of them were adenoma. In the same period of time, 26 proctocolitic adenocarcinomas were found. Adenomatous polyps appear to be 5 times less frequent in Senegal than in industrialized countries and frequency of colitic cancer should be of the same frequency, that is far less negligible. Even if proctocolitic cancer does not set up any Public Health problems one could envisage systematic screening of polyadenoma in every patient aged more than 40. Proctosigmoid being the seat of most adenoma, fibrosigmoidoscopy appears well adapted to this kind of screening because it does not require any preparation, it is easy to perform and well accepted.

[Value of ultrasonically-guided liver puncture biopsy in the diagnosis of primary liver cancer. Apropos of 84 cases]. / Valeur de la cytoponction hépatique écho-guidée dans le diagnostic de cancer primitif du foie. A propos de 84 observations.

Ultrasonographicaly guided fine needle aspiration of liver was performed in 84 patients having a confirmed HCC. This technics utilizes a CHIBA type fine needle, after blood coagulation tests have been checked. Out of 84 fine needle aspirations performed: 64 were positive (76,2%), 9 negative (10,7%), 11 (13,19%) were questionable (6) or nonanalysable (5). It is ascertained that the sensibility of this technics is over 75%. It should be possible to improve it by repeating such an exam in previously negative patients. The causes of failure are discussed. Tolerance of the technics is good. It is attraumatic, and of very easily performance. No accident, no mishap was noted.

[Several cases of giant epulis observed in West Africa]. / Quelques cas d'epulis géantes observés en Afrique de l'Ouest.

The presenting symptomatology in 9 cases of giant epulis seen in West Africa was constantly difficulties in mastication or even speech, and on some occasions tumefaction of the face. A certain number of factors are involved in the development of these benign tumors, and although inflammation represents the primum movens of this affection, other causes, including some specific to the African continent, must be considered with a view to a pathogenic approach.

[Odontogenic adenomatoid tumor. Apropos of 2 cases in Dakar]. / Tumeur odontogénique adénomatoïde. A propos de 2 observations à Dakar.

Two cases of large adenomatoid odontogenic tumor seen recently in Senegal are thought to be the first cases of this type reported in West Africa. One patient was a 25 year old woman and the other an 11 year old boy, the clinical history and lesions being identical in both cases. Simple enucleation appeared to be the treatment of choice in view of the constantly reported benign nature of these tumors. It is difficult, or almost impossible however, to differentiate this tumor from dentigerous cyst on radiology, justifying routine minute pathologic examination of all operated paradental cysts.

[Plummer-Vinson syndrome or related syndrome in 3 black African women]. / Syndrome de Plummer-Vinson ou syndrome apparenté chez trois africaines de race noire.

The Plummer-Vinson syndrome or "sideropenic dysphagia" is exceptional among Blacks. One case was recently reported in a female patient from Guadeloupe. This study pertains to three cases observed in Senegalese Black women aged 28, 27, and 41 years. These three women were admitted for a dysphagia, in fact in evidence 10, 4, and 7 years respectively before the diagnosis was made. A clinical anemia was noted twice in addition to mucocutaneous disorders (cases 1 and 2). The laboratory tests showed in all three cases a hypochromic microcytic sideropenic anemia (serum iron levels at 32, 14, and 31 mcg 100 ml respectively). Barium swallow films showed esophageal rings in front of C5-C6 (case 1) of T2-T3 (case 2) and a web of fine mucosal folds in front of C5-C6 (case 3). These films were confirmed cineradiographically by esophagoscopy. The treatment consisted of blood transfusions (cases 1 and 2) and administration of iron by injections and or per os. The endoscopic exams were repeated two or three times. Medical treatment rapidly changed the course of disease for the better. No cause for bleeding was found. A chemical achlorhydria (case 1), a provoked hypoachlorhydria (cases 2 and 3) can be retained as associated factors. In light of the frequency of esophageal membranes in the general population and the incidence of sideropenic anemias among African women, the Plummer-Vinson syndrome should be more often detected in Black Africa.

[Indications for laparoscopy in an internal medicine department in Dakar as indicated by echotomography]. / Indications de la laparoscopie dans un service de médecine interne à Dakar à l'heure de l'échotomographie (E.C.T.).

A real time ultrasonography was set up in a senegalese hospital, resulting in a decrease of laparoscopy indications. Laparoscopy is given up for the diagnosis of liver abcess, jaundice and "abdominal masses". It must no more be included in the first step check up for hepatocellular carcinoma, because ultrasonography and cytology after puncture are enough to confirm the diagnosis. Laparoscopy remains essential for peritoneal diseases. Hepatic needle biopsy under laparoscopy control remains necessary to ensure with certainty the diagnosis of cirrhosis and especially chronic hepatitis, provided that no countraindications are found.

[Hemorrhagic rectocolitis or ulcerative colitis in the black Senegalese. Apropos of 14 cases]. / La rectocolite hémorragique ou colite ulcéreuse chez le sénégalais de race noire. A propos de 14 cas.

Ulcerative colitis is exceptional in Africa South of the Sahara. The first case was described in 1964: up to 1982, 46 cases were reported. We report on 14 cases (6 females and 8 males) observed in black Senegalese for three years and a half. The medium age of patients was 30 years. All of them had a high social standard of living. Four patients showed intestinal amebiasis in their previous medical history. Clinical and evolutive patterns of ulcerative colitis in Africa present few differences in comparison with the classical ones. The diagnosis is established by endoscopy (rectosigmoidoscopy and/or colonoscopy) and histopathology. Cryptic abscesses were found in only 2 out of 14 cases. Rectal dysplasia was noted in 2 cases. The course of the disease developed on a fulminating acute mode in one case, on a continuous chronic mode in another case and on a chronic mode with relapses in 11 cases. Irrespective to the clinical form observed, intestinal amebiasis represents the most pressing differential diagnosis. Treatment appears to be difficult in severe acute forms out of an intensive care department, as well as in advanced extensive chronic forms. For the later in black Africa endoscopic and histopathological surveillance appears to be preferable to a total colectomy, made necessary by the important rectal lesions, because the functional sequelae of an ileostomy.