[Gastric tuberculosis, villous atrophy, dermatitis herpetiformis (author's transl)]

A case of gastric tuberculosis associated with villous atrophy is reported in a sixty-three years old female. Fifteen years before she had a skin-disease whose histology was compatible with a dermatitis herpetiformis. Under treatment by gluten exclusion and anti-tuberculous drugs, a cure of gastric tuberculosis and a dramatic relapse of jejunal morphology were observed.

[Folate and the nervous system (author's transl)]

The responsibility of the folate deficiency in some neuropsychiatric disorders is recent knowledge. The role of the folate on the nervous system is not yet well definite, but the action on the metabolism of the amino-acids, on the purine and the pyrimidine synthesis and on the metabolism of the catecholamins are certainly essential. The neuropsychiatric diseases secondary to the folate deficiency are numerous: dementia, schizophrenia like syndromes, insomnia, irritability, forgetfulness, endogenous depression, organic psychosis, pueperal psychosis, peripheral neuropathy, myelopathy (spinal cord syndrome and/or pyramidal tract damage), restless legs syndrome. Clinically the diagnosis may be difficult with sub acute combined degenration secondary to the pernicious anaemia, and the dosage of the folate (in serum, in red-cells and in cerebrospinal fluid) is necessary. The congenital defects in the uptake or utilization of the folate are associated with neuropsychiatric disturbances. The treatment is easy and safe if the vitamin B12 deficiency is eliminated and if employed with caution in epileptic patients because folate can induced seizures.

[Complications of digestive involvement in CRST syndrome. 3 cases (author's transl)]

In CRST syndrome, latent oesophageal involvement is common but not usually associated with any clinical manifestations. Involvement of the small intestine is rare. In three patients there occurred severe complications related to digestive involvement in the condition. In one case, involvement of the small intestine was associated with functional obstruction. In the other two patients, oesophageal involvement progressed to very tight stenosis of the lower end of the eosophagus. The generally accepted bening nature of this form of scleroderma must therefore be questioned.

Role of the ileocecal valve and site of intestinal resection in malabsorption after extensive small bowel resection

Intestinal absorption after extensive small bowel resections, for diseases other than Crohn's disease, was studied in 17 patients. When the ileocecal valve and the right colon were preserved, malabsorption was transient and moderate and had no prejudicial nutritional effect (fecal fat: 8.8 +/- 1.8 g/24 h in resections sparing the 2 distal bowel loops, and 16.2 +/- 4.8 g/24 h in resections including the distal ileum; mean +/- SEM). When colectomy was associated, malabsorption was severe and persistent (fecal fat: 47.4 +/- 12.2 g/24 h; mean +/- SEM). These findings suggest that the most important prognostic factor in extensive small bowel resection is the site of the resection, and particularly the presence or absence of the right colon and ileocecal valve.

[Current place of hemorrhagic rectocolitis in intestinal pathology]

Rectocolitis remains, at the present time, in spite of the large amount of work carried out, a condition of which the cause and the physiopathological mechanism are unknown: none of the theories proposed has been confirmed by the facts; none has made it possible to propose an effective therapeutic regimen. The diagnosis of haemorrhagic rectocolitis rests solely on an assembly of clinical, radiological, and anatomological findings, together with findings on progress of the disease; none of these findings taken separately being pathognomonic. Because of this it is essential in cases of inflammatory colic disorders to analyse critically these different elements before affirming the diagnosis that is often arrived at too easily. Different affections, even apart from Crohn's disease (parasitic, microbial, and iatrogenic affections, etc) may, in fact, give rise to radiological and clinical pictures close to those of haemorrhagic rectocolitis.