[Clinical overview of New World tegumentary leishmaniasis]. / Panorama clinique des leishmanioses tégumentaires du Nouveau Monde.

This richly illustrated article (80 color photographs) based on the authors' experience in French Guyana documents the clinical diversity of American tegumentary leishmaniasis. Main highlights include the often outstanding aspect of lesions, the high frequency of forms not associated with ulceration or scab formation that must be recognized to achieve diagnosis in travellers returning from endemic zones, and the special prognosis of clinical forms associated with intradermic, lymphatic or hematogenous spread. The article also reviews an original diagnostic method based on culture of cutaneous biopsy specimens on specific nutrient mediums that provides isolates in a high percentage of cases (80%) and thus allows identification of offending parasite.

[Military Bioforce, example of governmental humanitarian action]. / La Bioforce militaire, exemple de moyen humanitaire gouvernemental.

Governmental humanitarian action is an old concept in France, that is a topic of current interest. To conduct humanitarian action, the French government has deployed various facilities. The military biological risk team was established to control epidemics, provide expertise during epidemiological emergencies, and conduct mass vaccination programs. The author describe the missions carried out by the biological risk team during the 1990s as an illustration of governmental humanitarian action.

[Hepatitis C in tropical areas]. / L'hépatite C sous les tropiques.

The tropical features of hepatitis C have not yet been fully elucidated due to the scarcity of data. However it has been estimated that two-thirds of the infected population lives in tropics. The most heavily affected regions are Africa, China, and southeast Asia with prevalence rates of 5.3, 3.0, and 2.4 p. 100 respectively. In several countries mostly in Africa, prevalence rates range from 5 to 10 p. 100 or higher. Age is a major risk factor for infection. The classic transmission modes, i.e., blood transfusion and intravenous drug use, do not account for these high prevalence rates. Another mechanism could be parenteral injection under unsafe conditions. The most widespread genotypes in tropical areas are genotypes 1, 2, and 3. Other genotypes can be encountered locally including genotype 4 in black Africa and Egypt, genotype 6 in southeast Asia, and genotypes 1 and 3 in India. The association of hepatitis C with chronic liver disease has been the focus of several studies, mainly in Africa. The seroprevalence of virus C ranges from 2 to 55 p. 100 in cases of chronic hepatitis or cirrhosis and from 0 to 47 p. 100 in cases of hepatocellular cancer. Hepatitis C could be the underlying cause of 33 to 50 p. 100 of chronic liver diseases not linked to virus B. It is observed more often in patients with chronic hepatitis or cirrhosis than cancer in which virus B is dominant. Infection by both virus is rare without liver disease but is more frequent in patients with cancer than chronic non-tumoral liver disease.

[Study of a protocol of intra-articular analgesia after arthroscopy of the knee]. / Etude d'un protocole d'analgésie intra-articulaire après arthroscopie du genou.

The purpose of this study was to assess the analgesic effects of intra-articular injection of a morphine-bupivacaine combination following knee arthroscopy. 47 patients were evaluated. Knee arthroscopies were all performed under general anaesthesia, using propofol, alfentanil, isoflurane and nitrous oxide. Analgesic effects were evaluated by a visual analogic pain scale. Serum bupivacaine was measured during the first 8 postoperative hours. Analgesia was good in the immediate postoperative period, with minimal side effects. The serum bupivacaine levels were low. However the analgesic efficacy of intra-articular injection of morphine-bupivacaine should be corroborated through a double blind study.

Post-transcriptional regulation of nitrate reductase by light is abolished by an N-terminal deletion.

Higher plant nitrate reductases (NRs) carry an N-terminal domain whose sequence is not conserved in NRs from other organisms. A gene composed of a full-length tobacco NR cDNA with an internal deletion of 168 bp in the 5' end fused to the cauliflower mosaic virus 35S promoter and appropriate termination signals was constructed and designated as delta NR. An NR-deficient mutant of Nicotiana plumbaginifolia was transformed with this delta NR gene. In transgenic plants expressing this construct, NR activity was restored and normal growth resulted. Apart from a higher thermosensitivity, no appreciable modification of the kinetic parameters of the enzyme was detectable. The post-transcriptional regulation of NR by light was abolished in delta NR transformants. Consequently, deregulated production of glutamine and asparagine was detected in delta NR transformants. The absence of in vitro delta NR activity modulation by ATP suggests the impairment of delta NR phosphorylation and thereby suppression of delta NR post-translational regulation. These data imply that post-transcriptional control of NR expression is important for the flow of the nitrate assimilatory pathway.

Seroepidemiological survey of HTLV-I infection in French Polynesia, Cook Islands and Fiji.

Different population groups of French Polynesia, Cook Islands and Fiji were screened for Human T-Lymphotropic Virus type I (HTLV-I) antibodies. Among 1487 individuals sampled in French Polynesia, twelve were considered Western Blot (WB) indeterminate and one was considered WB-positive for HTLV-I infection. This positive subject originated from France and was a blood donor. Out of 196 Polynesians of the Cook Islands, one was WB-indeterminate. Among populations sampled in Fiji, one of 222 Melanesians was found WB-indeterminate and one of 211 Indians was WB-indeterminate.

Inhibition of tobacco nitrite reductase activity by expression of antisense RNA.

A tobacco nitrite reductase (NiR) cDNA and its corresponding gene were isolated from cDNA and genomic libraries. An NiR antisense mRNA was expressed in transgenic tobacco under the control of a double 35S promoter. Transformants were obtained on a medium containing ammonium as the sole source of nitrogen. One plant growing normally on ammonium but displaying drastically reduced development and chlorotic leaves when grown on nitrate as the sole source of nitrogen was studied further. This plant accumulated nitrite fivefold over wild-type level and showed reduced amounts of ammonium (11% wild-type level), glutamine (19%), and total protein (8%). NiR mRNA and activity were below detectable levels. Under these conditions, nitrate reductase (NR) activity and mRNA were overexpressed, suggesting that N-metabolites resulting from nitrate reduction are responsible for the repression of the expression of the NR gene, independently from the presence or absence of a functional NR protein.

[Goiter in Tahiti]. / Le goître à Tahiti.

The authors report on a prospective study about goitre in French Polynesia carried out in 1989, dealing with epidemiology and disease characterization in 39 patients. 1. Epidemiology of goitre in Tahiti; In schools: 517 children (236 boys and 281 girls) aged from 10 to 15. Prevalence rate is 1.55 p.c. (8/517); Adults: 226 adults (112 males and 114 females) aged from 50 to 65. Prevalence rate is 4.42 p.c. (10/226). 2. Case study on 39 Polynesian patients (38 females and 1 male) living in Tahiti (mean age: 35.6 years old) showing euthyroidic goitre, detected from 1989 April 1st and October 31; Goitre did not present in Tahiti any particularity. It is a pathology mainly feminine, at low evolution and late local consequences; In 3/4 of the cases, goitre is visible and more it is voluminous more modules are present; There is no iodine deficiency, and the mean value of iodine excretion (536 mcg/24 h) is very high in comparison with what is described in the literature; Presence of a high thiocyanatemia (greater than 100 mmol/l) is found in 1/4 of the patients; There is no correlation between consumption of foods well-known as cyanogenical ones and the level of thiocyanatemia; There is a correlation between the rate of thiocyanatemia and tabagism.

[Epidemiology of primary liver cancer in French Polynesia]. / Epidémiologie du cancer primitif du foie en Polynésie française.

Thirty-one cases of primary liver cancer recorded since 1980 to 1988 in French Polynesia are studied. Four risk factors are brought to the fore: male, more than 50 years old, birth in Austral archipelago and in this case AgHBs carriage. The relative risk for birth in Austral archipelago reach to 9.23. The relative risk for AgHBs carriers from this archipelago reach to 42.7. Costs of primary liver cancer and to immunization against hepatitis B virus are compared. Authors suggest to start an immunization program.