[Mucocutaneous leishmaniasis. Report of 2 cases]. / La Leishmaniose cutanéo muqueuse. A propos de deux cas.

Two new cases of midfacial granuloma caused by leishmaniasis are reported. This disease is very rare in France but very frequent in South America, where it occurs in two forms called UTA and Espundia. These are described here as well as the means of diagnosis and treatment for this disease. A brief review of the cases published in France seems to indicate that the disease is underestimated in this country. The study of the cases published in other African or European countries shows that all species of Leishmania can produce a midfacial granuloma.

[Incidence of mandibular osteoradionecrosis in a series of 13 cases of carcinoma of the mouth floor]. / Incidence des ostéo-radio-nécroses mandibulaires sur une série de 13 cas de carcinomes du plancher buccal.

In a 13-case series of epithelioma of the floor of the mouth given cobalt-therapy irrespective of the selected therapeutic protocol, the authors recorded 5 cases of osteoradionecrosis. In this study, they review both risk and prevention factors linked with radionecrosis at the localization site of this particular type of tumor. They also stress the importance of adapting the treatments, when introducing so-called néo-adjuvant systemic chemotherapy, the high efficacy rate of which is likely to reduce the risks of radionecrosis. This can be achieved either by eliminating completely or limiting the surgical step, or by bringing modifications to the post-operative radiation regimen.

[Cardiac toxicity of 5-fluorouracil. Reflections on a case]. / Toxicité cardiaque du 5-fluoro-uracile. Réflexions à propos d'un cas.

The authors relate a case of spasm occurring during cisplatin and 6-fluorouracil combination chemotherapy. The cardiotoxicity of 5-F.U., and namely the risk of coronary spasm, has been known since 1969. However, few cases have been reported in France. Referring themselves to the case of interest and to literature sources, the authors review current pathogenic hypotheses and specify the precautions commanded by the prescription of any protocol that includes 5-F.U.

Specific antibody response to Pasteurella multocida.

Six patients with culturally proven Pasteurella multocida infection were evaluated serologically. The infections were 1 foot abscess, 1 septicemia, 3 bronchitis and 1 bronchopneumonia. Most of them were elderly women closely exposed to pets or domestic animals. The serotypes of the strains were determined in 5 cases (3 A3, 2 A7). Specific antibodies against capsular and somatic antigens of P. multocida were determined by indirect hemagglutination and agglutination respectively. The antibodies were strictly directed against the capsular and somatic specificities of the isolated strain. The range of the serum antibody titers were 20 to 2,560 to capsular antigens and 5 to 640 to somatic antigens within 2 weeks after the first clinical signs of infection. Several months after successful treatment, the capsular antibodies were lower while the somatic antibodies had almost disappeared. These findings suggest a good sensitivity for these serologic methods in active cases. Declining antibody titers follow healing. Cross-reactivity of the serologic tests with other bacteria was not observed. Serologic diagnosis of P. multocida infections is a possible alternative to direct diagnosis when cultures are negative or when unusual localizations must be confirmed.

[Velopharyngeal rehabilitation after transmaxillary buccopharyngectomy extending to the soft palate]. / Réhabilitation vélo-pharyngée après bucco-pharyngectomie-transmaxillaire élargie à la région vélo-palatine.

Two types of velopharyngeal rehabilitation are proposed after transmaxillary buccopharyngectomy extending to the soft palate region. The first method is by velopharyngoplasty, when exeresis has not involved a half or a quarter of the soft palate and at least half of the posterior pharyngeal wall. The second procedure is for use after exeresis involving all or almost all of the soft palate and a half of the posterior pharyngeal wall, and makes use of velum palatinum reconstruction. The method of choice is velopharyngoplasty, excellent functional results being obtained for both phonation and feeding.

[Total glossectomy with preservation of the larynx and immediate reconstruction. Apropos of 27 cases]. / Glossectomies totales avec préservation du larynx et reconstruction immédiate. A propos de 27 cas.

Total glossectomy with preservation of larynx was performed in 27 patients with lesions affecting the whole tongue and developing from the base, the tonsilloglottal recess, of the junction zone and of the posterior wall, or from the mobile tongue. Results in patients followed up for more than one year (27 cases) showed: 11 survivors only, with 12 deaths from local, regional or metastatic recurrence. Among the 11 survivors, 7 presented very satisfactory functional rehabilitation--they no longer required tracheotomies, were free from pain and fed themselves without problem with mixed types of food. Phonation could be understood and they were reasonably autonomous. When tumoral excision is possible in patients with extension not evident as palpable glands, this operation appears quite justified for patients who are psychologically motivated and very insistent on some therapy, the modalities and risks of which have been exposed.

[Surgery of pericannular recurrence and extensive tumors of the trachea]. / La chirurgie des récidives péri-canulaires et des tumeurs étendues de la trachée.

Treatment proposed for pericannular recurrence and previously irradiated vast, extensive, subglottotracheal tumors involves the performance of a manubriectomy with reconstruction using a musculocutaneous flap. The former solves the problem of the route of approach and local carcinologic safety and the latter provides a solution to the problem of congruence of trachea and presternal teguments as well as postoperative complications by protecting the brachiocephalic arterial trunk.

[ORL manifestations reported in AIDS. Apropos of 54 cases]. / Manifestations ORL observées dans le SIDA. A propos de 54 observations.

A review of 54 cases of AIDS established the ORL manifestations of this constantly fatal disease. Simple infections such as sinusitis, otitis and tonsillitis were frequent and quite typical, but buccopharyngeal herpes and particularly buccopharyngo-esophageal candidosis were widespread affections. The onset of candidosis in a subject at risk is a valid diagnostic factor for AIDS. A buccopharyngeal Kaposi tumor is specific and is usually associated with lesions in other, particularly cutaneous localizations. Marked emphasis is placed on the role of specialists in the detection of this disease, currently increasing at a high rate. In the USA, where AIDS is very prevalent and doctors very clearly informed, 40% of cases are detected from cervicofacial manifestations.

[Experimental infection in goats caused by mycoplasma strain F.38 (contagious caprine pleuropneumonia)]. / Infection expérimentale de la chèvre par les souches de mycoplasme de type F.38 (pleuropneumonie contagieuse caprine).

The contagious pleuropneumonia syndrome is easily reproduced in goats, using cultures and lung lesion homogeneizate, given by endobronchial inoculation and by aerosol. The latter route causes hyperacure evolution, with septicaemia, multiple and disseminated lesions and death within three days following the onset of clinical signs. The same strains seem to be poorly pathogenic toward chick embryos inoculated in the yolk-sac. The nature of Mycoplasma capripneumoniae pathogenicity remains undetermined.

[Isolated fractures of the branches of the stapes. Apropos of 2 cases]. / Les fractures isolées des branches de l'étrier. A propos de deux cas.

Isolated fractures of the limbs of the stapes are relatively rare when compared with other traumatic lesions of the ossicula. Diagnosis, as in two recent cases, is suggested by the history of injury and the persistence of a recordable stapes reflex. Surgical re-establishment of transmission is simple but results are not always as spectacular as might be expected.

Standard antisera produced in ponies for the identification of bovine mycoplasmas: comparative growth-inhibition results from six laboratories.

Antisera to 10 mycoplasma species of bovine origin were produced in 10 ponies and were distributed for evaluation in growth-inhibition tests at 6 laboratories in Australia, England, Denmark, France, and the United States. Except for a few failures with some antigens produced at the 6 laboratories, the antisera induced large zones of growth inhibition in homologous, but not heterologous, systems. These antisera may be useful as standard reagents for the identification of the bovine mycoplasmas.

Haemagglutinating properties of Pasteurella multocida type A strains isolated from rabbits and poultry.

Thirty-one type A strains of Pasteurella multocida isolated from rabbits and poultry were able to agglutinate red blood cells (RBC) from human group O donors. Except for human RBC from group B which were also agglutinated by 3 strains, neither group A nor RBC from sheep and rabbits were agglutinated. Haemagglutination was mannose-resistant, and the two techniques used detected unrelated activities. One as tested by a slide haemagglutination (MRSH) test was common to most (31 out of 34 strains) capsulated strains, though non-mucoid ones obtained by growth on hyaluronidase-containing medium showed also this property. This haemagglutination activity was destroyed at 100 degrees C for 15 min but not at 56 degrees C for 30 min, was dependent upon an optimal pH range (7.4-7.5) and did not seem to be influenced by different enriched media. The other activity was assayed by the microhaemagglutination (MRMH) test. Only part (19 out of 34 strains) of the strains presented this activity, which was also destroyed by boiling for 15 min and was dependent on the addition of 0.5 of polyvinilpirrolidone to phosphate buffered saline, used to suspend RBC. A correlation between haemagglutination activities of P. multocida type A and the possibility of this microorganism harbouring fimbriate organelles is discussed.

[Combined vaccines in veterinary medicine in the developing countries]. / Intérèt des associations vaccinales pour les pays en voie de développement.

It is in the interest of developing countries to have combined vaccines in veterinary medicine, not so much because they reduce production costs, but rather because they increase convenience and efficacy concerning the logistics of prophylactic projects in the field, thus lowering the cost of these projects. Their drawbacks are basically due to the biological compatibility of immunogens (possible immunosuppression by some viruses) and to the interaction of the various components when mixed, or when lyophilization is carried out. Some examples of such associations of vaccines are: (1) cattle plague + pleuropneumonia and possibly anthrax, (2) anthrax + blackleg, (3) sheeppox + anthrax, (4) pleuropneumonia + blackleg, (5) Newcastle disease + fowlpox + fowl typhoid, (6) fowl typhoid + chicken pasteurellosis. Practical results have been most positive and include the eradication of cattle plague - a major scourge of almost all of the African continent - and control over peripneumonia as a first step towards its eradication.