Physical activity reduces oxidative stress and improves lipid profile made by smoking - Effectiveness of irregular and continuous training programs.

OBJECTIVE: The aim of the study was to identify the possible benefits of physical activity program in improving the antioxidant enzymes activity and lipid profile among smokers. PATIENTS AND METHODS: Fifteen cigarette smokers (CS), 14 hookah smokers (HS), and 14 non-smokers (NS) participated in the low-intensity continuous training (LCT). Eleven CS, 12 HS, and 12 NS participated in the moderate-intensity intermittent training (MIT). The LCT groups performed a 20 to 30-minute continuous exercise at 40% of the VO2max. The MIT groups performed 6 to 10 sets of 2-minute sprint at 70% of the VO2max interspersed by a 1-min recovery period. At baseline and after 12 weeks of intervention, the antioxidant defense activity and lipid profile were assessed. RESULTS: The improvement in antioxidant capacity under the effect of MIT program is statistically more significant than after LCT. The increase of glutathione peroxidase (GPx), superoxide dismutase (SOD), glutathione reductase (GR), malondialdehyde (MDA) and α-tocopherol was higher in smoker subjects participating in the MIT program compared to those participating in the LCT. In contrast, the LCT program has favorably altered lipid and lipoprotein profile of smokers and thus reduced their cardiovascular risk. CONCLUSIONS: The combination of the two training methods may have major implications in both defense and prevention programs.

[Swyer syndrome: report of 5 cases]. / Syndrome de Swyer: à propos de cinq cas.

INTRODUCTION: Swyer's syndrome is a distinct type of pure gonadal dysgenesis characterized by a 46 XY karyotype in female phenotypic patients. It shows an abnormality in testicular differentiation. The disease is a sex-reversal disorder resulting from embryonic testicular regression sequences. MATERIAL AND METHODS: We present the clinical, sonographic and endocrine findings in five cases of phenotypic young girls with XY karyotype and gonadal dysgenesis. The treatment and the follow-up are discussed. RESULTS: The mean age was of 17.6 years. All patients presented with primary amenorrhea. All patients had female-type external genitalia. Secondary sexual characters were merely developed in all cases. FSH levels were high with a mean of 80.5. The surgical findings were steak fibrous gonads, two cases of gonadoblastoma and one case of dysgerminoma in a 13-year-old teenager. CONCLUSION: The risk of gonadal neoplasia is high, dictating early prophylactic removal of these dysgenesic gonads.

[Immunohistochemical study of endometrial stromal sarcoma and smooth-muscle tumors of the uterus]. / Etude immunohistochimique des sarcomes du stroma endométrial et des tumeurs musculaires lisses de l'utérus.

OBJECTIVES: Positive and differential diagnoses of mesenchymal tumors of the uterus may be sometimes problematic. The purpose of this study was to evaluate the utility of a panel of antibodies in this diagnosis. MATERIALS AND METHODS: The expression of AML, desmin, h-caldesmon and CD10 was studied in nine endometrial stromal sarcomas (SSE), two leiomyosarcomas (LMS) and 10 highly-cellular leiomyoma (HCL). RESULTS: AML positivity was found in five SSE, in all HCL and in only one LMS. Desmin expression was found in two SSE, in all HCL and LMS. H-caldesmon was negative in all SSE, positive in all HCL and in one case of LMS. CD10 was expressed in two-third of SSE. However, neither HCL nor LMS was marqued. CONCLUSION: CD10 is the most specific antibody of SSE. It seems to have the best value in the diagnosis of mesenchymal tumors in association with desmin and h-caldesmon, specific markers of smooth-muscle differentiation.

[Ovarian fibrothecal tumors. Apropos of 12 cases]. / Les tumeurs fibrothécales de l'ovaire. A propos de 12 observations.

OBJECTIVE: To identify diagnosis, therapeutic and histological particularities of ovarian fibro-thecomas. STUDY DESIGN: A retrospective study of 12 patients who underwent surgical treatment for ovarian fibro-thecoma between January 1994 and December 1999 was reported. Clinical, ultRasonographic, tumour marker, therapeutic and histologic data were analysed. RESULTS: Mean age of patients was 46.83 years. Three patients were in perimenopausal period and six were menopausal. Ultrasonographic findings were: ovarian echogenic tumor in six cases, hypoechogenic tumor in three cases, mixed tumor in three cases and anechogenic tumour in one case. CA 125 level measured in 11 cases was normal. Nine patients underwent laparotomy. Three patients underwent laparoscopy, however, one was converted to laparotomy due to a suspected tumour. A conservative treatment was performed for three patients and radical treatment for nine patients. Histological findings were eight fibromas and five fibro-thecomas. CONCLUSION: Ovarian fibro-thecoma is uncommon. These lesions occur often in perimenopausal and menopausal patients. Clinical, ultrasonographic and tumour marker data remains the best preoperative approach currently available for ovarian tumours. However, the diagnosis remains histological. Tumorectomy is well indicated for young patients, however radical treatment is indicated for perimenopausal and menopausal patients.

[Intrauterine hydatidosis. A case report]. / Hydatidose intra-utérine. A propos d'un cas.

The authors describe a rare case of an intra uterine hydatid cyst in a 60 year old woman. Hydatid vesicles were found in the vagina. The diagnosis was made histologically. A total hysterectomy was carried out. The authors discuss the aetiology and pathogenicity of an occurrence at this site. Conservative treatment is suggested for young female patients.

[Virilism during pregnancy]. / Virilisme au cours de la grossesse: à propos d'un cas.

We discuss the causes of virilism in pregnancy and the impact of hyperandrogeny on the female foetus. We report a case of virilism in a 28-year-old, gravida 1, para 1 patient with normal pregnancy and review the literature. After conception, the patient had been well until the 18th week of gestation, when she developed signs of virilization; her serum testosterone was markedly elevated. She delivered of a normal male infant at term. After delivery, signs of virilization regressed with normalization of testosterone level but a wide mass of the left ovary that persisted for 8 months. The histological study of the tumor showed luteinized thecoma. Luteomas and hyper-reactio luteinalis were the principal causes of virilism in pregnancy, thecomas are rare.

[Male internal pseudohermaphroditism or a man with a uterus]. / Le pseudo-hermaphrodisme mâle interne ou homme à utérus.

Mullerian structures were discovered during cure of bilateral ectopic testes in a 14-year-old boy. The original feature of this case was the presence of both testes on the same side. The Mullerian structures were left in place as they were intimately adherent to the vas deferens. This attitude was adopted as no degeneration of these structures has been described and because of the possibility of reproduction of these patients during adulthood.

[Ultrasonographic diagnosis of ectopic pregnancies. A report of 109 cases]. / Diagnostic échographique des grossesses extra-utérines. A propos de 109 cas.

OBJECTIVE: To assess the accuracy of ultrasonographic diagnosis of ectopic pregnancies. METHODS: A retrospective study of ultrasonographic findings of 109 patients operated for ectopic pregnancy between january 1997 and december 1998. Ultrasonography was performed with an Aloka SSD 620 sonographic imager and a 5 MHz endovaginal transducer. RESULTS: All patients had a transvaginal sonography. Of these, 15 had a transabdominal sonography. Ultrasonographic findings of the 109 ectopic pregnancies were an extrauterine gestational sac in 10 cases (9.17%), an adnexel mass clearly separated from uterus and ovary in 87 cases (79.81%), a pelvic fluid in 90 cases (82.56%) and pseudogestational sac in 6 cases. Ultrasonography established the diagnosis of ectopic pregnancy in 89% of cases. Serum B HCG level was needed for diagnosis in 12 cases (11%). CONCLUSION: Transvaginal sonography is the method of choice for the evaluation of women with a suspected ectopic pregnancy. However, serum B HCG levels are useful for diagnosis in 11% of cases.

[Comparison of ultrasonographic and hysteroscopic results in perimenopausal metrorrhagias]. / Confrontation des résultats échographiques et hystéroscopiques dans les métrorragies périménopausiques.

84 perimenopausal women with uterine bleeding underwent transvaginal ultrasonography and hysteroscopy. Sonographic and hysteroscopic findings have been evaluated on the basis of specimens obtained from either endometrial biopsy, hysterectomy or operative hysteroscopy. Sensitivity, specificity, positive and negative predictive value of hysteroscopy and transvaginal ultrasonography were calculated. Hysteroscopy had 91.6% sensitivity, 83.3% specificity, 93.2% positive predictive value and 80% negative predictive value in the diagnosis of intrauterine abnormality, whereas transvaginal ultrasonography had only 67.3% sensitivity, 87.5% specificity, 89.7% positive predictive value and 62.2% negative predictive value. In consequence hysteroscopy is better than transvaginal sonography concerning only the sensitivity (p < 0.01). Transvaginal ultrasonography seems to be an excellent initial diagnostic method, but hysteroscopy is a highly accurate means of diagnosing the cause of excessive uterine bleeding.

[Heterotopic pregnancy: 3 case reports]. / Grossesse hétérotopique: à propos de 3 cas.

Heterotopic pregnancy is a rare event combining intra and extra uterine pregnancies. We report 3 cases observed in patients aged 32, 32 and 31 years consulting for pelvic pain and metrorragia with amenorrhea of 6 to 7 weeks. Treatment was conservative in 2 cases and radical for the third patient. The frequency of this association has been increased since the development of medical procreation technique and the increased of ectopic pregnancy. The foetomaternal prognosis will be improved by an early diagnosis.

[Prenatal diagnois of uropathies. Ten case reports]. / Diagnostic anténatal des uropathies. A propos de 10 observations.

UNLABELLED: Obstructive uropathies are a frequent cause of child renal failure. The prenatal diagnosis of such abnomalities should lead to appropriate management. OBJECTIVE: To evaluate the interest of ultrasonographic prenatal diagnosis of urinary tract malformations. PATIENTS AND METHODS: Retrospective study of 10 cases of urinary tract malformations diagnosed in utero. The mean age of the patients was 34.9 years and the mean gestational age at the prenatal diagnosis was 28.2 weeks of amenorrhea. The abnormalities diagnosed were: 2 cases of ureteropelvic junction obstruction, 3 cases of posterior urethral valves and 5 cases of mild hydronephrosis. The fetal karyotype, realised in 8 cases, was normal. In one case the urinary abnormalities was part of a multiple malformation syndrome and led to the termination of the pregnancy. 7 cases had a post-natal follow-up: 5 had a surgical management and two new borns had transient pyelectasies. The prediction of postnatal renal function is made by ultrasonographic appearance of the kidney and the amniotic fluid. Although the analysis of fetal urine for the assessment of renal function leads to conflicting results, it seems that sodium and beta-2 microglobulin urinary rates provide useful informations.

[Molar pregnancy. Retrospective study of 60 cases in Tunisia]. / Les grossesses môlaires. Etude rétrospective de 60 cas en Tunisie.

To identify the epidemiologic, clinical end therapeutic particularities of molar pregnancies in Tunisia. A retrospective study of 60 cases of molar pregnancy Diagnosis of MP was base on elevated urine HCG level and/or histologic examination of uterine revision done for all patients. The incidence of MP is 1/793(60/47624) pregnancies. The mean age of patients was 31.7 years and 16 patients had more than 35 years. The metrorragia is the main symptom (91.6%). Excessive uterine enlargement and lutein ovarian cysts were observed respectively in 57 and 6.6% of cases. Human chorionic gonadotropin level was upper than 50,000 UI/l in 91.4% of cases. Ultrasonography contributed to diagnosis in 82.8% of cases. Histological findings were complete molar in 33 cases and partial molar in 27 cases. 6 of 33 patients having complete molar developed persistent gestational trophoblastic tumor. Actinomycin D induced complete remission in all cases. Molar pregnancy is a relatively common disease in Tunisia. Careful and reliable human chorionic gonadotropin monitoring is essential for the early detection of post molar persistent gestational trophoblastic tumor.

[Emphysematous pyelonephritis. Apropos of 4 cases]. / La pyélonéphrite emphysémateuse. A propos de 4 cas.

The authors report four cases of emphysematous pyelonephritis. All patients (3 females and 1 male) were diabetic. The clinical symptoms and signs were non-specific. The diagnosis was suggested in every case on conventional x-rays and was confirmed by computed tomography, which provides a detailed assessment of the lesions by demonstrating diffusion of gas in or beyond the renal compartment (2 cases). Urine cultures isolated an E. coli in one case and Klebsiella pneumoniae in 2 cases. In the fourth patient, Candida albicans was present in the urine at pathological levels, as confirmed by the presence of spores on histological examination of the nephrectomy specimen. The only effective treatment remains nephrectomy which was performed primarily in 2 cases or secondarily, after drainage, in the other 2 cases. The prognosis remains severe, with a high mortality; 2 of our patients died in a context of severe septic shock with end-stage renal failure.

Perivascular epithelioid cell tumor of the uterus: a case report.

A case of a perivascular epithelioid cell tumor (PEComa) arising in the uterus of a 35-year-old woman is presented. Imaging studies revealed a 5 cm well circumscribed mass in the uterine fundus. The tumor was composed of clear to faintly eosinophilic, epithelioid and spindled cells. Immunohistochemically, most tumour cells were strongly positive for HMB-45, smooth muscle actin and desmine, but negative for epithelial markers, S-100 Protein and neuroendocrine markers. Reevaluation of the patient for signs of tuberous sclerosis complex after the diagnosis gave negative results. At the most recent follow-up 4 months later there was no evidence of recurrence.

[Proximal tubal unblocking by selective salpingography, apropos of 8 cases]. / Les désobstructions tubaires proximales par salpingographie sélective, à propos de huit observations.

Proximal tubal desobstuction by selective salpingography: through a study of eight cases, the authors give their first results about tubal desobstruction by selective salpingography.