High resolution autoradiographic study of normal lactating mammary gland and mammary tumors of the mouse: preliminary report.

Protein metabolism of normal lactating gland and mammary tumor cells was studied with high resolution autoradiography. Special attention was devoted to the Golgi zone in both cell types because of the involvement of this structure in milk protein secretion in the normal gland cell and the topographical relation of this apparatus with viral "inclusion bodies" in the tumor. In the normal gland, the cycle of protein secretion was completed in about 50 minutes, the main part of the cycle being represented by a heavy and extensive labeling of the Golgi zone. In the tumorous gland, marking was relatively stationary and remained within the cell, the label predominating in the ergastoplasm with only a faint labeling of the Golgi apparatus. Percent markins of the nucleus was notably greater in the tumor cell as opposed to the normal gland cell. In the calculation of the specific activities of the tissues, the size of the nucleus of both cell types was very similar, while the cytoplasm of the normal gland was five times that of the tumor cell. Comparison of the specific activities showed that the over-all activity of the two cell types was not significantly different. This phenomenon supports a theory proposed by Schultze whereby the ratio of protein incorporation into the nucleus and the cytoplasm is constant and the value of this ratio decreases as the metabolic activity of the cell increases.

[Pregnancy and motherhood after liver transplantation in terminal autoimmune active hepatitis with primary amenorrhea]. / Grossesse et maternité après transplantation hépatique pour hépatite active auto-immune terminale avec aménorrhée primaire.

We report the case of a young patient with end-stage auto-immune chronic active hepatitis and primary amenorrhea who became pregnant 18 months after orthotopic liver transplantation. She continued an uncomplicated pregnancy on treatment with ciclosporin A and spontaneously gave birth to a full term and healthy child.

[Risk-taking behavior and accidents in adolescence in developed countries]. / Comportement de prise de risque et accidents à l'adolescence dans les pays développés.

Injuries due to accidents are the primary cause of fatalities among adolescents. Between the ages of 10 and 19, mortality caused by accidents augments significantly, and there is an excess of male mortality, increasing with age. This mortality has remained virtually unchanged over the past 25 years, except for a small narrowing of rate differences by sex. Traffic accidents, particularly those involving motorcycles, are the leading cause of accident fatalities. Though not easily assessed, morbidity due to accidents is probably very high, especially among males. Sports accidents are the most frequent. Adolescents appear to be particularly exposed to some risks, but also tend to be careless about safety. Risk-taking is a source of rewards: pleasure, self-affirmation, sense of independence; but it is described by some authors as self-destructiveness, death from accidents reflecting suicidal tendencies. Paradoxical results of prevention have been observed in this age group.

[Pneumomediastinum in a young girl with anorexia nervosa]. / Pneumomédiastin chez une jeune fille anorexique.

BACKGROUND: Pneumomediastinum is a rare complication of anorexia nervosa. It may occur in patients with severe weight loss and a history of induced vomiting. CASE REPORT: A 14 year-old girl was admitted suffering from severe anorexia nervosa. Shortly after admission, she complained of anterior thoracic pain. Examination showed subcutaneous emphysema of the supraclavicular fossae and the base of the neck. Thoracic X-ray showed pneumomediastinum without pneumothorax. At the time, the patient admitted to a history of surreptitious chronic induced vomiting. Gastrografin esophagography ruled out an oesophageal tear. The pneumomediastinum gradually disappeared over a period of several days with simple clinical and radiological monitoring. CONCLUSIONS: This case, along with seven others reported in the literature, confirms that pneumomediastinum in anorexia nervosa is usually not accompanied by pneumothorax. An oesophageal perforation must always be ruled out. Spontaneous pneumomediastinum invariably has a favorable outcome.

[Medicine without boundaries, or the adolescent in the hospital]. / Médecine sans frontières, ou l'adolescent à l'hôpital.

Some of the most common problems set by the hospitalization of adolescents are summarized and the general conditions and specific problems attendant to this activity are analyzed. Answering the health requirements of adolescents implies that a pluridisciplinary staff be permanently prepared to take action. Strict requirements concerning the distribution of tasks between staff members are necessary. However, close communication between the different departments (practitioners, psychiatrists, social workers, outclinics) must be given attention in order to evolve truly therapeutic actions.

[The role of plasma ferritin determination in screening for iron deficiency. Apropos of a study in 2 groups of children of different socioeconomic background]. / Rôle du dosage de la ferritine plasmatique dans le dépistage de la carence martiale. A propos de l'étude de deux groupes d'enfants de niveau socio-économique différent.

A study of 72 children, aged between 6 and 24 months who came from socio-economic background has shown: plasma ferritin levels decrease gradually between 3 weeks and 6 months of age. Between 6 months and two years, levels reach a plateau but the values are lower than those of adults. The mean ferritin level is lower at any given age in children with iron deficiency but plasma ferritin levels may be in the normal range although there is obvious iron deficiency. By contrast the saturation of siderophillin can be used to determine inadequate supplies of iron to the marrow. The frequency of iron dificiency in infants under 1 year was similar in the two socio-economic groups. However between 1 and 2 years no iron deficiency was detected in the children under regular supervision but all the infants who were socially disadvantaged became iron-deficient demonstrating the need for regular iron supplements.

[A 3-year study of adolescent hospitalization in a department of pediatrics (author's transl)]. / Expérience de trois années orientées vers l'hospitalisation de l'adolescent en service de pédiatrie.

A 3-year experiment in adolescent hospitalization in a department of pediatrics is described. Details are given concerning patient referral to this specialized sub-unit and staff behavior.

[Child health in the school environment]. / La santé de l'enfant en milieu scolaire.

The authors studied the consequences of the present school system on children's health. They emphasize the causes of failures, mostly related to a misappreciation of children's individual differences and inequalities of the rate of physical and psychoaffective development. Overloaded school days, the lack of respect of sleep and extra-curricular needs, the overlooking of attention capacities were also studied.

[Abuse in adolescence. Incest. Apropos of 21 cases]. / Sévices à l'adolescence. L'inceste. A propos de 21 observations.

While violent behavior and delinquency in youth have been extensively described, the different patterns of violence that adolescents are subjected to in their families are far less known. Physical abuse is probably as frequent as in childhood and offers some distinctive features because of its appearance or prolongation in adolescence. Moreover, sexual assaults become more important, especially in girls. From review of the literature and the experience of 21 cases of incest observed in the Adolescent Medicine Unit of Hospital Bicêtre, we discuss the circumstances, impact on adolescents and role of the professionals involved. The majority of these cases of incest occur in an impoverished atmosphere, both on psychological and social levels. Intervention strategy is often very delicate.

[XY/XO mosaicism in a child with feminime phenotype manifesting internal genital ambiguity]. / Mosaique xy/xo chez un sujet de phénotype féminin présentant une amgiguite génitale interne.

A 18 year old patient presented with a female phenotype and no signs of sexual maturation. The leukocyte karyotype was XY. At laparotomy, there was no uterus and the gonadal streaks had a XY/XO mosaicism. There were rudiments of fallopian tubes and epididymis. Histologic examination of the gonads showed foci of Leydig and Sertoli cells.

[Adolescent medicine: who cares for what?]. / Une médecine d'adolescents: qui soigne quoi?

The expression of adolescence can be defined as a psychic maturation crisis. The purpose of this study was to better understand the specific institutional and health care needs this particular age group requires. The authors have analysed the nature of adolescent care within a pediatric ward, using data obtained from interview material. There was a growing awareness among the staff that feelings of rejection and alienation often jeopardize the delivery of optimal care to adolescents. This idea helped define the final formation of a unit designed for adolescents. The particular characteristics of such a practice are illustrated in the paper. In doing so, an effort was made to remain objective and to respect the ideas originated by the staff.

[Familial hemolytic-uremic syndrome with normal renal biopsy]. / Syndrome hemolytique et uremique familial avec biopsie renale normale

Five children from 3 different families, presented several attacks of hemolytic-uremic syndrome with peculiar features:--in 4/5 children the disease was familial; 4 presented 2 attacks, the 5th 3 attacks, separated by several months or years of time-interval;--the "bouts" were constantly marked by the initial high level of reticulocytes, rapid recovery of hematuria, renal failure and thrombocytopenia;--overall, repeated biopsies of the kidney never showed any lesion of the basement membrane of the glomerular capillaries or of the arteriolar walls leading to the diagnosis of thrombotic microangiopathy;--all etiological enquiries to precise the cause of chronic hemolysis were negative.

Acquired sideroblastic anaemia during treatment of Wilson's disease with triethylene tetramine dihydrochloride.

We report one case of acquired sideroblastic anaemia in a patient treated for Wilson's disease with triethylene tetramine dihydrochloride (TTH). No other cause of acquired sideroblastic anaemia was found, and neither iron nor pyridoxine therapy could correct this anaemia. In contrast, decreasing the dose of TTH led to disappearance of ringed sideroblasts. Thus TTH should be added as a further cause of secondary acquired sideroblastic anaemia. The pathophysiology of this finding, probably linked to an abnormality of mitochondrial iron metabolism, is briefly discussed.

[Late lymphedema in Turner's syndrome]. / Lymphoedeme tardif dans le syndrome de Turner.

Two cases of delayed unilateral lymphedema are reported in children presenting with Turner's syndrome. On this occasion, the frequency of lymphedema in Turner's syndrome and the more general problem of the lymphatic changes in this syndrome are discussed. The importance of isotopic lymphography is emphasized, because of its simplicity, its harmlessness and the good quality of the morphological and cinetic data obtained.

[Suicide attempts in adolescent girls. Epidemiological aspects]. / Les tentatives de suicides de l'adolescente. Aspects épidémiologiques.

The authors report the results of a study undertaken in 27 adolescent girls hospitalized for suicide attempts, interviewed according to the same procedure as 46 adolescent girls hospitalized during the same time period for other reasons. A statistical study of the questionnaire used showed answers significantly different, especially concerning grandparents, intra-familial relationships, parental picture, behaviours of adolescents outside their family, school attendance. The whole of these results suggests a disturbance in the communication systems of the suicidal adolescent.

[Visceral candidiasis in 2 children treated for acute leukemia]. / Candidose viscérale chez deux enfants traités pour leucémie aiguë.

The authors report two cases of splenic and hepatosplenic candidiasis occurring during a protracted neutropenia induced by chemotherapy for acute leukemia (lymphoblastic and myeloblastic respectively). Fungal infection was revealed by persistent or recurrent fever after correction of neutropenia. Diagnosis was suggested by findings at abdominal ultrasonography. It was confirmed by histological analysis which, in the first case, required open liver biopsy. In both cases, lack of improvement of splenic lesions despite treatment with Amphotericin B followed by fluconazole led to splenectomy. Both patients received postoperative anti fungal therapy with Ampho B and at one year's follow up, the patient who had the hepatosplenic candidiasis seems to have recovered.

Membranous glomerulonephritis and hepatitis B surface antigen in children.

Of 33 children with membranous nephropathy screened for HBs Ag, 14 were found to be HBs Ag carriers, whereas HBs Ag was detected in 3 of 170 and 4 of 100 children with glomerular and nonglomerular kidney diseases, respectively. HBs Ag was often associated with acute hepatitis at onset (five patients) or with elevated transminases values. This high incidence and the prevalence of an unusual subtype (ayw2) suggest a relationship between HBs Ag and the glomerular lesions. Using immunofluorescence, however, HBs Ag could not be detected within the deposits, so that the nature of the relationship cannot be considered as established. The clinical outcome (50% remission), the plasma complement component disturbances, and findings by immunofluorescence did not differ from those observed in children with MGN without detectable HBs Ag.

[Acquired immunodeficiency syndrome in an adolescent hemophiliac]. / Syndrome immunodéficitaire acquis chez un adolescent hémophile.

In an adolescent with hemophilia B, the diagnosis of AIDS was established in face of cachexia, orodigestive candidiasis, associated with lymphopenia, major decrease in T4/T8 ratio with marked decrease in T helper cells and presence of LAV-antibodies. The patient died rapidly from a cerebral infection due to Toxoplasma gondii. Difficulties in diagnosis and treatment of cerebral toxoplasmosis are discussed.