[Carrington's disease without eosinophils in the bronchial lavage]. / Une maladie de Carrington sans éosinophilie au lavage broncho-alvéolaire.

INTRODUCTION: Idiopathic chronic eosinophilic pneumonia (ICEP) or Carrington's disease is an infiltration of the lung parenchyma by eosinophils without known cause. The diagnosis of ICEP is based on well defined clinical and radiological characteristics associated with blood and/or alveolar eosinophilia. Alveolar hypereosinophilia is marked and regarded as a constant feature. CASE REPORT: We report the case of a 57 year old man seen on account of a cough and deterioration of general health associated with radiographic peripheral pulmonary infiltrates, blood hypereosinophilia but no hypereosinophilia in the bronchial lavage (BL). The diagnosis of ICEP was made after histological examination of a surgical lung biopsy. CONCLUSION: Absence of alveolar hypereosinophilia in ICEP remains exceptional and in this case confirmation of the diagnosis may depend on examination of a lung biopsy.

Cell abnormalities associated with human papillomavirus-induced squamous intraepithelial cervical lesions. Multivariate data analysis.

One hundred ninety-six cervical scrapings were obtained for simultaneous research of cell abnormalities in Papanicolaou smears and detection of genital human papillomavirus (HPV) genotypes by polymerase chain reaction in extracted DNA from each clinical sample. The samples described by six discriminant cytologic parameters, and a synthetic HPV-presence/absence parameter provided an efficient matrix for multiple correspondence analysis. This statistical analysis displayed a plurality of HPV-related cell abnormalities in squamous intraepithelial lesions, and a high correspondence between HPV infection and the presence of multinucleated squamous cells, morphologically transformed keratinocytes (dyskaryotic cells), koilocytes, and cellular changes related to epithelial maturation. Because of the low proportion of detectable koilocytes in the HPV-infected scrapings, the authors also inferred that cellular changes related to epithelial maturation and morphologically transformed keratinocytes are the most accurate and efficient cell abnormalities, in terms of frequency and correlation, for cytodiagnosis of HPV-induced or associated squamous intraepithelial cervical lesions.

Familial symphalangism syndrome transmitted through five generations.

We report on proximal symphalangism of the four last fingers, transmitted through five generations of an African family. Intrafamilial variations of the disorder are due to the heterogeneity of associated anomalies. This familial trait resembles multiple synostosis disease, however, it is not restricted to synostoses and appears to be more generalised. To our knowledge this is the first report of a familial trait associating proximal and distal symphalangism. The distribution of elementary anomalies in this family suggests a link in their pathogeny and raises the question of embryological equivalence for some of them. Symphalangism seems to be a symptom of a more generalised disorder, the comprehension of which requires a better coordination of clinical, embryological and genetic data.

[Fine needle cytopuncture of the pancreas. Apropos of 45 cases]. / Cytoponction pancréatique à l'aiguille fine. A propos de 45 observations.

In this report, we examined the sensitivity and specificity of pancreatic fine needle aspiration cytology in the diagnosis of pancreatic cancer. Aspiration cytodiagnosis was performed in 45 patients (36 cancers and 9 benign pancreatic lesions) using a 22 Gauge fine needle either percutaneously in 25 patients with real-time ultrasonic guidance or during surgery in 20 patients. Cytologic examination included a precise description and the classification in one of the 4 Papanicolaou classes, the fourth only being considered as positive in terms of cancer. No complication occurred with either technic. Overall sensitivity was 75 p. 100, 74 p. 100 percutaneously and 77 p. 100 intraoperatively, but specificity was 78 p. 100 due to two false-positive results recorded among the 9 benign lesions. Retrospective analysis of cytologic examinations of the 29 class IV lesions led us to differentiate cases with "sure malignancy" (20 cases) from those with "strong suspicion of malignancy" (9 cases including the 2 false-positives). Only class IV lesions with "sure malignancy" call for aggressive treatment, whereas a "strong suspicion of malignancy", which may result from carcinoma or severe cellular abnormalities occasionally found in inflammatory pancreatic lesions, should lead to a second pancreatic aspiration.

[Percutaneous bone puncture biopsy with trocar. Apropos of 60 cases]. / Ponction biopsie osseuse percutanée au trocart. A propos de 60 observations.

Deep bone biopsies were performed in 58 patients over the last 2 years, in a radiology department in Tours, France, under television screen control. Data obtained included pathologic, cytologic and bacteriologic features in the 60 biopsies conducted, localization being the spine in 52 cases (12 dorsal, 36 lumbar, 4 sacroiliac) and the pelvis 8 times. Etiology was a tumoral process in 15 cases (14 metastases and 1 reticulosarcoma), 7 infectious processes including 2 cases of tuberculosis, 26 cases of decalcifying degenerative osteopathies, 1 Paget's disease, 1 ankylosing spondylitis and 1 bone infarct. Biopsy was unsuccessful in 9 cases, the success rate being an overall 85%. Complications were not observed. Conducted under local anesthesia, deep bone biopsy provides a rapid diagnosis and allows a shortened hospital stay. Surgery is generally avoided and appropriate treatment instituted more rapidly.

[Immunocytopathology of tumors of the breast. Test of 2 monoclonal antibodies on the products of cytologic aspiration of breast tumors and metastases]. / Immunocytopathologie des tumeurs du sein. Essai de deux anticorps monoclonaux sur des produits de cytoponction de tumeurs mammaires et de métastases.

Two monoclonal antibodies selected for specific well-developed antigens in certain epithelial tumors were used in accordance with immuno methods for marking tissues. They were used on samples of cells obtained by aspiration from malignant lesions and from benign lesions of the breast and from lymph node metastases as well as from adenocarcinomata of the skin of the breasts. No work has yet published about one of these markers (anti-breast carcinoma). The positive results that we have obtained give hope that a new approach to the microscopic diagnosis of the cells of the breast in very early tumors is on its way, as well as the precise diagnosis of metastases.

[Pulmonary malacoplakia and Rhodococcus equi pneumonia in a patient infected with the human immunodeficiency virus. A case report with review of the literature]. / Malacoplasie pulmonaire et pneumonie à Rhodococcus equi chez un patient infecté par le virus de l'immunodépression humaine. A propos d'un cas avec revue de la littérature.

We report a case of pulmonary malakoplakia in a patient suffering from AIDS secondary to a Rhodococcus equi pneumonia. The association between these two pathologies only occurring in the immunodepressed does not seen fortuitous. Deficiency in cellular immunity and macrophage cellular activity as well as failure of intracellular bactericidal and phagolysosomal function are very probably the links. The treatment of this opportunistic germ rests on prolonged poly-antibiotic therapy or indeed surgical excision.

[Immunogenicity of a hepatitis B vaccine obtained by genetic recombination and containing products of S and pre-S2 genes]. / Immunogénicité d'un vaccin contre l'hépatite B obtenu par recombinaison génétique et contenant les produits des gènes S et pré S2.

Immunization against hepatitis B by means of a vaccine obtained by genetic recombination on chinese hamster ovary cells was attempted in 32 adult subjects. The HBs antigen was purified from the culture supernatant and contained S and pre S2 genes products. Three 20 micrograms doses were injected intramuscularly at intervals of one month. Anti-HBs seroconversion levels and the geometrical mean of antibodies were slightly higher than those observed with plasma vaccines or genetically engineered yeast-derived vaccine. Antibodies directed against HBs appeared more rapidly and at a higher titre. Anti-pre S2 antibodies were detected after the third injection in 84 per cent of the subjects vaccinated. This recombinant hepatitis B vaccine prepared from chinese hamster ovary cells will probably be as effective as the first generation vaccines obtained by purifying the HBs antigen obtained from the blood of asymptomatic carriers.

[Detection of human type 16 papillomavirus in epithelial cells of the uterine cervix]. / Détection du papillomavirus humain de type 16 dans les cellules épithéliales du col utérin.

Cervical cells obtained by scraping from 126 women living in the Tours area, France, were tested for the presence of HPV 16 infection, using the PCR method. In all samples analysed no evidence was found of HPV 16 b subtype. The incidence of HPV 16 infection ranged from 4% in women without history of genital HPV infection to 48% in women with high-grade squamous intraepithelial lesions (SIL). It must be noted that HPV 16 infection is twice as frequent in women with a history of HPV-induced cervical lesions as in those without this history. Thus, a normal cytology does not always mean an absence of HPV infection of the uterine cervix. It may be concluded from these results that detection of cervical HPV 16 infection by the PCR method makes it possible to identify a group of women at high risk of developing SIL or cervical cancer. Regular cytological surveillance of these women who are healthy carriers of HPV 16 without detectable squamous cell abnormalities must be implemented.

[Femoral implants of coral and ceramics: histological results after 120 days]. / Implants fémoraux de corail et de céramique: résultats histologiques à 120 jours.

The authors have made an histological study of the evolution, after 120 days, of coral implant and tricalcic phosphate ceramic implant in each femur of 12 rabbits. The results have shown on the one hand that ceramic is resorbed faster than coral, on the other hand that for both types of biomaterials the resorption was much faster for the implants in contact with the bone-marrow than for those which were not.

[Sideroses of alveolar macrophages. Analysis of a continuous series of 360 bronchoalveolar lavages]. / Sidéroses ds macrophages alvéolaires. Analyse d'une série continue de 360 lavages broncho-alvéolaires.

360 consecutive bronchoalveolar lavage fluids (BAL) were studied using semi-quantitative method described by GOLDE (GOLDE score). 44 hemosiderosis were detected (12%). Most of them corresponded to massive alveolar hemorrhage (AH). Depending on pathological contexts, we distinguished three main groups of AH frequency: a group of high frequency (around 40%), an intermediate group (10%) and a low frequency group with less than 5%. Matching cytological results with clinical and radiological data, revealed that AH was often too late diagnosed because inconstancy of typical clinical and radiological signs. Even with a variable prognosis related to different physiopathological mechanisms, AH evolution is unpredictable. The authors suggest thus BAL cytological examination may systematically include a research of hemosiderosis in AH high frequency groups.

[Histochemical and ultrastructural proofs of heart innervation of Protopterus annectens (Dipneust, fishes)]. / Preuves histochimiques et ultrastructurales de l'innervation du coeur de Protopterus annectens (poisson dipneuste).

The identification of an extrinsic cardiac innervation in Protopterus has been reported for the first time. It has been based on histological, histochemical and ultrastructural methods. The heart of Protopterus receives a rich cholinergic parasympathic innervation which ramifies in the atria and the ventricle. The induced fluorescence did'nt permit us to detect any mono-aminergic fibres ; meanwhile this method has enabled us to distinguish a particular type of cells containing catecholamines in the heart.

[Histological study of the voluntary traumatic inclusion of a foreign body in the gingival mucosa]. / Etude histologique de l'inclusion traumatique volontaire d'un corps étranger dans la muqueuse gingivale

First histological features of traditional tattooing of gingival mucosae using smoke-black are reported. They show the complete tolerance of connective tissue. The microscopic examination occurs several weeks or months after the tattoo was done. Thus, one can notice that carbon particles localize particularly around blood vessels (small arteries), and that never arises inflammatory reaction of any type.

[Presence in the heart of Protopterus annectens (Fishes, Dipneuste) of nodal and conducting cells histologically distinct from common myocardial cells]. / Sur la présence dans le coeur de Protopterus annectens (Poisson Dipneuste) de cellules nodales et conductrices histologiquement distinctes des cellules myocardiques ordinaires

Contrary to Francis and Davies's assumption according to which the impulse-conducting system of the Homoiothermal Vertebrates is a neomorphic structure, we have been able to identify in the heart of a Poikilothermal (Protopterus) impulse-conducting cells which possess distinctive histological characters.