ABSTRACT
The aim of this study was to evaluate local differences in smooth muscle differentiation in venous valves of patients suffering from chronic venous insufficiency, in relation to functional hemodynamic parameters measured by echo Doppler. These functional parameters did not correlate with smooth muscle differentiation at the valvular site. These results failed to support an initiating role of valvular structure in the development of chronic venous insufficiency. However, this work stresses differences in cellular differentiation of valve wall and nonvalvular smooth muscle cells in culture, and we found histologic differences in the structure of endovein and media (connective tissue relative content) between valvular and nonvalvular venous wall. The presence of smooth muscle cells in the valve cusp was demonstrated by smooth muscle alpha-actin-specific labeling and was observed to be restricted to one side of the valve cusp.
Subject(s)
Muscle, Smooth, Vascular/pathology , Venous Insufficiency/pathology , Actins/analysis , Adult , Aged , Cell Differentiation , Cells, Cultured , Chronic Disease , Female , Humans , Immunohistochemistry , Male , Middle Aged , Muscle, Smooth, Vascular/chemistry , Saphenous Vein/pathology , Tunica Intima/pathologyABSTRACT
OBJECTIVES: The incidence of tuberculosis has risen since 1992. We studied cases observed in our department to search for factors favouring this increased incidence. METHODS: A retrospective assessment of 151 cases of tuberculosis observed over a 3 year period in a department of pneumology in Paris was performed. RESULTS: Fifty-two percent of the patients were foreigners; 66% lived in a poor socio-economic environment included 18% with no permanent residence; 29% were alcoholics. An association with human immunodeficiency virus infection was seen in 7% of the cases. Another immunodepression factor was found in 15%. Tuberculosis was discovered in a context of respiratory distress in 7% or the patients. Outcome was fatal in 6%. Three months after diagnosis 22% of the patients were lost to follow-up. CONCLUSION: This series emphasizes the major role of socio-economic factors in the rising incidence of tuberculosis and the need for urgent and adapted measures for therapeutic management in an often non-compliant and socially instable population.
