[Leiomyosarcoma of the inferior vena cava]. / Léiomyosarcome de la veine cave inférieure.

A case of leiomyosarcoma of the inferior vena cava in a 74 year old woman is reported. The clinical and pathological features are described and the outcome and response to treatment analysed. This is a very rare form of malignant disease (less than 100 published cases) which mainly affects elderly women. The diagnosis is often made at a late stage because the symptomatology is not specific and because the tumour is so rare. Treatment is mainly surgical and is only possible in the infrarenal part of the inferior vena cava. It is very difficult or impossible to operate on the upper part of the vessel. The prognostic is poor. There are no reports of survival after 5 years.

[Mushroom grower's lung. Apropos of 3 cases]. / Le poumon du champignonniste. A propos de trois cas.

Three cases of mushroom growers lung, responding to the criteria for an extrinsic allergic alveolitis, have been observed in the Hôpital Bichat, Paris. In the first case, a "semi-delayed" hypersensitivity phenomenon of type III was evoked, an "immediate" type I phenomenon in case 2, and an association of the two in the third case. Clinical manifestations may develop very rapidly in subjects working in areas where they are exposed to a high inoculum of fungal products. Multiple antigens are involved: Psalliota, actinomycetes of different varieties, manure substrate, fungal spores, bacteria, cereal dust, etc. A recognized occupational disease, it leads to a change in activity and the right to compensation.

[Conduction disorders during cardiac sarcoidosis (author's transl)]. / Les troubles de la conduction au cours de la sarcoïdose cardiaque.

The authors report 2 observations of auriculoventricular blockage developed during a mediastino-pulmonary sarcoidosis, requiring a heart pacer in the first case and corticosteroid treatment in the second. The frequency of the disorders of intracardiac conduction was evaluated by a retrospective study of 412 cases of mediastino-pulmonary sarcoidosis. Seventy two ECG were considered abnormal, a frequency of 17.2%. The disorders of auriculo-ventricular and intra-ventricular conduction represented a third of cases. What is known on the risk of lethal evolution of cardiac sarcoidosis in which those abnormalities are significant, justifies an electrophysiological investigation. The indications for a definitive cardiac stimulation and corticosteroid treatment are debated. On this final point, it seemed necessary to plan a prospective study to confirm the merits of the treatment and to define its modalities.

[Management in pollinosis and false pollinosis]. / Conduite à tenir face aux pollinoses et aux fausses pollinoses.

Typical cases of pollen allergen (hayfever, allergic asthma), together with isolated non-respiratory "equivalent" manifestations (urticaria, eye conditions, headache, etc.), are easy to detect on the basis of skin tests and the clinical history. Such manifestations may also occur in "false pollen allergy", related in most instances by atmospheric moulds (Dematiaceae), sometimes by house dust or dermatophytes (Candida Albicans, Trichophyton sp), by food or by a bacterial infection or allergy. A combination of pollen allergy and false pollen allergy is common. In cases of false pollen allergy the proportion of negative skin reactions would appear to worsen with the repeated use of prolonged action corticosteroid injections, given on a preventive basis. Similarly, these disorders, initially seasonal, change to more chronic manifestations throughout the year. Desensitization with aqueous extracts of allergens ensured the most complete protection against the causes of pollen allergy and false pollen allergy. Allergen extracts percipitated with alun (semi-retard extracts), more effective than tyrosine adsorbates (Pollinex) have the advantage of offering more rapid treatment without the risk of dangerous reactions. The best therapeutic results have obtained over the course of the last ten years, by the authors, combining on each occasion a semi-retard allergen with an aqueous allergen, thereby acquiring the benefit of the adjuvant effect of the first, in a course of ten to fifteen injections per year. Non specific therapy (antihistamines, cromoglycate, theophylline, etc.) retains all of its symptomatic indications. Oral corticosteroid therapy is better metabolized in the organism and has less of a disturbing effect on the circadian rhythm of cortisol, and is hence to be preferred to injections of delyaed action corticosteroid suspensions.