Core temperature circadian rhythm across aging in Spontaneously Hypertensive Rats.

The purpose of this study was to evaluate the circadian rhythm of core temperature (Tcore) across aging in Spontaneously Hypertensive Rats (SHR) with comparison to the two rat strains often used as their normotensive control animals, namely, Wistar (WIS) and Wistar Kyoto (WKY). METHODS: WIS, WKY and SHR rats were subdivided into three different groups according their age: WIS16, WIS48, WIS72, WKY16, WKY48, WKY72, SHR16, SHR48 and SHR72 weeks-old. Body mass and blood pressure were periodically measured along the experiments. All animal group had their circadian rhythm of Tcore evaluated over three consecutive days (72 h) by telemetry using an implanted temperature sensor. The Tcore circadian rhythm was averaged in 1-h blocks and analyzed using the cosinor method. RESULTS: Sixteen-week-old SHR (SHR16) presented higher Tcore than WIS16 (from 06am to 06pm) and WKY16 (from 07am to 06pm). Both normotensive groups exhibited increases in Tcore during circadian rhythm with aging. The cosinor analysis showed no differences between strains and ages for the acrophase. An age effect on the SHR strain (SHR16 < SHR72) was observed regarding the amplitude. SHR16 had higher values regarding MESOR compared to WIS16 and WKY16. In addition, WIS72 and WKY72 showed higher values than WIS16 and WKY16, respectively. Finally, no differences were observed in the strength rhythm analysis. CONCLUSIONS: SHR presented impaired thermoregulatory control at only 16 weeks of age when showing a higher body temperature during the activity phase, while other circadian rhythm parameters showed no differences across aging. Therefore, in taking our results as a whole we can conclude that WIS and WKY are appropriate Wistar strains to be used as normotensive controls for SHR.

[Pseudomalignant endoscopic appearance in hyperplastic polyp at esophagogastric junction: case report]. / Aspect endoscopique pseudocarcinomateux d'un polype hyperplasique au niveau de la jonction oesogastrique: à propos d'un cas.

Hyperplastic polyps are by far the most common benign tumors in the stomach larger than 5mm. Although the malignant potential of hyperplastic gastric polyps was originally denied, a low risk for carcinomatous conversion is now recognized. Its has been recommended that all gastric polyps of 5mm or more in diameter have to be removed. We present here the case of a large hyperplastic gastric polyp located at the esophagogastric junction with endoscopic malignant appearance. The description of its endoscopic and histological characteristics gives us the opportunity to discuss the difficulty of endoscopic diagnosis in the case of gastric polyps and to remind their prognosis.

Frequency and significance of granulomas in a cohort of incident cases of Crohn's disease.

BACKGROUND AND AIMS: Epithelioid granulomas is one of the best histological criterion for distinguishing Crohn's disease (CD) from other inflammatory bowel diseases. Few data are available on the time of occurrence of epithelioid granulomas, and the value of epithelioid granulomas in predicting outcome has been determined only in cohorts of prevalent CD cases. Our objective was to evaluate epithelioid granuloma occurrence in incident CD cases and to examine the associations between epithelioid granulomas and outcome. PATIENTS AND METHODS: We reviewed the histological reports of endoscopic and surgical specimens in a cohort of 188 consecutive incident CD cases seen in 1994 and 1995, and recorded the occurrence of epithelioid granulomas, isolated giant cells, and microgranulomas. Kaplan-Meier curves were plotted for time from CD diagnosis to immunosuppressive treatment or surgery, and associations between epithelioid granulomas and outcome were evaluated in a multivariate analysis. Follow up was at least five years. RESULTS: Granulomas were found in 69 (37%) patients, including 46 (25%) at presentation. Median time from CD diagnosis to epithelioid granuloma detection was 0.16 (0-63) months overall, and 9.59 (0.1-63) months in 23 patients who became epithelioid granuloma positive during follow up. Isolated giant cells were found in 6% of patients and microgranulomas in 12%. Epithelioid granuloma detection increased with the number of endoscopic sampling procedures; sampling site had no influence. By multivariate analysis, epithelioid granulomas were associated with surgical resection but not immunosuppressive therapy. CONCLUSIONS: Epithelioid granulomas may separate CD into two pathological subsets and may indicate aggressive disease.

[Incidence of inflammatory bowel disease in children in Brittany (1994-1997). Breton association of study and research on digestive system diseases (Abermad)]. / Incidence des maladies inflammatoires du tube digestif chez l'enfant en Bretagne (1994-1997). Association bretonne d'étude et de recherche sur les maladies de l'appareil digestif (Abermad).

BACKGROUND: The aim of this work was to determine in Brittany the incidence and main clinical pattern of inflammatory bowel disease (IBD) occurring during childhood. These data are compared to the previous epidemiologic data available from the Northern France registry or around the world. METHODS: Private and public Brittany gastroenterologists (2,836,418 inhabitants including 618,049 children under 17 years of age) referred all patients consulting for inflammatory bowel disease from January 1994 to December 1997. An interviewer-practitioner completed at the gastroenterologist's office a standard questionnaire for each patient. Each case was independently reviewed by four experts in a blind manner and made a final diagnosis of Crohn's disease (CD), ulcerative colitis (UC), or ulcerative proctitis and acute colitis (onset of symptoms < 6 weeks) or unclassified chronic colitis. RESULTS: Among 1,309 cases recorded, 88 were under 17 years of age (6.7%): 43 (49%) had CD (including three possible cases), 14 (16%) had UC (including three proctitis), 24 (27%) acute colitis and 7 (8%) unclassified chronic colitis. The crude mean annual incidence (per 100,000 children) based on definite and probable cases only was 2.5 for IBD, 1.6 for CD and 0.57 for UC, without variation between 1994 and 1997. The male/female ratio was 2.3 for CD and 1.3 for UC. The mean time between onset of disease and diagnosis was equal to 7.2 and 8.6 months for CD and UC respectively (median: 3 and 5 months). A familial history of IBD was present in 5 cases (8%). In CD, the small and large bowel were involved in 58% of patients, whereas an isolated involvement of small or large bowel occurred in 15% and 23% of cases. Among the 14 UC, there were three proctitis and four pancolitis. Among 43 CD, a granuloma was present in 48% of cases. CONCLUSIONS: In Brittany the incidence of CD and UC in childhood was similar to the published data from Northern France. Clinical presentation and symptoms were not different. However, the rate of acute colitis was higher and the accurate incidence of IBD could be underestimated, requiring a follow-up to classify these cases.

[Incidence of inflammatory bowel diseases in Bretagne (1994-1995). ABERMAD. Association Bertonne d'Etude et de Recherche des Maladies de l'Appareil Digesif]. / Incidence des maladies inflammatoires du tube digestif en Bretagne (1994-1995). ABERMAD. Association Bertonne d'Etude et de Recherche des Maladies de l'Appareil Digesif.

OBJECTIVES: The aim of the study was to determine the incidence and the main clinical data of inflammatory bowel disease in Brittany. METHODS: According to EPIMAD registry's methodology, private and public gastroenterologists (n = 139) of Brittany (2836418 inhabitants) referred all patients consulting for the first time, in 1994 and 1995 with clinical symptoms compatible with inflammatory bowel disease. An interviewer practitioner completed at the gastroenterologist's consulting room a standard questionnaire for each patient. Each case was reviewed separately by four experts to assign a diagnosis of definite, probable, possible Crohn's disease, ulcerative colitis, unclassifiable chronic colitis, or acute colitis (onset of symptoms < 6 weeks). RESULTS: 657 cases were recorded: 205 Crohn's disease (31%), 165 ulcerative colitis (25%) including 75 ulcerative proctitis (46%), 42 unclassifiable chronic colitis (7%), 245 acute colitis (37%). The crude mean annual incidence (per 10(5) inhabitants) based on definite and probable cases only was 2.8 for Crohn's disease and 2.9 for ulcerative colitis. The female/male ratio was 0.9 for Crohn's disease and 0.5 for ulcerative colitis. The median age at time of diagnosis was 27 for Crohn's disease and 36 for ulcerative colitis. The median time between onset of symptoms and diagnosis was equal to 3 months for Crohn's disease and ulcerative colitis. CONCLUSION: In Brittany the observed incidence of ulcerative colitis is similar to that of Crohn's disease and close to that observed in northern France. The incidence of Crohn's disease is lower. However, the real incidence of inflammatory bowel disease is currently underestimated due to the large number of acute colitis requiring a follow up and the cases of Crohn's disease classified as possible not taken into account.

[Post-exposure antirabies vaccination. Early serological response to vaccine cultivated on VERO cells using a reduced 2-1-1 schedule]. / Vaccination antirabique après exposition. Réponse sérologique précoce au vaccin cultivé sur cellules VERO utilisé en schéma réduit 2-1-1.

OBJECTIVES: An abbreviated 2-1-1 schedule for post-exposure rabies vaccination would theoretically lead to more rapid production of specific antibodies than the classical schedule. We measured early serological response to the 2-1-1 schedule. METHODS: Patients consulting the antirabies centre of the Epinal hospital from June 1992 to June 1993 who had never been vaccinated and whose exposure history justified antirabies vaccination were included in this study. Fifty subjects were vaccinated with PVRV (purified vero rabies vaccine, Pasteur Institute) cultured on VERO (vervet monkey origin) cells using the abbreviated 2-1-1 schedule of 2 doses (0.5 ml = 2.5 IU/dose) on day 0 and 1 dose on days 7 and 21. Antirabies antibodies were assayed using the Platelia Rage immunoenzyme method (Diagnostic Pasteur) on day 21. Titres above 0.5 IU were considered to give protection and non-protected subjects were seen again on day 28 for a supplementary dose. RESULTS: Only 34 subjects (68%) had protective antibody titres on day 21, but by day 28, 48 (96%) had acquired immunity. In this study population, the age range was from 1 to 83 years and age over 30 years appeared to delay antibody formation. CONCLUSION: These findings emphasize the importance of initial antirabies immunoglobulins if short incubation in suspected and the need for serological follow-up if delayed antibody formation is suspected (subjects over 30).

[Parenchymatous abscess in Streptococcus anginosus (Streptococcus milleri) septicemia. Value of their systematic search, apropos of 4 cases]. / Abcès parenchymateux lors des septicémies à Streptococcus anginosus (Streptococcus milleri). Intérêt de leur recherche systématique, à propos de quatre cas.

Streptococcus anginosus, the term suggested to cover a set of streptococci previously known under various names (milleri, MG, anginosus, intermedius, constellatus), is characterized by a propensity to create parenchymatous abscesses, essentially cerebral or hepatic, particularly within the terms of septicemia. These abscesses are sometimes difficult to detect due to a difficult or non-existent symptomatology. The authors report on four cases illustrating the necessity to search for them systematically by cerebral CT scan and abdominal echography or CT scan in all cases of septicemia caused by Streptococcus anginosus.

[Polyneuropathies and myelopathy associated with a circulating anticoagulant. Apropos of 4 cases]. / Polyneuropathies et myélopathie associées à un anticoagulant circulant. A propos de quatre cas.

During one year from July 1992 to July 1993, we performed usual hemostasis tests in a population or 3,700 patients. We found 12 patients with a lupus like anticoagulant (incidence: 1/1,000). Among these 12, four had unexplained polyneuropathy or myélopathy. Lupus like anticoagulant was either isolated (two cases), either associated with thrombosis (two cases). We report these four cases and we discuss the causal or uncasual nature of this association.

Heredity of idiopathic haemochromatosis: a study of 106 families.

More than 80% of the first degree relatives of 106 patients with iron overload - 97 with idiopathic haemochromatosis (I.H.) and nine with haemosiderosis secondary to alcohol induced liver disease (A.H. - were examined. Physical examination and measurement of plasma iron level and UIBC were done in all subjects; relatives who presented with some anomaly were submitted to a desferrioxamine test and, if the latter showed a high urinary iron output, to a liver biopsy. While absent in relatives of A.H. patients, iron overload was present in 78 out of 499 relatives of I.H. patients: 29 major and 49 minor forms. The major forms involved the sibships almost exclusively. The genetic analysis showed much evidence in favour of a recessive or rather intermediate form of inheritance, with heterozygous developing minor forms. However, other modes of transmission, especially polygenic (probably oligogenic), cannot be totally excluded. Data from recent studies showing a strong correlation between I.H. and certain HLA antigens do not conflict with the above conclusions.

[Diabetes of idiopathic haemochromatosis and common diabetes mellitus. Results of a prospective study of 97 families with idiopathic haemochromatosis (author's transl)]. / Diatete de l'hémochromatose idiopathique et diabéte commun. Résultats d'une étude prospective de 97 familles d'hémochromatose idiopathique

The purpose of this study was to investigate through an epidemiological approach two controversial aspects of the pathogenesis of the diabetes mellitus of idiopathic haemochromatosis (I.H.) : the possible inheritance of the gene(s) for common diabetes mellitus (C.D.), and the diabetogenic role of iron overload. More than 80% of the living first degree relatives of 97 patients with I.H. were examined, while data were collected by inquiry concerning first degree relatives who had refused investigations or had died. Data on the more distant family members were also collected by inquiry. Physical examination and estimation of serum iron level and unsaturated-iron-binding capacity were systematically performed. When an anomaly had been thus detected further investigation for iron overload was carried out by mean of a deferoxamine test and eventually by liver biopsy. Evaluation of carbohydrate metabolism included testing for post-prandial glycosuria, estimation of post-prandial blood sugar, and eventually an oral glucose tolerance test. The results were compared to those of an inquiry for family history of diabetes in 100 patients with C.D. successively admitted to our department. Among the first degree relatives of patients with C.D. the prevalence of overt diabetes was 33 of 612 (5.4 %); whereas in the I.H. group it was 8 of 735 (1.1 %). The differences between the C.D. and I.H. groups were significant, whether the total I.H. group (p less than 10(-5)) or only I.H. proposite having overt diabetes (p less than 2 X 10(-2)) were considered. With respect to the more distant relatives the number of affected families was significantly higher in the C.D. group (31 of 100) than in the total I.H. group (5 of 97 ; p less than 10(-5)) or in the I.H. sub-group diabetic proposite (3 of 36 ; p less than 10(-2)). The frequency of carbohydrate intolerance in relatives bore no relation to the carbohydrate pattern of propositi. Carbohydrate intolerance was frequently found in relatives with iron overload (17 of 72). However, no correlation was observed between blood sugar and serum iron level or unsaturated-iron-binding-capacity, relatively gross parameters. Thus, the pathogenesis of diabetes mellitus associated with I.H. remains uncertain, but the inheritance of gene(s) for common diabetes is unlikely to play a determinant role.