[Cutaneous mucormycosis in a diabetic woman. Diagnostic and therapeutic problems]. / Mucormycose cutanée chez une diabétique. Problèmes diagnostiques et thérapeutiques.

We report a new case of cutaneous mucormycosis in a diabetic woman. The major favouring circumstances are found in this patient: ketoacidosis diabetes, use of bandages, local corticosteroid applications, renal insufficiency. The diagnosis, rarely made on the clinical aspect, is based on the histological and mycological data. A trial of treatment by ketoconazole has been carried out, but without success. The usual treatment by intravenous amphotericine B has been successful.

[Inflammatory pseudotumors of the liver. Apropos of a pediatric case with radiological and ultrasonographic features and anatomopathological correlations]. / Les pseudotumeurs inflammatoires du foie. A propos d'un cas pédiatrique avec aspects radiologiques et échographiques et corrélations anatomopathologiques.

Inflammatory pseudo-tumor of the liver (IPT) are benign encapsulated masses. IPT or inflammatory myofibroblastic tumor is a myofibroblastic proliferation with chronic inflammatory cell infiltration of unknown origin. A four-year-old girl, with cutaneous flushing of the face and biological inflammatory syndrome was referred for abdominal investigation. Ultrasound examination showed a 5-cm mass located in the anterior segment of the right hepatic lobe. After abdominal CT showing slightly vascular feature of this right hepatic mass, diagnosis was made through percutaneous US-guided fine needle biopsy. Surgical resection was performed and pathologic examination of the mass confirmed preoperative diagnosis. Clinical outcome was good.

[Pleuro-pericardial cyst in children]. / Kyste pleuro-péricardique de l'enfant.

We report the case of 3 1/2 year old child presenting a left pleuropericarditic cyst causing febrile cough and an opacity of the left lower lobe of the lung. We underline the importance of computed tomography of the thorax allows differential diagnosis with encysted effusion. Surgical treatment rarely indicated in pleuropericarditic cysts has stopped respiratory symptoms.

[Cavernous hemangioma of the bladder in children. Apropos of a case]. / Hémangiome caverneux de la vessie chez l'enfant. A propos d'un cas.

Benign tumours of the urinary bladder are very rare in children. A new case of cavernous haemangioma of the bladder is reported in a five year old boy presenting with macroscopic haematuria. This tumour is a hamartoma which usually presents with painless haematuria. In about 30% of cases, the bladder tumour is associated with angiomatous lesions in other parts of the body. The diagnosis may be suspected on intravenous urography or ultrasound examination, but it is generally made at cystoscopy. Biopsy and transurethral resection must be avoided because of the risks of haemorrhage. Partial cystectomy appears to be the most effective method of treatment.

[Use of 99mTc-tetrofosmin scintigraphy in the diagnosis of patients with hyperparathyroidism]. / Utilización de la gammagrafía con 99Tc-tetrofosmin en el diagnóstico de pacientes con hiperparatioidismo.

UNLABELLED: The aim of the work was to study the diagnostic value of 99mTc-tetrofosmin to localize anomalous parathyroid glands in patients with hyperparathyroidism. METHODS: We have studied 33 patients: 12 with primary and 21 with secondary hyperparathyroidism, 9 of them renal graft recipients. Sixteen patients underwent surgery, 12 with primary and 4 with secondary hyperparathyroidism. All patients were injected with 740 MBq of 99mTc-tetrofosmin. Subsequently at 15, 30 and 60 minutes images were acquired for 300 seconds using a pin-hole collimator. A pertechnetate thyroid scintigraphy was obtained in 7 cases (24-48 h later) when the thyroid activity made difficult the identification of parathyroid glands. RESULTS: In the group of patients with primary hyperparathyroidism, all cases showed a focal uptake in lower right localization. In the secondary hyperparathyroidism group, 12 patients showed diffuse tracer uptake in two or more glands and histology confirmed hyperplasia in four of them. Seven cases showed a greater focal uptake in a gland: two of them were renal graft recipients and three were chronic renal failure cases in haemodyalisis, and two were evaluated postsurgery showing uptake in the remnant parathyroid gland. The two remaining patients had a normal scintigraphy and corresponded to two false negative cases. In conclusion, our results suggest that 99Tc-tetrofosmin may be used as a suitable tracer for preoperative detection and screening of anomalous parathyroid glands.

[Contusions of the abdomen in children]. / Les contusions de l'abdomen chez l'enfant.

Marked progress in the treatment of abdominal contusions in children over the last few years is due to the development of conservative surgery to the spleen and even possible abstention from operation following splenic injuries. The reliability of paraclinical exploratory procedures has increased, and ultrasound and CT scan imaging have reduced the need for peritoneal puncture-lavage. However, and unresolved problem concerns associated visceral lesions, and although treatment of isolated splenic injuries is fairly well detailed that of hepatic lesions raises difficulties because of lack of data on exact location of lesions and the anatomical damage produced. Injuries provoked and treatment instituted are described in relation to children admitted for severe abdominal contusions between 1970 and 1985. Since 1984, 52 children have undergone initial ultrasound imaging and only 6 (8%) peritoneal puncture-lavage procedures were necessary. Ultrasound is of value for diagnosis of a hemoperitoneum but of very limited use for defining sites of lesions, a more refined diagnosis being established by computed tomography. Finally, routine simplified emergency intravenous urography is performed in any child with severe abdominal contusion with even microscopic hematuria to detect possible subadventitial rupture of renal artery.

[Consequences of ischemia of the terminal ileum in the rat: influence of exclusive parenteral nutrition]. / Conséquences de l'ischémie de l'ileon terminal chez le rat: influence de la nutrition parentérale exclusive.

An experimental model of ischemia of the distal part of the small intestine has been realized in rats. This experimental study realizes a moderate ischemia of the distal part of ileum loops, by vascular ligations. An important decreasing of the intestinal motility is observed 2 days after the operation, by in vitro study. The motility became normal 7 days after. During this time a microbiological evaluation revealed an important increasing of anaerobic germ in the distal ileum. Total parenteral nutrition preserves the intestinal motility and the endoluminal flora. Ischemia of the small bowel is an important component of enterocolitis by modification of the peristalsis. The total Parenteral Nutrition in such condition seems to protect the intestinal flora.

Plasma and tissue fibronectin in diabetes.

Plasma fibronectin was determined by laser immunonephelometry in controls (90 women, 66 men) and 167 diabetic patients between 10 and 60 years of age, 72 insulin-dependent males, 45 insulin-dependent females, 29 noninsulin-dependent males and 21 non-insulin-dependent females. The distribution and intensity of immunofluorescent tissue fibronectin were also studied in the patients using skin biopsies. The diabetic patients had a significantly lower plasma fibronectin level than the controls of the same age-groups and did not exhibit the strong age-dependent increase found for controls. This was true for both females and males, and especially pronounced for the insulin-dependent male patients below 45 years. The duration (less or more than 10 years), and control of diabetes (judged by the glycosylated hemoglobin A1C levels, presence or absence of retinopathy), had a lesser influence on plasma fibronectin levels, although the duration of the disease tended to increase plasma fibronectin levels. Tissue fibronectin appeared to increase as estimated by the intensity and distribution of immunofluorescence in the papillary dermis, and in vascular and dermo-epidermal basement membranes, suggesting an inverse variation of tissue and plasma fibronectin in diabetes.

[Diverticulum of the stomach in children. Apropos of a case of congenital diverticulum]. / Diverticule de l'estomac chez l'enfant. A propos d'un cas de diverticule congénital.

We describe a patient with a large diverticulum of the gastric fundus disclosed by an episode of epigastric pain. Hematemesis occurred, requiring surgical removal of the diverticulum. Gastric diverticula are uncommon embryologic anomalies that are usually asymptomatic. Surgical treatment is necessary if a complication develops.

Distribution of fibronectin in diabetic skin.

Distribution of the fibronectin (FN) present in the forearm skin was studied in 23 controls and 34 insulin dependent diabetics. All the subjects were lean males under 50 years. After biopsy FN was studied by an indirect immunofluorescence technic. A semi-quantitative evaluation was attempted by giving a score to the fluorescent intensity read at the three following sites: vascular basement membranes, papillary dermis, and the dermo-epidermal basement membranes. We found an increased amount of FN-immunofluorescence in diabetic skins. This increase was seen not only in vascular basement membranes but also at the two other sites. No correlation was found between apparent FN levels and the duration or equilibration of diabetes. These results are consistent with other findings of the literature concerning the involvement of the intercellular matrix in diabetes.

An Explanation for Earth's Long-Term Rotational Stability

Paleomagnetic data show less than approximately 1000 kilometers of motion between the paleomagnetic and hotspot reference frames-that is, true polar wander-during the past 100 million years, which implies that Earth's rotation axis has been very stable. This long-term rotational stability can be explained by the slow rate of change in the large-scale pattern of plate tectonic motions during Cenozoic and late Mesozoic time, provided that subducted lithosphere is a major component of the mantle density heterogeneity generated by convection. Therefore, it is unnecessary to invoke other mechanisms, such as sluggish readjustment of the rotational bulge, to explain the observed low rate of true polar wander.