[Acute pericarditis of unusual etiology]. / Une péricardite aiguë d'étiologie inhabituelle.

Extrapulmonary manifestations of Legionella pneumophilia infection are infrequent. Cardiac involvement can occur. We observed an unusual case which led to acute pericarditis and reviewed the literature on cardiac involvement, particularly pericarditis, in patients which legionellosis.

[A tropical pulmonary nodule]. / Un nodule pulmonaire "tropical".

The authors report a case of american pulmonary histoplasmosis discovered by chance on a chest radiograph in a non immunocompromised patient, back from a stay in French Guyana. Confronted with the negativity of usual mycotic research, diagnosis has been made thanks to wedge excision by video-assisted thoracic surgery. The authors briefly sum up the recent facts regarding this imported infection, stressing the interest of a direct approach by surgical practices not very invasive that allow to eliminate with certainty neoplasm or tuberculosis.

[Pulmonary cancer and recurrent arterial and venous thromboses]. / Cancer pulmonaire et thromboses artérielles et veineuses récidivantes.

Coagulation disorders frequently complicate cancer. We observed a patient with lung cancer who developed recurrent thromboembolism. Hypercoagulation was induced by tumor cells via different factors enhancing coagulation. Heparinotherapy, or in certain cases oral anticoagulants, are often ineffective.

Clinical validation of the new ELSA-CA 125 II assay: report of a European multicentre evaluation.

The ELSA-CA 125 II is a second-generation radioimmunoassay for the quantification of CA 125 in serum. In a multicentre study involving 49 follow-ups of patients with ovarian cancers, and 880 other patients, 2.8% of healthy persons, 25% of 149 patients with benign gynaecological diseases and 39% of 82 patients with benign non-gynaecological diseases had CA 125 levels above 35 U/ml. Using the 35 U/ml cut-off, sensitivities among epithelial ovarian cancers were found to be 85% in serous tumors, 41% in mucinous tumors and 83% in other types. During follow-up of patients with serous ovarian cancers, we observed an equivalent behaviour of both assays--first- and second-generation--with the clinical evolution. We also compared results obtained with other assays commercially available; these were significantly different when a polyclonal antibody was used in the sandwich assay.

[PS2 as a prognostic factor in 1065 cases of human breast cancer. A multicenter study]. / Rôle pronostique de la protéine pS2 dans 1065 cas de cancer du sein. Etude multicentrique.

pS2 protein assay was performed with Elsa-pS2 kit (CIS-Biointernational) on a group of 1,065 patients with operable breast cancer who underwent breast surgery in the years 1982 through 1990. The median follow-up was 57 months. This group included exclusively infiltrating ductal carcinoma with primary surgery. Age mean was 58 yr; T0-T1, 33.6%; T2-T4, 66.4%; Differentiation grade I, 29%; node negative, 53%; estrogen receptor (ER) positive, 62.4%; progesterone receptor (PR) positive, 55.2%; mean tumor size, 2.4 cm; local recurrence, 5.2%; metastasis, 17.5%. pS2 values varied from 0.1 to 707 ng/mg of cytosol protein (median, 5.6; mean 24.5; 95th percentile 112 ng/mg p). There was no significant relationship between the mean level of pS2 and age, tumor size, nodal status, whereas pS2 was related to histological grade (P < 10(-3)), ER (P < 10(-5)), and PR (P < 10(-5)). By using 2 ng/mg p as pS2 cutoff, 77/391 (19.7%) of ER+PR+ tumors were pS2-, and 122/345 (35.4%) of ER-PR-tumors were pS2+; with this cutoff, a strong relationship existed between pS2 and overall survival, but not between pS2 and relapse-free survival. With Cox multivariate analysis, pS2 protein was classified after lymph node status, histological size, ER, differentiation grade, age, clinical stage, PR. In patients with axillary lymph node involvement (N+), pS2 status could discriminate between good and bad prognosis, specially for patients with small tumors (< 2 cm) and with less than seven invaded nodes. This study showed that pS2 protein was a poor prognostic factor in comparison with classical factors.

Proton NMR spectroscopy of plasma lipoproteins in the experimental Lewis lung carcinoma.

Plasma and fractionated lipoproteins from 40 Lewis Lung Carcinoma grafted mice were tested from the first day up to the fatal issue by biochemical analyses and water suppressed 1H NMR spectroscopy. We have confirmed first, that the 1H NMR spectra of plasma lipoproteins are modified by the tumoral state and could provide a useful marker of the disease as long as they are used for individual follow-up with appropriate spectral parameters. Using fractionated lipoproteins we have demonstrated secondly, that the observed spectral modifications do not result from a specific cancer lipoprotein but from quantitatively modified ratio between Very Light Density Lipoproteins and High Density Lipoproteins.

[Effects of chronic administration of lithium on thyroxine (T4), triiodothyronine (T3), reverse T3 (rT3) free thyroxine ratio (FTR) and thyreostimuline (TSH) in thyrotoxicosis (author's transl)]. / Effet chronique du lithium sur la thyroxine (T4), la triiodothyronine (T3), la T3 inverse (rT3), l'index de thyroxie libre (ITL) et le thyréostimuline (TSH) chez l'hyperthyroïdien.

Fourteen hyperthyroid subjects were studied between 3 and 141 days. The reduction of thyrotoxicosis is rarely obtained (2 cases), mainly because on the one hand, correct plasma lithium level (0.7-1.2 mEq/L) is rarely obtained (3 cases only), on the other hand because a high dose of lithium is required, perhaps owing to high clearance of lithium in thyrotoxicosis. The indications of lithium use in thyrotoxicosis are reviewed.

[Serum IgE values in human scabies: study of 79 cases (author's transl)]. / IgE sériques et gale humaine. A propos de 79 cas.

The authors studied seric IgE levels in 79 patients with scabies: 48 p. 100 had significant elevated concentration of IgE (greater than 300 U. I./ml) (p less than 0,001). This is the fact of scabies infestation and is not the result of internal parasitic infestation, associated illnesses or atopic disease. There is a statistically significant correlation between high IgE levels and degree of extension (p less than 0,1) and, overall, eczematization (or) and superinfection (p less than 0,001).

[Post-partum galactorrhea with hyperprolactinaemia persistent during a clonidine treatment (author's transl)]. / Galactorrhée du post partum avec hyperprolactinisme, persistante sous clonidine.

Persistence of a post-partum galactorrhea with an hyper-prolactinaemia leads to charge clonidin, an hypotensive-drug. When clonidine is stopped, galactorrhea and hyper-prolactinaemia case. Explanation of the role of the drug is uneasy.

[Serum thyroid hormones and TSH response to TRH during treatment of Graves' disease by carbimazole (author's transl)]. / Hormones thyroïdiennes plasmatiques et test à la TRH au cours de la maladie de Basedow traitée par le carbimazole.

Serum concentrations of Thyroxine (T4), triiodothyronine (T3) free thyroxine index (F.T.I.) and TSH response to TRH were evaluated in 55 Graves' diseases treated by Carbimazole. There is a good correlation between serum thyroid hormones and clinical state: 83,7% for T4; 79,5% for T3; on the other hand there is a discrepancy between T3 and T4 in many cases and between delta TSH and T4 (47%) or T3 (46%). The decrease of T4 occurs before that of T3: 46,6% normal at the 4th month and 72,5% at the 9th month for T4 against 41% and 50% for T3. At the end of the treatment 96,4% of patients are clinically normal but 20% of them remain with T3 and T4 values above normal.

[Diagnosis of hyperprolactinaemias: respective value of response to THR and to bromocriptine (author's transl)]. / Diagnostic des hyperprolactinémies: valeur respective du test de stimulation à la T.R.H. et du test de freinage à la bromocriptine.

Seventy tests of stimulation with hypothalamic thyreotrophic hormone liberation factor, and 35 bromocriptine inhibition tests were carried out on a routine basis in patients with latent or frank hyperprolactinaemia. Pathological hyperprolactinaemia does not have a single clinical pattern: frank, it takes the form either of an exteriorised pituitary adenoma (14 cases), or of an amenorrhoea-galactorrhoea syndrome with or without micro-adenoma (12 cases); latent, it takes the form either of isolated amenorrhoea (17 cases) or of dysovulatory sterility (16 cases). Amongst the dynamic tests available, it is worthwhile to make a choice, and in the case of frank hyperprolactinaemia, the authors propose use of the bromocriptine inhibition test in the first instance. The TRH test is reserved for verification of the results of neurosurgery. As far as latent hyperprolactinaemia is concerned, it may be identify only by the TRH test, with the resultant possibility of specific treatment.