[Pathological fracture revealing an osseous histoplasmosis. A case report on a 60-year patient]. / Fracture pathologique révélant une histoplasmose osseuse. A propos d'une observation chez une patiente de 60 ans.

The authors report a new case of African Histoplasmosis in a 60-year-old patient. It was an humeral localization revealing a pathological fracture which grew into an extension of osteolysis and a cutaneous fistulization likely to be a malignant bone tumor. The case has been diagnosed by surgical biopsy and histological analysis. Its antifungal treatment in progress resulted in the drainage of the out-flow that should permit the bone reconstruction by graft. The authors stress on the need to focus on this affection whenever, in a tropical area, one is faced with any chronic bone fistula that cannot positively be cured in spite of sound medical cares.

An atypical aortic atherosclerotic lesion in cynomolgus monkeys during hypercholesterolemia: a protection by smooth muscle cells against advanced lesions?

This study focuses on the fortuitous discovery of an atypical atherosclerotic lesion in four of 49 male adult cynomolgus monkeys (macacus fascicularis) which were maintained for a long time at a high level of hypercholesterolemia, and in seven of 19 female cynomolgus monkeys examined from the second to the 24th week of hypercholesterolemic diet: this lesion was in formation or already mature during this period of diet. This atypical lesion was formed by a collagen and elastic network surrounding synthetic smooth muscle cells without fibrofatty or fibrous plaques. Lipids were occasionally seen in the inner intima. The lesion appeared early (from the third week of diet). Once established, its morphology did not change. It became more extensive, but was not complicated by lipid overload in spite of prolonged, permanent hypercholesterolemia. This response to hypercholesterolemia is interesting because the activity of the smooth muscle cells differs from that observed in the classic lesion: they intervene earlier, their replication is very marked and rapid, their elastin secretion is greater and remains constant over time, and their phagocytic properties are reduced. This experimental study examines the installation and the maintenance of this lesion and raises the problem of its origin.

[The first Congolese case of cervical clear cell adenocarcinoma]. / Première observation congolaise d'un adénocarcinome à cellules claires du col de l'utérus.

The authors report the first Congolese case of uterine cervix clear cell adenocarcinoma in a menopausal multipara, whose mother had not been treated by diethystilboestrol (DES). The histological diagnosis was made on embedded-paraffin samples, stained by HE and PAS. Discharged from hospital on parents' request in order to be on infusion and brew-based traditional treatment, the patient died at home two months after diagnosis.

[Anatomopathologic diagnosis of parasitosis in Congo]. / Le diagnostic anatomopathologique des parasitoses au Congo.

In the part ten years, 9,650 anatomopathologic examinations have been carried out in the National Laboratory of Histopathology for Public Health in Brazzaville: 250 cases of parasitic infestation were diagnosed. In order of frequency were noted; 144 cases of bilharzia due to Schistosoma haematobium with 75 genito-urinary localisations and 51 appendicular cases, 31 cases of onchocercosis with a majority of subcutaneous nodules (17), 17 cases of digestive helminthiasis all locate in the ileo-caecal-appendix and discovered during systematic appendicular exploration, 13 cases of colitic or recto-sigmoidal amebiasis. These results point out 68 cases of appendicular parasitism. This should be in favour of more systematic anatomopathological examination of the ileo-caecal appendix both in tropical and in temperate regions.

[Repair of the connective tissue in a non-sutured skin wound]. / La réparation conjonctive d'une plaie cutanée non suturée.

During the healing of a second intention wound, granulation tissue is built up during the inflammatory and detersive phase which commences in the wound edges as soon as the loss of substance is created. Granulation tissue becomes scar tissue via connective and vascular proliferation and epidermization takes place concurrently. The origin of the fibroblasts composing the granulation tissue is debated: monocytes or fibroblasts from the wound edges? Ultrastructural and immunohistochemical data from studies of experimental wounds in the pig and the monkey make it possible to determine their origin and follow their progress. These cells originate from the fibroblasts of the wound edges and become undifferentiated cells which multiply and migrate to reach the loss of substance. There they become activated fibroblasts and contribute to repairing the loss of substance by secreting fibronectin and type I and type III collagen. As differentiated fibroblasts and myofibroblasts, they remodel and contract scar tissue.

[The fibroblast]. / Le fibroblaste.

The fibroblast, major cell of connective tissue, secretes the various elements of interstitium: collagens, proelastin, glycoproteins and proteoglycans. It maintains the turnover of these structures and intervenes, also, in the cholesterol LDL metabolism. These various properties explains its different morphological aspects. In young patients, it is an active secretory cell. Its voluminous cytoplasm contains a well developed endoplasmic reticulum and others organelles. It is always in close connection with collagen fibers. The cytoskeleton consists of a fine network visible throughout the cytoplasm and near of secretory areas. In adult patients, the fibroblast keeps the same characteristics, but the endoplasmic reticulum is poorer than in young subjects. In old patients (physiologic or pathologic ageing) it becomes a quiescent cell. It is a flattened cell; its cytoplasm contains a poorly developed endoplasmic reticulum and numerous dense bodies. Its cytoskeleton is characterized by voluminous fascicles or bundles of microfilaments into large cytoplasmic areas. This modified fibroblast has not direct contact with collagen. In all cases, various stimuli can: activate the fibroblast. Then this cell becomes a large cell with very abundant reticulum endoplasmic, ribosomes, polysomes, and numerous secretory vesicles. It is an active secreting cell; becomes fibroblast and; change into myofibroblast by presence of myofilaments in its cytoplasm.

[Experimental atherogenesis: early wall changes in the cynomolgus monkey]. / Athérogénèse expérimentale: modifications pariétales précoces chez le singe cynomolgus.

The early parietal changes in atherogenesis are characterized by: Increase of endothelial permeability with proteoglycans and L.D.L. storage. Lysis of internal elastic lamellae. Penetration into sub-endothelial space of monocytes macrophages and transformation into foam cells. Parietal fibrosis and proliferating smooth muscle cells play a role in the extension of lipid deposit.

[Entomophthoramycosis: a case report of a Congolese child with rapid regression using ketoconazole]. / Basidiobolomycose: une observation chez un enfant congolais avec régression rapide sous kétoconazole.

We report the second Congolese case of subcutaneous entomophthoramycasis, a rare tropical disease expressed as cellulitis. Despite characteristic clinical features, the diagnosis for this twelve-year old child was confirmed four years after the beginning of the disease. Dramatic clinical improvement was observed within the first month of treatment with ketoconazole.

[Pneumocystis carinii pneumonia in patients with AIDS in the Congo]. / Pneumocystoses observées au Congo chez les malades atteints de SIDA.

Forty-five bronchoalveolar lavages (BAL) were performed in Brazzaville in AIDS patients who did not expectorate acid- and alcohol-resistant bacilli (AARB). All patients presented with respiratory symptoms (cough, dyspnoea or chest pain), and all but 6 of them had abnormal radiography of the chest. Four cases of pneumocystosis were diagnosed (9%); 3 of these patients had interstitial pneumonia and dyspnoea. No AARB was found at microscopic examination of BAL which showed Pneumocyctis carinii; no culture on Löwehstein's medium could be made. The authors consider that the low prevalence of pneumocystosis in Africa, compared with industrial countries, is due to a smaller dissemination of the parasite in Africa rather than to immunodepression which is known to be more pronounced in AIDS patients from industrial countries.

Fibroblasts in dermal tissue repair. Electron microscopic and immunohistochemical study.

The cellular dynamics of dermal regeneration were studied in nonsutured cutaneous wounds of female pigs and monkeys with electron microscopy and immunohistochemistry to demonstrate the origin and the development of fibroblasts forming granulation tissue. The results indicate that fibroblasts do not originate from histiocytes but from resting fibroblasts in the wound margins. These resting fibroblasts first become undifferentiated mesenchymal cells termed "X" cells. The "X" cells then multiply, migrate, and invade the wound defect in approximately 3 days, transforming into highly active fibroblasts. The active fibroblasts are endowed with the capacity of further transformation to fibroclasts and myofibroblasts. The latter two cell populations then effectively cause remodeling of newly formed tissue and contraction of wound margins.

Coronary atheroma in the cynomolgus monkey: predictive value of serum and cutaneous lipoprotein measurement.

Hyperlipaemia was induced by a high fat diet in 11 cynomolgus monkeys. Morphological study of coronary arteries was carried out in 5 coronary samples from these 11 monkeys. The degree of arterial involvement was compared with the serum and cutaneous lipoprotein levels. These experimental data confirm that cutaneous apoprotein B measurement is the best marker for evaluation of coronary atheroma.