Search

Self-absorption effect has a significant impact on gamma spectrometry measurement for the highly precise determination of the radionuclides activity. Among the main factors affecting the self-absorption effect especially at low gamma energies is the matrix composition of the sample. For this purpose, we studied the matrix composition effect on the self-absorption correction for plant and soil matrices using a Monte Carlo simulation model, composed of High Purity Germanium (HPGe) detector and a cylindrical geometry source. The simulated configuration model was validated by comparison of simulated full energy peak efficiency (FEPE) values with the experimental ones using a standard radioactive solution, covering large interval gamma energies in the range of 59.54–1836.12 keV. The results show that the FEPE values of low gamma energies are affected by the matrix composition, where in the soil matrix the FEPEs decreased by 36% and only by 1% in the plant matrix. The Monte Carlo results were applied in order to accurately calculate the transfer factor of the environmental radionuclides 226Ra, 232Th and 40K from soils to several crops, mustard, artichoke and fennel through their specific activities.

It is advised to use a new formula to calculate the (p, n) reaction cross section at 7.5 MeV. We propose six new parameters for the formula proposed by Broeders, C. and Konobeyev, A.Y. (2008. Systematics of (p,n) reaction crosssection. Radiochim. Acta 96: 387–397) to fit experimental data. It should be noted that our systematics is only applicable to isotopes with a ratio of 7.5 MeV to the reaction threshold above 1.3 (7.5/E th > 1.3). This is based on analytical calculations generated from the semi-empirical mass formula, the evaporation model, and the pre-equilibrium exciton model. We were able to find new parameters for the Broders et al. formula through this inquiry that guarantee a good fit with the revised experimental data (EXFOR2022) and provide a minimum value for the statistical parameters ∑ and χ 2.

This study discusses the effect of using 232Th instead of 238U on the neutronic characteristics and the main operating parameters of the pressurized water reactor (PWR). MCNPX version 2.7 was used to compare the neutronic characteristics of UO2 with (Th, 235U)O2 and (Th, 233U) O2. Firstly, the infinity multiplication factor (Kinf), thermal neutron flux, and power distribution have been studied for the investigated fuel types. Secondly, the effect of Gd2O3 and Er2O3 on the Kinf and on the radial thermal neutron flux and thermal power has been investigated to distinguish which of them is more suitable than the other in reactivity management. Thirdly, to illustrate the effectiveness of 232Th in decreasing the inventory of both the actinides and non-actinides, the concentration of plutonium (Pu) isotopes and minor actinides (MAs) has been simulated with the fuel burnup. Besides, due to their large thermal neutron absorption cross-section, the concentrations of 135Xe, 149Sm, and 151Sm with the fuel burnup have been investigated. Finally, the main safety parameters such as the reactivity worth of the control rods (ρCR), the effective delayed neutron fraction βeff, and the Doppler reactivity coefficient (DRC) were calculated to determine to which extent these fuel types achieve the acceptable limits.

At FLNP JINR Dubna new prospects for developing new neutron facilities have already been started, that will replace the IBR-2 neutron pulsed research reactor which shut down in the year 2032. Several agreed projects use the fission processes induced by neutrons on neptunium-based fuels. An investigation of the neutron fission process on the 237Np nucleus was conducted in the present research. Several parameters were analyzed during neutron-induced fission of 237Np including the neutron cross-section, mass distributions, prompt neutron emission, isotope production, and neutron spectra. Evaluations of the above observables were conducted using TALYS – 9.1 Software, with incident neutron energies ranging from 0.4 to 25 MeV. The exact value of cross-section was obtained as 5 – 5.5 MeV in the present work, whereas from literature, it was found up to 10 MeV. Neutron spectra were analyzed and separated contributions from different nuclear reaction mechanisms were obtained. Our investigations have revealed some important yields and isotope production cross-sections that were in good agreement with literature data.

In this study, we have estimated the (n,2n) reaction cross-section for 14.6 MeV incident neutron energy by using the artificial neural network (ANN) method. We have also predicted the reaction cross-sections whose experimental data are not available in the literature. For the construction of the present ANN, available experimental data in the literature has been borrowed. The ANN estimations have been compared with the available experimental data and the results from a theoretical calculation and the two commonly used computer codes. According to the results that the ANN results are in good agreement with the experimental data than the codes and this shows that the method can be a powerful tool for the estimation of cross-section data for the neutron-induced reactions. Considering the predictions of the ANN of the cross-sections whose experimental data are not available in the literature, it is seen that they are in line with the trend of the experimental data, but far from the results given by the theoretical calculations and two computer codes.

Climate change has been described as the biggest global health threat of the 21st century1 and has significant implications for gastrointestinal (GI) health and disease,2 which is the focus of this consensus commentary provided by the World Gastroenterology Organisation (WGO) Climate Change Working Group (CCWG). The CCWG has members from 18 countries representing high-income, medium-income and low-income populations. The WGO includes gastroenterology societies from 108 countries, which represent more than 60 000 medical practitioner members. The CCWG members, who have coauthored this consensus commentary, aim to review the scientific literature on climate and GI health, to encourage education and the undertaking of actionable measures including advocacy, and to further research and collaborations within the global GI community. The CCWG’s objective is to assist GI health providers worldwide to adapt to, and mitigate, the effects of climate change on health. The CCWG has partnered with three major GI journals, which are copublishing this commentary, given the timeliness and importance of the topic.3 4 ### Climate change The earth’s climate is changing because of increasing concentrations of greenhouse gases in the atmosphere, which has already warmed by more than 1°C compared with preindustrial times. The aim of mitigation efforts is to keep the rise in global mean surface temperature (GMST) below 2°C by 2100. An increase of 2°C might not seem like a major change, but variations of similar magnitude have been associated with profound alterations of climate in the past. It is important to note that even if this somewhat arbitrary target can be met, catastrophic changes in earth ecosystems can still occur. The Intergovernmental Panel on Climate Change was established in 1988 with a mandate to assess relevant scientific literature related to climate change. It produces regular reports and updates about climate change. The Intergovernmental Panel on Climate Change projects that …

In the present work, the classical Bethe–Weizsacker (BW) mass formula with five energy terms is revisited and updated. We use the least-squares adjustments on the binding energy of 2497 different nuclides from the last update of the atomic mass evaluation, AME2016 published in March 2017, to provide a new set of energy coefficients of the mass formula. The obtained set of formula coefficients allowed us to reproduce most of the experimental values of the binding energies for each nucleus with $$A \ge 50$$. The comparison between the binding energies provided with updated mass formula and those of AME2016 on the one hand, and those of previous works, on the other hand, yields relative errors that oscillate between less than $$0.05\%$$ and $$1.5\%$$. The revisited BW formula is in very good agreement with the experimental data.

The cross-sections for (n, p) reactions around 14 MeV are important for nuclear research field and applications of nuclear energy. Also these neutron-induced reactions have been extensively studied in the literature. In this study, we have theoretically estimated the (n, p) reaction cross-section of different elements for 14.5 MeV incident neutron energy by using artificial neural network (ANN) methods whose experimental data are not available in the literature. For the construction of the ANN, available experimental data have been used. The results from the constructed ANN have been compared with the experimental data and those obtained from the theoretical formula. Furthermore, by using the constructed ANN through the limited experimental data, the new cross-section data for some (n, p) reactions have been generated and the results have been compared with a common database. The results give a good agreement with the literature and indicate that the method can be a powerful tool for the estimation of neutron cross-section data for the neutron-induced reaction.

Being the first woman to serve as the president of the World Gastroenterology Organisation gives me the opportunity to reflect on the place of women in gastroenterology and enables me to assess both how far we have come and the scale of the tasks still facing us.

The numerical transmutation of Americium heterogeneous loaded for one cycle in thermal high flux reactor category was realized. The transmutation calculations are performed based on ChainSolver 2.34 code. A comparison with the measurement and calculation results of the burn up of 241Am irradiated in HFR at Petten was examined to evaluate the accuracy of current available numerical tool. To reach the Am destruction with a short irradiation time, a high flux SM3 reactor having a flux density of thermal neutrons higher than 1015 cm−2 s−1 was proposed. To obtain transmutation rate of 99.75%, the Am samples needed only 90 exposure days in full power for SM3 reactor. The effectiveness results suggested an effective use of SM3 as compared to Petten HFR. Finally, the results have been discussed in order to propose a new concept of high flux reactor destined for the destruction of actinide minors, in particular 241Am.

A formula for neutron radiative capture cross section is derived within the framework of compound nucleus hypothesis for incident neutron energy ( E n ) above the resonance region up to MeV. Based on this formula, we find a linear relationship between the logarithm of an (n, γ) cross section at fixed E n divided by A1.4 and the relative neutron excess of the target nucleus, and new systematics are established between the (n, γ) reaction cross section and the energy level density of a compound nucleus. The calculated (n, γ) cross sections for odd-A target nuclei from this relationship are in good agreement with the experimental data, which suggests that this new systematical law is helpful to analyze the experimental data. It would be helpful in estimating the (n, γ) cross sections of neighboring odd-A isotopes for which no experimental data are available.

Background Oesophago-gastroduodenoscopy is the standard method for the diagnosis of recurrent oesophago-gastric varices after endoscopic treatment and eradication. The aim of this study was to evaluate the PillCam®Eso capsule endoscopy in this setting. Methods Prospective, multicentre study in which patients with history of oesophageal varices treated by band ligation underwent PillCam®Eso capsule and oesophago-gastroduodenoscopy. Capsule recordings were blindly read by two endoscopists. Indication for a new prophylactic treatment and patient satisfaction were determined for both procedures. Results 80 patients (80% males, mean age: 57 ± 12 years) were included, after a median delay of 16 months from last endoscopic treatment. Recurrent oesophageal varices requiring a new prophylactic treatment were detected in 26 patients (32.5%). The mean oesophageal transit time of the capsule was 153 s (range 2–930 s). Capsule sensitivity, specificity, negative and positive predictive values for indication of new prophylactic treatments were 65%, 83%, 83%, and 65%, respectively. Capsule adequately classified 77.5% of the patients for prophylaxis indication. Inter-observer concordance for capsule readings was 88% for the prophylaxis indication. Conclusion This study demonstrates that accuracy of PillCam®Eso capsule for the diagnosis of recurrent oesophageal varices after endoscopic eradication is suboptimal. PillCam®Eso capsule might therefore be proposed in patients unable or unwilling to undergo oesophago-gastroduodenoscopy.

Introduction : Le syndrome de l’immunodeficience acquise (SIDA) s’accompagne souvent d’atteintes du tube digestif, tumorales ou secondaires a des infections opportunistes. Le but du travail est de determiner les aspects endoscopiques et anatomo-pathologiques des atteintes digestives secondaires au SIDA et d’etudier leur correlation. Patients et methodes : 68 patients atteints du SIDA ont ete explores au service EFD-HGE sur une periode de 5 ans. Tous les patients ont beneficie d’une endoscopie œso-gastroduodenale (EOGD) et/ou d’une ileo-coloscopie avec une etude anatomo-pathologique des biopsies. Resultats : Les lesions digestives hautes etaient: une œsophagite mycosique dans 19 cas, une gastrite congestive dans 14 cas, une gastrite ulcerative chez un patient, une gastrite erosive chez un patient, une duodenite congestive dans 9 cas et des lesions angiomateuses tres evocatrices de la maladie de Kaposi dans 6 cas. L’etude anatomopathologique des biopsies a conclu a des lesions digestives hautes liees au SIDA dans 27 cas (53 %). Les lesions digestives basses etaient : une colite ulcerative dans 22 cas, des angiodysplasies dans 4 cas, une colite erosive dans 16 cas. La coloscopie totale etait normale chez 2 patients. L’etude anatomo-pathologique des biopsies ileales et coliques a conclu a des lesions secondaires au SIDA dans 8 cas (18,1 %). Il existait une correlation statiquement significative entre les aspects endoscopiques et anatomopathologiques specifiques au SIDA (coefficient kappa = 0,730). Conclusion : Les atteintes digestives liees au SIDA sont assez frequentes, elles etaient de 51,4 % dans cette etude dominees par les infections opportunistes. Une correlation etait retrouvee entre les lesions endoscopiques et specifiques au SIDA.

Background Anorectal manometry (ARM) and endoanal ultrasound (EAU) are two non-invasive diagnostic procedures used for an accurate examination of the anal sphincter apparatus. Their performance is likely to modify the diagnostic and therapeutic decision tree in the management of fecal incontinence. The aim of our study was to evaluate the compatibility of these two procedures.

But La dysphagie est consideree, a juste titre, comme un symptome d’alarme imposant le recours a l’endoscopie digestive haute qui peut etre normale. La manometrie oesophagienne est le deuxieme examen demande pour explorer ce symptome. Le but de cette etude est d’evaluer la frequence et identifier le type de troubles moteurs oesophagiens chez des patients dysphagiques ayant une endoscopie digestive haute normale.

Summary Background Intestinal tumors represent less than 6% of digestive tumors and, because of the limitations of intestinal investigations, these tumors are difficult to diagnose. In this context, capsule endoscopy (CE) has proven effective especially in patients with obscure digestive bleeding. The aim of the present study was to calculate the frequency, and evaluate the diagnostic and therapeutic impact of CE in cases of small bowel tumors. Patients and methods A total of 95 patients (57 males and 38 females, mean age of 56 years) with negative endoscopy and colonoscopy results were directed to undergo CE examination. Results Of the 95 patients, 13 (13.7%) were diagnosed with small bowel tumors. The main indications for CE were obscure (occult and overt) gastrointestinal bleeding. The mean duration of symptoms before diagnosis was 10 months. The final histological diagnosis was established through surgery. In our patients, this included gastrointestinal stromal tumor (nine cases), adenocarcinoma (two cases) and carcinoid tumor (two cases). Conclusion This study revealed that the prevalence of intestinal tumors appears to be higher than expected in patients through the use of CE.

In this study we present data on the transmutation of the long lived fission product Technetium to the stable Ruthenium under irradiation in the high flux reactor BR2. The Technetium transmutation rate and the evolution of Ruthenium mass under irradiation were numerically simulated using ChainSolver 2.34 code.

Background Giant hepatic hemangiomas are very rare. These hemangiomas can be complicated exceptionally by the Kasabach-Meritt syndrome. This syndrome associates a coagulopathy and a hemolysis. We report a new case of a giant hepatic hemagioma associated with the Kasabach-Merritt syndrome.

Introduction Le cancer colorectal (CCR) represente le troisieme cancer a l’echelle mondiale. L’objectif de notre etude est de determiner le profil epidemiologique de cette affection.

Introduction La maladie de Rendu-Osler-Weber (MRO) familiale est une maladie autosomique dominante, caracterisee par la presence de telengiectasies cutaneomuqueuses et viscerales. L’atteinte hepatique de la maladie de MRO est classiquement decrite dans 8 a 31 % des cas, due a des malformations arterioveineuses pouvant entrainer dans certains cas une hypertension portale.

Les adenomes villeux gastriques sont tres rares. Ils se caracterisent par leur grand potentiel de transformation maligne et leur association avec d’autres neoplasies du tube digestif. Les auteurs rapportent quatre cas de tumeurs villeuses gastriques dont trois diagnostiquees au stade de transformation maligne en insistant sur leurs caracteristiques cliniques, radiologiques et endoscopiques ainsi que sur leur prise en charge therapeutique.

In this study the effectiveness of transmutation for the long lived fission product technetium-99 in the experimental fast reactor “JOYO” is evaluated. The cluster of reflector subassembly was replaced with a new moderator and target subassembly. The Beryllium metal is selected as moderator. The calculation of Ruthenium concentration evolution under irradiation was performed using ChainSolver 2.20 code. For 140 full power irradiation days, the transmutation yield is ∼30% and 87% in the radial reflector and target subassembly, respectively. The approximation used for the transmutation calculation is the assumption that the influence of change in irradiated materials structures on the reactor operator mode characteristics is insignificant.

Les angiodysplasies digestives ont fait l’objet de nombreux travaux et suscitent encore plusieurs controverses sur la pathogenie des lesions, leur histoire naturelle et leur traitement. Leur association au syndrome de Willebrand acquis (AvWS) est rapportee, mais demeure inexpliquee. Le syndrome de Willebrand acquis est un syndrome hemorragique rare. Parmi les affections sous-jacentes a l’origine de ce syndrome, le myelome multiple est le plus frequent. L’apparition du AvWS est liee soit a la presence d’anticorps diriges contre le facteur von Willebrand (vWF), soit a une adsorption sur des cellules tumorales.

l’achalasie crico-pharyngee primitive (ACPP) est un trouble fonctionnel rare du sphincter superieur de l’œsophage (SSO) caracterise par un defaut isole de relaxation et d’ouverture du SSO. C’est une pathologie specifique du sujet âge marquee par une involution musculaire des muscles du SSO liee au processus du vieillissement. il s’agit d’un homme âge de 54 ans, hospitalise pour une dysphagie haute associee a une toux et des fausses routes. L’endoscopie œsogastroduodenale a montre une stenose infranchissable de la bouche de Killian. Le transit œsophagien a objective une importante dilatation pseudokystique des sinus piriformes en amont de la stenose. L’examen ORL et la TDM cervicale ont permis d’eliminer une cause tumorale. La realisation d’un transit pharyngo-œsophagien avec etude en radiocinema a confirme le diagnostic d’ACPP. Le patient a ete traite chirurgicalement par myotomie avec evolution favorable. l’ACPP est un diagnostic d’elimination, son origine fonctionnelle est etablie par l’association de l’endoscopie, de la manometrie et de la cine-radiographie. Le traitement de choix est la myotomie du cricopharyngien. Elle peut se realiser par endoscopie rigide, suivant une technique similaire a celle utilisee pour le diverticule de Zenker. La dilatation endoscopique peut etre efficace dans la moitie des cas et devrait etre tentee de premiere intention. primitive cricopharyngeal achalasia (PCPA) is a rare case of functional disorder of the upper esophageal sphincter (UES), characterized by an isolated defect of the relaxation and opening of the UES. This disease affects specifically older people, with a muscular involution of the muscles in the UES due to aging. a 54 year-old male, was admitted for upper dysphasia associated with cough and choking. Gastrooesophageal endoscopy showed impassable stenosis of Killian’s mouth. The esophageal barium swallow revealed a cystic dilatation of the pyriform sinus. ENT assessment and cervical computed tomography excluded a tumoral origin. The pharyngoesophageal transit with a cinevideographic study confirmed the diagnosis of PCPA. The patient underwent a surgical treatment: myotomy with a positive outcome. PCPA is an elimination diagnosis; its functional origin is demonstrated through endoscopy, manometry and cine-radiography altogether. The treatment of choice is cricopharyngeal myotomy. It can be achieved through rigid endoscopy, using a technique similar to endoscopic treatment of Zenker’s diverticulum. Pneumatic dilatation is efficient in half of cases, and should be tried first.

Les etiologies de la granulomatose hepatique sont nombreuses et leur identification peut etre difficile et ce, d’autant plus qu’elles different d’un pays a l’autre. Les auteurs rapportent l’observation d’une hepatite chronique active (HCA) post virale C traitee par bitherapie pegylee chez une femme de 48 ans, particuliere par la persistante d’une cytolyse malgre l’eradication virale. Cette cytolyse parait en rapport probablement avec l’apparition d’un granulome epithelio-giganto-cellulaire a l’etude histologique de la PBH de controle. La tuberculose et la sarcoidose, diagnostics les plus probables chez la patiente ont ete elimines apres une enquete etiologique acharnee. La survenue de la granulomatose est imputee en definitif a l’interferon. Les mecanismes selon lesquels ce dernier pourrait medier le developpement de la granulomatose hepatique, bien qu’imparfaitement elucides, seront discutes. The causes of hepatic granulomas (HGs) are numerous and their identification can be difficult and this all the more that they differ from one country to another. The authors present an observation of chronic hepatitis C virus (HCV) infection treated by pegylated bitherapy in a 48-year-old woman. It was marked by the persistence of a cytolysis despite the viral eradication. This cytolysis seems to be linked to the discovery of a non caseating epithelioid granuloma in the liver biopsy. The tuberculosis and the sarcoidosis, the most probable diagnosis in this patient, were ruled out after a careful etiological investigation. The arising of HGs is finally ascribed to the interferon. The mechanisms through which the Interferon can mediate the development of HGs will be discussed here.

Objectif: La recherche d’un dysfonctionnement anorectal dans la prise en charge d’une constipation rebelle est imperative. En effet, differentes therapeutiques peuvent etre proposees selon qu’il s’agit d’une constipation terminale, mixte ou de progression isolee. Le but de notre etude etait d’evaluer les limites de la clinique par rapport a la manometrie anorectale (MAR) dans la reconnaissance du caractere terminal de la constipation. Materiels et methodes: Apres avoir eliminer toute pathologie organique, 104 patients consecutifs, presentant une constipation chronique fonctionnelle selon les criteres de Rome II et resistante au traitement usuel, ont ete inclus dans notre etude. Tous avaient beneficie d’une MAR. Resultats: (Voir tableau 1) Sur les 59 patients ayant une constipation terminale clinique, 43 patients (41%) avaient une anomalie manometrique. Les 16 autres, etaient convertis alors en constipation de progression isolee. Quant aux 45 patients sans signes cliniques en faveur d’une constipation terminale, 25 patients (24%) avaient un dysfonctionnement de l’appareil anorectal a la MAR. Conclusion: La clinique est un moyen subjectif pour prejuger du caractere terminal d’une constipation chronique avec une sensibilite et une specificite faible respectivement 63,2% (VPN 65%) et 55% (VPP 72,8%). La MAR parait donc plus performante dans la reconnaissance d’une constipation terminale et permet une orientation therapeutique plus adaptee fondee sur des parametres objectifs et surtout quantifiables. The search for a dysfunction anorectal in the assumption of responsibility for an untractable constipation is imperative. Indeed, different therapeutics can be proposed according to whether it is a distal constipation, mixed or of isolated progression. The goal of our study was to evaluate the limits of the clinic investigations compared to the anorectal manometry (MAR) in the recognition of the distal character of the constipation. After having eliminated any organic pathology, 104 consecutive patients, presenting with chronic functional constipation, according to Rome II criteria, and resistant to the usual treatments, were included in our study. All had benefited from anorectal manometry (ARM). (See table 1) Out of the 59 patients with clinical signs of distal constipation, only 43 patients (41%) presented a manometric anomaly. The 16 other patients, were converted in a group of isolated slow-transit constipation (STC). As for the 45 patients without clinical signs of distal constipation, the ARM showed an anorectal dysfunction in 25 of them (24%). The clinical examination is a subjective means to prejudge the distal character of a chronic constipation with a weak sensitivity and specificity of respectively 63.2% (NPV 65%) and 55% (PPV 72,8%). The ARM thus appears more efficient in the recognition of a terminal constipation and allows a better therapeutic orientation, based on objective and quantifiable parameters.

Background. Iron deficiency anemia (IDA) is a recognised feature of celiac disease (CD) in adults and can be its only presentation. Aim. To define the prevalence of CD in Moroccan adult patients with IDA of obscure origin and to determine the yield of small bowel biopsy performed during routine endoscopy. Methods. 437 patients with IDA of obscure origin were included. 4 endoscopic mucosal biopsies were taken from the second part of duodenum and 2 biopsies from antrum and fundus, respectively. Endoscopic aspect and severity of anemia were correlated with histological diagnoses using coefficient Kappa. Results. 29 out of 437 patients (6.63%) had CD. Endoscopic aspect was normal in 66%, a mosaic pattern of mucosa in 17%, and scalloping of the small bowel folds in 17%. 12 patients had Marsh III, 8 had Marsh II, 6 had Marsh I, and 3 had Marsh IV lesions. There was no correlation between degree of anemia, endoscopic aspect, and severity of duodenal lesions . Conclusion. Routine duodenal biopsy gives an additional 6.63% diagnostic benefit of CD and should be indicated in all patients with IDA. The finding of normal endoscopic appearance of mucosa should not preclude duodenal biopsies.

Introduction Le syndrome d’hypersensibilite medicamenteuse ou DRESS (Drug Rash with Eosinophilia and Systemic symptoms) est une entite nouvellement decrite en 1996, pouvant mimer un tableau de sepsis severe avec au premier plan un ictere febrile. Devant de telles manifestations, il faut penser a ce syndrome. Plusieurs reactivations virales ont ete decrites en association avec ce syndrome pour le groupe Herpes virus (HHV6, HHV7, HHV8 et Epstein-Barr virus) [1,2,3]. En revanche, nous ne disposons pas de cas documentes en ce qui concerne l’herpes simplex 1 et 2. Nous rapportons le cas d’un patient ayant presente suite a une prise medicamenteuse de phenylbutazone, un DRESS syndrome associe a une reactivation virale a herpes simplex 1 et 2.

Le Reflux Gastro-Œsophagien (RGO) est le passage du contenu gastrique, generalement acide, dans l’œsophage. Ce phenomene, tout a fait physiologique en post prandial, peut devenir pathologique par sa frequence, sa duree et les manifestations cliniques qui en resultent. Ces dernieres sont tres evocatrices en presence de pyrosis et de regurgitations avec ou sans syndrome postural. Elles sont atypiques une fois sur deux et rendent le diagnostic plus delicat.

Objectif: Repondre a un certain nombre d’interrogations, classees en: Materiel et methode: Etude retrospective de 388 cas de suspicion d’achalasie, sur 1434 examens manometriques realises au service, sur une periode de 10 ans allant de janvier 1990 a decembre 2000. Seuls 184 cas ont ete retenus selon nos criteres d’inclusion. Le materiel et la technique de manometrie œsophagienne utilises ont ete conformes aux regles methodologiques preconisees par l’Agence Nationale d’Accreditation et d’Evaluation en Sante (ANAES). L’analyse statistique a ete faite a l’aide d’un logiciel SPSS. Resultats: La prevalence de l’achalasie dans notre serie etait de 12,8 %. La dysphagie etait le maitre symptome retrouve dans 97,3 % des cas. Le delai moyen entre l’apparition des signes cliniques et le diagnostic manometrique etait de 38,2 ±4 mois. Le diagnostic de l’achalasie a ete porte a un stade precoce d’achalasie vigoureuse ou hyperkinetique chez 40,2 % des patients, et a un stade d’achalasie hypokinetique dans 59,8 % des cas. La manometrie a mis en evidence les signes majeurs de l’achalasie: une relaxation du SIO en reponse a la deglutition absente ou incomplete dans 96,7 % des cas, un aperistaltisme œsophagien dans 95,6 % des cas, et l’hypertonie du SIO, signe mineur, a ete objectivee chez 80,4 % des patients. La pression sphincterienne etait encore normale chez 60 % des patients dans le groupe d’achalasie vigoureuse ou hyperkinetique (p = 0,02). Nous n’avons pas mis en evidence de particularites manometriques liees a l’âge, au sexe; de meme, nous n’avons pas note de difference significative entre la frequence des signes cliniques, et les donnees manometriques: la pression du SIO, la relaxation et l’aperistaltisme. Conclusion: La manometrie œsophagienne est incontournable pour le diagnostic precoce d’achalasie, alors que les autres examens sont encore normaux. La precocite du diagnostic permet d’ameliorer les resultats fonctionnels post-therapeutiques. La realisation de la manometrie pre-operatoire oriente l’acte therapeutique. Aims of study:To answer to a certain number of questions: Material and method: Retrospective study of 388 cases with achalasia suspicion, on 1,434 manometry examination performed in the Functional digestive explorations department, at University hospital “Ibn Sina” of Rabat in Morocco, on a period of 10 years between January 1990 to December 2000. Only 184 cases have been kept in the clinical study, according to our inclusion criteria. Material and technique of esophageal manometry used were compliant to the methodological rules recommended by the French National Agency of Health Accreditation and Evaluation (ANAES). The statistical analysis has been made with the help of a software SPSS. Results:Prevalence of the achalasia in our study was 12,8 %. Dysphagia was the main symptom found in 97,3 % of cases. The mean delay between apparition of clinical signs and manometrie diagnosis was 38,2 ± 4 months. The diagnosis of achalasia was made at an early stage of vigorous or hyper kinetic achalasia in 40,2 % of patients, and at a stage of hypokinetic achalasia in 59,8 % of cases. Manometry diagnoses the major signs of the achalasia: relaxation of the LES in response to an absent or incomplete swallowing in 96,7 % of cases, esophageal aperistalsis in 95,6 % of cases, and hypertonic LES as a minor sign, was found in 80,4 % of patients. Sphincterian pressure was even normal in 60 % of patients in the group of vigorous or hyperkinetic achalasia (P = 0,02). We did not note any manometric particularities bound to age or gender, neither did we note any significant difference between the frequency of clinical signs, and manometric data: the pressure of the LES, relaxation and the absence of peristalsis. Conclusion:Esophageal manometry is indispensable for early diagnosis of achalasia, even if the other exams are normal. The forwardness of the diagnosis allows to improve the posttherapeutic functional results. The realization of the preoperative manometry orients the therapeutic act.

Objectif: Le but principal de ce travail est de comparer l'efficacite de trois protocoles therapeutiques differents utilises dans le traitement d'eradication de l'Helicobacter pylori, chez des malades porteurs d'une gastrite chronique avec ou sans ulcere.

Les tumeurs primitives de l’œsophage comportent en general les carcinomes epidermoides et les adenocarcinomes du cardia. Les autres tumeurs malignes de l’œsophage sont rares, comme le lymphome qui, dans la plupart des cas, est secondaire. Les auteurs rapportent une observation originale d’un lymphome malin non hodgkinien (LMNH) a cellule B primitif de l’œsophage et la prise en charge endoscopique des complications therapeutiques.

Les tumeurs stromales gastro-intestinales (GIST) sont actuellement classees comme une entite bien etablie grâce a une meilleure comprehension de la cellule d’origine et des marqueurs immunohistochimiques. Nous rapportons ici un cas rare et interessant d’un patient de 46 ans presentant une volumineuse GIST bulbaire avec une importante metastase hepatique.

Le trichobezoard gastrique est une affection rare, dont le diagnostic est facile en presence d’un contexte evocateur. Son traitement peut etre endoscopique, mais il est le plus souvent chirurgical. Nous rapportons le cas d’une patiente âgee de 19 ans, ayant des antecedents de trichophagie, presentant des epigastralgies avec une volumineuse masse epigastrique a l’examen clinique. La gastroscopie a permis le diagnostic de trichobezoard. Une exerese chirurgicale de celui-ci a ete realisee a travers une gastrotomie, sans complications. Un suivi psychiatrique de la patiente a ete recommande.

But La sclerodermie est une maladie generale au cours de laquelle l’atteinte de la motricite de l’œsophage est la plus frequente des atteintes viscerales, pouvant meme etre inaugurale. Souvent asymptomatique, les troubles moteurs œsophagiens (TMO) doivent etre recherches systematiquement par la pratique de la manometrie œsophagienne.

Les pancreatites aigues (PA) secondaires a la mesalazine sont rares. Trente-neuf cas ont ete decrits dans la litterature. Nous rapportons un nouveau cas de PA secondaire a la prise de mesalazine pour le traitement d’une rectocolite ulcerohemorragique (RCH). Il s’agissait d’une jeune femme de 38 ans ayant une soeur qui a presente une PA secondaire a un traitement par sulfasalazine pour la maladie de Crohn. Notre patiente recevait de la mesalazine orale et topique. Une semaine apres le debut du traitement, la patiente etait admise pour des epigastralgies de type pancreatique associees a des vomissements. La lipasemie etait elevee a trois fois la limite superieure de la normale. L’echographie abdominale ainsi que la tomodensitometrie (TDM) abdominale montraient une tete du pancreas augmentee de volume, heterogene sans anomalies du canal de Wirsung ni des voies biliaires. L’arret de la mesalazine s’accompagnait d’une evolution favorable avec une regression des douleurs pancreatiques, une normalisation de la lipasemie en dix jours. Une surveillance scannographique et echoendoscopique des anomalies radiologiques a ete entreprise, ces deux examens ont montre la normalisation des lesions pancreatiques en deux mois. La PA secondaire a la prise de la mesalazine est une complication rare du traitement des maladies inflammatoires chroniques intestinales. Ce diagnostic doit etre evoque chez tout patient recevant ce type de traitement devant des epigastralgies de type pancreatique apres avoir elimine les autres etiologies de la PA.

The effectiveness of transmutation for the long-lived fission product Technetium-99 in a high flux research reactor is evaluated, taking into account its large capture cross section in the thermal and epithermal regions. Calculation of the evolution of the Ruthenium concentration under irradiation was performed using the ChainSolver 2.20 code. The results on Technetium transmutation suggest an effective use of this kind of research reactors and describes a new concept of multi-recycle Technetium transmutation using HFRTRAN (high flux research reactor for transmutation).

Chez pres de la moitie des malades souffrant du sarcome de Kaposi cutane, l’atteinte du tractus digestif est retrouvee [1]. Cette atteinte digestive est souvent asymptomatique, rarement inaugurale et sa mise en evidence peut etre fortuite lors d’une endoscopie.

Background/Aim. Metabolic Bone disorders are well-recognized extrahepatic complications of cirrhosis. The aim was to report their prevalence and the associated factors to their development in patients with viral cirrhosis. Patients and Methods. All consecutive patients with viral cirrhosis were prospectively enrolled. Parathyroid hormone, 25-hydroxyvitamin D, liver function, and phosphocalcic tests were measured in all patients. Bone mineral density was measured at the lumbar spine and total hip by dual-energy X-ray absorptiometry. Data were analyzed using SPSS software. Results. Forty-six cirrhotic patients were included with hepatitis C (87%) and hepatitis B (13%). The Child-Pugh score was grade A in 87% of cases and grade B in 13%. Thirty-seven patients had decreased bone mineral density with osteopenia in 24 patients and osteoporosis in 13 patients. Decreased 25-hydroxyvitamin D was found in 95.6% of cases. Bone disorders were significantly more frequent in old patients with low body mass index, long duration of liver disease, and low 25-hydroxyvitamin D level. None of these factors was an independent factor associated with bone disorders. Conclusion. Our study revealed a high prevalence of metabolic bone disorders among viral cirrhotic patients. Consequently, bone mineral density assessment should be performed systematically in all cirrhotic patients.

Introduction : Le fibroscan ou l’elastometrie impulsionnelle est un examen non invasif qui permet d’evaluer la fibrose hepatique en mesurant le degre d’elasticite du foie. Il occupe une place importante dans l’evaluation de la fibrose hepatique chez les malades atteints de maladies chroniques du foie. Le but du travail est de montrer l’interet du fibroscan dans l’evaluation de la fibrose hepatique chez les porteurs inactifs de l’antigene Hbs.Materiels et methodes : De Mars 2006 a avril 2014, tous les patients porteurs inactifs de l’AgHbs ont ete inclus. Le portage inactif est defini par : un examen clinique normal, une echographie abdominale normale, normalite des transaminases a plusieurs reprises, AgHbs positif, AgHbe negatif, et ADN virale inferieure a 2000 UI/ml sur controle trimestriel sur 1 an. L’interpretation des resultats du fibroscan a pris en compte 10 mesures validees par l’appareil avec l’interquartile range (IQR) 60 %. Les resultats ont ete analyses par le logiciel SPSS version 20.Resultats : Sur un total de 2 152 fibroscans realises, 198 patients sont des porteurs inactifs du Virus B soit 9,2 %. L’âge moyen des patients etait de 49,2 ± 11,3 ans. On remarque une predominance masculine 61,1 % avec sex ratio (H/F) 1,6. La mediane de la valeur de l’elasticite etait de 5,2 Kpa (2,8 – 14,6 Kpa). La fibrose etait non significative dans 89,9 % (fibrose absente : 61,6 % et fibrose minime : 28,3 %) et la fibrose etait significative dans 10,1 % (fibrose moderee: 4,5 % ; severe: 4,5 % et cirrhose : 1 %). Il y avait un echec du fibroscan chez un patient ayant un IMC > 35kg/m2.Conclusion : Le fibroscan a montre l’absence de fibrose significative chez la majorite des patients porteurs inactifs de l’AgHbs. Il a permis de faire le diagnostic de fibrose significative et de cirrhose dans 10 % des cas. Le fibroscan est un excellent examen non invasif pour l’evaluation initiale de la fibrose chez les porteurs inactifs du virus B.

Epidemiological and experimental evidence support the role of host genetics in treatment response and viral clearance in chronic hepatitis C (CHC). Recently, the CC genotype of IL28B single-nucleotide polymorphism (SNP) rs12979860 has been associated with spontaneous viral clearance and a better treatment response. The distribution of this polymorphism varies according to populations. Frequency of rs12979860 SNP alleles in the Moroccan population is unknown. The aim of our study was to estimate the frequency of the C allele of this SNP in the Moroccan population and, in parallel, in a cohort of Moroccan patients with CHC treated with pegylated interferon-alpha and ribavirin.We used real-time polymerase chain reaction assay based on TaqMan technology to determine the allele frequency of the rs12979860 SNP in 100 Moroccan newborn infants. We also compared the frequency of the CC genotype between two groups of patients with genotype 1-CHC treated by combination therapy: group1, n=30 patients, responders who achieved sustained viral response (SVR) and group2, n=30 patients, nonresponders.The rs12979860 C allele frequency was estimated to be 73% in the Moroccan population. The frequency of this allele in the group of patients with CHC was only 58.3%, and the CC genotype is more prevalent in group1 (62.5%) than in group 2.This is the first report providing genetic data related to the frequency of genetic polymorphisms of IL28B in Morocco. The C-allele frequency of the IL28B gene SNP rs12979860 in Morocco is higher than in the African populations. Distribution of this SNP distinguishes in a population of CHC between SVR and nonresponders. This result merits consideration and should be studied by analyzing a larger sample size of patients.