[School reinsertion of children treated for tumors of the brain: experience of the Léon-Bérard center]. / Intérêt des projets d'accueil individualisés pour la réinsertion scolaire des enfants traités pour tumeur cérébrale: l'expérience du centre Léon-Bérard.

School integration of children with brain tumor is part of the quality of their life. It may also become a nightmare both for the child and for the teacher when no recommendation has been addressed to the latter. In France, official recommendations allow the meeting and information exchanges in the school between teachers and all the people who take care medically of the child. We report our experience in Centre Léon-Bérard of Lyon, concerning 38 children with brain tumors (102 meetings). Though difficult to assess scientifically, the benefit from these meetings is obvious. For the teachers: the knowledge and understanding of the physiopathology of brain tumors and secondary sequellae facilitates teaching. For the child: the disappearance of surrounding fears and fantasms make life easier. This experience is so rich that it should be extended to other pathologies.

New prospects in immunology of toxoplasmosis: skin-tests for control of immunity and immuno-assays and agglutination tests for the detection of specific IgM antibodies.

An excretory-secretory (ES) antigen was extracted from supernatants of cell cultures infected with Toxoplasma gondii, purified and controlled according to current standards. In 638 volunteers, the correlation with fluorescent antibody was 94.2% and no false positive skin tests were noted. The skin test did not transform an originally negative serological test into a positive one. For the prevention of congenital toxoplasmosis, this sensitive, specific and inexpensive skin test can be widely used for the detection of immunity to Toxoplasma in women before their first pregnancy. During pregnancy, the detection of specific IgM is very important for the diagnosis of a recently acquired toxoplasmosis and allows for an immediate treatment. For this detection and for the diagnosis of congenital toxoplasmosis, five different serological tests were compared: Indirect Fluorescent Antibody-test (IFA), ELISA test, ELISA test After Capture of IgM (ACCAs), Reverse Enzyme Immuno Assay R-EIA), Double-Sandwich Enzyme Linked ImmunoSorbent Assay (DS-ELISA) and ImmunoSorbent AGglutination Assay (ISAGA). For 37 sera of recently acquired toxoplasmosis, IgM were detected in 98.7% with ISAGA, in 89.5% with DS-ELISA and ELISA in 83% with R-EIA and in 59% with IFA test. The best specificity is obtained with ISAGA, DS-ELISA and R-EIA, from controls with non immune patients (99 cases), patients with chronic toxoplasmosis (77 sera), rheumatoid factors (35 sera) or anti-nuclear antibodies (7 sera). In 21 sera from infants with congenital toxoplasmosis, ISAGA was positive in 13 cases (62%), IFA in 5 cases (24%), ELISA and R-EIA in 2 cases (9.5%) and DS-ELISA in 9 cases (43%).(ABSTRACT TRUNCATED AT 250 WORDS)

[Association of cryoglobulins and hepatic disease: incidence, nature and immunochemical characteristics of cryoglobulinemia]. / Association cryoglobuline et maladie hépatique: fréquence, nature et caractères immuno-chimiques de la cryoglobulinémie.

Mixed cryoglobulinemia associated with liver disease is well known, but its mechanism and signification still have to be elucidated. The purpose of this study was to identify and to characterize hepatic disease by their immunochemical features among 60 patients presenting with mixed cryoglobulinemia. Thirteen cases of alcoholic liver disease and 8 of virus B hepatitis out of 40 cases in all of hepatic disease in this group were studied. A higher frequency of type III immunochemical features of cryoglobulinemia in alcoholic disease (83 p. 100), no matter how severe, as well as a higher frequency of type II in virus B hepatitis (62 p. 100) was demonstrated. There was no relationship between virus B hepatitis and cryoglobulinemia in our population. Therefore, the responsibility of virus B hepatitis in essential mixed cryoglobulinemia genesis has to be clarified. The localization of cryoglobulin in the Kupffer cell in two patients with chronic hepatitis confirms the essential role of the reticuloendothelial system in blood clearance of circulating immune complexes.

Detection of toxoplasmic immunity by multipuncture skin test with excretory-secretory antigen.

In 414 volunteers the sensitivity and specificity of a multipuncture skin test with excretory-secretory (ES) toxoplasma antigen was compared with serological detection by an indirect fluorescent antibody (IFA) test. The ES antigen was extracted from supernatants of cell cultures infected with Toxoplasma gondii, purified, and standardised, and the antigen used met current safety standards. The correlation between the skin test and IFA result was 94.2% (97.8% when the skin test was repeated 30 days later). No false-positive skin tests were noted. The skin test did not transform an originally negative serological test into a positive one. In programmes to prevent congenital toxoplasmosis, this sensitive, specific, and inexpensive skin test can be widely used for the detection of immunity to toxoplasma in women before their first pregnancy.