Salivary trichomoniasis. A case report of infestation of a submaxillary gland by Trichomonas tenax.

A tumor was suspected after detection of an asymptomatic submaxillary swelling in an 85-year-old woman. Clinical, radiologic, and biologic investigations were fruitless. Transcutaneous needle aspiration revealed numerous trichomonads and led to the conclusion that a salivary duct was infested by Trichomonas tenax. The patient recovered following treatment with metronidazole, and there has been no recurrence after 2 years. This case sheds new light on the pathogenic properties of trichomonads. Peculiar features of this previously unreported location are discussed. Trichomonas tenax is often unrecognized by pathologists, and surely such cases are often misdiagnosed.

[Heteromultinodular goitres. Clinical and therapeutic study (author's transl)]. / Les goitres hétéromultinodulaires. Etude clinique. Traitement.

Heteromultinodular goitres are frequent and the involutive forms require early surgical treatment for three reasons: these goitres are usually resistant to medical treatment; association with carcinoma is not uncommon (6.5% in this series); and the late surgery is hazardous, as it leads to extensive tissue resection and often entails a risk of recurrence and lesions of the parathyroid glands. Post-operative hormonal treatment should be reserved to those patients who have had wide tissue resection (replacement therapy for life, monitored by TSH assays) or to young patients who require a 2-year protective treatment. Prevention may perhaps be achieved by systematic 2-3 years' treatment of active homogenous hyperplasia in young subjects. Hyperplasia has a natural tendency to nodular involution, in most cases over several decades, but curiously, 30-35 years' old adults with large multinodular goitres are being operated upon as though these lesions had greater evolutive potential. This could be an argument in favour of post-operative protective therapy in these young patients.

Immunological investigation and immunotherapy in patients operated on for breast carcinoma.

The tumor-host relationship is an essential factor in the onset, development, and recovery from malignancies. A basic consideration in the treatment of cancer patients must therefore be to understand this relationship and attempt to modify it in order to favor the host. We here discuss the results of a study of the immunologic status of 91 breast cancer patients. The use of a battery of tests with five subcutaneous hypersensitivity antigens allowed us to detect some differences in the immunological profiles of patients with or without lymph node involvement. The effect of an immunostimulant fraction prepared from Corynebacterium granulosum, P40 is also analyzed. This fraction significantly modifies tumoral recurrence in DMBA-induced mammary cancers in the Sprague Dawley rat, causes regression of mammary permeation nodules following in situ injection and modifies the cutaneous reactions of one-half of the anergic breast cancer patients although regular re-challenge is still necessary.

[Haemorrhagic necrosis of the digestive tract consecutive to massive digitalis intoxication (author's transl)]. / Nécrose hémorragique du tube digestif au cours d'une intoxication digitalique massive.

A 60-year-old man under digitalis treatment for hypertensive heart tried to commit suicide by absorbing a 15 mg dose of digitoxin. Severe intestinal bleeding occurred 12 hours later, followed by pseudo-occlusive syndrome and ischaemia of the distal lower limbs. On abdominal incision the whole gut was found to be invaded by haemorrhagic necrosis and perforated on three points. The patients subsequently died of peritonitis. The responsibility of digitoxin in these events was demonstrated by the absence of any other cause of ischaemia, such as heart failure, shock, arrhythmia, consumption coagulopathy or use of sympathomimetic drugs. This case shows that the vasoconstrictor effect of digitalis, experimentally demonstrated but clinically controversial, is a reality, and that digitalis compounds are contra-indicated in patients with haemorrhagic necrosis of the digestive tract.

[Breast cancer: a dynamic approach of cellular immunity and immunostimulation with an immunoadjuvant: P40 fraction. (author's transl)]. / Cancer du sein opérable. Appréciation dynamique de l'immunité cellulaire et de l'immuno-stimulation par l'adjuvant P40.

The study of the immune status of breast cancer patients with delayed hypersensitivity skin tests reveals a clear immune deficiency in comparison with a reference patients group. This immunstatus was significantly improved by an immunstimulation with the P40 fraction. The responsive capacity to an immunstimulation appears independant of the lymphnodes involvment, whereas, on the contrary, the initial degree of immune deficiency appears connected. The P40 fraction has an immunstimulant effect comparable with the BCG and has not occasioned any local or general undesirable reaction.

[Thyroid carcinoma. Indications and results of treatment (author's transl)]. / Cancers thyroïdiens. Indications et résultats thérapeutiques.

Frozen section histological study of all cold nodules requiring total extracapsular lobectomy is absolutely essential during surgery. Whilst total thyroidectomy for intracapsular carcinomas is most often proposed in extracapsular carcinomas, the authors deliberately leave a small part of the gland in contact with the parathyroids. The need for recurrent laryngeal lymph node dissection is accepted, as is the principle of jugulo-carotid dissection.