Aim. To evaluate characteristics of esophageal involvement in scleroderma. Methods. The study was prospective and concerned 194 patients with a definite systemic sclerosis. Gastroesophageal endoscopy and esophageal manometry were performed in all the cases. Results. Symptoms were present in 118 cases (60.8%); they were signs of GERD or dysphagia, respectively, in 94 (48.4%) and 91 patients (46.9%). Reflux esophagitis was found in 73 cases (37.6%); it was mild or moderate in 47 cases (24.2%) and severe or complicated in the remaining cases. Manometry revealed a lower esophageal sphincter incompetence and esophageal motor disorders, respectively, in 118 (60.8%) and 157 cases (80.9%). Presence of these late was not related to age, duration, or skin extension of the disease, but with clinical complaint and/or mucosal damage. Conclusion. Esophageal involvement is frequent during scleroderma. Manometry is the most sensible examination and could be a screening procedure.

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Introduction : L'ingestion d'un produit caustique (PC) est un accident fréquent et grave, la survenue d'une sténose oesophagienne (SCO) est une séquelle redoutable. Objectif : Étudier l'apport de la dilatation à l'aide des bougies de Savary-Gilliard dans les sténoses caustiques oesophagiennes de l'adulte. Patients et méthodes : Ce travail prospectif a porté sur 132 patients adultes recrutés en quatre ans. L'âge moyen était de 26,7 ± 11 ans et le sex-ratio de 0,32. Le PC a été une base dans 78 % des cas et un acide dans 20 % des cas. Tous les patients ont bénéficié d'une endoscopie et d'un transit oesogastroduodénal (TOGD). La SCO était sévère dans 74 % des cas et était associée à une sténose gastrique dans 23 % des cas. La dilatation a été réalisée avec le dilatateur de Savary-Gilliard. Les résultats ont été jugés après une année de traitement. Résultats : Chaque patient a subi en moyenne 11 ± 8,5 séan-ces de dilatation. Un succès a été obtenu dans 80 % des cas et un échec dans près de 20 %. Une perforation est survenue dans quatre cas. Conclusion : La dilatation instrumentale est la méthode thé-rapeutique de choix des sténoses caustiques oesophagiennes. La chirurgie sera réservée aux échecs de la dilatation.Mots clés Dilatateur de Savary-Gilliard · Dilatation instrumentale · Ingestion de caustique · Sténose caustique oesophagienne Abstract Introduction: Ingestion of caustic is common, and it causes serious injury. Occurrence of esophageal stricture is a terrible sequel. Aim: To evaluate efficiency and security of dilatation with Savary-Gilliard dilator in esophageal caustic stenosis in adults.Patients and methods: This prospective study included 132 patients during a period of four years. The mean age was 26.7 ± 11 years (16/78). The sex ratio was 0.32. The substance drunken was a strong alkali in 78% and a strong acid in 20%. All the patients underwent an upper gastrointestinal endoscopy and a barium swallow. A severe esophageal stricture was noticed in 74% of the cases, and a gastric stricture was associated in 23%. Dilatation was realized with Savary-Gilliard dilator. The therapeutic results were judged after 12 months. Results: The average number of dilatation was 11 ± 8.5 (2/46). Success was observed in 80% and failure in 20% of the cases. Four perforations were recorded. Conclusion: The dilatation with Savary-Gilliard dilator is an efficient, sure, and simple method of treatment in esophageal caustic stenosis. It must be used at first; surgery should be planned in case of failure of dilatation.

International audienceThe Laasraoui-Jonas (LJ), Kocks-Mecking (KM), and power law (PW) stress-strain equations pertaining to hot working of metals within the range of moderate strains (i.e., before the occurrence of dynamic recrystallization) are compared. It is shown that it is not possible to select the "best" one to fit a given experimental flow curve, neither in the sigma - epsilon nor in the diagram. Noting that each of the three laws depends on two constitutive parameters, transformation formulae are then derived allowing the parameters of one law to be derived from the parameters of any of the two others. The fit of a given LJ equation by a PW law is then discussed. Finally, the transformation formulae are used to estimate the current rate of dynamic recovery when the flow rule is known in the form a PW law. The above theoretical derivations are illustrated by the specific case of a Fe-C alloy in the ferritic phase domain. However, they suggest that the conclusions are widely applicable to hot working of metals and alloys

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