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Irradiation accidents may unfortunately occur in all fields of activities, whether they are medical, industrial or scientific. They are usually classified in two categories, depending on the number of people involved: large-scale accidents on one hand and, on the other hand, events limited to small groups, mostly workers. The first are very rare, but well-documented. The latter occur more often, but no comprehensive report is yet available, especially for those with benign consequences. Whatever their seriousness, all these situations deserve careful analysis in order to draw appropriate conclusions and improve prevention. Although the number of radiation-related deaths is low (approximately 1 per year, during the last forty years, in Western countries), the frequency of such accidents remains constant, while the applications for the use of radiation increase. Analysis of accidents shows that most of the serious consequences might have been avoided or limited. This, once again, stresses the need of precise rules for every occupation involving ionizing radiation.

Last September, "Nature" reported a great increase in the frequency of thyroid cancer in children in Belarus. Some additional data are now available and strengthen the previous findings. The overall incidence of thyroid cancer in children rose from an average of four cases per year till 1989 to more than 50 in 1991 and 1992. Nearly all of the 146 cancers recorded since 1986 are papillary carcinomas. Moreover these cancers appear relatively aggressive. The occurrence of such an increase within a few years of exposure--and only in children--is quite unexpected. Therefore, it seems very important to monitor trends in future and more information is needed, as different questions remain unanswered: dosimetry, diagnosis methods, other thyroid diseases... In conclusion, the authors stress on the very importance of iodine prophylaxis in case of an accidental contamination by radioisotopes of iodine. It seems possible that cancer excess would have been less important, if Belarus children had been given stable iodine.

The epidemiological studies on cancer incidence or mortality among workers in the nuclear industry have been reviewed in a comparative manner. The results concerning workers monitored for external radiation or internal contamination and those on female workers have been analysed separately. A lower cancer risk was found in most studies, which is explained by the "healthy worker effect"; no difference was found between the workers with or without a radiation record. A high rate was found for a few cancers at specific sites, but results were variable in the different studies and no relationship was found between cumulative dose and excess mortality due to cancer. A link between ionizing radiation, multiple myeloma and prostatic cancer was indicated in more than one study; in the latter case, there might be a relationship with internal contamination, especially by tritium. In spite of the difficulties and limitations involved, it is important to pursue these studies and pool them, in order to directly evaluate the risks of cancer following exposure to low-dose radiation and low dose rates, instead of calculating these by extrapolation from high doses.

Through a retrospective study of 81 anaesthesias for primary excision with immediate grafting (performed within the first 72 hours after burning), the authors, using in most of the cases an anaesthetic procedure including neuroleptanalgesia and nitrous oxyde, with controlled ventilation, tried to determine: --the incidence of such a type of anaesthesia on the patient condition, --the period during which anaesthetic risk is the least. Studies of hemodynamic, respiratory and thermic changes, related with anaesthesia, and a study of coagulation changes, related with surgical procedure, have been performed. It appears that neuroleptanalgesia is a method available for primary excision with immediate grafting and that the elective period for anaesthesia and surgical procedure is situated within 12 hours after burning.

In this study based on 2 personal cases and 23 cases from the literature the main clinical and therapeutic features of meningitis caused by Bacteroides fragilis are reviewed. The disease occurs in either very young or elderly people, with contributing factors in 54% of the cases. Clinically, the infectious syndrome is associated with meningoencephalitis and sometimes motor disorders. Although septicaemia is present in 80% of the cases, the patient's general condition is moderately affected. Blood leucocyte counts are definitely increased and CSF disturbances are those common to all types of bacterial meningitis. The initial focus of infection can be determined in 60% of the cases. The mortality rate is higher in adults than in children. Neurological complications are frequent. Nitro-imidazole derivatives, which are active against Bacteroides fragilis and reach high CSF concentrations, constitute the treatment of choice.

Repeated estimations of circulating total lipids and various fractions were made during the postoperative period in patients receiving parenteral nutrition for more than ten days. The patients were paired in relation to the underlying pathology and divided into two group : the first receiving energy supplements in the form of carbohydrates alone, whilst the second received part of this supply in the form of lipid emulsions (Trive 1000). Total lipids and various plasma fractions, with the exception of free fatty acids, increased progressively during the postoperative period, regardless of the inital values and independently of the lipid content of the nutrition fluids given. There was no significant difference between those patients who received lipid emulsions and those who did not. Free fatty acids remained at levels slightly greater than normal in the group which did not receive lipids. They were significantly higher in the group given lipid emulsions, though it was not possible to precisely define their orgin.

Two observations of congenital partial atresia of the larynx are studied. They thus illustrate the diagnostic and therapeutic difficulties with which the clinician is faced. A rare malformation (one out of a million births), sometimes in the same family (3,6%) the congenital partial atresia of the larynx presents a wide anatomical variety and consecutively a wide clinical variety. Diagnosis is always confirmed by endoscopy. Treatment uses either continuous gauging of the larynx (or discontinuous) with tracheotomy or surgery. It is at present impossible to define formally any therapeutic; nevertheless exhaustive study of the literature, and the progress of micro-surgery (with the contribution of the laser) should allow the therapy to be specified on the basis of the anatomy, the age and the degree to which the malformation is tolerated.

Among the many leafhoppers which we have collected and identified in Morocco, Turkey, Syria and France (Corsica), only the species Neoaliturus haematoceps was found to be infected with Spiroplasma citri. In Syria, this leafhopper was encountered on ornamental stock plants (Matthiola incana L.) in the Oronte valley, and on Salsola kali L., a wild Chenopodiacae of the semi-arid regions of the coastal area. In Corsica, we found it on wild stock plants (Matthiola sinuata R.Br.) of the oriental coast and on bush plants. A breeding of this leafhopper was initiated, and we demonstrated that it was able to acquire S. citri from infected periwinkles, multiply the organisms in its body and transmit them to healthy plants. This leafhopper can also be infected after injection of S. citri. The leafhoppers thus inoculated can transmit the spiroplasma very efficiently to healthy plants. This is the first report of the transmission of S. citri by Neoaliturus haematoceps both after acquisition on a diseased plant and after injection.

Over a period of four years, 16 patients with generalized peritonitis have been treated by postoperative peritoneal irrigation in an Intensive Care Unit. The majority of cases involved postoperative peritonitis accompanied by severe visceral failure. The irrigation liquid, containing an antibacterial agent, was perfused for between one and eleven days at a high flow rate (mean 16.5 I). The overall mortality in the series was extremely high (75 p. 100), and even greater (85 p. 100) if only the cases of postoperative peritonitis were considered. Anatomical examination of the peritoneum, performed on reintervention or at autopsy, revealed an abnormally high incidence of residual abscesses. These are responsable for the continuation or recurrence of infection, and explain the high mortality. These observations, combined with the frequent occurrence of local or general complications, led the authors to reject peritoneal irrigation in postoperative peritonitis in the presence of severe visceral failure, and to use it, in selected cases, only for periods not exceeding 48 hours.