Lesions of the ovary with T1-hypersignal.

Pelvic magnetic resonance imaging (MRI) has been used successfully to diagnose ovarian masses that cannot be adequately evaluated using pelvic ultrasound. T1 hyperintensity is a common finding in an ovarian mass and has important diagnostic implications. The aims of this review are to list the substances that may produce high signal intensity on T1-weighted MRI, to explain the physical basis for causes of the high T1 signal intensity, and to describe common and uncommon T1 hyperintense ovarian lesions. The morphological findings, the imaging features of the additional sequences, and clinical variables can help in the differential diagnosis, and in some cases, enable a specific diagnosis, leading to appropriate management of the patient.

[Pulmonary complications of Chronic Granulomatous Disease]. / Complications pulmonaires de la granulomatose septique chronique.

Chronic Granulomatosis Disease (CGD) is an inherited immune deficiency due to a mutation in the genes coding for the subunits of the NADPH oxidase enzyme that affects the oxidative capacity of phagocytic cells. It is characterized by increased susceptibility to bacterial and fungal infections, particularly Aspergillus, as well as complications associated with hyperinflammation and granulomatous tissue infiltration. There exist two types of frequently encountered pulmonary manifestations: (1) due to their being initially pauci-symptomatic, possibly life-threatening infectious complications are often discovered at a late stage. Though their incidence has decreased through systematic anti-bacterial and anti-fungal prophylaxis, they remain a major cause of morbidity and mortality; (2) inflammatory complications consist in persistent granulomatous mass or interstitial pneumoniae, eventually requiring immunosuppressive treatment. Pulmonary complications recurring since infancy generate parenchymal and bronchial sequelae that impact functional prognosis. Hematopoietic stem cell allograft is a curative treatment; it is arguably life-sustaining and may limit the morbidity of the disease. As a result of improved pediatric management, life expectancy has increased dramatically. That said, new challenges have appeared with regard to adults: difficulties of compliance, increased inflammatory manifestations, acquired resistance to anti-infectious therapies. These different developments underscore the importance of the transition period and the need for multidisciplinary management.

Serum interleukin-10 in acquired immunodeficiency syndrome lymphoma patients. Seroco-Hemoco Study Group.

Interleukin-10 (IL-10) has multiple effects on lymphoid development, particularly as a stimulant of activated B-cell proliferation and differentiation. It is thought that IL-10 might play a role in the development of B lymphoid malignancies based on the observation that lymphomatous tissues from HIV+ patients contain numerous cells containing IL-10 mRNA as well as IL-10 protein. The aim of this study using an Elisa test was to analyze IL-10 in the serum of 18 HIV+ patients with non Hodgkin's B lymphoma (NHL) and compared the presence of this cytokine in the serum of 18 HIV+ patients without NHL. In this comparative study we also considered the different parameters such as the mode of contamination, sex, age and number of CD4 cells. 44% of the patients with HIV-related NHL had significant levels of IL-10 (> or = 12 pg/ml) in their serum, in comparison to the patients without NHL who did not show detectable serum IL-10.

[Cystic adenoid carcinoma of the larynx: two cases]. / Carcinome adénoïde kystique du larynx. A propos de deux cas.

Adenoid cystic carcinoma is the most common malignant tumor of the minor salivary glands in the head and neck. Laryngeal localization is rare due to the poor distribution of the accessory salivary glands in this area. It arises exceptionally before 20 years and no risk factor is known. Diagnosis is a histological finding because symptoms do not differ greatly from other laryngeal tumors. Histological features, stage, quality of tumor resection and nerve invasion are prognostic factors. These tumors grow slowly and local recurrence or systemic metastasis are exceptional. Surgery is the treatment of choice but outcome is always fatal, after a long clinical course in many patients.

[Value of the retraining of patients with laryngectomy at special centers]. / Intérêt de la rééducation des laryngectomisés en centre spécialisé.

The authors tell about the interest of a voice therapy in a special center for the total laryngectomised patients. The oesophageal voice therapy is followed in the collaboration of orthophonist, psychologist and a logopedist doctor. The patient is positioned to insert himself socialy. The medical control is realised by an oto-rhino-laryngologist. After the final of voice therapy (4 to 6 weeks), the laryngectomised patient will continue the exercises helped with an logopedist.

[A case history of lateral cervical tumor]. / Histoire d'une tumeur cervicale latérale.

The authors report on the observation of a voluminous aneurysm of the common carotid that had developed over 20 years in an 88-years old female patient. This was treated surgically by a Gore-Tex carotid graft with perfectly straightforward operative sequellae. With respect to this case, the author briefly review the semiology and diagnosis of aneurysms of the neck.

[Non invasive naso-sinusal aspergillosis. Contribution of endonasal microsurgery. Apropos of 16 cases]. / Aspergillose naso-sinusienne non invasive. Apport de la micro-chirurgie endonasale. A propos de 16 cas.

The authors report on 16 new cases of non-invasive nasosinusal aspergillar sinusitis over a period of 4 years. They stress the importance of the local inducive factors in such apparently healthy patients. The value of treatment by endonasal microsurgery is underlined, enabling the positive diagnosis and cure of these chronic sinusites that do not respond to medical treatment.

[Thyroid surgery: risks and complications. Apropos of 134 cases]. / Chirurgie thyroïdienne: risques et complications. A propos de 134 cas.

From a retrospective covering 134 patients operated from the thyroid gland, the authors have tempted, over at least a year's survey, to clarify the incidence of the main post-operative complications. Recurrent laryngeal nerve paralysis and permanent hypoparathyroïdism are the two major risks, with a respective percentage of 2.25% and 7.4%. After a general review of publications the discussion is focused on the etiology of the different complications already found and on the possible means to avoid them or, at least, to minimize them.

[Sudden deafness: different pathologies and results of treatment by normovolemic hemodilution]. / Surdités de survenue brutale: différentes pathologies et résultats d'un traitement par hémodilution normovolémique.

The authors report 75 cases (including 4 children) treated between 1983 and 1988 by normovolemic hemodilution, corticoids and vasodilators for deafness of various origins. This treatment has an action in deafness of brutal occurrence and all the more so when applied early. The youngest subjects, with viral disorders and the oldest with vascular disorders receive less favourable prognoses. The main risk factors found are represented by a previous vascular and otological history. When hemodilution fails, it is best to associate hyperbaric oxygen therapy rapidly.

[Ankyloglossum superius: apropos of a case]. / Ankyloglossum superius: à propos d'une observation.

The authors report a rare observation of ankyloglossum superius i.e. the attachment of the tip of the tongue to the anterior part of the palate, with an ectrodactyl of the fingers and toes. Following a review of the literature, this provide an opportunity to recall this pathology, the physiopathogenesis of which remains unknown falling within syndromes of malformation affecting both the mouth, face and limb, namely orofacio-digital syndromes and syndromes of hypogenesis of the mouth, jaw and limbs.

[An atypical case of Wegener's disease]. / Un cas atypique de Maladie de Wegener.

The authors report on a case of Wegener's syndrome diagnosed fortuitously by the discovery of a perforation of the nasal septum during a bronchial fibroscopy for monitoring of a pulmonary fibrosis. In addition to the late appearance of the nasal perforation, the clinical picture includes classic polyvisceral impairment with pulmonary fibrosis, polyarthralgias and renal insufficiency. After 21 months of treatment, a stabilization of the visceral lesions was recorded, with the all but total disappearance of the E.N.T. lesions.

[An atypical presentation of Kikuchi-Fujimoto disease]. / Maladie de Kikuchi-Fujimoto: une présentation atypique.

INTRODUCTION: Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease) is a rare clinical entity characterized by the association of enlarged lymph nodes in the posterior cervical region and fever. The disease is more frequent in young women. CASE REPORT: We report a 41-year-old African patient who presented with atypical features of Kikuchi's disease including cutaneous lupus, haemophagocytosis, and lymphocytic meningitis. The ethnic origin and the clinical presentation were initially suggestive of tuberculous meningitis. However, microbiological analyses remained negative, histological findings were suggestive of Kikuchi's disease and HHV6 DNA integration was documented in our patient. CONCLUSION: Kikuchi's disease should be suspected in an African patient when lymphocytic meningitis is associated with enlarged cervical lymph nodes, hemophagocytosis and HHV6 DNA integration.

Synchrotron radiation X-ray phase micro-computed tomography as a new method to detect iron oxide nanoparticles in the brain.

PURPOSE: The purpose of this study was to introduce synchrotron radiation X-ray phase computed tomography (SR-PCT) as a new method of visualizing ultrasmall superparamagnetic particles of iron oxide (USPIO) distribution into the brains of mice with neuroinflammation. PROCEDURES: The sensitivity of the technique was assessed by performing back-to-back SR-PCT and magnetic resonance imaging (MRI) in mice stereotaxically injected with a range of USPIO concentrations. Eight mice with cerebral ischemia were then intravenously injected with USPIOs and imaged back-to-back with MRI and SR-PCT. RESULTS: SR-PCT proved sensitive enough to detect iron in nanomolar quantities. In stroke-induced animals, SR-PCT showed hyperintense areas in the regions of MR signal loss and immunostaining for macrophages. SR-PCT, moreover, identified brain anatomy as clearly as histology, without the need for sectioning or staining, with an examination time of 44 min per brain at an isotropic spatial resolution of 8 µm. CONCLUSION: SR-PCT has potential for cellular imaging in intact brain, with unequaled neuroanatomy.

[Impact of malaria on HIV infection]. / Impact du paludisme sur l'infection par le VIH.

Malaria and HIV are two major public health issues, especially in sub-Saharan Africa. HIV infection increases the incidence of clinical malaria, inversely correlated with the degree of immunodepression. The effect of malaria on HIV infection is not as well established. Malaria, when fever and parasitemia are high, may be associated with transient increases in HIV viral load. The effect of subclinical malaria on HIV viral load is uncertain. During pregnancy, placental malaria is associated with higher plasma and placental HIV viral loads, independently of the severity of immunodeficiency. However, the clinical impact of these transient increases of HIV viral load remains unknown. Although some data suggests that malaria might enhance sexual and mother-to-child transmissions, no clinical study has confirmed this. Nevertheless pregnant women and children with malaria-induced anemia are also exposed to HIV through blood transfusions. Integrated HIV and malaria control programs in the regions where both infections overlap are necessary.