A comparison of triage methods for Kenyan women who screen positive for cervical intraepithelial neoplasia by visual inspection of the cervix with acetic acid.

BACKGROUND: Only about one in seven visual inspection with acetic acid (VIA)-positive women has high-grade disease; further confirmatory testing could rule out false positives. OBJECTIVES: To determine if visual inspection with Lugol's iodine (VILI) or visual inspection with acetic acid and magnification (VIAM) can accurately confirm the presence of disease among rural Kenyan women referred to a district hospital because of a VIA-positive result at a primary health facility. METHODS: Referred women received cervical cytology and either VILI and/or VIAM as triage methods. All women were assessed by colposcopy and biopsied, if necessary. RESULTS: Of the 490 VIA-positive subjects referred, 332 (68%) attended the district hospital and received at least one of two triage tests and cervical cytology. The sensitivity and specificity for histologically-confirmed CIN 2 and 3 were 93% (14/15) and 32% (52/161) for VIAM; 100% (3/3) and 77% (49/64) for VILI; and 80% (16/20) and 48% (110/228) for cervical cytology. VILI reduced the number of false-positive screening results by 73%, without missing any true positives. CONCLUSIONS: VILI had comparable sensitivity and significantly higher specificity compared to VIAM and cervical cytology. VILI may be a promising triage test for screen-positive women in low-resource settings; additional research is required.

[Myositis ossificans circumscripta: a case report]. / La myosite ossifiante circonscrite: à propos d'un cas.

Myositis ossificans circumscripta is a benign lesion characterized by focal heterotopic soft tissue ossification, occurring in young people generally after localized trauma. Clinical and radiological appearances may mimic a sarcomatous neoplastic process. We report a case of myositis ossificans occurring after trauma, so as to illustrate the different imaging features of this benign pathology on conventional radiographs and computed tomography.

[Intracerebral chondrosarcoma in a 12 year old child]. / Chondrosarcome intracérébral frontal chez un enfant de 12 ans.

Chondrosarcoma is a rare cartilaginous tumor, representing less than 0,5% of intracranial tumors. This tumor occurs primarily in elderly patients and involves long and pelvic bones. The authors report a case of intracerebral chondrosarcoma in a 12 year old child, probably fronto-ethmoidal in origin. CT and MR imaging showed a lytic partly calcified soft tissue mass.

[Frontal osteosarcoma: a case report]. / Ostéosarcome frontal: à propos d'un cas.

Osteosarcoma is a malignant neoplasm of bone usually affecting long bones. Skull involvement is rare. Primary cranial involvement accounts for less than 3% of all skull neoplasms. We report the imaging findings of a case of osteosarcoma of the frontal bone.

Autologous reconstitution combined with durable leukemic remission after allogeneic BMT for CML: absence of persistence of a donor-derived T cell effector population.

We report a case of autologous hematopoietic recovery with durable leukemic remission after BMT from a phenotypically HLA-identical donor in a 30-year-old male with CML. Graft loss was diagnosed from day 60 post-BMT by VNTR PCR. To assess for the presence of a minor donor-derived T cell population that could exert an anti-leukemic effect, we serially applied a sensitive process of chimerism analysis by fluorescent PCR on sorted T cells. No residual donor T cells could be detected. We also showed retrospectively that a very sensitive method of MRD analysis by real-time quantitative PCR could have permitted prediction of relapse in this case.

Hydatid cyst of the kidney: diagnosis and treatment.

Renal echinococcosis is relatively uncommon compared to liver and lung localizations. Kidney involvement represents 4% of confirmed cases of hydatid disease. We reviewed the clinical findings of a personal series of renal hydatidosis with emphasis on diagnostic and therapeutic issues. A total of 178 renal cysts were collected over a period of 33 years from 1963 to 1996. Clinical, radiologic and laboratory data are analyzed. Radiologic exploration has had an interesting evolution, with the appearance of ultrasonography and computed tomography. Diagnostic accuracy has been greater since the availability of ultrasonography and immunologic studies. Their contribution to the diagnosis of renal hydatid disease is important. We try, with our experience of ultrasonography in the matter of renal hydatid cysts, to underline the role of this exploration. The treatment of hydatid cyst of the kidney is surgical. Renal-sparing surgery, cystectomy plus pericystectomy, is possible in most cases (75%). Nephrectomy (25% of cases) must be reserved for destroyed kidneys resulting from aged cysts opening into the excretory cavities and complicated by renal infection. Whether conservative or radical, the first surgery performed is cystectomy, with germinate membrane removal after controlled evacuation and opening of the cyst, making the subsequent steps of surgery easier.

[Bone metastasis revealing a primary prostate cancer]. / Métastase osseuse révélatrice d'un cancer prostatique simulant une tumeur primitive.

Spiculated reactive periosteal bone is usually found in cases of primary malignant bone tumors; rarely in secondary bone lesions. The authors report a case of bone tumor of the clavicle in a 62 year-old patient with "sunburst " periosteal reaction on radiographs. The metastatic nature of this lesion from an unknown prostate carcinoma was confirmed by immunohistochemical studies of the clavicle biopsy. Tumorectomy was performed and the patient's status is stable with a follow-up of 10 months.

[Primary leiomyosarcoma of the kidney. A case report]. / Léiomyosarcome primitif du rein. A propos d'un cas.

Primary sarcomas of the kidney are exceptional, representing 1 to 3% of all renal tumours in adults. They have a poor prognosis. The authors report a case of primary leiomyosarcoma of the kidney in a 44-year old patient, presenting in the form of low back pain and haematuria. Treatment consisted of radical nephrectomy. Two months later, the patient presented with hepatic metastases. The patient is currently receiving chemotherapy.

[Role of the unstable bladder in certain pathologies of the lower urinary tract]. / Place de l'instabilité vésicale dans certaines pathologies du bas appareil urinaire.

The authors report their experience of 57 cases of unstable bladder, 20 cases of which were neurogenic in origin. It is a frequent disease encountered in 19% of cases. The sex ratio is one male/one female. Infants are not spared (17 cases). Unstable bladder is a urodynamic concept; therefore, diagnosis of certitude is based on cystometry. The analytic study enables the authors to underline the clinical symptoms, to establish the urodynamic criteria of detrusor hyperactivity and to enumerate the side effects on bladder and renal function. The different etiologies, organic or functional, of detrusor hyperreflexia are exposed. Finally, the therapeutic possibilities are discussed.

Growth inhibition and morphological alteration of L 1210 cells by polyglutaraldehyde nanospheres.

The potentials drug vectors, polyglutaraldehyde nanospheres (Ns), are cytotoxic. The neutralization by amine groups of their aldehydic functions lowers their toxicity. When adriamycin is bound to Ns it cannot enter the cells, nevertheless it remains cytotoxic. Cellular morphological alterations induced by different Ns derivatives do not depend on the potency of the toxic element, they are related to nature of the Ns.

[Continence disorders in hereditary spinocerebellar degeneration. Comparison of clinical and urodynamic findings in 55 cases]. / Les troubles de la continence dans les hérédo-dégénérescences spino-cérébelleuses. Confrontations des données cliniques et urodynamiques dans 55 cas.

Urodynamic exploration with cystometry was performed at random on 55 of the 195 patients suffering from hereditary spinocerebellar degeneration (Friedreich's disease 43 cases, Pierre-Marie hereditary ataxia nine cases, Strumpell-Lorrain disease three cases). The authors observed disturbances in continence without urinary disorders, even when the bladder was atonic. In the case of Friedreich's disease, among the 18 patients with urgent urination or with urinary leakage, the bladder was found to be normal in only two cases. Although 25 patients evidenced no urinary disturbances, a through study revealed nine abnormal bladders. In the case of Pierre-Marie disease, six normal bladders and three pathological bladders were found. A single abnormal bladder was found in Strumpell-Lorrain disease. Two types of pathological bladder were observed: the atonic bladder was compared with the traumatic bladder, and was found primarily in conjunction with peripheral sensory disturbances. The hypertonic bladder appears when sensory involvement is not evident. The authors discuss the pathophysiology of these disturbances of continence.