Specific sites of bone expansion depend on the level of volleyball practice in prepubescent boys.

The purpose of this study was to investigate the effect of 18 months of high and low levels of volleyball practice on bone acquisition. 130 prepubescent boys (mean age 11.4 ± 0.7) were divided into a high-level training group (HLG), low-level training group (LLG), and controls. Bone mineral content (BMC) and bone area at the whole body, lumbar spine L2-L4, femoral neck of the dominant leg, and right and left radius were measured using dual-photon X-ray absorptiometry. Enhanced BMC resulted from high-training volleyball activity in all measured sites except the third left and right distal radius, which is not modified by low-level training in prepubescent players but it was accompanied by a bone area expansion in radius and weight-bearing sites for the HLG, and in legs, whole right and left radius for the LLG. Significant improvement of skeletal tissues is associated with the intensity and duration of volleyball training.

[Genioplasty: technique and applications]. / Les génioplasties: techniques et applications.

The chin is an element as important in facial profile as the nose and the forehead. It is subject to morphological anomalies in the sagittal (retrogenius or progenius), vertical (excess or insufficient height), or transversal (laterogenius) axes. Genioplasty used alone or in complement to other maxillomandibular osteotomies, allows for the correction of these malformations by modifying the position of the chin bones in three planes. Many types of genioplasty may be used to reach the desire goal, such as advancement, retraction, or adjustment of height or of symmetry. This genioplasty also has functional applications, notably in the treatment of obstructive sleep apnoea disorders. The anatomic bases of genioplasty and the interest of cephalometric analysis in diagnosing chin position anomalies are reviewed as well as the different operative steps for horizontal advancement osteotomy and the specific principles and indications for other types of genioplasty.

[Mandibular aneurysmal bone cyst mimicking a malignant tumor]. / Kyste osseux anévrismal mandibulaire mimant une tumeur maligne.

CASE: We report the case of a 24-year-old woman presenting with a rapidly growing mass in the right masseteric region. MRI suggested a diagnosis of a rhabdomyosarcoma but CT-scan evoked a benign lesion such as chondroblastoma or aneurismal bone cyst. The biopsy specimen proved the diagnosis of aneurismal bone cyst and the patient was treated by surgical curettage. There was no recurrence after 4 years of follow-up. DISCUSSION: The aneurismal bone cyst of the jaw is a rare pseudocystic lesion, characterized by replacement of the normal bone with fibro-osseous tissue containing blood-filled sinusoidal or cavernous spaces. The lesion generally affects young persons under 20 years of age. The molar region, the angle, and the ascending ramus of the mandible are the predominantly affected sites. The lesion does not have any clinical or radiological specificity and surgical curettage is the standard treatment. Recurrence is rare and occurs within 30 months after surgery.

Hydatid cyst of the kidney. A report of 147 controlled cases.

OBJECTIVES: We report our experience in the management of 147 hydatid cysts of the kidney over an 11-year period. MATERIAL AND METHODS: The records of 147 patients operated for hydatid cysts of the kidney between 1985 and 1996 were reviewed in order to address patient's symptoms at presentation, radiological findings, diagnostic tests and surgical outcome. All patients were managed with open surgery. No preoperative or postoperative antiparasitic medication was used. RESULTS: Lumbar or lumbo-abdominal pain was the most frequent symptom (84%). Hydaturia was observed in 28% of the cases. Preoperative diagnosis was based upon intravenous pyelography (IVP), ultrasound and serology tests. CT scan was performed only in litigating cases (15%). In 20 cases, damage to the renal parenchyma was so extensive as to justify nephrectomy. Abstention concerned 5 involutive type V cysts. The remaining patients had an excision of the prominent part of the cyst (partial cystopericystectomy). Postoperative course was smooth in all cases. Postoperative IVP (3-6 months) showed a restituo ad integrum in 80% of the cases and residual pelvicaliceal distortions in 20%. CONCLUSIONS: Diagnosis of hydatid cyst of the kidney is based mainly on ultrasonography and IVP. Open surgery is the treatment of choice with excellent results.

[Role of cryptosporidia and microsporidia in diarrhea in immunocompromised patients]. / Place des cryptosporidies et des microsporidies dans les diarrhees des immunodeprimes.

Cryptosporidium and Microsporidian play an important part in the diarrhoeic pathology of the immunocompromised patients. The study of 35 cases of cryptosporidiosis and 4 cases of intestinal microsporidiosis diagnosed in the parasitology laboratory of Rabta hospital of Tunis shows that cryptosporidiosis prevalence is 17.24% for AIDS patients, 3.45% for immunocompromised patients VIH (-), and microsporidiosis prevalence is 5.7% for patients with acquired immunodeficiency syndrome. Common points for these two parasitosis are: Clinical syndromes dominated by an acute diarrhea A diagnosis based on specific techniques showing the significance of the clinical orientation. Lack of an effective specific therapy.

[Study of psychosocial factors in HIV infected patients in Tunisia]. / Etude des facteurs psychosociaux des patients infectés par le VIH en Tunisie.

We conducted a prospective study using an anonymous questionnaire and semistructured interviews on 60 patients with HIV to assess the psychological and socioenvironmental factors that may result in risk-taking behaviour. The patients were mainly young males (mean age 33.1 +/- 7.0 years) (sex ratio 2.3) deprived in both social and educational terms. Injecting drug use was the predominant risk factor and was characteristic of a first group of young men raised in large families shattered by rural-urban migration, with an antisocial personality. A second group consisted of women, mostly illiterate from traditional rural settings. They had been infected by their spouses who had worked abroad, whether drug users or not. Approaches for the prevention of HIV infection are proposed.

[Study of psychosocial factors of HIV infected patients in Tunisia]

We conducted a prospective study using an anonymous questionnaire and semistructured interviews on 60 patients with HIV to assess the psychological and socioenvironmental factors that may result in risk-taking behaviour. The patients were mainly young males [mean age 33.1 +/- 7.0 years] [sex ratio 2.3] deprived in both social and educational terms. Injecting drug use was the predominant risk factor and was characteristic of a first group of young men raised in large families shattered by rural-urban migration, with an antisocial personality. A second group consisted of women, mostly illiterate from traditional rural settings. They had been infected by their spouses who had worked abroad, whether drug users or not. Approaches for the prevention of HIV infection are proposed

[Standard radiological characteristics of thoracic sites of tuberculosis in patients with AIDS in a Tunisian population]. / Particularités radiologiques standards des localisations thoraciques de la tuberculose chez des sidéens dans une population Tunisienne.

Aspects of tuberculosis on the standard chest X-ray in a population of 18 AIDS patients in Tunisia were examined. The diagnosis of pulmonary tuberculosis was confirmed in all cases with bacteriology tests. Diffuse lesions of the parenchyma predominated contrasting with the exceptional nature of cavernous formations. Localized infiltrations were infrequent and intrathoracic node enlagement was rare. Cases with no abnormal radiological signs were also seen in advanced HIV infection. Such atypical cases, in agreement with data in the literature, would be explained by immunoradiologic correlation. Thus it is necessary to search for the tuberculosis bacilli in all patients with HIV infection whatever the aspect on the standard chest X-ray.

PIP: The chest X-ray is a fundamental element in the diagnosis of pulmonary tuberculosis (TB). In the person co-infected with HIV and TB, radiological signs can be deceiving given the degree of immunodepression and the resulting clinical manifestations. TB is endemic in Tunisia with a prevalence of 120 people infected per 100,000 population. TB affects 42% of people with AIDS in Tunisia, the major opportunistic infection in that population. The authors report upon their examination of aspects of TB in the standard chest X-ray of 18 AIDS patients in Tunisia. The diagnosis of pulmonary TB was confirmed in all cases with bacteriology tests. Diffuse lesions of the parenchyma predominated contrasting with the exceptional nature of cavernous formations. Localized infiltrations were infrequent and intrathoracic node enlargement was rare. Cases with no abnormal radiological signs were also seen in advanced HIV infection. Such atypical cases, in agreement with data in the literature, could be explained by immunoradiologic correlation. The authors stress the need to search for the TB bacilli in all patients with HIV infection regardless of the aspect on the standard chest X-ray.

[Cerebral miliary tuberculosis. Apropos of 5 cases and review of the literature]. / Miliaire tuberculeuse cérébrale. A propos de 5 cas et revue de la littérature.

The authors report 5 cases of cerebral miliary tuberculosis studied by computerized tomography and review 5 cases of the literature. Computerized tomography can see very small tuberculomas, of several millimeters. Chest miliary tuberculosis is found in all their cases, and 3 of the 5 cases of the other authors. Because of the discretion of neurological signs and the association with chest miliary, we suggest to make a computed tomography of brain of all patients who have chest miliary tuberculosis despite the absence of neurological signs and we think that we will find out other cases of brain miliary tuberculosis.