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Cryptoglandular anal fistulae are the most frequently occurring form of perianal sepsis. Characteristically they have an endoanal primary opening, a fistula track and an abscess and/or an external purulent opening. Antibiotic therapy is not of use in initial management except in special cases. Treatment of an abscess, if present, is required urgently and when possible, consists of its incision under local anaesthesia. Treating the fistula track occurs afterwards and aims to dry up the purulent discharge and avoid recurrence of the abscess by means of surgical fistulotomy. These techniques are very effective in terms of eradication of the problem but there is sometimes a risk of anal incontinence. This explains the increasing interest in sphincter preserving techniques using the advancement of a covering flap of rectal mucosa and the injection of fibrin glue.

Anal epidermoid carcinoma is a rare malignant tumor, comprising less than 5% of all carcinomas of the colon, rectum, and anus. The primary therapy now includes radiotherapy, often in combination with chemotherapy. Radical surgery is now rarely indicated. Therapeutic indications are based on locoregional staging, the presence of visceral metastases and an evaluation of the medical history. Anorectal endosonography is helpful in evaluating locoregional extension. In addition, magnetic resonance imaging, positron emission tomography scanning and inguinal sentinel lymph node procedure should play a role in a more selective approach in patients with anal carcinoma.

The incidence of radiation-induced chronic hemorrhagic proctitis is less than 10 to 20%. The onset of this proctitis is delayed relative to the radiation therapy and generally develops from 6 to 24 months later. There are numerous predisposing factors, the most important of which is the radiation therapy dose: risk increases exponentially above 40-45 Gy. Its pathophysiology involves progressive obliterating endarteritis and transmural interstitial fibrosis, which induce chronic ischemia that is irreversible and progressive during the years after radiation therapy. Its diagnosis depends most often on the combination of clinical history and typical endoscopic appearance (congestive mucosa and/or telangiectases). Topical administrative of sucralfate or corticosteroids as well as argon plasma coagulation, with formalin treatment if necessary, provides relief for most patients.

We report an anal metastasis from a lung cancer which was diagnosed on symptoms mimicking an acute anal abcess. The diagnosis was based on specific immunohistochemistry.

A case of bilingualism (French-German) characterized by the conflict of two languages, has made it possible to develop various language investment and « image- creating » systems in a subject who has neurotically lived out his identification against the background of his mother tongue and his father tongue. The opposed meanings which languages can cover in such a conflict have been spelled out, and the effect on the imagination of the formal différencies in the two languages are discribed. Mention is made of the genealogy of the fields of knowledge which have developed on the basis of those languages. Finally, the way in which an event connected with schooling in a foreign language has brought about a process of repetition in the subject's relation to culture, is shown. This observation leads on to the question of « imaginarization of the symbolic-system » (symbolical image-creation in speech) and to that of language as an eroticised object aiming at the « enjoyment » of the Other, as it may be envisaged on the basis of Lacan' s theory., Un cas de bilinguisme (français-allemand) caractérisé par le conflit des deux langues nous a permis de développer différents modes d'investissement et d'« imagi- narisation » des langues, chez un sujet qui a vécu névrotiquement son identification par rapport aux langues de son père et de sa mère. Nous avons précisé les significations opposées que peuvent prendre les langues dans un tel conflit; nous avons décrit les effets imaginaires des différences formelles des deux langues. Nous avons évoqué la généalogie des domaines de connaissance qui se sont développés à partir de ces langues. Enfin nous avons montré comment un événement de la scolarisation dans une langue étrangère a manifesté un processus de répétition dans la relation du sujet à la culture. Cette observation débouche sur la question de « l'imaginarisation du symbolique», et sur la question de la langue comme objet érotisé où est visée la jouissance de l'Autre, telle que nous pouvons l'envisager à partir de la théorie lacanienne., Bauer Jean-Pierre. L'enfant et les langues.. In: Enfance, tome 32, n°3-4, 1979. pp. 195-205.