Evaluation of peripheral blood T lymphocytes in renal adenocarcinoma before and after surgical removal of the tumor.

Peripheral blood T lymphocytes were studied in 24 untreated patients with renal adenocarcinoma, 80 per cent of whom had local extension of the tumor. T lymphocytes were evaluated with the total and the active rosette assays, and were further submitted to stimulation by a range of phytohemagglutinin concentrations in vitro. Controls were healthy volunteers tested on the same days as the patients. Total E-rosette forming cells were slightly decreased but the difference compared to controls was not significant. Active rosettes were normal. When present lymphocytopenia affected total E-rosette forming cells. The mean of the log-converted stimulation indexes was reduced significantly in the patient group only when a suboptimal concentration of phytohemagglutinin was used. Total E-rosette forming cells returned to normal 3 weeks postoperatively but lymphocyte reactivity did not improve and active rosette forming cells remained within normal range. Thus, only minor abnormalities of T lymphocytes were disclosed in this study, suggesting functional alterations rather than depletion. Our study confirms that a cancer operation may act as immunotherapy.

[Renal staghorn calculi in adults. A study of eighty patients with ninety two calculi (author's transl)]. / La lithiase coralliforme du rein de l'adulte. A propos de quatre-vingt-douze calculs chez quatre-vingts malades.

A homogeneous sery dealing with 80 cases of staghorn calculi in adult patients is examined from clinical and therapeutic points of view. Among 75 operated patients, 8 bilaterally, 67 conservative operations were performed. Enlarged intra-sinusal pyelotomy gives the best short and long-term results and is the surgical procedure of choice.

[Recent advances in isotopic exploration of the skeletal system in prostate cancer (author's transl)]. / Mise au point sur les explorations isotopiques du squelette dans les cancers de la prostate.

Skeletal isotopic exploration is fundamental in patients with prostatic cancer. Bone scintiscan is reliable. Its sensibility can be increased by using new radioactive isotopes and quantitative isotopic explorations. Bone marrow histologic study is indicated in case of a doubtful diagnosis, when there is a discordance between radiological and isotopic exploration.

[Isotopic kidney investigations in staghorn lithiasis in the adult (author's transl)]. / Les explorations rènales isotopiques dans la lithiase coralliforme de l'adulte.

The authors report a study of 37 kidneys in 30 patients with staghorn calculi undergoing isotopic investigation of renal function by sequential scintigraphy and isotopic nephrogram by gamma-camera. 7 of the patients had bilateral staghorn calculi. Tracers used: Hippuran labelled with I131 and DPTA labelled with Technetium 99 m. 62% of kidneys poorly tolerated their staghorn calculus as shown by severe impairment of the isotopic nephrogram involving the uptake phase. Amongst the 20 cases of unilateral lithiasis, a nephrectomy was performed whenever the functional value was less than 20% normal (7 kidneys). Twelve stones were removed with conservation of the kidney. It should be noted that with renal function greater than 70% normal, the thickness of the renal parenchyma as assessed by IVU is never less by more than 1/2 cm that of the contralateral kidney. In the group, 11 patients underwent postoperative urography and scintigraphy with a mean follow up of 4 years. All extractions of calculi by pyelotomy with or without a small nephrotomy benefited initially impaired kidneys. By contrast, in 5 kidneys where a large nephrotomy was made, there was a gain in function in only one. 1 remained stationary and the others lost respectively 20, 30 and 100% of their function. Correlation was good with other methods of split renal function studies (IVU and renal arteriography). Of essential importance is the fact that the irradiation associated with these isotopic investigations is 20 to 50 times less than that of IVU. Isotopic investigation is thus a good method for the assessment of changes in renal function after surgery for staghorn calculus.

[Heavy haematuria as the presentation of attenuated haemophilia B (author's transl)]. / A propos d'une hématurie grave révélatrice d'une hémophilie B atténuée.

The authors report a rare case of eosinophilic cystitis presenting with heavy haematuria which led to the discovery of attenuated haemophilia B. Bleeding and clotting times in this patient, with no past history of haemorrhage, were normal. Complete coagulation studies led to the diagnosis in the presence of poor plasma prothrombin consumption and a moderate deficit in clotting factor IX, defining haemophilia B. Despite two partial cystectomies for haemorrhagic lesions of the dome of the bladder (eosinophilic cystitis), carried out with transfusion cover and the administration of P.P.S.B., recurrence of haematuria made it necessary to "rest" the bladder by a cutaneous ureterostomy. Subsequently, the restoration of urinary continuity was possible by uretero-ileo-cystoplasty, without any haemorrhagic complications by virtue of the use of P.P.S.B. The value of the association of epsilon amino-caproic acid with P.P.S.B. is emphasised in the prevention of haemorrhagic complications during surgery in haemokphilia B patients. In attenuated forms of haemophilia B (factor IX level between 5 and 15%) haemorrhages may be only occasional and occur only late in life.

Ultrastructural changes of the intestinal wall after transileal cutaneous ureterostomy in men. A preliminary study. (With 1 color plate).

Pre- and postoperative specimens of ileal loops used in transileal ureteroplasty have been taken and ultrastructural modifications concerning the intestinal mucosa with special attention to the epithelial cells are described. The enterocytes undergo significant modifications because of the operation (i.e. collapse of striated border and entrancement of lysosomal inclusions). Contact with the urine brings about osmotic changes of the intestinal epithelium as well as irritation of the capillar endothelium. But most structural modifications observed histologically or by electron microscopy seem to be reversible. 6 months after the operation the histological structure of the ileum in contact with urine again becomes morphologically normal.

[Isolated angiomyolipomas of the kidney. Diagnostic difficulties]. / Les angiomyolipomes isolés du rein. Difficultés diagnostiques.

The authors report 4 cases angiomyolipomas in which the preoperative diagnosis was that of a malignant tumour. They stress the difficulties of arteriographic and even histological diagnosis of these rare tumours of the renal parenchyma.