[Hepatic epithelioid hemangioendothelioma: review of 3 cases]. / Hémangioendothéliome épithélioïde hépatique: à propos de 3 cas.

Hepatic epithelioid hemangioendothelioma (EHE) is a rare neoplasm of vascular origin. EHE is an intermediate-grade malignancy, between benign hemangioma and angiosarcoma, with variable aggressiveness. Involvement often is multinodular simulating metastases from a primatry extra-hepatic malignancy leading to delays in diagnosis. We report the imaging features in three cases of histologically proven hepatic EHE. The imaging features suggestive of EHE will be emphasized, especially for multinodular lesions suggesting liver metastases in patients with no known primary.

[Percutaneous retrieval of intravascular foreign bodies]. / Retrait percutané de corps étrangers intravasculaires.

Percutaneous extraction of intravascular foreign bodies is becoming an increasingly common technique. It is an effective and low aggressive way to avoid surgery. We report four new cases of percutaneous retrieval.

["Méta-analyse": a web-based tool for research and analysis of radiology papers]. / "Méta-analyse" : un outil de recherche et d'analyse d'articles de radiologie sur le web.

Finding articles providing answers to specific clinical questions is greatly facilitated by the availability of indexed Medline abstracts using the Pubmed search engine. Nonetheless, the large number of references sometimes requires a time-consuming review of multiple abstracts. In order to streamline the search process, we have created a tool facilitating the search and review of these abstracts. We present here this tool named "Méta-analyse".

[Isolated synovial chondromatosis of the subacromial bursa: report of a new case and review of the literature]. / La chondromatose synoviale isolée de la bourse sous acromiodeltoïdienne: un nouveau cas et revue de la littérature.

Synovial chondromatosis is a rare metaplasia of the synovium of unknown etiology that may involve occasionally the subacromial bursa. We report a new case diagnosed by ultrasound in a 30-year-old man and we present pathogenetic, diagnostic and therapeutic features of this disease with a literature review.

[Ectopic thyroid]. / Thyroïde ectopique.

PURPOSE OF STUDY: Ectopic thyroid is defined as thyroid tissue not located anterolaterally between the second and the fourth tracheal cartilage. This anomalous localization results from abnormal embryologic development and/or migration of the gland. The purpose of this study is to demonstrate the role of imaging in the preoperative evaluation of ectopic thyroid. MATERIAL AND METHODS: A 13-year-old girl with no other significant medical history, consulted for dysphonia, fullness in the throat and breathing difficulties. Examination of the oral cavity and oropharynx showed a large mass attached to the base of the tongue, the mass was evaluated by ultrasanography, computed tomography, magnetic resonance imaging and scintigraphy. RESULTS: Ultrasound sonography showed a well-defined hypoechogenic mass in the posterior end of the tongue. Scintigraphy showed hyperfixation at the base of the tongue with no fixation in the normal thyroid site. Computed tomography scan revealed a spontaneously hyperdense spherical basilingual mass with a high enhancement after contrast injection. In MRI, the mass was isointense with the muscle in T1-weighted images and hyperintense in T2 weighted images. CONCLUSION: Ectopic thyroid must be evoked in the presence of any basilangual mass. Scintigraphy and ultrasanography are gold standard in demonstration the ectopic thyroid tissue. But computed tomography and MRI playing an increasingly important role in the diagnosis, in determination of the malignant transformation and planning the surgical approach.

[Vertebral and spinal cord hydatidosis: contribution of imaging]. / Hydatidose vertébromédullaire: intérêt de l'imagerie.

The authors report the case of a vertebromedullary hydatidosis revealed by medullar compression in a 40-year-old male patient. Magnetic resonance imaging showed lesions of the seventh and eighth dorsal vertebras, cystic lesions in the epidural space and in the perivertebral soft tissues. Surgical excision lead to clinical cure. Vertebromedullary hydatidosis is rare and severe. Modern techniques of imaging are very helpful for the diagnosis and the follow-up of patients after treatment.

Nonspecific and immune-specific up-regulation of cytokines in rabbit dermal tuberculous (BCG) lesions.

To our knowledge, this is the first sequential study of cytokines in tissue sections of developing and healing tuberculous (BCG) lesions. In situ hybridization, immunohistochemical, and RT-PCR techniques were used. Cytokine mRNAs showed a biphasic pattern. The percentage of mononuclear cells (MN) containing IL-1beta, TNF-alpha, MCP-1, and IL-8 mRNAs was highest in 1- to 3-day lesions, apparently because of the nonspecific inflammatory response caused by the tubercle bacilli in the BCG vaccine. At 5 days, this percentage was significantly reduced. With IFN-gamma, the peak and trough were delayed by 2 days. By 9 days, the percentage of MN containing the mRNAs of all five cytokines had again increased and the rabbits had become tuberculin-positive. In general, MCP-1 and TNF-alpha proteins and the vascular adhesion molecules, ICAM, VCAM, and perhaps ELAM, peaked at about 3 days. Many mononuclear cells surrounding the central areas of solid and liquefied caseous necrosis contained chemokine IL-8 mRNA. IL-8 is known to attract PMN, and PMN were present nearby. In contrast, MN containing chemokine MCP-1 mRNA were present more peripherally in areas rich in macrophages and lymphocytes. The early nonspecific cytokine response seems to be an adjuvant effect of the mycobacteria in BCG vaccine in that it causes a rapid entry of macrophages, lymphocytes, granulocytes, and probably dendritic cells into local sites of antigen deposition. This effect should be considered in developing improved vaccines for the prevention of tuberculosis, because BCG vaccines producing a strong early cytokine response should be more immunogenic than BCG vaccines with similar antigens producing a weak response.

Passage of human T-cell leukemia virus type-1 during progression to cutaneous T-cell lymphoma results in myelopathic disease in an HTLV-1 infection model.

Studies comparing functional differences in human T-cell leukemia virus type 1 (HTLV-1) clones that mediate distinct outcomes in experimentally infected rabbits, resulted in a dermatopathic smoldering adult T-cell leukemia/lymphoma following chronic infection with HTLV-1 strain RH/K34. During the 3.5 years' follow-up, HTLV-1 skin disease progressed to cutaneous T-cell lymphoma. When infection was passed to several naive rabbits, progressive paraparesis due to myelopathic neurodegeneration, analogous to HTLV-associated myelopathy, resulted in one of 4 transfusion recipients. Similar proviral loads were detected in the two diseases, regardless of stage of progression or tissue compartment of infection. Complete proviral sequences obtained from the donor and affected recipient aligned identically with each other and with the inoculated virus clone. Existence of disparate pathogenic outcomes following infectious transmission further extends the analogy of using rabbits to model human infection and disease. Although the experimental outcomes shown are limited by numbers of animals affected, they mimic the infrequency of HTLV-1 disease and authenticate epidemiological evidence of virus sequence stability regardless of disease phenotype. The findings suggest that further investigation of a possible role for HTLV-1 in some forms of cutaneous T-cell lymphoma is warranted.

Source and route of exposure influence infectivity of a molecular clone of human T cell leukemia virus type I.

Infection with human T cell leukemia virus type I (HTLV-I) is typically asymptomatic, but does result in diverse diseases ranging from adult T cell leukemia to spastic neuromyelopathy. To date, differences in HTLV-I provirus structure have not been correlated with pathogenic or asymptomatic outcome of infection. Molecular clones of HTLV-I are now available and represent a powerful tool to link virus structure to pathogenesis. Present studies to explore in vivo infectivity and pathogenicity of an HTLV-I molecular clone, K30p, have utilized the rabbit as a model system. This clone was administered to neonatal or adult rabbits by several different routes and infectivity and pathogenicity were examined. Detection of antiviral humoral immune responses, presence of provirus in tissue samples, and isolation of virus in cultures of blood lymphocytes were used to establish systemic HTLV-I infection. Intramuscular, but not nervous system, exposure to K30p HTLV-I naked DNA resulted in infection. Conversely, neural exposure to T cells that had been transfected with the K30p HTLV-I DNA consistently resulted in systemic infection. Despite detection of HTLV-I provirus in brain and spinal cord of some infected rabbits, no clinical or neuropathological changes occurred. Source and route of virus exposure played a role in infectivity, but did not influence the pathogenic outcome of HTLV-I infection.

Appendectomies in patients with nephritis.

A retrospective study of 150 records of patients attending a renal clinic revealed a high (10 per cent) incidence of history of appendectomy. The possibility that an acute exacerbation of pyelonephritis, especially on the right side, might be misdiagnosed in some cases as appendicitis is discussed. Acute renal failure following unnecessary appendectomy in a patient with previously unrecognized and asymptomatic chronic renal disease may occur if this possibility is not borne in mind before operating on an atypical case of appendicitis.

Washout urography in the diagnosis of renal hypertension.

Washout urography was used as a screening test for 100 hypertensive patients. Eleven patients had renal hypertension. These were 4 cases of unilateral renal artery stenosis, 6 cases of unilateral pyelonephritis and one case of bilateral pyelonephritis with atherosclerosis of the right renal artery. The increase in size of the affected kidneys after Lasix injection was much restricted relatvie to the normal contralateral kidneys. The test proved valuable for screening cases of renovascular hypertension and unilateral pyelonephritis.

Role of bilateral nephrectomy in the treatment of renal disease and hypertension.

The case summaries of 13 patients who were bilaterally nephrectomized for treatment of various renal diseases and hypertension are described. The present concept concerning the role of bilateral nephrectomy in the treatment of renal disease and hypertension is discussed.

Reconsideration of split kidney function tests in hypertension: a new technique.

The role of the split kidney function tests in the diagnosis of renal hypertension is reviewed, and a new technique is described which is designed to diminish the number of false negative results sometimes encountered in unilateral pyelonephritis and segmental renal arterial stenosis. Split kidney function tests still have an important role in diagnosis of renal hypertension, particularly when the results of other investigations are equivocal and when facilities for differential renal renin assay are not available.

Treatment of uremic pericarditis and pericardial effusion by augmented hemodialysis.

Six out of 21 patients attending maintenance hemodialysis had uremic pericarditis. Three patients had one or more recurrences of pericarditis while under regular intermittent dialysis. Two patients developed pericardial effusion and one of them had ascites. Augmented hemodialysis was successful in treating uremic pericarditis even in patients with pericardial effusion. The single instance of ascites was also controlled by augmented hemodialysis.

Acute glomerulonephritis with bacteriuria: a probable etiologic relationship.

Twenty-one cases of acute glomerulonephritis in children with no previous history of renal disease were studied. Urinary infection with a rising titre of serum agglutinins against the organisms isolated from urine was found in 5 cases. No evidence of previous streptococcal infection was found in these cases. In the meantime all 8 cases with post-streptococcal glomerulonephritis remained without bacteriuria. In one case acute glomerulonephritis followed virus hepatitis, and in the remaining 7 cases the cause of glomerulonephritis was unknown. It is suggested that in predisposed patients the bacteria present in urinary infections might act as antigens starting immunologic reactions in the glomeruli, leading to glomerulonephritis. The final proof of this theory awaits immunofluorescence identification of these antigens in the glomeruli.

Kidney function and histopathological changes in unilateral hydronephrosis with special reference to bilharzial ureter.

Fifty-six patients with unilateral hydronephrosis were the subject of this study. The patients were classified into 4 groups according to the stage of hydronephrosis as assessed by radiological criteria. Split kidney function, histopathological studies, and measurement of intraureteral pressure were performed. Urinary Bilharziasis was held responsible for obstructive nephropathy in 77% of cases. Complicating urinary infection was present in 66%. The study has shown that creatinine excretion was slightly decreased in early, moderate, and moderately advanced hydronephrosis. On the other hand, a marked lowering of urine osmolality was found even in the early stages of hydronephrosis. The hydronephrotic kidney was found to be a salt losing one only in early, moderate, and moderately advanced hydronephroses, but not in the very advanced cases. The histopathological changes were mainly tubular, but some cases showed proliferative changes in the glomeruli. Eradication of urinary Bilharziasis and early treatment of this disease would markedly contribute to the prevention of obstructive nephropathies in countries where this disease is endemic.

[Diaphragmatic bronchogenic cyst: a rare case report]. / Kyste bronchogénique du diaphragme : à propos d'un cas rare.

Retroperitoneal bronchogenic cysts are rare and those located in the diaphragm are exceptional. We describe an additional case of bronchogenic cyst of the left crus of diaphragm. Diagnosis of a diaphragmatic lesion was confirmed during laparotomy and complete resection was successful. Final diagnosis was done on pathology.

[Encapsulating peritonitis disclosing primary melanoma of the small intestine: a case report]. / Péritonite enccapsulante révélatrice d'un mélanome primitif du grêle: à propos d'une observation.

Encapsulating peritonitis is a chronic peritonitis leading to the constitution of the thick white nacred fibrosis membrane. It is a rare affection. Its physiopathology is poorly elucidated. Diagnosis is usually at operation. We report an unpublished case of a 36-year-old patient, admitted for an abdominal mass. The different investigations demonstrated small bowel tumor with entrapped ileal and jejunal loops within a capsule. Diagnosis was made at the time of operation by discovering an encapsulating peritonitis caused by a primary malignant melanoma of the small bowel, which is an exceptional affection.

Prevalence of hepatitis B virus among chronic schizophrenia patients.

We aimed to determine the prevalence of hepatitis B surface antigen (HBsAg) among chronic schizophrenia patients in Jordan. Over a period of 12 months, 192 patients (106 male and 86 female) were tested for hepatitis B virus (HBV) by enzyme immunoassay. An equal number of age- and sex-matched healthy controls was also tested. Of the schizophrenia patients, 14 (10 male and 4 female) were positive for HBsAg while only 5 (4 male and 1 female) of the control subjects tested positive. The difference was not statistically significant but it indicates that chronic schizophrenia patients are a risk group for HBV infection and likely to benefit from preventive measures (health education and immunization against HBV).

[Carpal scaphoid chondroma complicated by fracture: a case report]. / Chondrome du scaphoïde carpien compliqué d'une fracture: à propos d'un cas.

The carpal scaphoid is an uncommon localization for chondroma. Ten cases have been reported in the literature. We report a new case of right carpal scaphoid chondroma complicated by fracture in a 30 year-old man. The diagnosis was strongly suggested by the computed tomography scan and confirmed at pathology examination of the operative specimen. Treatment consisted in tumor enucleation and a cortico-cancellous graft to fill the gap followed by plaster case immobilization. Clinical and radiological outcome was favorable.