Monoclonal gammopathies in the adult population of Finistère, France.

Three hundred and thirty-four monoclonal gammopathies were detected in the sera of 30 279 adults from Finistère. Monoclonal gammopathies (MG) are more common in Finistère than in Paris and their distribution is not homogeneous. IgG paraproteins are particularly common in the northeast of Finistère whereas IgM paraproteins are more common in the southwest. Family studies and the high degree of inbreeding would support the hypothesis that there is a genetic predisposition to develop MG but the occurrence of paraproteins among three non-consanguineous couples seems to favour the existence of an environmental factor.

[Flow cytometric analysis of cellular DNA content in Barret's esophagus. A study of 66 cases]. / Analyse du contenu cellulaire en ADN par cytométrie en flux dans les endobrachyoesophages. Etude de 66 cas.

Dysplasia is the only marker for malignant potential in Barrett's esophagus. The histologic interpretation of dysplasia is sometimes difficult, particularly when attempting to distinguish dysplastic changes from those of a regenerating and inflammatory mucosa. In order to find an objective marker to identify patients with high risk of malignant transformation, the authors evaluated 497 biopsies from 66 patients with Barrett's esophagus with flow cytometry. The aim of the study was to correlate DNA content and proliferative abnormalities with histology. All biopsies classified histologically as negative for dysplasia had a diploid DNA content. The percentage of biopsies with an aneuploid DNA content increased with the histologic grade of dysplasia: 2 percent of indefinite dysplasia, 11 percent of low grade dysplasia, 44 percent of high grade dysplasia and 78 percent of biopsy specimens with cancer biopsies were aneuploid. Mean S and G2M fractions of diploid biopsy specimens increased with the severity of histologic changes. The S and G2M fraction threshold values that could differentiate patients that were negative for dysplasia from those with high grade dysplasia or cancer were 9 percent and 6 percent, respectively. Aneuploidy or G2M fraction greater than 6 percent was the best discriminating criteria between those two distinct groups of patients. All 6 patients with high grade dysplasia or cancer had aneuploid cell populations or increased G2M fraction, whereas none of the 35 patients whose biopsies were histologically negative for dysplasia had evidence of genomic instability or increased G2M fraction. Flow cytometric abnormalities were found in 10 out of 25 patients whose biopsies were classified as indefinite for dysplasia or low grade dysplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

[Monoclonal gammapathy in the adult population of Finistère (France). Results of an inquiry resting on 30,279 persons (author's transl)]. / Gammapathies monoclonales dans la population adulte du Finiestère. Résultats d'une enquête portant sur 30,279 sujets.

The study of 30,279 adult sera, most issued from Finistère, detected 334 monoclonal gammapathies. The analysis of the results discloses that monoclonal gammapathies appear more frequently in this district (Finistère) than in Paris' one and that their repartition is not homogeneous. Two areas seem to be more particularly affected: one in the north-east, where IgG paraproteins are particularly frequent and the other in southwest, more particularly touched by IgM. The role of a genetic tendency could be backed by a discovery of numerous cases of monoclonal gammapathies occuring in families, and the high rate occuring between "half brother and sisters", but the case study of three couples would be more in favor of an environmental stimulus.

[Recurrent ocular herpes simplex infection and HLA antigens; preliminary results (author's transl)]. / Herpès oculaire récidivant et antigènes HLA; étude préliminaire.

HLA-antigens of 80 patients with recurrent ocular herpes simplex infection were compared to a control population. HLA-B5 antigen was significantly more common in the first group. Several hypothesis are discussed in order to explain a relationship between recurrent ocular herpes simplex infection and HLA-antigens.

[Hormonal profile and HLA typing of adult subjects from 7 families with congenital adrenal hyperplasia caused by 21-hydroxylase deficiency]. / Profil hormonal et typage HLA des sujets adultes de 7 familles d'hyperplasie congénitale des surrénales par déficit en 21-hydroxylase.

Most members of seven families in whom one subject was known to have congenital adrenal hyperplasia due to 21-hydroxylase deficiency were haplotyped for HLA B antigen which was supposed to be linked to the defective gene. Heterozygous males (group 1, n = 9), and females (group 3, n = 8) were recognized. These had no clinical abnormalities. All heterozygotes, as well as eight normal males (group 2) and ten normal females (group 4) received in IM injection of Synacthen. Plasma samples obtained before (PRE) and three hours after (POST) the injection was assayed for cortisol, testosterone, androstenedione, 17-hydroxyprogesterone, and dehydroepiandrosterone. All steroids increased significantly after ACTH except for testosterone. The ratio cortisol/17-OHP (F/17-OHP) decreased in group 1. POST 17-OHP (ng/ml) (x +/- SEM) was higher and F/17-OHP lower in groups 1 and 3 respectively: (5.83 +/- 1.83, 60 +/- 20; 4.53 +/- 1.13, 81 +/- 34) than in groups 2 and 4: (1.95 +/- 0.72, 196 +/- 67; 1.94 +/- 0.65, 269 +/- 167). POST F levels were not different among groups. When the distributions were standardized, individual POST 17-OHP levels of heterozygotes were different from the mean POST 17-OHP of the respective normal group and vice versa. The two normal males from the affected families could also be separated from heterozygous but not from normal males.

[Mucoviscidosis: current diagnostic possibilities. Applications in perinatology]. / Mucoviscidose: de nouvelles possibilités diagnostiques. Applications en anténatalogie.

The gene of cystic fibrosis is localised on the long arm of chromosome 7. DNA probes placed close to the gene enable a study of restriction polymorphism to follow the transmission of the gene in index families. It is now possible to counsel those families, who already have an affected child, with an early antenatal diagnosis at ten weeks after the last period. In our personal experience, based on a study of the genotype of 48 families, 70% were informative when they were studied by two probes corresponding to the local pJ3.11 and met. When the latter probes Km19-XV2c were studied concurrently useful information was achieved in 96%. DNA analysis non enables the detection of the chromosome carrying the deleterious gene in practically every family where there is a child suffering from the disease.

[Anti-HBc in blood donors. Distribution by sex and age classes]. / Anticorps anti-HBc chez les donneurs de sang. Répartition par sexes et classes d'âge.

Among the 21,341 blood donors who gave their blood in 1990, 638 were anti-HBc positive. There is a significant difference between men and women who are 18 to 22 years old and those who are more than 50 years old. In the first case, this difference can be referred to the heterogeneity of the male population and in the second case, to the aftermath of military campaigns.

[Practical impact of instructions concerning AIDS]. / Impact pratique des instructions concernant le SIDA.

Following an inquiry to determine what measures has been taken since january 1984 in French Blood Centers to avoid transmission of AIDS by blood, answers from 49 % of the centers, representing 75 % of the blood collection in France were analyzed. Due to the absence of a biological marker, only information given to blood donors, unpaid in France, permitting spontaneous autoexclusion had been used to screen donors in blood center. Direct questioning of donor for risk factors before taking blood raised numerous problems in donors of whole blood, but could be satisfactorily implemented in cytapheresis and plasmapheresis donors mainly because of closer human contact between volunteers and the medical staff.

[The micro-computer card. Possible applications to transfusion from A to Z]. / La carte à micro-calculateur. Applications possibles à la transfusion de A à Z.

Following characteristics of micro-computer cards: inaccessibility to selected secret information; strong resistance to aggressive external agents; impossibility of altering stored data without destroying it; instant reading and reproduction by authorized services; make them a perfect material for building up individual records of civil and biological data. Their application to blood transfusion allows increased safety not only for blood donation registrations, but above all when transfusion takes place; they may also be used as credit cards for health expenditures. They consequently serve as real LIFE cards.

[Bisalbuminaemia. Three aetiologies: hereditary mutation, antibiotic therapy, pseudocyst of the pancreas (author's transl)]. / Les bisalbuminémies. Trois étiologies: mutation héréditaire, antibiothérapie, pseudo-kyste du pancréas.

The demonstration of a double albumin line on blood protein electrophoresis has important practical applications: after eliminating congenital bisalbuminaemia, with no pathological consequences, this abnormality may make it possible to detect an overdose of beta-lactamines, requiring the interruption of treatment, or a serious effusion of pancreatic origin justifying surgery.

[Results of a survey on post-transfusional malaria in France between 1960 and 1974]. / Résultats d'une enquête sur le paludisme post-transfusionnel en France entre 1960 et 1974

This inquire demonstrated that transfusion malaria was not so rare as we thought. So 56 cases have been numbered between 1960 and 1974, and probably they do not reflect exactly the real situation. In our country, plasmodium falciparum, specifically responsible of the most serious accidents, is the form most frequently incriminated and its frequency increases among the years: 76,1% of the infects between 1970 and 1974. At last we have confirmed that a prevent of those accidents must consider as a subject any one having resided in an impaluded country, and that implies a constant knowledge of the epidemiologic map of this parisitism. This prevent will be increased so that the transfusion malaria will not get a illness disease in France.

[Transfusional malaria in France (1960-1979) (author's transl)]. / Paludisme transfusionnel en France de 1960 à 1979.

Transfusional Malaria is not a rare condition in France: in the past 20 years, 110 cases were cited in the literature and/or reported to us in answers to a recent questionnaire. Of these, 24 cases occurred between 1960 and 1969 and 78 between 1970 and 1979. This apparent increase in occurrence in the past decade is most probably due to the increase in the number of transfusions of whole blood or fresh fractions containing infected erythrocytes, although population exchanges with inter-tropical Africa may also play a preponderant role. Our study confirms that Plasmodium falciparum is the most prevalent pathogen responsible for this condition in France; it caused 84% of cases in the past five years. We think this point must be taken in account by the legislator.

[Distribution of HLA antigens among the population of Finistère (France) (author's transl)]. / Distribution des antigènes HLA dans la population du Finistère.

We have studied by using HLA system, 200 people, without filiation but having the same geographic origine (Finistère). The results have been compared with those measured for Parisian and Basque population. A significantly decrease of antigen A29, B18 and BW16 frequency have been observed in the population from Finistere. But, antigen B8 and B27 seems to be more frequent than in population from Paris. A linkage desequilibrium is described for A1-B8 and A3-B7 haplotypes as in population from Paris; but the desequilibrium for A11-B5 seens to be characteristic of population from Finistere.

[Distribution of HLA antigens among the population of Finistère (France) (author's transl)]. / Distribution des antigènes HLA dans la population du Finistére.

We have studied by using HLA system, 200 people, without filiation but having the same geographic origine (Finistère). The results have been compared with those measured for Parisian and Basque population. A significantly decrease of antigen A29, B18 and BW16 frequency have been observed in the population from Finistere. But, antigen B8 and B27 seems to be more frequent than in population from Paris. A linkage desequilibrium is described for A1-B8 and A3-B7 haplotypes as in population from Paris, but the desequilibrium for A11-B5 seens to be characteristic of population from Finistere.

[Acquired deficit in factor X associated with amyloidosis. One case (author's transl)]. / Déficit acquis en facteur X associé à une amyloïdose. Un cas.

A 75-year-old woman developed a haemorrhagic syndrome due to an acquired deficit in factor X whic resulted in death from gastrointestinal bleeding. This deficit was associated with primary amyloidosis. The relationship between the two conditions, the particular features of the haemostatic picutre and the ineffectiveness of replacement therapy are discussed.

HLA antigens and monoclonal gammapathy.

Despite the strict criteria required to distinguish Multiple Myeloma (M.M.) or Waldström's Macroglobulinemia (W.M.) from Benign Monoclonal Gammapathy (B.M.G.), nosological frontiers are still unclear and accordingly justify a comparative serological study of M.M., W.M., and B.M.G. patients.

[Release of diethyl-2-hexyl phthalate from stored blood on contact with polyvinyl chloride]. / Relargage du di-(éthyl-2, héxyl) phtalate dans le sang conservé au contact du chlorure de polyvinyle.

Softness and flexibility of PVC are due to the addition of plasticizers in high concentration; the most used of them for blood storage bags is DEHP. In this work, a method for labelling DEHP with 14C from 14C phtalic anhydrid is given. A piece of PVC from a commercial blood bag is labelled, in our laboratory, with 14C DEHP and used to follow the kinetics of DEHP leaching in blood during storage. It is also used to study the influence of some parameters such as lipids amount of blood, shaking, and plastic sterilisation on this leaching. DEHP leaching is a three steps phenomenon and the level is not correlated to lipids content of blood. Thermal treatment of PVC and shaking have an influence on leaching. DEHP is not metabolised during blood storage at 4 degrees C and can not be detected as free molecule; it is absorbed on plasmatic proteins.