[Colonic lymphoma simulating cryptogenetic colitis associated with common variable hypogammaglobulinemia]. / Lymphome colique simulant une colite cryptogénétique et associé à une hypogammaglobulinémie commune variable.

We report the case of a 72 year-old woman with late-onset common variable immunoglobulin deficiency who was hospitalized for diarrhoea and fever. Colonoscopy showed aphtoïd and deep ulcerations in the rectum, the sigmoid and transverse colon, suggestive of Crohn's disease. Histologic and immunohistochemical study revealed a low grade B cell mucosa-associated lymphoid tissue (MALT) lymphoma. This is an unusual presentation for colonic lymphoma, and the second case of colonic lymphoma associated with late-onset common variable immunoglobulin deficiency.

[Intestinal flora]. / Flore digestive.

The intestinal flora consists of a considerable mass of 10(14) cells which accompany the individual step by step from birth to death. It builds up multiple relations with the host housing it and represents a complex ecosystem, in dynamic equilibrium. The stability of the latter is maintained by virtue of only partially understood interactions. Gastric acidity, peristalsis and the immune system participate in this stability. However, this ecosystem is constantly subject to the actions of the outside medium, whether in the form of exogenous bacteria which are ingested on a constant basis of dietary substances. This fight against infection is one of the key factors in the role of the ecosystem. The actions of the flora are nevertheless far more extensive. It may also act on the host and, taking all populations into account, it is easy to see the enormous enzyme potential and the possibility of a range of metabolic effects, nutritional in particular. However, the state of equilibrium is fragile. Disturbances in the flora secondary to antibiotics and to bacterial infections cause disorders which are transitory as a rule. Equilibrium is most often restored by endogenous means (mucus, immune system, peristalsis).

Effect of a moderate alcohol intake on the lipoproteins of normotriglyceridemic obese subjects compared with normoponderal controls.

Moderate alcohol intake is frequently associated with an elevated concentration of high-density lipoprotein (HDL), which is one of the potential causes for the relative decrease in cardiovascular risk reported in moderate drinkers. Conversely, low HDL concentrations, particularly HDL2, in obese subjects may be a risk factor. The effect of 30 g alcohol daily (wine) during 14 days following a period of abstinence was studied in seven normolipidemic obese subjects (body mass index [BMI], 30 +/- 1.7 kg/m2) compared with seven normoponderal controls (BMI, 22 +/- 1.2 kg/m2). Alcohol caused apolipoprotein (apo) AI and apo AII concentrations to increase in all controls by 12% and 16% (P less than .05), but not in obese subjects. Lipoprotein (Lp) AI HDL particles (without AII) were initially in the same proportions in the two groups. Their increase in controls only (P less than .03) was not matched by an increase in HDL2 in all subjects. In obese subjects, neither Lp AI nor HDL2 were increased by alcohol, but their HDL-triglyceride (TG) contents, initially elevated, were normalized. Cholesterol ester (CE) transfer activity was not different in controls and obese subjects during abstinence (105.7 +/- 40.8 v 104.8 +/- 34.5 mmol/mg protein/h). It was notably depressed by alcohol in controls (74.2 +/- 27.4, P less than .002), but not in obese subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

[Acute diarrhea in adults in a Parisian district. Clinical, bacteriologic endoscopic and histologic aspects. Study of 52 cases]. / La diarrhée aiguë de l'adulte en région parisienne. Aspects cliniques, bactériologiques, endoscopiques et histologiques. Etude de 52 cas.

From 1985 through 1988, 52 patients aged 16 to 85 years and referred for acute diarrhea underwent routine clinical, microbiological, endoscopic and histopathological examinations. Enteropathogens were isolated in 50 percent of patients, mostly from stool samples rather than from biopsy samples, though results were sometimes dissociated. Significantly lower digestive endoscopic abnormalities were seen in 60 percent of patients. Upper gastrointestinal endoscopy was not contributive. Rectal and colonic biopsies showed histological abnormalities in nearly all cases half of which were polymorphonuclear infiltrates and crypt abscesses. Glandular distortion was not found. An analysis of clinical, endoscopic and histological data showed that major abnormalities were mostly, but not constantly, related to infections due to enteroinvasive bacteria. As in other studies, a high rate of negative stool cultures was observed. Based on these results, we suggest to perform either further and more sophisticated microbiological investigations, or to conduct a routine search for viral infections whose incidence, among adult patients with acute diarrhea, is actually unknown.

[Spontaneous esophageal perforation. Radiological diagnosis]. / Perforation oesophagienne spontanée. Diagnostic radiologique.

Esophageal perforations are rare and usually occur after instrumentation. We relate here a case unsuspected spontaneous esophageal perforation. Computed chest tomography firstly showed signs of mediastinal abscess. Secondary barium meal confirmed the diagnosis.