[3 new cases of internal male pseudohermaphroditism]. / Trois nouvelles observations de pseudohermaphrodisme mâle interne.

The authors report 3 new cases of Male Internal Pseudohermaphrodism. It is a scarce entity. The discovery is fortuous during the cure of hernia or cryptorchidism. The family history has nothing particular. The main problem of this syndrome is its treatment. Our attitude consisted in conserving the mullerian derivatives and treating the hernia or the cryptorchidism. Hysterectomy is not justified for the following reasons; no case of cancerisation of the mullerian derivatives has not yet been reported. The vasa deferens and uterus are in intimate relationship; the dissection is therefore dangerous. We did not perform systematic castration in order to protect fertility. The removal of the testis is performed only when the gland is intraabdominal and undescendable considering the major risk of cancerisation.

[Thoracic actinobacteriosis due to Actinomyces naeslundii]. / Actinobactériose thoracique à Actinomyces Naeslundii.

The authors report the first case of thoracic actinomycosis due to Actinomyces Naeslundii. A precostal abscess with a large mediastinal and thoracic collection on CT scan was the presenting symptom. Evolution was favorable without sequelae after 6 weeks of Penicillin therapy (10.000.000 U/day).

[Peritoneal splenosis disclosed by infectious mononucleosis in an adolescent. Contribution of scintigraphy]. / Splénose péritonéale révélée par une mononucléose infectieuse chez un adolescent. Apport de la scintigraphie.

This article does not deal with the general problem of splenosis, but with the pathology of splenic nodules implanted in the peritoneum. This condition is uncommon, and chiefly hematological and infectious in the index case. Although this issue is debated, functional activity of these nodules is substantiated, leading to consider therapeutical applications in some exceptional cases.

[Cervical spine injuries in children]. / Les traumatismes du rachis cervical chez l'enfant.

Cervical spine injuries in children are usually benign, severe traumatism being exceptional. The authors report 4 observations of severe traumatisms, 2 of which have required surgical treatment. Moreover they insist on the interest of acupuncture in the treatment of torticollis and of pain in the cervical spine after injury. The authors also point out the frequent aspect of anterior pseudo-subluxation C2-C3 which corresponds to a genuine medio-cervical physiological hinge.

Effect of acetylcysteine (Mucomyst) on epithelial wound healing.

The rate of reepithelialization of the rabbit cornea, receiving isotonic NaCl solution and acetylcysteine (Mucomyst) solution at 10 and 20% concentrations, following a superficial epithelial ulcer was studied by fluorescein staining, photography and light microscopy. Acetylcysteine solution does not seem to retard normal epithelial healing compared with control animals which received isotonic NaCl solution.

[Left ventricular relaxation in myocardial diseases. Hemodynamic study]. / La relaxation ventriculaire gauche dans les maladies myocardiques. Etude hémodynamique.

Left ventricular relaxation as opposed to contraction, was studied by recordings of left ventricular pressure and its first derivation in primary hypertrophic cardiomyopathy without obstruction (25 cases, Group II) in primary dilated cardiomyopathy (33 cases, Group III) and in normal subjects (22 cases, Group I). Simultaneous recording of the pressure, the first derivation and intraventricular and intraaortic phonocardiogrammes showed the significance of certain features of the tracings and allowed a simplified protocol: ventricular relaxation was then defined from the pressure tracing (high fidelity recording) and its first derivation. The onset of isovolumic relaxation corresponded to the point of inflection on the descending part of the first derivation tracing, preceding its negative peak by an average of 0.02 s. The end of isovolumic relaxation corresponded to the crossing point of the atrial and ventricular pressure curves. In the absence of atrial pressure tracings the initial part of the rapid filling phase was included as far as the return of the first derivation tracing to its baseline (early diastole on the ventricular pressure tracing) as the duration of this period seemed remarkably constant (0.07 s). The parameters studied were: duration of isovolumic relaxation or the period defined above including the rapid filling phase; the average rate of fall of left ventricular pressure during this part of diastole; the value of the negative peak of the first derivation (dp/dt min); the rate of lengthening of the contractile elements at minimum dp/dt (dp/dt min/28P). Changes in relaxation were obvious in the pathological groups. The duration was increased and its average speed, dp/dt min, and dp/dt min/28 P were reduced. In the hypertrophic group, however, these changes seemed to be primary and contractility was usually unaffected. In dilated cardiomyopathy these changes could be considered secondary to decreased contractility. The hypothesis that changes in relaxation are specific for hypertrophic forms, and that changes in contractility are specific for dilated forms of primary cardiomyopathy may therefore be proposed.

Immunoenzymatic study of the protein pathway through the glomerular barrier in rat glomerulonephritides.

Circulating anti-horseradish peroxidase (HRP) IgG antibodies were used in the rat to study the glomerular leakage of proteins in glomerulonephritis (GN) induced by aminonucleoside (AN) and in glomerulonephritis induced by mercuric chloride to produce anti-glomerular basement membrane (GBM) antibodies. In ANGN, autologous albumin and fibrinogen were also detected by immunoperoxidase techniques. In both types of GN, the proteins studied were observed in the glomerular urinary space and proximal tubular cells. No channels were visible in the lamina densa. No accumulation of proteins was seen under the epithelial slits that were not closed. In ANGN, accumulation of proteins was observed in the subepithelial space where the podocytes act as a barrier (closed slits, subepithelial blind pockets, areas covered by broad sheets of cytoplasm), but no accumulation was seen in the lamina rara externa under normal or enlarged slits and areas of large epithelial cytoplasm detachment. Statistical analysis showed that in ANGN, at the time of maximal proteinuria, the number of "micropinocytotic" vesicles in the GBM-embedded part of podocytes was not increased as compared with controls. Such vesicles were not labeled. We conclude that in both types of GN, the permeability of the GBM is diffusely increased and that the plasma proteins pass into the urinary space via an extracellular pathway.

[Prognostic factors after keratoplasty for herpetic keratitis (author's transl)]. / Eléments du pronostic des kératoplasties sur kératites herpétiques.

Visual acuity was assessed after keratoplasty in 109 patients with various types of herpetic keratitis at different stages of the disease. Functional results appear to be independent of the age of the patient and the duration of the disease. On the contrary, they are related to the type of herpetic keratopathy present, and the surgical technique employed, whether lamellar or penetrating.

[Evaluation of the rapidity of progression of keratoconus by a study of the relationship between age when first detected and age at operation (author's transl)]. / Vitesse d'évolution du kératocone. Etude des relations entre l'âge de découverte t l'âge auquel il est opéré.

The rapidity of progression of keratoconus was evaluated by studying the relationship between the age when the condition was first detected and that when transfixing keratoplasty became necessary. Apparently, the younger the patient the more rapid is the progression of the keratoconus to stage III and IV, when surgical intervention is required. To test this hypothesis, 187 case reports were analyzed by computer. The same criteria had been applied when making the decision to operate, as the same surgeon was involved in all cases. Statistical analysis of the data demonstrated that the course of keratoconus is quite independent of the age when it is detected clinically, the average period before operation being constant at approximately 10 years.

[Fourier transformation study of corneal stroma]. / Etude par transformation de Fourier du stroma cornéen.

The various patterns observed by generating Fourier transforms of the fixed normal corneal stroma are described. The patterns are analysed in terms of the dimensions of the stromal fibers, the dimensional and directional order of the fiber distribution and the order of the fiber-fiber functions by proteoglycans.

Combined macular dystrophy and cornea guttata: an electron microscopic study.

Four cases of macular dystrophy in siblings were studied, 2 brothers and 2 sisters (49, 52, 55, 57 years old). The two youngest had an associated cornea guttata. We performed histologic, transmission, and scanning electron microscopic studies, and in addition a morphometric analysis of Descemet's membrane and of guttata excrescences. Previous studies have been confirmed and the problem of the relationship between the two conditions of macular dystrophy and guttate excrescences is emphasised.

[Familial congenital dystrophy of the corneal stroma: Turpin's syndrome (author's transl)]. / L'A DYSTROphie congènitale hèrèditaire du stroma cornèen of Turpin.

In 1939, R. Turpin and al. described cases of hereditary and congenital corneal opacities in three generations of one family. The members of this family have since been followed-up regularly by the author, examination of the corneas of the grandmother and the grand'daughter made by electron microscopy, the morphology compared, and an attempt made to establish the progression of the lesion. It so happened that at the same time, witschel and al. published (June, 1978) the results of their examination of the American members of the same family. Their conclusions were the same, in that this familial congenital dystrophy of the cornea is mainly stromal and differs therefore from familial congenital endothelial dystrophies. The author's analysis is complementary to theirs.

Reis-Bückler's dystrophy.

A case of Reis-Bückler's dystrophy in a 36-year-old man is reported. Its clinical aspect is compared with its histological and ultrastructural features. The slight reticular opacities situated superficially in the central part of the cornea, immediately beneath the epithelium, correspond to dark, irregular deposits. These replaced the basal membrane and Bowman's membrane and are composed of granular material, glycogen granules, and short fibers. These short, curved, osmiophilic fibers whose diameter is approximately 130 A are also located inside the anterior stromal lamellae. These deposits seem to be the characteristic feature of this particular and rare dystrophy, stated as by Hogan. Their nature and origin are discussed.