Molar tubal ectopic pregnancy: Report of two cases.

Ectopic molar pregnancy is a rare occurrence and consequently not often considered as a diagnostic possibility. We report two cases of molar hydatidiform tubal pregnancy. Diagnosis of ectopic pregnancy was confirmed on clinical biological and sonographic investigations. Diagnosis of molar pregnancy was done on histopathology. The clinical course was favorable for both patients. Although rare, molar changes can occur at any site of an ectopic pregnancy. Clinical diagnosis of a molar pregnancy is difficult but histopathology is the gold standard for diagnosis.

Immunohistological study of involucrin expression in Darier's disease skin.

BACKGROUND: Darier's disease (DD) is an autosomal dominant skin disorder characterized by acantholysis and abnormal keratinization. The gene responsible for DD, ATP2A2 encodes for the sarco/endoplasmic reticulum (ER) Ca2+-ATPase isoform 2 protein. Involucrin, considered as a marker of terminal epidermal differentiation, could be altered in some keratinization disorders including DD. PATIENTS AND METHODS: An immunohistochemical staining using anti-involucrin antibody was carried out on 16 DD patients epidermis. Involucrin staining was compared with biopsies from cutaneous lesions of three healthy individuals and of patients with Hailey-Hailey disease (five cases) and Mal de Meleda (four cases). A semi-quantitative analysis was performed in order to evaluate involucrin immunostaining on the basis of intensity, extension and epidermal distribution. The involucrin expression was examined afterward with confocal laser scanning microscopy. RESULTS: In contrast to normal skin, all DD cases showed premature expression of involucrin in the lower epidermal layers in four cases with a strong labeling in both keratinocytes cell membrane and cytoplasm. Other keratinization disorders share premature expression of involucrin but displayed differences in cytoplasm/cell membrane labeling. CONCLUSIONS: DD skin displayed a constant immunohistochemical involucrin pattern characterized by both premature expression and a particular cytoplasmic/cell membrane localization distribution.

[Pulmonary alveolar proteinosis in two siblings. A case report]. / La protéinose alvéolaire pulmonaire de l'enfant. A propos d'une observation familiale.

Pulmonary alveolar proteinosis (PAP) is a rare disorder in children. This report describes two siblings in whom PAP developed during infancy (three years for the boy and four years two months for the girl). The girl was admitted for chronic respiratory distress. Chest x-ray showed a reticulonodular pattern. Her brother was asymptomatic. The diagnosis of PAP was confirmed by open lung biopsy for the boy and broncho-alveolar lavage for the girl. Therapeutic broncho-alveolar lavages were performed (six for the girl and two for the boy), the girl lost dependence on oxygen therapy. 6 years later, the brother is still asymptomatic. The sister had two episodes of respiratory distress, after two and four years, that required therapeutic lavages. The last therapeutic bronch-oalveolar lavage was performed for the first time by a Tunisian team.

[Villous atrophy and idiopathic epilepsy]. / L'atrophie villositaire au cours de l'epilepsie essentielle.

Reports of an association between epilepsy and coeliac disease (CD) are not new. Chapmann reported a prevalence of epilepsy in CD of 5.5% and accepted a figure of 0.5% for the community. Prevalence of coeliac disease among epileptic patients is not well established. The aim of this study is to determine the prevalence of CD in epileptic patients for this 49 epileptic patients (31 male and 28 female) were selected between January 96 et June 99 to underwent fibroscopy with intestinal biopsy. Anti body to gluten were measured in most patients. The patients with villous atrophy underwent cranial computed tomography. 4 of 49 patients (8.1%) were identified as having coeliac disease on the basis of a flat intestinal mucosa with increasing of LIE. 2 among this 4 patients had recurrent diarrhea. Any patient showed cerebral calcification associated with epilepsy and CD. Only one patient among 4, followed a gluten free-diet with a significant reduction in seizure frequency. This suggest that CD should be ruled out in all case of epilepsy of unexplained origin.

[Frequency of Pneumocystis carinii pneumonia in HIV-infected patients in Tunisia]. / Frequence des pneumopathies a Pneumocystis carinii chez le sujet infecte par vih en Tunisie.

In Tunisia, as in most african countries, Pneumocystis carinii pneumonia (PCP) is considered to be rare in HIV-infected patients. Frequencies of 8.6% and 21% have been reported. We examined 27 broncho-alveolar lavage specimens collected from HIV-infected tunisian individuals with respiratory symptoms over 4 years (1994-1997), by cyto centrifugation, Giemsa and Gomori-Grocott stain. Pneumocystis carinii (P carinii) was present in 9 cases, accounting for 33.3% of all specimens. Investigation of the reasons for the differences between african reports is necessary to establish appropriate therapeutic management. Technical difficulties of direct recognition of P carinii and selection bias may account for differences between african reports. However, differences still remain between the frequencies recorded in Africa and in other parts of the world, and recent advances seems to correlate this with geographical biodiversity of human-derived strains of P carinii and with differences in host ethnic background.