[Candida glabrata chorioamnionitis following in vitro fertilization]. / Chorioamniotite à Candida glabrata après fécondation in vitro.

We report one case of severe Candida glabrata chorioamnionitis and septicemy occurring in a twin pregnancies achieved by in vitro fertilization techniques which resulted in pregnancy loss after preterm rupture of the membrane at 22 weeks of gestation despite a treatment with amphotericin B.

Mechanism of gluconate synthesis in Rhizobium meliloti by using in vivo NMR.

The dehydrogenation of [1-(13)C]- and [2-(13)C]glucose into gluconate was monitored by NMR spectroscopy in living cell suspensions of two Rhizobium meliloti strains. The synthesis of gluconate was accompanied, in the cellular environment, by the formation of two gluconolactones, a gamma-lactone being detected in addition to the expected delta-lactone. These lactones--as well as the gluconate--could be further metabolized by the cells. The delta-lactone was utilized faster than the gamma-lactone. The presence--in significant amounts--and the relative stability of the lactones raise the question of their possible physiological significance.

Evaluation of the Abbott Cell-DYN 3500 hematology analyzer in university hospital.

The Abbott (R) Cell-Dyn 3500 (Abbott CD 3500, Abbott Diagnostics Division, Mountain View, CA) is a fully automated hematology analyzer capable of providing a complete blood count (CBC) profile, including a five-part differential leukocyte count (DLC) and flagging system in this study. The CBC profile and DLC flagging system of the Abbott CD 3500 were evaluated according to the HA-20 protocol of the National Committee for Clinical and Laboratory Standards (NCCLS) and compared to the Technicon H*2 blood analyzer currently used in the authors' laboratory. Linearity, carryover, precision, and stability were all within the limits established by the manufacturer. No significant break-downs were found during the evaluation period. Evaluation of DLC indicated an excellent correlation with the manual reference method for neutrophils, lymphocytes, and eosinophils (r = 0.916, 0.936, 0.967, respectively), a good correlation for monocytes (r = 0.811) and a poor correlation for basophils (r = 0.224). Overall flagging for morphologic abnormalities displayed higher sensitivity (85%) than specificity (67%), with a false-positive ratio of 33%. In general, these results are in accordance with those obtained by other authors in the same period of time.

In vivo 13C-NMR studies of polymer synthesis in rhizobium meliloti M5N1 strain

The use of in vivo 13C-NMR approach for the monitoring of the synthesis of various polymers within cells of Rhizobium meliloti (M5N1 strain) is reported. Significant differences in polymer biosynthesis have been shown as a function of the metabolic state of the cells and the labeled carbon source used. Consumption of carbon source and produced glycogen was complete with mid-exponential phase harvested cells. This was not the case with stationary phase harvested cells, for which polyhydroxybutyrate synthesis was higher and gluconate synthesis was lower than the former. [1-13C]fructose-grown cells produced more exopolysaccharide and polyhydroxybutyrate, but less beta-(1,2) glucan and gluconate than [1-13C]glucose-grown cells. This approach offers a suitable tool to examine the kinetics of polymer biosynthesis by Rhizobia. Copyright 1998 John Wiley & Sons, Inc.

Characterization of water distribution in cell pellets using nonlabeled sodium thiosulfate as an interstitial space marker.

A procedure for determination of the intracellular water content of cells using a single, nonlabeled solute as an interstitial space marker is proposed. Sodium thiosulfate, which can be accurately assayed by a tritrimetric method, is found to be a good compound for this purpose. Cells are recovered both by filtration and centrifugation; the two techniques gave the same value for internal water, i.e., 650 mg of H2O/g of wet matter for Corynebacterium melassecola and 390 mg of H2O/g of wet matter for Penicillium roquefortii spores. The methodology of data handling, based on a regression technique, is also described. It allows one to obtain very reliable results and should be useful for any marker.

[Blink reflex and jaw reflex in neurinoma of the acoustic and trigeminal nerves (author's transl)]. / La réflexe de clignement et le réflexe massétérin au cours des neurinomes de l'accoustique et du trijumeau. Discussion de l'intérêt diagnostique de ces techniques.

The blink reflex was studied in four patients with neurinoma of the acoustic nerve and in two patients with trigeminal neurinoma. It was abnormal in all cases except in one neurinoma of the acoustic nerve inside the canal. The jaw reflex, studied in four cases, showed unilateral impairment in two cases of trigeminal neurinoma and one case of acoustic neurinoma; it was normal in the case of acoustic neurinoma in the canal. The blink reflex and jaw reflex merit inclusion among the further tests conducted in cases of suspected neurinoma of the trigeminal or acoustic nerves. However, they are of less interest than oto-vestibular tets in the early diagnosis of neurinoma of the eighth nerve. These techniques deserve a place of choice in investigations of atypical facial neuralgia in general and suspected neurinoma of the trigeminal in particular.

[Treatment of hepatitis C virus infection in the Poitou- Charentes region]. / Prise en charge de l'infection par le virus de l'hépatite C dans la région Poitou-Charentes.

OBJECTIVES: The prognosis of hepatitis C virus infection could be improved by early treatment. However, this is only possible if most patients with hepatitis C consult a specialized institution. The aim of this study was to evaluate the modalities of care of hepatitis C virus infection in one French district. METHODS: Between November and December 1997, 89 biological laboratories from the "Poitou-Charentes" district were asked to provide results of hepatitis C virus serology tests performed during this period. A questionnaire concerning epidemiological and follow-up data was sent to the medical practitioner who prescribed the test, for all positive tests. RESULTS: Seventy eight out of 89 (88%) laboratoires agreed to participate in the study. During the study period, 6,168 subjects were tested and 196 (3.2%) were positive. This test was a diagnostic test in 69 cases (53%) and a confirmation test in 61 cases (47%). The epidemiological questionnaire was filled out in 130 cases. The main putative factors of viral contamination were: intravenous or nasal drug addiction in 69 cases (53%), blood transfusion in 39 cases (30%), and a nosocomial risk factor in 16 cases (12%). Treatment and care of virus infection was evaluated in 113 cases from the follow-up questionnaire: a liver biopsy was performed in 30 cases (27%) and interferon therapy was administered in 13 cases (12%). Liver biopsy was not performed in 83 cases (73%) due to normal transaminase levels or a contraindication to interferon therapy. The main causes of an absence of care or follow-up were: fear of complications of liver biopsy and/or side effects to interferon therapy (19%), chronic alcoholism (18%) and active drug addiction (8%). CONCLUSION: The main causes of failure to administer adequate care in hepatitis C patients were chronic alcoholism, drug addiction and fear of liver biopsy or side effects of interferon therapy. These data should be taken into account for future screening or information compaigns for the general population.

[Abnormal changes in erythrocyte membrane proteins in hereditary spherocytosis and their relation to clinical and biological aspects of the disease]. / Alteraciones proteicas de la membrana eritrocitaria en la esferocitosis hereditaria y su relación con la expresividad clínica y biológica de la enfermedad.

BACKGROUND: In the present paper we report a study of 20 patients with hereditary spherocytosis (HS) performed with the aim of provide further information on the electrophoretic abnormalities of red blood cell (RBC) membrane proteins and their putative relationship with the clinical, biological and genetic aspects of the disease. METHODS: General hematological parameters, reticulocyte count, osmotic fragility test and erythrocyte morphology analysis, were performed by routine procedures. Membrane proteins of erythrocyte were analyzed by SDS-polyacrylamide gradient gel electrophoresis (SDS-PAGE) using the Laemmli and Fairbanks methods. RESULTS: In 8 out of 20 cases (40%) a defect of band 3, alone or associated with a slight deficiency of protein 4.2, was observed. In addition to the presence of spherocytes, in all these 8 patients, a peculiar morphologic RBC alteration called pincered RBCs was also observed. Moreover, 2 cases showed a deficiency of protein 4.2, 2 cases a deficiency of ankyrin and 2 cases a deficiency of spectrin. In 6 cases (30%) the electrophoretical pattern of the erythrocyte membrane proteins was normal. A significant (r = -0.6; p < 0.01) correlation between the protein 4.2 (pallidin) and the mean corpuscular haemoglobin concentration (MCHC) was found. Also, the multiple regression analysis showed a correlation (r2 = 0.6; p < 0.0001) between the amount of protein 2.1 (ankyrin) and two hematological parameters: the mean corpuscular volume (MCV) and the red cell distribution width (RDW). CONCLUSIONS: The defect of band 3 is the most frequent membrane protein abnormality associated with HS.

[Bone marrow transplantation from unrelated donors in chronic myeloid leukemia: the results in 15 patients]. / Transplante de médula ósea a partir de donantes no emparentados en la leucemia mieloide crónica: resultados en 15 pacientes.

BACKGROUND: Bone marrow transplantation (BMT) from a histocompatible donor is the only curative treatment in chronic myeloid leukemia (CML). Only a minority of patients dispose of an adequate donor from among his/her relatives. The remaining transplant receptors must look to unrelated donors (URD). The experience of the Escuela de Hematología Farreras Valentí (Farreras Valentí School of Hematology, Barcelona, Spain) in BMT from URD in CML in the first chronic phase is herein reported. METHODS: Fifteen patients (9 males and 6 females, median age 33 years; range 14-48 years) were transplanted from October 1988 to May 1994. Serologic identity was expressed in the A, B and D loci in 9 cases and minor incompatibility in 6. Conditioning included total body irradiation and cyclophosphamide in 14 patients and busulphan plus cyclophosphamide in 1. Partial and selective T lymphocyte depletion was performed by elutriation in 7 cases. RESULTS: Primary implant failure was detected in 2 out of 14 risk patients (14%) and secondary failure was observed in 3 out of 12 cases (25%). The actuarial probability of acute graft versus host disease (GVHD) was 55 +/- 15% at 7 weeks with a probability of appearance with an intensity of II-IV of 31 +/- 13%. Five out of 7 patients with a survival of greater than 100 days, developed chronic GVHD (71%). Ten presented fatal complications. In 5 cases, death was due to pulmonary problems. Recurrence of CML was not observed in any of the patients in the series. The probability of disease free survival at 2 years was 30 +/- 12%. CONCLUSIONS: Bone marrow transplantation from an unrelated donor is an effective treatment for a proportion of patients with chronic myeloid leukemia although severe complications are frequent and originate a high mortality.

[Central neurologic forms of Waldenström's disease. Bing-Neel syndrome. 3 cases]. / Formes neurologiques centrales de la maladie de Waldenström. Syndrome de Bing-Neel. Trois cas.

Three cases of central nervous system involvement in Waldenström's macroglobulinemia (Bing Neel's syndrome) are reported. Such cases are unusual and have a poor prognosis. One patient received chemotherapy including BCNU, cyclophosphamide, vincristine, melphalan and prednisolone, which was followed by a dramatic improvement. The pathogenesis of Bing Neel's syndrome is discussed.

[Immunoblastic lymphadenopathy occurring during treatment with carbamazepine. 2 cases]. / Lymphadénopathie dysimmunitaire survenant au cours d'un traitement par la carbamazépine. Deux observations.

Dysimmune lymphadenopathies during carbamazepine treatment. A report of two cases. We report on two cases of dysimmune lymphadenopathies with histological aspect of angio immunoblastic lymphadenopathy (AIL) developing after administration of carbamazepine. Clinical manifestations consisted of fever, erythroderma, generalized pruritus, facial edema, lymphadenopathy, liver enlargement. The two patients had anemia, hypogammaglobulinemia, impaired liver function and a negative Coomb's test. Lymphocyte stimulation test with carbamazepine in vitro was positive in both cases. Lymph node biopsy disclosed the angioimmunoblastic proliferation characteristic of AIL. After discontinuing carbamazepine, a complete remission was obtained.

Red cell membrane Na+ transport systems in hereditary spherocytosis: relevance to understanding the increased Na+ permeability.

Red blood cells (RBCs) in hereditary spherocytosis (HS) show high sodium (Na+) and potassium (K+) movement across the membrane, resulting in dehydration. In general, these abnormal cation fluxes have been interpreted as "increased leaks" due to passive or electrodiffusional permeability of the RBC membrane. A study to elucidate the contribution of concomitant ouabain-resistant pathways (Na-K-2Cl cotransport and Na-Li countertransport) to abnormal Na+ permeability present in RBCs of subjects with HS has been undertaken. Accordingly, erythrocyte Na+ and K+ content and transmembrane cation movements via the Na-K pump, Na-K-2Cl cotransport, Na-Li countertransport, and Na+ passive diffusion, were measured in 25 non-splenectomized patients with HS and compared with the results obtained from the study of 11 patients with congenital non-spherocytic haemolytic anaemia (CNSHA) due to hereditary elliptocytosis (7 cases) and RBC enzyme defects (4 cases) and of 30 normal controls. Compared to the controls, patients with HS exhibited a highly significant (P<0.001) increase in all the Na+ transmembrane movements via passive diffusion (411+/-243 vs 105+/-40), Na-K pump (2615+/-970 vs 1874+/-359), Na-K-2Cl cotransport (males: 371+/-138 vs 190+/-42; females: 401+/-134 vs 104+/-44) and Na-Li countertransport (207+/-131 vs 98+/-41). This was associated with increased Na+ and decreased K+ content, resulting in a reduction of total cation (Na+ + K+) RBC concentration. Furthermore, significant correlations were also found between the patients' RBC cationic content and the mean corpuscular haemoglobin concentration (MCHC) (r=0.51, P<0.05) and between the Na+ passive leak and the haematocrit value (r=-0.44, P<0.05). In the patients with CNSHA, a less significant (P<0.01) increase of active (Na-K pump) and passive (leak) transmembrane permeability to Na+ was associated with normal transmembrane movements via Na-K-2Cl cotransport and Na-Li countertransport. The present study demonstrates that in HS, RBCs are characterized by a variable, but always significant increase of all the membrane transport systems leading to the extrusion of Na+, and that these abnormalities, regardless of their relation to membrane structural defects, may probably be valuable for the differential diagnosis between HS and other congenital defects of RBCs.