Primary pelvic hydatid cyst an unusual cause of cystic adnexal image (mass).

Hydatid cyst is a parasitic human infection which is endemic in North Africa. It is more frequently localized in the liver and the lung. Involvement of others sites is usually secondary to these primary localizations. We report 2 exceptional cases of primary pelvic hydatid cyst diagnosed respectively in a 37-year-old and in a 48-year-old women. These cases will focus on the different characteristics of the infection, and the benefit of including epidemiologic arguments in using the diagnostical approach of adnexal masses.

Comparative RH maps of the river buffalo and bovine Y chromosomes.

Radiation hybrid maps were constructed for river buffalo and cattle Y chromosomes. A total of 41 cattle-derived Y-chromosome molecular markers were selected and tested with 2 previously described 5,000-rad whole-genome radiation hybrid (RH) panels (river buffalo - BBURH(5000) and cattle - BTARH(5000)) for generation of maps. Among the initial 41 selected markers, a subset of 26 markers generated PCR products suitable for scoring with the BBURH(5000) panel. Of these, 19 markers (73%) were distributed in 1 linkage group spanning 341.3 cR. Retention frequencies (RF) for individual markers ranged from 17.8% for SMCY to 56.7% for BTY1, with an average RF of 37.6%. From the selected markers, 37 generated reliable scores using the BTARH(5000) panel. The newly constructed BTAY RH map contains 28 markers distributed within 1 linkage group. Twenty-four of these markers had been previously mapped on BTAY using a 7,000-rad cattle-hamster WG-RH panel and 4 markers were mapped for the first time (ZFY, SeqRep, RepSeqS4 and BTY1). The length of the BTAY RH map was estimated to be 602.4 cR. Retention frequencies for individual mapped markers ranged from 10% (INRA126) to 63.3% (SeqRep), with an average RF of 35.3%. RH marker positions along the Y chromosome were compared between BBUY and BTAY, which revealed differences in the order of some of the markers. The BBUY pseudoautosomal region (PAR) is delineated by 3 BTAY PAR markers (MAF45, TGLA325 and UMN2008). These markers are telomeric in both species but are not found in the same order. Here we have demonstrated the effective use of bovine Y chromosome markers for the development of the first BBUY RH map. Likewise, these set of markers can be used for comparative assessment of Y chromosomes in other members of the Bovidae family.

Uncommon cause of acute pelvic pain: isolated torsion of hydrosalpinx.

Isolated torsion of hydrosalpinx is a rare cause of acute pelvic pain. Pre-operative diagnosis is very difficult because of non specific clinical presentation. Definitive diagnosis is always made at surgical exploration performed for suspected adnexal torsion and salpingectomy is performed in the majority of cases. A 34-year-old woman was admitted for acute pelvic pain with nausea and vomiting. Vaginal examination revealed a right adnexal tender mass and ultrasound revealed a well circumscribed right adnexal cystic mass. Surgical exploration has revealed torsion of a right hydrosalpinx and right salpingectomy was performed. Differential diagnosis between adnexal and tubal torsion is very difficult, however both should be managed by rapid surgical exploration which an allow precocious diagnosis and conservative treatment.

[Squamous cell carcinoma of the breast review of the literature: illustrated by the report of a case]. / Carcinome épidermoïde du sein: revue de la littérature illustrée par une observation.

We report the case of 37-year-old women with primary Squamous cell carcinoma of the right breast. The tumor was nodular, 13cm, with important hemorrhagic and necrotic reshaping. There was no central or peripheral cystic altering. Histologically, the tumoral cells were polyedric, dyskeratosic with intercellular junction. This rare breast entity has controversy histogenesis. The development was characterized by metastases frequency. The treatment remains no codified.

[Mammary tuberculosis: a series of 14 cases]. / Tuberculose mammaire.

OBJECTIVES: We examined cases of mammary tuberculosis in order to determine the different modes of presentation and analyze diagnostic difficulties. METHODS: Retrospective analysis of 14 cases of mammary tuberculosis treated at the Ibn Rochd University Hospital in Casablanca over a 16 year period. RESULTS: Patient age ranged from 16 to 65 years. Contact with a contaminated person was recognized in 2 cases. The predominant clinical presentation was a tumor formation (12 cases) which sometimes simulated cancer. Axillary nodes were observed in 10 cases with 1 case of fistulization. Mammography suggested cancer in 3 cases. The diagnosis of mammary tuberculosis was based on pathology findings in 14 cases (2 biopsies, 12 peroperative specimens) and isolation of bacilli from pus in one case. Medical treatment was given. Surgery was associated as needed (abscess drainage, residual lesions). Except for one death due to tuberculous meningoencephalitis, clinical course was favorable with ad integrun breast recovery. DISCUSSION: Mammary tuberculosis is uncommon and often produces a pseudoneoplastic presentation. Pathology confirmation is required for diagnosis.

[Chronic renal failure and pregnancy]. / Insuffisance rénale chronique et grossesse.

The women who are suffering from chronic renal failure in an advanced stage have a deficient fertility but they are not sterile. Hemodialysis has improved considerably the fertility of these patients. The aim of this study is to give the results of our experience, from 1990 to 1996, about pregnancies among the uremic patients, dialysed or no and to make a literature review about this subject. We have noticed that pregnancies in the dialysis patients are rare and their evolution is precarious. We have also noticed more miscarriage or pregnancy interruption. Complications are frequent. Mothers have a high risk of hemorrhagic accident (ablatio placentae), of anemia aggravation, of thrombosis of the vascular approach and a high risk of liver anomalies (gravidic cholestasis). The fetus suffers from the maternal anemia and from chronic hypoxia. He's threatened by hydramnios in the case of bad volemic supervision. The intra uterine delayed developement and the prematurity are usual. The absence of high blood pressure and a residual renal function are representing the favourable elements of the good march of pregnancy. A therapeutic intensification is necessary in order to lead this pregnancies to a viable term. The management is heavy not only for the nephrologic, the obstetrical and the neonatal physicians, but also for the patient who is the only one who can decide to continue or to interrupt the pregnancy. It seems better to inform the patient rather than to procure her abortion by proposing her an effective and inoffensive contraceptive method meanwhile to be pregnant after renal transplantation.

[Delivery of large baby after cesarean section: role of trial of labor. Apropos of 355 cases]. / Accouchement du gros bébé sur utérus cicatriciel : la place de l'épreuve utérine.

OBJECTIVE: Our goal is to determine whether a trial of labor in women with suspected fetal macrosomia would be a valuable alternative to elective repeat cesarean. MATERIAL: and methods: Based on retrospective analysis of 355 women with previous cesarean section who delivered macrosomic infants (> or =4,000g), we tried to determine the impact of fetal weight on a trial of labor. The outcomes of trial of labor with fetal macrosomia were compared on the one hand to those of elective repeat cesarean and on the other hand to those of trial of labor with normal birth weight (<4,000g). RESULTS: The trial of labor was conducted in 297 cases (83,7%), and had led to vaginal birth in 189 cases (63,6%). There were 4 uterine ruptures (1,3%) and 8 uterine dehiscences (2,7%) among the women who underwent a trial of labor. In this group, there were 4 perinatal deaths (1,3%) related in one case to uterine rupture, and 2 brachial plexus injuries related to shoulder dystocia after vaginal birth. Perinatal and maternal outcomes of trial of labor were similar to those of elective repeat cesarean. A trial of labor was more associated with scar separations and lower success rate if the infant weighed 4,000g or more. CONCLUSIONS: It appears that the use of trial of labor for delivery of large baby with prior cesarean section was associated with lower success rate and the maternal and fetal risks could be increased. However, carefully others controlled studies are necessary to establish the appropriate management in this setting.

Rapid detection and quantification of Cryptosporidium baileyi oocysts in feces and organs of chickens using a microscopic slide flotation method.

A simple semiquantitative microscopic slide flotation (MSF) method using modified Sheather's sugar solution (MSSS) is presented for the rapid detection and quantification of Cryptosporidium baileyi oocysts in the feces and mucosal and/or organ scrapings of chickens. Oocyst shedding was evaluated by examination of the surface of coverslips, and the average quantitative score (0-5) recorded for 10 microscopic fields (magnification x250) is reported. The equivalence between these scores and the actual number of oocysts counted per gram of feces was assessed (rs = 0.89; P < 0.001). The applicability of this method was tested by comparison of the kinetics of oocyst shedding in feces of inoculated chickens with those reported by other authors working under similar conditions. In organs the MSF method was compared to histology. Fewer false-negative results were obtained using MSF versus the histology method. The MSF method was particularly more efficient in tracheae with low levels of infection and in the lungs, regardless of the level of infection. The MSF method was also very efficient in detecting oocysts in air sacs from chickens with aerosacculitis. It provides a specific and sufficiently sensitive, simple, rapid, reliable, and low-cost means of diagnosing C. baileyi in the feces and organs of chickens. This method can be used in the routine diagnosis of cryptosporidia in chickens, and it could be extended to other avian species and used in epidemiology studies to evaluate the prevalence of cryptosporidiosis in fowl.

Interaction of Marek's disease virus and Cryptosporidium baileyi in experimentally infected chickens.

Histocompatible B13/B13 white specific-pathogen-free leghorn chickens were used to investigate the effect of coinfection with Cryptosporidium baileyi and the HPRS 16 strain of Marek's disease virus (MDV) in chickens and to assess the pathogenicity of C. baileyi when MDV is given before or after the parasite. Groups of chickens concurrently infected with C. baileyi orally inoculated at day (D)4 and MDV inoculated at hatching (C4M0 group) or at D8 (C4M8 group) were compared with relevant control groups inoculated with only C. baileyi at D4 (C4 group), only MDV at hatching (M0 group) or at D8 (M8 group), and an uninoculated control group (UC group). The chickens were kept in isolator units until the end of the experiment at D62. Our results showed a considerable synergistic effect in concurrently infected chickens and more severe consequences when chickens received MDV before C. baileyi infection. In fact, except for a slight transitory weakness, the chickens in C4 group remained free of overt clinical signs and there was no mortality. However, coinfection with both pathogens induced more lasting or permanent oocyst shedding. Severe clinical cryptosporidiosis with weakness, anorexia, depression, growth retardation, and chronic and severe respiratory disease causing death occurred in all chickens in the C4M0 group between D12 and D43 and in 67% of the chickens in the C4M8 group between D17 and D57. Eighty-two percent and 33%, respectively, died before the development of specific Marek's disease lesions. Mortality rates were 27% and 33% in the M0 and M8 groups, respectively. The presence of MDV enhanced the establishment of more lasting cryptosporidial infection in the respiratory tract, esophagus, crop, proventriculus, and kidneys (only in C4M0 group) as well as in bursa of Fabricius, ceca, and cloaca. Serologic analysis showed that chickens with chronic cryptosporidiosis in the C4M8 group had an increased level of C. baileyi-specific immunoglobulin A. Our results may explain some cases of mortality in chickens naturally infected with MDV and Cryptosporidium.

[Maternal complications of cesarean section: retrospective analysis of 3,231 interventions at the Casablanca University Hospital, Morocco]. / Complications maternelles des césariennes: analyse rétrospective de 3,231 interventions à la maternité universitaire de Casablanca, Maroc.

We carried out a retrospective analysis of 3,231 cases of cesarean section between 1994 and 1997, to assess the maternal mortality and morbidity associated with this intervention. The frequency of cesarean delivery was 12.4%. The indications for cesarean section were of three types: elective indications (627 cases, 19.4%), emergency indications (454 cases, 14.1%), failure of normal labor (2,150 cases, 66.5%). Nine maternal deaths were noted (2.8 per thousand), one of which was directly linked to surgery. The peroperative complications were primarily major hemorrhagia (39 cases, 1.2%), visceral lesions such as bladder rupture (3 cases, 0.1%) and intestinal lesions (3 cases, 0.1%). Postoperative morbidity was predominated by infectious complications, particularly endometritis (5.1%). Thromboembolism was reported in 7 cases (0.2%). Cesarean section is used to preserve the life of both the mother and the child. However, maternal morbidity and mortality rates are higher with cesarean section than with vaginal delivery and therefore its indications must be justified.

Effect of Cryptosporidium baileyi in specific pathogen free chickens vaccinated (CVI988/Rispens) and challenged with HPRS-16 strain of Marek's.

This study was performed to examine the effect of Marek's disease virus (MDV) serotype 1 vaccine (CVI988/Rispens) on the pathogenicity of Cryptosporidium baileyi , and to determine whether C. baileyi infection could prevent the development of vaccinal Marek's disease (MD) immunity in specific pathogen free (SPF) chickens. Sixty-eight SPF homozygous B13 White Leghorn chickens were divided into seven groups. C. baileyi was orally administered at 5 days of age (day 4) in chickens infected with Rispens vaccine at day 0 or at day 8 and challenged with HPRS-16 strain of oncogenic MDV at day 15. Relevant control groups were constituted. The chickens were kept in isolators until the end of the experiment at day 62. The parameters evaluated were clinical signs, kinetics of oocyst shedding, mortality, macroscopic and microscopic lesions, cryptosporidia location in various organs and serum anti- C. baileyi antibodies at days 42 and 62. Our results show that C. baileyi , which is considered to be non-pathogenic when inoculated orally, may become highly pathogenic. It induced severe mortality and developed in organs other than classical target sites when chickens were vaccinated with Rispens vaccine and challenged with the HPRS-16 strain of MDV.However,parasite infection does not prevent the induction of vaccinal immunity for MD. Our results also show that vaccination of B13 chickens at hatching induces higher protection against challenge with HPRS-16 MDV at day 15 than vaccination at day 8.

Renal Cryptosporidiosis (Cryptosporidium baileyi) in specific-pathogen-free chickens experimentally coinfected with Marek's disease virus.

Renal Cryptosporidiosis was experimentally induced during a study to investigate the pathogenicity of Cryptosporidium baileyi in specific-pathogen-free (SPF) chickens coinfected with Marek's disease virus (MDV). Cryptosporidium baileyi was administered orally at 4 days of age to chickens previously infected at hatching (day 0) with the HPRS 16 strain of oncogenic MDV. Three control groups received MDV at hatching, C. baileyi on day 4, or placebo consisting of distilled water. Renal cryptosporidiosis lesions were induced in the group coinfected with MDV and C. baileyi. The kidneys were markedly swollen and pale, with visible urate crystals in the ureters and surface tubules. Oocysts of C. baileyi were demonstrated in six of seven cases tested by a scoring method with modified Sheather's sugar solution on renal tissue scrapings and were confirmed in three cases by histologic examination of paraffin-embedded kidney sections. Histologic study also revealed subacute interstitial nephritis, acute ureteritis, and attachment of cryptosporidia on the epithelial cell surface of the ureters and collecting ducts, collecting tubules, and distal convoluted tubules. Various developmental stages of the parasite were present in the kidney sections. To our knowledge, this is the first report of experimentally induced renal cryptosporidiosis in SPF chickens coinfected with MDV.

A review of the importance of cryptosporidiosis in farm animals.

Cryptosporidium species are coccidian parasites with a large capacity to reproduce and to disseminate. Several species are known to infect farm animals, although the economic importance of cryptosporidiosis is highly host species dependent. This paper reviews the impact of cryptosporidial infections in livestock and poultry. For different farm animals, the Cryptosporidium spp. that occur, as well as their clinical and pathological features, and their interactions with other pathogens, are described. In addition, data concerning the prevalence, the transmission and the epidemiology of the disease are mentioned and a description of the economic losses associated with cryptosporidiosis in each of the hosts is given. Cryptosporidiosis seems to be mainly a problem in neonatal ruminants. Cryptosporidium parvum is considered to be an important agent in the aetiology of the neonatal diarrhoea syndrome of calves, lambs and goat kids, causing considerable direct and indirect economic losses. Avian cryptosporidiosis is an emerging health problem in poultry, associated with respiratory disease in chickens and other Galliformes, and with intestinal disease in turkeys and quails. Because of limited availability of effective drugs, the control of cryptosporidiosis relies mainly on hygienic measures and good management.

[Twin delivery after cesarean section: is a trial of labor warranted?]. / Accouchement gémellaire sur utérus cicatriciel: peut-on autoriser l'épreuve utérine?

OBJECTIVE: To determine whether a trial of labor in twin pregnancy is a valuable alternative to routine repeat cesarean section. MATERIAL AND METHODS: Based on retrospective analysis of 31 cases of twin gestation with previous cesarean section, we tried to assess the outcomes of 25 cases of trial of labor. The outcomes of trial of labor in twin pregnancy were compared to those of trial of labor in singleton pregnancy. RESULTS: The trial of labor was successful in 21 cases (84%). There was one case of scar dehiscence among the women who underwent a trial of labor, that occurred in the parturient with two previous cesarean sections after complete breech extraction. There were no significant differences in perinatal outcomes in any comparison of trial of labor versus no trial of labor. The outcomes of trial of labor in the twin pregnancy were similar to singleton pregnancy. CONCLUSIONS: Routine repeat cesarean section in the twin pregnancy is not necessarily warranted; a controlled trial of labor in selected cases would be a valuable alternative.

[Vaginal birth after cesarean delivery: can the trial of labor be extended]. / Accouchement des utérus cicatriciels: peut-on élargir l'épreuve utérine?

Based on a retrospective analysis of 1000 cases of scared uteri following cesarean section(s) (one cesarean, n = 857, 85.7%); two n = 129, 12.9%; three n = 14, 1.4%), we tried to answer two questions. Is trial of labor in case of low segment uterine-scar (excepting pelvic abnormalities, corporeal scar and more than two scars) free of risk for the mother and child? Can trial of labor be extended to cases of breech presentation, two previous cesarean sections, twin pregnancy and suspected macrosomia? In this series, the cesarean was indicated before labor in 138 cases (13.8%). Trial of labor was conducted in 862 cases (86.2%), and led to vaginal birth in 728 (84.5%). Successful trial of labor was observed in 75% of twin pregnancies, in 100% of breech presentations and in 69.6% of macrosomic infants. Uterine rupture occurred in 23 cases (2.7%), especially in cases with unknown corporeal scars (15 cases). No case of perinatal death related to uterine rupture was observed in this series.

[Trial of labor after 2 cesarean sections. Prospective study of 130 cases]. / Epreuve du travail sur utérus bicicatriciel. Etude prospective à propos de 130 cas.

The mode of delivery in the parturient women with two prior cesarean is controversial. Based on a prospective analysis of 130 cases, we tried to assess the outcome of trial of labor after two cesarean sections. Among 167 patients with two uterine scars, 130 (77.8%) were selected for a trial of labor that was successful in 65 cases (50%). The overall rate of vaginal birth and cesarean section was 39% and 61%, respectively. There were 4 scar dehiscences and 2 uterine ruptures among the women who underwent trial of labor, but no case of perinatal death or morbidity related to these complications was observed. In the majority of the cases, these scar separations were due to poor obstetrical conditions. Trial of vaginal delivery after two prior cesarean sections seems to us a reasonable attitude if it is well indicated and supervised correctly.

Passive protection of specific pathogen free chicks against infectious bursal disease by in-ovo injection of semi-purified egg-yolk antiviral immunoglobulins.

In order to develop an experimental model for passive immunity in SPF chickens, active neutralizing immunoglobulins (Ig) directed against infectious bursal disease virus (IBDV) were extracted from the yolk of eggs laid by conventional layers immunized against IBDV. Concentrated Ig extracts were inoculated via the intra-vitellin route into 7-day-old embryonated SPF hen eggs. Although detrimental to hatchability, Ig inoculation resulted in hatching two series of SPF chicks with passive immunity against IBDV. The neutralizing and ELISA antibody titres at 1 day-old (respectively 12.64 and 13.15 log2; and 4915 and 4277), the kinetics of decay of the anti-IBDV antibodies and the protection afforded by passive antibodies against highly virulent IBDV challenge proved highly consistent with data previously reported on conventional chicks. In-ovo inoculation of purified egg-yolk immunoglobulins may hence be a good experimental model for anti-IBDV maternally-transmitted immunity. This experimental model might possibly be adapted to other pathogens or vaccines for which interference with maternally derived antibodies is a matter of concern at 1 day-old.

[Jaundice and pregnancy. The role of viral hepatitis]. / Ictère et grossesse. La place de l'hépatite virale.

Through a series of 76 cases of jaundice observed in pregnant women, the authors emphasize on the biggest frequency of viral hepatitis among the all of etiology. In fact that one represents the 2/3 of cases. They insist on the graves forms of the diseases which are responsible of a high maternal mortality and big foetal complications.

[Uterine rupture due to placenta accreta at 28 weeks of pregnancy]. / Rupture utérine par placenta accreta à 28 semaines de grossesse.

The authors report the case of uterine rupture occurring after 28 weeks of amenorrhea and related to placenta accreta and treated by means of hysterectomy. They stress the diagnostic problems and discuss possible conservative treatment.

[Synovial osteochondromatosis of the elbow in a 60-year-old woman]. / Ostéochondromatose synoviale du coude chez une femme de 60 ans.

The authors report the case of a 60 year old woman with synovial osteochondromatosis of the elbow treated by total synovectomy. The result was good for all symptoms. They discuss the etiology, pathogenesis, diagnosis and treatment.