[Study of the psychometric properties of the CES-D in a sample of French-speaking adolescents]. / Étude des propriétés psychométriques de l'échelle CES-D sur un échantillon d'adolescents francophones scolarisés.

UNLABELLED: The aim of this paper is to study and validate the French version of the Center for Epidemiologic Studies Depression Scale developed by Radloff (in 1977) in an adolescent sample. This scale was developed to measure levels of depressive symptomatology, with special emphasis on the affective components and depressed mood. METHOD: The data used in this study were collected in 11 schools. Our sample was composed of 1496 French-speaking, Belgian secondary school students aged 12 to 16 years. The questionnaire included demographic information such as age, gender, grade and family composition. The position of the CES-D scale has not changed and was placed in the last part of the self-administered questionnaire. RESULTS: After an exploratory factor analysis, we conducted confirmatory factor analysis to test our factor model. We tested the model with four factors proposed by Radloff (in 1977) and also the model proposed by Chabrol (in 2002). Our results indicate a better match with Radloff's model in our sample, showing the relevance of using Radloff's model with four factors in adolescents. Although our analysis shows a clear gender difference with regard to depressive symptoms, the tested factor model remained stable regardless of the gender of the adolescent.

[Breast reconstruction after prolonged tissue expansion. About 247 cases]. / Reconstruction mammaire prothétique après expansion préalable prolongée. A propos de 247 cas.

SUBJECT: The purpose of this study was to analyse the complications and the aesthetic results in case of slow tissue expansion in prosthetic breast reconstruction. PATIENTS AND METHODS: We tracked 237 patients representing 247 mammary reconstructions operated between 1992 and 2004. These patients were distributed in two series, a series of 148 operated mammary reconstructions between 1992 and 2000 and a series of 99 reconstructions operated between 2001 and 2004. For every reconstruction, we analysed the progress of the expansion, the complications and the quality of the aesthetic results according to the radiotherapy and the type of implant used. RESULTS: The radiotherapy increases the risk of failure of the breast reconstruction and degrades the quality of the aesthetic results. Capsular contractures are rare and their frequency does not depend on the irradiation. Prosthesis infections and exposure are more frequent on irradiated ground. DISCUSSION: The tissue expansion in prosthetic breast reconstruction is a technique studied well in the literature, but few authors use a chronic expansion and compare the long-term results according to the radiotherapy. If our study confirms the noxious role of the radiotherapy as for the complications and for the aesthetic aspect of the results, it is not a question for us of an absolute contraindication. The weak rate of capsular contracture is attributable to the chronic character of the expansion, which allows the maturation of the capsule. The use of silicone gel implants decreases the deflations but does not improve the results. CONCLUSIONS: The radiotherapy increases the risks of failure of the tissulaire expansion and decreases the quality of the aesthetic results. The chronic character of the expansion allows to obtain a rate of capsular contracture weak, even on irradiated ground. The silicone gel implants make it possible to obtain a perennial result.

[Sarcoidosis during the treatment of hepatitis C by interferon-alpha and ribavirin: 2 cases]. / Sarcoïdose au cours du traitement de l'hépatite C par interféron alpha et ribavirine: deux cas.

INTRODUCTION: Interferon-alpha (IFN alpha) used to treat chronic hepatitis C can be responsible for some side effects. We report two cases of sarcoidosis which appeared in patients treated with IFN alpha and ribavirin for chronic hepatitis C. EXEGESIS: A first patient, treated for 5 months with IFN alpha and ribavirin because of chronic hepatitis C, after the failure of a first treatment with IFN alpha alone, was hospitalized for dyspnea. The chest X-ray and scanner revealed an interstitial syndrome and mediastinal adenopathies. Biopsies of bronchial spurs revealed epithelioid and giganto-cellular granuloma. After discontinuation of antiviral treatment and starting corticosteroid therapy, the evolution was favourable but viremia reappeared. A second patient with IFN alpha and ribavirin for 4 months because of chronic hepatitis C (after the failure of a first treatment with IFN alpha alone) was hospitalized for fever, arthralgias, erythema nodosa and modification of previous skin scars. The biopsy of a scar showed an epithelioid and giganto-cellular granuloma. After discontinuation of antiviral therapy and starting corticosteroid treatment, the evolution was favourable. CONCLUSION: Some publications mention occurrence of sarcoidosis during IFN alpha therapy, occasionally associated with ribavirin, disappearing after discontinuation of the treatment, though sometimes corticotherapy is necessary. The roles of IFN alpha and ribavirin are discussed.

Characterization of liver-associated natural killer cells in patients with liver tumors.

The existence of a marginal lymphocyte population in rat liver sinusoids has already been demonstrated using the sinusoidal lavage method. We used the same technique to study the lymphocyte population in human liver obtained ex vivo after partial hepatectomy for benign or malignant tumors and compared it with peripheral and portal blood lymphocyte populations. Percentages of lymphocyte surface phenotypes were evaluated by flow cytometry. The lymphocyte population obtained from human liver is mainly made up of CD56+ (35%) cells. This percentage is three times greater than that found in peripheral and portal blood. Two-color flow cytometry analysis showed that within the CD56+ liver cell population, at least three distinct subsets could be found: (a) CD3+/CD56+/CD16-; (b) CD3-/CD56+/CD16-; and (c) CD3-/CD56+/CD16+. Although these subsets were also present in peripheral and portal blood, the percentage distribution was completely different because most CD56+ cells in peripheral and portal blood belonged to the CD3-/CD56+/CD16+ subset. These results show the existence of a heterogeneous natural killer cell population in human livers with tumors. The functional significance of this heterogeneity still needs to be explained.

The increase in the number of liver sinusoidal pit cells in four patients with primary or metastatic cancer of the liver.

Four patients with liver carcinoma (case 1: hepatocellular carcinoma; cases 2 and 3: metastases; case 4: adenocarcinoma possibly of hepatic origin) underwent a wedge liver biopsy taken at some distance from the tumor. Liver histology was normal in cases 2 and 3. Sinusoids were dilated in case 4. Fibrosis formed bridges between portal tracts in case 1. In all 4 cases, sinusoids contained lymphocytic cells. By electron microscopy (perfusion-fixation with glutaraldehyde) numerous lymphocytes could be identified as pit cells with characteristic dense granules and occasional rod-cored vesicles. The majority of the pit cells were luminal cells in contact with endothelial or Kupffer cells; some were in the Disse space. It is now accepted that pit cells are resident large granular lymphocytes with natural killer activity. The increase in the number of pit cells in liver carcinoma compared to the number observed in the control group (uncomplicated gallbladder lithiasis) could be hypothetically interpreted as a defense mechanism against tumor extension.

Endometrial progesterone concentrations during the menstrual cycle.

Endometrial progesterone concentrations have been determined during the menstrual cycle and compared to plasma progesterone and estradiol-17 beta concentration. There is a good relationship between endometrial and plasma progesterone concentrations but none between endometrial progesterone and estradiol-17 beta concentration.