Heart blocks during sleep: a case report in a healthy subject.

Cardiac arrhythmia was fortuitously discovered during an experimental sleep recording in a healthy 50-year-old man. a 24 hr electrocardiographic (ECG) monitoring revealed the prevalence of these abnormalities during sleep and their absence during the awake period. Sleep and ECG were recorded during 4 consecutive nights. Numerous (500-1, 100 events/night) heart blocks and sinus pauses occurred 60-80 min after going to bed. They were never observed during awakenings and were exacerbated during paradoxical sleep. The atrioventricular blocks were of the Wenckebach-Luciani type. No other abnormality was found. These conduction abnormalities are discussed as possibly due to phasic increases in vagal firing, which during paradoxical sleep would be superimposed on the tonic increase in heart rate.

[Tumor of the peripheral nerve sheath with rhabdomyoblastic differentiation arising in a ganglioneuroma: neurilemmoma? A fortuitously detected case]. / Tumeur des gaines des nerfs périphériques à différenciation musculaire survenant sur un ganglioneurome: tumeur de Triton?

An otherwise healthy 21-year-old man with no evidence or family history of Von Recklinghausen's neurofibromatosis presented a posterior mediastinal mass detected on routine chest radiographs. The findings of standard light microscopy, ultrastructural examination and immunohistochemical studies suggested the working hypothesis of an unusual malignant "Triton" tumour: -arising in a pre-existing de novo ganglioneuroma; -fortuitously detected; -predominantly made of multinucleated spindle cells with only ultrastructural and immunohistochemical rhabdomyoblastic differentiation.

[Late abdominal metastases of primary meningeal melanoma. Contribution of MRI]. / Métastases abdominales tardives d'un mélanome méningé primitif. Apport de l'IRM.

A case of abdominal metastasis from primary meningeal melanoma is reported. MR imaging demonstrated hyperintensity on T1-weighted images in all the lesions and suggested their melanotic nature.

[Hemophagocytic syndrome: an underestimated cause of the syndrome of non-infectious fever?]. / Le syndrome d'activation monocytomacrophagique: une cause méconnue de syndrome fébrile non infectieux?

Haemophagocytic syndrome (HM) is a severe disorder with characteristic clinical and biological features. The case of a patient with malignant lymphoma who experienced HM during Herpes virus I pulmonary infection is reported. Main clinical, biologial and pathological findings are described. The risk of underestimation of this disease in patients requiring intensive care as well as the absolute necessity of an early diagnosis are emphasised.

[Chondroma of the soft tissues of the hand. Report of a recurrent case]. / Chondromes des parties molles de la main. A propos d'un cas récidivé.

A twenty six-year-old man presented a mass of the fifth left finger. X Ray and pathological examination after surgical treatment showed an extraskeletal chondroma. One month later, this tumor recurred, leading to a second surgical procedure. At one year follow up there was no evidence of new recurrence. A review of the literature shows that recurrence of this type of tumor is extremely rare. Also, it stresses the importance of a proper diagnosis which allows an appropriate treatment initially and after a recurrence.

[Anatomic pathology of testicular tumors]. / Anatomie pathologique des tumeurs du testicule.

Pathological examination of testicular tumours demonstrates the heterogeneity of the histological types encountered. Germ cell tumours, with one or several components, represent 95% of all testicular tumours. The distinction between these various types is always based on morphological criteria, but may also be facilitated by the use of immunolabelling techniques on fixed sections. The local and regional extension and the distinction between seminomatous and non-seminomatous germ cell tumours are important criteria in the subsequent therapeutic strategy. At the present time, there is no consensus concerning the selection of other histoprognostic criteria, which may be observed in the primary tumour it its metastases. Residual masses also have a variable histology and their pathophysiology is sometimes difficult to interpret.

[Histamine food poisoning]. / Les intoxications alimentaires histaminiques.

The authors describe a collective histamine related food-poisoning epidemic that occurred in the Navy due to the consumption of imported smoked swordfish (Xyphias gladius). Twenty cases were detected. The relative risk among consumers of swordfish is at 7.44 (C.I. of 95%: 2.57-21.59) and the doses of histamine were from 2.030 to 4.750 ppm in 9 samples of tested fish (N < 200 ppm). The interest in using a high-resolution chromatographic liquid to ensure a diagnosis, and in using the community norms in force are shown. A recent review of the literature serves to show the variety of fish responsible for this type of accident, to insist on the mildness, elusiveness, variability, and lack of specificity of clinical signs and therefore risks error in diagnoses, treatment and under-reporting of this type of collective food-poisoning.

[Tuberculous pericarditis: still a relevant disease]. / La péricardite tuberculeuse: un diagnostic qui reste d'actualité

Vaccination against tuberculosis is not an obligation anymore in France, except for children at risk, but this disease remains not so rare, including its extrapulmonary forms. The authors report the case of a 27-year-old Madagascan HIV seronegative patient, who developed a pericardial effusion when coming back from a long stay in Madagascar. An anti-inflammatory treatment and then a probabilistic antibiotic treatment were ineffective, and at the same time echocardiographic signs of tamponade appeared. As a consequence, it was decided to perform a surgical pericardial drainage and a biopsy, and to introduce an antituberculosis chemotherapy, given the epidemiologic status. The course was then quickly favorable. The presence of granulomatous inflammation on the biopsy and an elevated pericardial adenosine deaminase activity level retrospectively supported the diagnosis of tuberculous pericarditis.

[Pathologic anatomy of tumors of the testis]. / Anatomie pathologique des tumeurs du testicule.

Pathological examination of testicular tumours demonstrates the heterogeneity of the histological types encountered. Germ cell tumours, with one or several components, represent 95% of all testicular tumours. The distinction between these various types is always based on morphological criteria, but may also be facilitated by the use of immunolabelling techniques on fixed sections. The local and regional extension and the distinction between seminomatous and non-seminomatous germ cell tumours are important criteria in the subsequent therapeutic strategy. At the present time, there is no consensus concerning the selection of other histoprognostic criteria, which may be observed in the primary tumour it its metastases. Residual masses also have a variable histology and their pathophysiology is sometimes difficult to interpret.

[Dedifferentiated chondrosarcoma with maxillary involvement. An anatomo-clinical study, surgical treatment and prosthetic rehabilitation. Apropos of a case]. / Chondrosarcome dédifférencié à localisation maxillaire. Etude anatomo-clinique, traitement chirurgical et réhabilitation prothétique. A propos d'un cas.

A 19 year old girl presented with a dedifferentiated chondrosarcoma of maxilla. The recurring tumor, diagnosed initially from the provoked pain, appeared on the scan image as a heterogeneous mass containing numerous calcifications. Histology showed, within a well differentiated chondrosarcoma, an anaplastic sarcomatous zone of the malignant fibrous histiocytoma (MFH) type. This histologic appearance is consistent with a poorer clinical prognosis. Radical surgery of the 4th tumor recurrence was combined with maxillofacial prosthetic rehabilitation. This appears to be first reported case of a dedifferentiated chondrosarcoma of the MFH type located in the maxilla.