The genus Apterogyna Latreille, 1809 in Egypt, with three new species (Hymenoptera: Bradynobaenidae: Apterogyninae).

The genus Apterogyna Latreille is reviewed from Egypt, based on specimens collected from Wadi Digla (Cairo), Saint Catherine (South Sinai) and those deposited in Egyptian and Italian insect collections as well as recorded data from the literature. Five Apterogyna species were previously recorded from Egypt: A. grandii Invrea, A. latreillei Klug, A. mickeli Giner Marí, A. mocsaryi André, and A. olivieri Latreille. Three new species Apterogyna flavicapillata Soliman & Gadallah sp. nov. (South Sinai), A. oshaibahi Soliman & Gadallah sp. nov. (Wadi Digla), and A. similis Soliman & Gadallah sp. nov. (Giza) are described and illustrated. An illustrated key of eight Egyptian species of Apterogyna is given. 

[Iatrogenic false aneurysm of the splenic artery after cephalic duodenopancreatectomy]. / Faux anévrisme iatrogène de l'artère splénique après duodénopancréatectomie céphalique.

Splenic artery aneurysms are rare entities with many causes. Rupture can be fatal and usually occurs when the aneurismal diameter is greater than 2 cm. Nevertheless, smaller aneurysms, especially false aneurysms, can also rupture. We report a case of iatrogenic, false aneurysm of the splenic artery subsequent to percutaneous drainage of a retrogastric collection after cephalic duodenopancreatectomy. Splenectomy enabled favorable recovery.

Cervico-vaginal dysplasia--papillomavirus-induced and HIV-1 infection: role of correlated markers for prognostic evaluation.

Sexually-transmitted diseases (STD) can facilitate the progression of HIV-1 infection. Among them, as we have previously demonstrated, cervico-vaginal dysplasia-papillomavirus (HPV)-induced, together with HSV-2 co-infection, seems to be correlated with a more evident immunodepression in HIV-positive women, compared with other sexually transmitted diseases. Here we have analysed some of the main correlated markers of HIV-1 infection progression: CD4 + T lymphocyte concentration, CD4 +/CD8 + T cells ratio, HIV-1 RNA loads and haemoglobin (Hb) concentration in 30 HIV-1 positive women co-infected with HPV, and suffering from cervico-vaginal dysplasia, in different stages. In particular, we noticed a positive correlation, evaluated by Spearman's test, between the degree of progression of dysplastic stages (CIN1 --> 3) until invasive carcinoma (IC) and HIV-1 RNA loads (C(s) = +0.78; p < 0.001), and in contrast, a negative correlation between the same stages of progression and respectively CD4 + T cell concentration (C(s) = -0.54; p = 0.01), ratio (C(s) = - 0.63; p = 0.002) and Hb concentration (C(s) = -0.85; p < 0.001). In conclusion, it is important to underline that low levels of Hb generally paralleled the degree of immunodepression. In fact CD4 + T cell levels and ratio positively correlated with Hb concentrations respectively, with C(s) = + 0.83; p < 0.001 and C(s) = + 0.90; p < 0.001. Finally, the most efficacious antiretroviral combined therapy (HAART = Highly Active Antiretroviral Therapy) can improve the above described laboratory parameters in HIV-1/HPV co-infected women and seems to prevent the progression of CIN1 to the following stages of the dysplastic disease.

Sexually transmitted infections and cervicovaginal dysplasia in a cohort of human immunodeficiency virus-positive women in Turin.

The correlation between sexually transmitted infections and cervicovaginal dysplasia has been evaluated in a cohort of 135 women who tested positive for human immunodeficiency virus type I (HIV-1) and were admitted to Amedeo di Savoia Hospital of Turin during the years 1997 and 1998 (stages B2 and B3 or C2 and C3). Of these women. 31 presented with sexually transmitted diseases (STDs; mean age, 33.5 +/- 5.9 years). Among them, 14 were affected by cervicovaginal dysplasia of differing severity; human papillomavirus (HPV) infection was found in 13 subjects (10 with cervicovaginal dysplasia). Herpes simplex virus type 2 (HSV-2) infection was detected in six women. Finally, Trichomonas vaginalis and Candida albicans were found in 10 and in 6 patients, respectively. Immunologic and hematologic evaluations were performed in the patients affected by STDs; in 28 patients of our case report unaffected by STDs but of similar ages (34.1 +/- 5.6 years) and stage of infection; and in 20 HIV-negative women unaffected by STDs. A significant reduction among the patients affected by STDs, as compared to those unaffected, was found in the case of white cells, CD4+ T cells, and ratio values (CD4 +/ and CD8 + T cells). Moreover, red cell count and hemoglobin concentration were lower in those women in the STD group. A lack of correlation was found between HIV RNA loads and CD4 + T cell counts and between HIV RNA and hemoglobin concentration in the patients with cervicovaginal dysplasia and in those affected by HSV-2 infection, which differed from the findings in subjects affected only by trichomoniasis or candidiasis. This suggests that the two former pathologic conditions (cervico-vaginal dysplasia and HSV-2 infection), other than HIV- I infection, may contribute to the impairment of these values. Moreover in our case report, T vaginalis and HSV-2 infections, which are suspected to have an oncogenic potential, do not seem to be relevant in the induction or facilitation of genital neoplastic diseases. Noteworthy is that the patients affected by HSV-2 infection, such as those affected by genital neoplastic diseases, showed the most compromised values of total white cells, CD4+ T cells, ratio index, red cells, and hemoglobin concentration.

[Hematic pseudocysts of the adrenal gland. Apropos of a case]. / Les pseudokystes hématiques de la surrénale. A propos d'une observation.

We report an adrenal pseudocyst fortuitously discovered in a 30-year-old young woman. Diagnostic of this uncommon pathology is characterized by absence of specific clinical signs and the importance of recent radiologic examinations, echography and NMR. Percutaneous aspiration appears to be warranted prior to or instead of surgery in patients with symptomatic cysts or cystic lesions that do not fulfill the imaging criteria for simple cysts. Treatment is based on adrenal gland resection owing to the seriousness of the potential complications.

[Paraganglioma of the organ of Zuckerkandl]. / Paragangliomes de l'organe de Zuckerkandl.

From the study of one case of non secreting paraganglioma of the organ of Zuckerkandl, the authors have surveyed the existing literature gathering 95 cases from 1902 to 1992. It is an exceptional tumor of the paraganglioma and it often a secreting one. When it is not it looks like a malignant retroperitoneal tumor. The surgical resection is often performed without the operating diagnosis. Asserting the malignancy of these tumors only depends on the presents of metastasis appearing lately. There fore a long continued control of the patients who have been operated upon is a must all the more as 30% of the paraganglioma of Zuckerkandl prove to be malignants.

[Influence of the Strasbourg School of Health (1794) on the creation of the Imperial School of the Military Health Service]. / Influence de l'Ecole de Santé de Strasbourg (1794) sur la création dans cette ville de l'Ecole Impériale du service de santé militaire.

The two-hundredth anniversary of the creation of the School of Health in Strasbourg was celebrated on December 3rd, 1994. Early in its history, the School also trained officers in the military health service. The close relationship between civilians and the military at the School led to the creation of the Imperial School of the Military Health Service which opened its doors in Strasbourg in 1856. Teaching was unfortunately halted by the war in 1870 and the school did not reopen until it was transfered to Lyon in 1888 where the former organization of the Imperial School of Strasbourg was maintained. "Si la faculté de Strasbourg a emprunté plus d'un de ses professeurs à la médecine militaire, combien celle-ci, en même temps, ne lui a-t-elle pas fourni de disciples?"

[Peritonitis caused by rupture of a retroperitoneal abscess]. / Péritonite par rupture d'abcès rétropéritonéal.

A 30 year old man presented with an initial clinical picture limited to low back pain. Increasing severity of the pain after one month led to his admission to a surgical department and the diagnosis of a large right retroperitoneal abscess. Several hours before the proposed operation for extraperitoneal surgical drainage of the abscess through a lumbar approach, his condition was complicated by the intraperitoneal rupture of the abscess. The resulting peritonitis and the retroperitoneal abscess were treated through a laparotomy and the postoperative course was uncomplicated. A literature review showed this to be only the second case of this rare generalized peritonitis complication to be reported, for which a parallel can be drawn with the intraperitoneal rupture of a pyonephrosis. A general overview of retroperitoneal abscesses is presented.

[Acute chyloperitoneum]. / Le chylopéritoine aigu.

A patient presenting with the symptomatology of an appendicular syndrome was later diagnosed as having an acute chylous ascites. The etiology was an acute edematous pancreatitis, the anatomy of the lymphatic pathways with the proximity of the pancreas explaining this etiology, as well as the possibility of a pancreatitis secondary to obstruction of the thoracic duct. The early post-operative clinical course was marked by an acute occlusion of small intestine on the 15th day, related to the adherence potency of the chyle. A general review of the acute chylous ascites syndrome showed the prognosis to be generally favorable, with a mortality of 4%, in contrast to the 40% mortality reported for the chronic chylous ascites of adults.

[External biliary fistula after right lateral sectorial hepatectomy for liver injury. Recovery by cholecysto-fistulous anastomosis]. / Fistule biliaire externe après hépatectomie sectorielle latérale droite pour traumatisme du foie. Guérison par anastomose cholécysto-fistuleuse.

An external biliary fistula persisting for 14 months after right lateral hepatectomy for liver trauma is reported. Recovery was obtained by an unusual technique: the fistulo-cholecystostomy.

[Villous tumor of the appendix]. / Tumeur villeuse de l'appendice.

An infrequently diagnosed lesion, villous tumor is extremely rare in its appendicular localization. Its diagnosis is then fortuitous and its secondary treatment is still debatable if surveillance is univocal. A further case of appendicular villous tumor is reported.

[Encapsulating peritonitis. Apropos of a new case]. / Péritonite encapsulante. A propos d'un nouveau cas.

The physiopathology of the rare affection encapsulating peritonitis is poorly elucidated, but its etiologies are now more clearly defined. Diagnosis is usually at operation, as in the present case, a 65 year old man with known alcoholism and wearing a LeVeen type peritoneo-jugular valve, probably the cause of the peritonitis.

Cystic hygroma: prenatal diagnosis and genetic counselling.

Six cases of cystic hygromas detected during second trimester ultrasound examination are reported: 4 fetuses (67 per cent) had a 45, X karyotype, 1 fetus had trisomy 18, 1 fetus had a normal karyotype (46,XX) and at autopsy multiple anomalies were observed. In the latter case the family history suggested an autosomal recessive pattern of inheritance. In order to reach a definite diagnosis and give proper genetic counselling when a fetus is found to have cystic hygroma, a fetal karyotype as well as a family and reproductive history should be obtained.

[Surgical treatment of acute necrotizing hemorrhagic pancreatitis. Analysis and prospective deductions on 58 cases]. / Traitement chirurgical des pancréatites aiguës nécrotico-hémorragiques. Etude analytique et déductions prospectives de 58 observations.

Three degrees of severity could be recognized in 58 patients operated upon for severe acute hemorrhagic pancreatitis, based on results of intensive care, particularly anti-shock therapy, wide peritoneal lavage, and possible need for endoscopic relief of sphincter of Oddi obstruction due to a stone. The principal parameters evaluated were clinical and biological features and the course of the affection. As a result of these data, 44 pancreatic resections of variable extension and 14 excisions of necrotic tissues were performed. Results of these two types of operations, as well as the dominant causes of postoperative and secondary deaths, are analyzed in detail. The indications for surgery are discussed, together with the tactical methods to be applied as a function of the general condition and the detailed study of the pancreas and the state of the adjacent organs. Particular importance should be attached to the presence of respiratory insufficiency. The possible need for routine biliary external drainage is discussed, and the major role played by parenteral nutrition, which should be initiated as early as possible, is emphasized. These findings suggest that two fundamental principles should guide surgery of acute hemorrhagic pancreatitis: the need for surgery in selected cases, though over-aggressive operations should be avoided, and, more particularly, the concept, to be shared of the need for repeated operations, enabling avoidance of excessive procedures during initial surgery.