[Pre-leukemic granulocytic sarcoma of the uterus. Report of a case]. / Sarcome granulocytaire pré-leucémique de l'utérus. A propos d'un cas.

A case of pre-leukemic granulocytic sarcoma (GS) of the uterus was found in a 73-year old woman. The diagnosis was suggested by vaginal cytology and the green color of the gross lesions, then confirmed by naphthol AS-D chloro acetate esterase stain and immunohistochemistry on fixed tissue with the anti-lysozyme, anti-myeloperoxidase, CD 43 and CD15 antibodies. At the time of GS discovery, the patient presented no evident leukemia but myelogram contained 20% of blast cells. She developed acute myeloid leukemia 2 months later. Cytogenetic study of the bone marrow revealed chromosome 21 trisomy. GS is frequently mistaken for malignant lymphoma since it expresses some of the leukocytic antigens (leukocyte common antigen, CD 45 RO (UCHL1), MB2). Therefore, the use of a large panel of antibodies, including anti-myeloperoxidase, anti-lysozyme and CD15, is recommended. Precise diagnosis is essential because all GS must be treated as acute myeloid leukemias.

[Prevention of neonatal conjunctivitis. A comparative clinical and bacteriologic study of 2 eyedrops: silver nitrate and oxytetracycline chlorhydrate]. / Prévention des conjonctivites néonatales. Etude comparative clinique et bactériologique de deux collyres: nitrate d'argent et chlorhydrate d'oxytétracycline.

This study carried out at the Saint-Germain-en-Laye Hospital maternity ward included all the neonates delivered between February and September 1989 who exhibited no abnormal manifestations during their stay in the ward, except for ocular symptoms in some subjects. Nine hundred neonates were enrolled. Each day, one of two eyedrop preparations for the prevention of neonatal ocular infections was selected at random. Investigators were blinded to the preparation used. Study subjects were evaluated twice, between D1 and D7 (900 infants) and between D15 and D30 (407 infants). Ocular findings were classified as follows: normal, minimally abnormal (isolated swelling of the eyelids, clear discharge), or frankly abnormal (conjunctivitis, purulent discharge). A bacteriologic study was performed in all patients with minimally abnormal or abnormal findings. Between D1 and D7, ocular symptoms were significantly (p less than 0.05) more prevalent in neonates treated with silver nitrate than in neonates treated with oxytetracycline hydrochloride. This difference was no longer present between D15 and D30. Bacteriologic studies recovered no gonococci. One enfant in the oxytetracycline group had bacteriologically confirmed Chlamydia trachomatis ocular infection. The other organisms recovered were mainly Staphylococcus aureus and non-hemolytic streptococci. In inclusion, no currently available eyedrop preparation offers complete protection against C. trachomatis but tolerance is considerably better with oxytetracycline hydrochlorate than with silver nitrate.

[Estimation of the date of onset of pregnancy. Relative accuracy and logical use of different clinical and paraclinical factors]. / Estimation de la date du début de la grossesse. Précision relative et utilisation raisonnée des différents éléments cliniques ou paracliniques.

The authors have noted that in daily hospital practice there is often a lack of accuracy in assessing the duration of pregnancies. This makes it more difficult to care for pregnant women and makes certain obstetrical decisions less valid. They review the clinical and paraclinical means that are available to estimate the date when pregnancy started, which is the essential reference point. They show how precise different types of information are and how useful they are for the practitioner. In this report they draw attention particularly to the date of the periods, to the levels of chorionic gonadotrophin and to the ultrasound pictures. They have classified under three headings simple rules to make a sensible use of the information that is available: easy cases where the date of conception is know, average cases where the date of the last periods remains the most reliable indication and difficult cases where ultrasound is useful as long as it is carried out early.

[Prospective study of rotavirus infection in a maternity unit. Demonstration of a nosocomial infection]. / Etude prospective sur l'infection à rotavirus dans une maternité. Mise en évidence d'une infection nosocomiale.

Eighty-eight children born at the maternity hospital in Saint-Germain-en-Laye between May 24 and June 7, 1983 were followed clinically, with a special supervision concerning stools, weight curves and the way of feeding. Stool samplings looking for Rotavirus were performed in all the children and their mothers, at the 3rd and 6th days of life. No mother was found with Rotavirus infection. In neonates, Rotavirus excretion was significantly related to a slow down in weight curves and the occurrence of diarrhea. All rotaviruses had the same electrophoretype. Breast-feeding had an undeniable protective effect.

[Rectovaginal colonization by group B streptococcus]. / Colonisation recto-vaginale par le streptocoque du groupe B.

The influence of various factors, including age, pregnancy, contraceptive methods, menstrual cycle and use of vaginal tampons, on rectal and vaginal colonization with group B streptococci was investigated in 81 women, 25 of whom were pregnant. The organism was found more frequently in the anus (22.2%) than in the vagina (16%) or the pharynx (2.4%). The colonization rate was higher in women younger than 20, and higher in non pregnant (30%) than in pregnant (12%) women. It was also higher during the first phase of the menstrual cycle (45.4%) than during the second phase (21.8%). No significant difference was observed between users and non-users of intrauterine devices, oral contraceptives and vaginal tampons.

[Silent pericardial effusion in late pregnancy: echocardiographic detection in the third trimester of pregnancy (author's transl)]. / Les épanchements péricardiques latents de la femme enceinte. Détection échocardiographique lors du dernier trimestre de la grossesse.

Of 123 healthy pregnant women (mean age 28 yrs) who have been studied at various stages of their gestation by Tm and two dimensional echocardiography, 46 were in their late pregnancy (32nd to 38th week of pregnancy). Echocardiograms showed definite signs of pericardial effusion (PE) in 19 of those 46 women: the effusion was large in two, moderate in four and small in thirteen cases. PE was clinically silent as neither precordial pain nor pericardial friction rub was present. In all cases, pregnancies were uncomplicated; clinical examination was normal; however blood pressure was slightly elevated in three women. The electrocardiogram was normal or showed non specific ST-T change. PE appeared in the late pregnancy and did not occur before the 32 nd week; it was always transient and could not any longer be seen within the two months following delivery. It was likely to result from water and salt inflation as the mean weight gain was significantly higher in the group of women with PE. PE has not been reported so far during normal pregnancy. Echocardiography affords a safe and reliable approach of its diagnostic.

Measurement of plasma human chorionic gonadotropin (hCG) and beta-hCG activities in the late luteal phase: evidence of the occurrence of spontaneous menstrual abortions in infertile women.

Plasma luteinizing hormone (LH-human chorionic gonadotropin (hCG) and beta-hCG activities were measured during the late luteal phase in 321 cycles of 147 infertile women. In 71 cycles the hCG measurement permitted the diagnosis of pregnancy between the 10th and 14th days after the thermal nadir. The slope of the regression line derived from hCG levels during the first 22 days of pregnancy was significantly lower in pregnancies which aborted before the 60th day than in normal pregnancies (P less than 0.01). Among 72 cycles ended by apparently normal menses which exhibited an LH-hCG activity at least equal to 7 mIU of hCG/ml during the late luteal phase, the beta-hCG activity was measured in 49 cycles during which hCG had not been given. Significant beta-hCG activity (greater than or equal to 4 mIU of hCG/ml) was detected in 19 cases. This finding supports the assumption that secretory trophoblastic tissue had been present and that spontaneous menstrual abortions had occurred in these women.

[Diagnosis of pregnancy before the menstrual period is delayed. Interest of the determination of plasma chorionic gonadotropin (HCG) in fertility disorders]. / Diagnostic de la grossesse avant le retard de règles. Intérêt du dosage de la gonadotrophine chorionique (HCG) plasmatique dans les troubles de la fertilité

Estimating plasma HCG levels in the last days of the menstrual cycle have very early diagnosis of pregnancy. In 86 cycles occurring in 65 women being treated for sterility the levels were estimated between the 10th and the 15th day following the low point in the temperature curve for the purpose of trying to estimate the practical use of this method. In 30 cycles studied one case of fertilisation took place and was confirmed by the evolution of a pregnancy. From the 11th day onwards with the exception of one solitary case the concentrations of HCG ranged between 15 and 405 mUl-2 degrees-IS-hCC/ml. These levels, therefore are higher than the apparent concentrations found in a group of women used as controls who were not pregnant (0 to 4.5 mUl/ml.). In 56 other cycles apparently normal periods followed on the expected date. All the same, the apparent concentration of HCG (2 to 32 mUl/ml) is far higher often than in the control group. The interference of LH in the level makes it impossible to decide between two hypotheses: whether raised levels of LH are associated with irregular menstrual function or with fertilisation, followed by premature expulsion of the oocyte.