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24 cases of osteoarticular tuberculosis have been observed in two years in the Regional Hospital of Bouaké (Ivory-Coast). Multifocus and pluri-visceral localizations are frequent. Diagnosis is based on a network of evidence and on the research of an evolutive bacillary focus out of bones. The medical treatment used alone because of local conditions of practice, appears to be effective, even in advanced and complicated cases. But mid-term follow-up is still not very satisfactory.

The authors report the observation of a 46 year old man with a case history of myocardial infarction at the age of 26 years, transient ischemic injury at 41 years of age, and in whom a focalised digital ischemic syndrome of microembolic nature led to the discovery of an intracardial thrombosis which was operated upon and progressed without complication. Bloody microembolisms of cardiac origin may be selectively revealed by acrosyndromes, the diagnostic elements of which are mentioned. They are poorly understood conditions. Their significance must not be neglected because of the risk of recurrence in macroembolic form. The pathogenesis of these obstructions and their specific responsibility for ischemic cardiopathies is reviewed. It is appropriate to emphasise the novelty of this observation since, in the context of ischemic cardiopathies, no attention has been devoted to microembolisms, in contrast to the numerous publications relating to macroembolisms. The symptomatic treatment is unremarkable, the etiological treatment of intracardial thrombosis is discussed.

The authors report 2 cases of probable algodystrophy of the lower extremities, associated to a definite deep venous thrombosis. They discuss the relationships between the two diseases and the difficulties of the differential diagnosis in light of a third case where the algodystrophy is definite and manifests itself as a deep venous thrombosis confirmed by phlebography. They insist on the absolute need to rule out a deep venous thrombosis before considering the exceptional diagnosis of algodystrophy with pseudo-phlebitic manifestations.

Hemorheological constants (plasma viscosimetry and erythrocyte filtrability index) were studied in 153 male subjects aged 19 to 23. Borderline hypertension defined by clinical criteria was found in 61 of these patients. Whilst there was no notable modification in plasma viscosity, by contrast there was a significant link between erythrometry and systolic and diastolic blood pressure. Erythrocyte deformability was all the more marked as blood pressure rose. These results would contrast with findings in the literature in cases of definite hypertension. The borderline nature of hypertension and the youth of the population was such that it could be considered that barometric factors had not yet influenced erythrocyte filtrability. The following hypothesis is therefore attractive: initially the red cell adapts itself to any possible increase in peripheral resistance. As the years go by its deformability is lessened by adverse changes affecting its membrane cytoskeleton.

Unlabelled: The measurement of the pulse wave velocity (PWV) is widely used in clinical practice to assess the elasticity of the arterial system. It can be influenced by a number of factors. The present study was undertaken to assess the possible role of anthropometric factors, hemorheological parameters and blood pressure on this element., Study Design: Sixty-three male subjects, mean age: 21 +/- 1.6 years,; height: 177 +/- 7 cm; weight: 76 +/- 13 kg, were subjected to Doppler measurement of the carotid-femoral PWV with synchronous recording of blood pressure. In parallel, the following were carried out: nycthemeral blood pressure recording, measurement of plasma vicosity and erythrocyte deformability, determination of hematocrit, fibrinogen and total proteins. The Quetelet indices and body surface area (BSA) were calculated for each patient. These data were analyzed by multiple linear regression., Results: Three parameters affect PWV: 24-hours diastolic blood pressure, hematocrit, and body surface area (the coefficient of multiple correlation: r = 0.597, the percent variability of the explained variable is equal to 35.7%, the regression equation can be written: PWV CF (cm/sec) + 0.283*Diast/24 hours + 0.742* hematocrit + 9.486* BSA = 0.629). The following parameters are not involved: plasma viscosity, erythrometry, total proteins, fibrinogen, Quetelet index, systolic and diastolic blood pressure during the investigation, mean systolic pressure and mean heart rate over 24 hours., Comments: The PWV-diastolic pressure relationship is well-known. In contrast, the effect of the hematocrit and body surface area has never been reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Purpose: Evaluating Blood Pressure Monitoring contribution at rest to the diagnosis and pathophysiology of borderline (BL) hypertension in the twenties., Method: a nycthemeral blood pressure recording each 15 minute has been performed during the 48 first hours of hospitalisation on two groups of white twenties males with a Dinamap: 143 CONTROLS. Mean age: 21.1 +/- 2 yrs, mean height: 177 +/- 7 cm, mean weight: 71 +/- 11 kg; 104 BL hypertensive patients. Mean age: 21 +/- 2 yrs, mean height: 178 +/- 7 cm, mean weight: 78 +/- 12 kg. Mean BP recording levels are smaller than casual measurements in two groups: CONTROLS (Casual BP: 125/71, BP recording on 24 hours: 117/60, day time: 121/63, nighttime: 110/54 mmHg). BL hypertensives (Casual BP: 144/83, BP recording on 24 h: 132/69, daytime: 137/73, nighttime: 121/60 mmHg). Nycthemeral BP variability measured by the standard deviation of mean pressure is not different in two groups for systolic variability, it significantly differs for diastolic variability (BL: 7.6/CONTROLS: 5.5, p less than 0.01). Correlations between casual BP and diurnal records are stronger in controls than in BL patients showing a lower predictive value of clinical assessment in BL patients. Though the same heart rate at sleep, BP is significantly higher in BL than in controls. It probably means that factors different from sympathetic activity are involved in pathophysiology of borderline hypertension. The whole measurement study on 24 hours of two groups show an important overlap (the 65th percentile in BL systolic BP correspond with the 95th of controls, the 74th percentile in BL diastolic BP correspond with the 95th in controls). That make difficult the recording evaluation for a given patient.

The authors describe a disseminated multivisceral form of african histoplasmosis due to H. duboisii in a 45 years old black woman. Clinical examination shows characteristic lesions of skin, bones and lymph glands. Lymphography reveals lesions of deep lymph glands and laparascopy lesions of liver and spleen. First untimely stopped, treatment was started again with ketoconazole. 20 months later, the course of the disease is, as for as we can appreciate it, favourable.

Kaposi's sarcoma was diagnosed in a 62 year old female at the last stage of an indefined malignant lymphoma. Clinically and histopathologically, some cutaneous aspects were consistent with mycosis fungoides. However, the histological examination of lymph-nodes led to the diagnosis of Hodgkin's disease, sometimes associated with features of Kaposi's sarcoma. During the past few years, the occurrence of Kaposi's sarcoma in the course of cancers, malignant lymphomas and especially during Hodgkin's disease, has been reported. It has been suggested that immunosuppressive therapy undertaken for the initial tumor could account for a viral carcinogenesis. In this respect, the vascular proliferation observed in Kaposi's sarcoma could be compared with the lymphocyte induced angiogenesis, which occurs during the experimental graft versus host reaction. Therefore, Kaposi's sarcoma could be the result of a tumoral rejection. In the case of our observation, it does not seem possible to diagnose an angio-immunoblastic lymphadenopathy; but it is of interest to note that, in this later disease, histological features of vascular neogenesis have also been reported.