Microflora of the nasopharynx in Caucasian and Maghrebian subjects with and without nasopharyngeal carcinoma.

The possible role of bacteria in the etiology of nasopharyngeal carcinoma (NPC) was studied by bacteriological and biochemical analyses of nasopharyngeal swabs collected in the cavum and in the fossa of Rosenmüller of NPC patients and healthy controls in France and Algeria. Counts of total bacteria and of total nitrate-reducing bacteria, mainly enterobacteria, were higher in the Maghrebians than in the Caucasians. The composition of the bacterial flora was different: in Maghrebians, enterobacteria were present in five of 17 control subjects and eight of 15 NPC patients, while the prevalence was only one out of 15 control subjects in Caucasians. Twelve of 32 bacterial species isolated from Caucasians and Maghrebians with normal or tumorous nasopharyngeal microflora were able to catalyse nitrosation of morpholine in vitro. This result suggests that colonization of the nasopharynx by microflora that contain nitrate-reducing microorganisms which can form N-nitroso compounds might represent a risk factor for NPC in Maghrebian populations.

Decreased urinary 5 alpha-androstane-3 alpha,17 beta-diol glucuronide excretion in patients with benign prostatic hyperplasia.

Urinary testosterone and 3 alpha-androstanediol (3 alpha diol G) glucuronides together with plasma testosterone, 5 alpha-dihydrotestosterone (DHT), and delta 4-androstenedione (delta 4) were measured in 43 normal young men (18-36 yr old), 23 elderly men without clinically evident prostatic pathology (54-89 yr old), 68 elderly men with benign prostatic hyperplasia (BPH group; 54-91 yr old), and 26 elderly men with well differentiated cancer of the prostate (K group; 63-97 yr old). Plasma testosterone decreased slightly with age in all 3 elderly groups (from 591 to 438, 479, and 444 ng/100 ml, respectively). Plasma DHT, on the contrary, was significantly (P less than 0.01) higher in the BPH group than in the other three groups (68 vs. 30, 37, and 32 ng/100 ml, respectively). Plasma delta 4 was significantly lower (P less than 0.01) in the elderly K group than in all other groups (59 vs. 109, 83, and 78 ng/100 ml, respectively). Urinary testosterone glucuronide decreased with age in all 3 elderly groups (from 109 to 55, 38, and 44 micrograms/24 h, respectively) as a result of decreased androgen production rates with age. All 3 elderly groups also had decreased urinary 3 alpha diol G, from 194 to 123, 55, and 118 micrograms/24 h, respectively. The group of elderly patients with BPH had the lowest mean urinary 3 alpha diol G excretion together with the highest mean plasma DHT. This low urinary 3 alpha diol G excretion, which reflects a decrease in both androgen production and DHT metabolism, suggests a decrease in 3 alpha-hydroxysteroid dehydrogenase activity, which, in turn, could explain the increased DHT availability and tissue retention in most target organs. Moreover, the extent of these modifications in androgen metabolism specific to the BPH condition raises the question of an overall alteration of androgen metabolism in patients with BPH which could be the cause of the disease.

[Cystic dystrophy of the urinary excretory mucosa. An unusual cause of recurring urinary tract infection in pregnancy]. / La dystrophie kystique de la muqueuse excréto-urinaire. Une cause inhabituelle d'infection urinaire gravidique récidivante.

Cystic pyeloureteritis is an uncommon anatomo-radiological phenomenon which occurs following injuries to the mucosa often accompanied by inflammatory changes. Treatment is not well defined and the prognosis for renal function is problematic. The authors report one case that occurred after delivery. The literature has been reviewed and the case described has been discussed. Attention has been focused on infections of the urinary tract in pregnancy and the long-term prognosis. This appears to be worse when it is associated with the not-uncommon abnormalities of the urinary tract. These should be looked for systematically using ultrasound and intravenous pyelogram techniques.

[Varicocele and infertility. Facts, uncertainties and hypotheses]. / Varicocèle et infertilité. Faits, incertitudes et hypothèses.

The association between varicocele and male subfertility would seem to be borne out by its incidence in the subfertile male population and the presence of disturbances in spermatogenesis, as well as a description of the different physiopathological mechanisms based on renospermatic venous reflux, and the improvement in the sperm and the obtaining of pregnancy after surgical cure of the reflux. The literature on the subject, and the number of successful case reports, have greatly increased in recent years. There is a tendency to extend the surgical indications to include infraclinical forms of varicocele, and even to perform preventive procedures, against male sterility in varicocele-carrying adolescents. In fact, however, there are wide variations in the estimates of the incidence of varicocele, not only in the general population, but also in the female subfertile population. The relationship between sperm characteristics and fertility is difficult to define. While the presence of renospermatic venous reflux is, in most cases, unquestionable, the exact mechanism or mechanisms of its action are uncertain. The efficacy of surgical management itself is variously assessed, and the methodology employed in many studies is open to question. Only an approach based on fertility epidemiological data and comparative studies employing a methodology which is not open to criticism, will ultimately enable us to define the role of varicocele in male subfertility and the role of surgical management in its treatment.

[Complete ureteral avulsion. Complication of vaginal delivery of an infant dying in utero during the second trimester of pregnancy]. / Avulsion urétérale complète. Complication de l'évacuation par voi basse d'une mort in utero du deuxième trimestre.

The authors report a case of complete avulsion of the ureter occurring during the vaginal evacuation of a fetus that had died in utero in the second trimester. This case leads us to discuss the diagnostic and therapeutic measures that should be taken in this kind of situation. At present there are people who wish to increase the number of indications for second trimester terminations of pregnancy. As this is so, we wish to draw attention to a rare but very serious complication of late evacuation of the uterus, namely damage to the ureter.

[Total serum and non-conjugated estriol in the 3d trimester of pregnancy. Inter-individual, intra-individual variations during the day and from one day to another. Study of at-risk pregnancies]. / Estriol sérique total et non conjugué pendant le 3e trimestre de la grossesse. Variabilité inter-individuelle, intra-individuelle au cours de la journée et d'un jour à l'autre. Etudes de grossesses à risque.

It is possible to estimate the daily rate of oestriol production by the fetoplacental unit to monitor pregnancy by radio-immunoassay of the concentrations of unconjugated and total oestriol in the serum. The usefulness of these two parameters was compared by comparing variations from day to day in the same individuals and between them and other individuals, as well as over 24 hours. We think the best choice of test for biochemical monitoring of at-risk pregnancies is the estimation of unconjugated oestriol because there is a lower day to day variation in the same individual as well as throughout the 24 hours.

[Varicocele and male hypofertility. Report of 100 cases]. / Varicocèle et stérilité masculine. A propos de cent observations.

100 cases of man-hypofertility associated with a varicocele have been submitted to a varicocelectomy using Ivanissevitch's procedure. Pre-operative spermogram and spermocytogram as well as testicular biopsy proved to be of no prognostic value. The only difference between pre-operative and post-operative spermocytograms concerns sperm motility. The main prognostic factor seems to be normal findings in the gynecologic examination of the female partner. Ligation of spermatic artery appears to be associated with a higher rate of failure.

[Malignant tumour of adrenal with feminizing syndrome and primary hyperaldosteronism (author's transl)]. / Corticosurrénalome malin avec syndrome féminisant et hyperaldostéronisme primaire. Etude clinique et biochimique ("in vivo", "in vitro").

Feminizing tumour of adrenals are rare. Gynecomasty, abdominal tumour are the more frequently observed symptoms. The described case in a 38 years aged man is of special interest because of association with primary hyperaldosteronism. Studies in vivo and in vitro are reported. In vitro studies shown a high 18 hydroxylation biosynthetic activity of tumoral fragment and a great synthesis of polar phenolsteroids with testosterone as precurseurs.

[The radio immune level of total serum oestriol during pregnancy. An examination of the method and comparison of the concentrations of total serum oestriol, non-conjugated serum oestriol and the excretion of total urinary oestrogens (author's transl)]. / Dosage radio immunologique de l'estriol sérique total pendant la grossesse. Examen de la méthode et comparaison des concentrations de l'estriol sérique total, de l'estriol sérique non conjugué et de l'excrétion des oestrogènes urinaires totaux.

The authors report on a preliminary study of the level of total serum oestriol in the third trimester of pregnancy by the bundle method of estimating this with "oestriol 1251 RIA Kit" (Amersham, Buchler). The criteria on which the quality of the method depends, viz, sensitivity, specificity, reliability, and accuracy, together with its practicability are satisfactory. Correlations between total serum oestriol and free serum oestriol and total urinary oestrogens are good and correspond with those given in the literature. This method therefore can be used in clinical practice. All the same, it still has to be established which parameter better reflects the feto-placental state. Is it the free serum oestriol or the total serum oestriol?

[Feminishing adrenal tumor with primary hyperaldosteronism. Report of a case (author's transl)]. / Tumeur féminisante de la surrénale avec hyperaldostéronisme primaire et hypertension artérielle maligne. Evolution terminale

A case of feminishing adrenal tumor with primary hyperaldosteronism is reported. The aim of this report is to emphasize on the terminal evolution of the disease. This phase was marked by malignant hypertension, severe renal insufficiency, and iatrogenic cellular hyperhydration with hyponatremia secondary to spironolactone therapy.