Kaposi's sarcoma: presence of herpes-type virus particles in a tumor specimen.

Three Kaposi's sarcoma biopsy specimens obtained from three African patients with typical nodular cutaneous tumors were investigated morphologically for cellular modifications suggestive of a viral origin. In one case a Kaposi's sarcoma cell of the endothelial type contained a few intranuclear herpes-type viral inclusions. The present findings complement previous reports of herpes-type viral particles in Kaposi's sarcoma cultured cell lines and suggest that, at least under certain conditions, Kaposi's sarcoma cells enter a virus-producing phase.

Prevalence and genetic variants of hepatitis GB-C/HG and TT viruses in Gabon, equatorial Africa.

The distribution of Hepatitis GB-C/HG (GB-C/HG) and TT viruses (TTV) infections was investigated in selected populations from Gabon using Polymerase Chain Reaction (PCR) and Enzyme Linked Immunosorbent Assay (ELISA) for anti-Envelop 2 (anti-E2) GBV-C/HGV antibodies. Among pregnant women, 29 of 229 (12.6%) were Hepatitis GB virus-C and Hepatitis G virus (GBV-C/HGV) RNA positive (+) and 32 of 81 (39.5%) anti-E2 + versus 8 of 39 (20.5%) TTV DNA +. Among sickle cell anemia patients, 9.7% (3/31) were GBV-C/HGV RNA + versus 22.5% (7/31) TTV DNA +. For tuberculosis patients, the figures were 11.5% (4/35) and 0%. A study of hepatocellular carcinoma cases (n = 27) versus controls (n = 66) did not show significant differences for GBV-C/HGV RNA (10.7% versus 12.1%) and TTV DNA (44.4% versus 30.3%). According to phylogenetic analysis, the 15 GBV-C/HGV strains investigated clustered in group 1, the most common in sub-Saharan Africa whereas TTV sequences (n = 4) mostly clustered in genotypes G1 and one close to genotype G3. In the Gabonese populations investigated, GBV-C/HGV and TTV infections were highly endemic. These data are consistent with the low pathogenicity of these agents.

[Results of a systematic search for Plasmodium in internal medicine in Gabon]. / Résultats d'une recherche systématique d'hématozoaires en médecine interne au Gabon.

Among 158 adults hospitalized at the University Hospital of Libreville who did not receive any treatment against malaria before blood screening, 20 were carriers of malaria parasites. Plasmodium falciparum was seen in 19 cases with a parasitic density lower than 1,000 trophozoits/mm3 of blood in 18 cases. The most important prevalence was observed into the group of older people. In most cases symptoms related to malaria did not occur during the hospitalization. We conclude that, in such patients, a parasitic density lower than 1,000 trophozoits/mm3 is not sufficient to assess the diagnosis of malaria and does not deserve systematic treatment.

[First clinical and serological description of leptospirosis in Gabon]. / Première description clinique et sérologique de la leptospirose au Gabon.

We report the first case of leptospirosis describe in Gabon. Several environmental factors could favour the transmission of the disease in that country.

[Meningeal attacks during the course of congenital syphilis and therapeutic consequences]. / Atteinte méningée au cours de la syphilis congénitale et conséquences thérapeutiques.

In a study carried out in Gabon, antibodies against the treponema were looked for in the cerebrospinal fluid (CSF) in 13 children with active congenital syphilis (presence of specific IgM antibodies) and in 7 children with positive serologic reactions reflecting transplacental passage of maternal antibodies. Serologic reactions used included the VDRL test, the TPHA test, and the FTA-ABS IgG and IgM tests. Among the 13 children with syphilis, 7 had a positive FTA-ABS IgG test in the CSF without correlation with severity of clinical features, CSF protein levels or CSF cytologic findings. The TPHA test was positive in only four children and the VDRL test was always negative. Passage of antibodies into the CSF is possible (1 case in this study after treatment of the mother), but TPHA is helpful in developing countries of research of neurosyphilis.

[Kaposi's sarcoma. A vascular neoplasm of presumably viral origin. Histologic and ultrastructural characteristics]. / Le sarcome de Kaposi. Un néoplasme vasculaire présumé d'origine virale. Caractères histologiques et ultrastructuraux.

Kaposi's sarcoma is a multiform mesenchymal neoplasm of uncertain histogenesis but of possible viral origin. Several anatomo-clinical forms have been described the cutaneous nodular lesion being the most common and at highest frequency in equatorial Africa. Eighteen of such typical lesions were reported; their morphology was uniform and associated: 1) spindle cells, 2) an excess of vascular spaces composed of intratumoral intercellular slits and of intra and peritumoral well structured vessels, 3) a lymphoplasmocytic inflammatory infiltration. The lesions of the other and less common forms of Kaposi's sarcoma associated the same histological features in variable combination. At one end of the histological spectrum the lesions are essentially composed of irregular capillaries with few spindle cells, at the other end the tumor is a highly cellular neoplasm with few or no angiogenic features. The vascular structure of the typical lesions appeared clearly at the ultrastructural level. Most tumor cells were of endothelial type and formed cylinders with virtual or large central lumina, reminiscing of vascular sprouts. Pericyte-like cells were also present. In one the three ultrastructurally investigated cases, a tumor cell of the endothelial type contained intranuclear herpes virus like inclusions, group to which belongs the cytomegalovirus (CMV), a possible promoter of Kaposi's sarcoma.

[Distribution of glycosylated hemoglobin (HbA1) in an internal medicine service in Gabon]. / Distribution de l'hémoglobine glyquée (HbA1) en médecine interne au Gabon.

Measurement of glycated hemoglobin (HbA1) concentration is commonly recommended to monitor diabetes, but the relevance of this parameter in some black African populations is questionable. To assess the suitability of this test and study factors affecting HbA1 concentration, we measured HbA1 concentration in 297 consecutive patients (185 men and 112 women) hospitalized in the Internal Medicine Department of the Libreville Hospital Center in Gabon. Distribution of HbA1 was asymmetric with a median at 7.2% (IC95: 6.8-7.6%). Metabolic abnormalities associated with diabetes, renal insufficiency, hyper-bilirubinemia and hypertriglyceridemia were not preferentially correlated with a distribution of HbA1 concentration above the normal threshold of 7.5 %. Elevated concentration were observed in 81 patients presenting no abnormalities. These findings was not due ro technical problems, alcohol abuse, or aspirin intake or to congenital hematologic abnormalities that have been documented in Gabon. On the other hand, an increase in glycation secondary to latent infection which is frequent in tropical areas may partially explain these findings. Regardless of the explanation, HbA1 appears to be unsuitable for monitoring diabetes in this population group.

[Primary non-Hodgkin malignant lymphoma of the spleen in Africa. Apropos of 2 probable cases]. / Les lymphomes malins non Hodgkiniens primitifs de la rate en Afrique. A propos de deux cas probables.

The authors report two cases of primary splenic presentation of malignant lymphoma in Gabon. This disease seems very uncommon but its frequency is perhaps underestimated in Africa. The hypothesis of a possible relation with tropical splenomegaly deserves consideration. At the beginning of the disease large cell types follow a local growing pattern but symptoms are already obvious. Therefore early diagnosis would permit curative splenectomy.

[Acute gastroenteritis and breast feeding in Gabon. Preliminary results]. / Gastroentérites aiguës et allaitement maternel au Gabon. Résultats préliminaires.

76 diarrheic infants (from 15 days to 2 years) had a stool examination for rotavirus (ELISA method) and a stool culture and were classified according to breast feeding or not. This study was performed in a semi-urban region (Haut-Ogooué, Gabon). The preliminary results suggest a protection by breast feeding against rotavirus and enteropathogenic bacteria, rapid elimination of diarrheic agents may be facilitated by human milk.

[Types of sugar diabetes encountered in internal medicine in Gabon]. / Typologie des diabètes sucrés rencontrés en medecine interne au Gabon.

In the 108 patients with diabetes (75 men and 33 women between the ages of 15 and 86 years) hospitalized in the Internal Medicine Department of the Libreville Hospital Center between January 1, 1989 and December 31, 1991, 53 were easily classified, 12 being due to alcohol-induced chronic calcific pancreatitis, two to insulin-dependent diabetes, and 39 to non-insulin-dependent diabetes. Fifty-five patients treated with insulin were not immediately classifiable including 11 who were obese and probably should not have required insulin. In the remaining 44 patients who were not overweight, the youngest often presented features comparable to those observed in patients with chronic calcific pancreatitis except with regard to calcification. Most of the older patients were women in whom diagnosis was coincidental. These findings indicate that authentic insulin-dependent diabetes is uncommon, that non-insulin-dependent diabetes are frequent, and that the endocrine pancreas is particularly susceptible to alcohol abuse.