[Current status of Wegener's syndrome. Apropos of 2 cases]. / Actualité du syndrome de Wegener. A propos de 2 observations.

In the context of two recent cases, the authors briefly review the clinical, laboratory and anatomical features of Wegener's granulomatosis and, in particular, its clinical course in response to treatment. These 2 cases include fairly original features: one case presented with abundant haemoptysis with a radiological picture of extensive diffuse bilateral pneumonia; the other case presented with a very large pleural effusion with no E.N.T. involvement whatsoever. The authors then summarise the classical features of this severe form of granulomatous vasculitis, which essentially affects the lungs, the kidneys and the ear, nose and throat. The lesions have a typical histological appearance. The major interest of this disease lies in its treatment. The natural evolution of this disease is very serious with a mean survival of 5 months. However, with immunosuppressant and corticosteroid treatment, a complete remission is obtained and maintained in more than 90% of cases. The therapeutic protocol used, as in one of the present cases, prevents the development of the lesion responsible for the very serious prognosis, irreversible renal failure.

[Influence of the localization on the prognostic value of E, E-active and autologous rosettes in lung, esophagus and otorhinolaryngologic cancer]. / Influence de la localisation sur la valeur pronostique des rosettes E, E-actives et autologues au cours des cancers du poumon, de l'oesophage et ORL.

E, E-active and autologous-rosette-forming-lymphocytes (E, Eact-, auto-RFC) were studied in 66 patients with lung cancer (2 stage I, 17 stage II, 20 stage III, 27 stage IV), 42 patients with head and neck cancer (14 stage III, 28 stage IV) and 22 patients with esophagus cancer (11 stage II, 6 stage III, 5 stage IV). Compared to controls, E-RFC were found to be depressed in each of the three different localizations (p less than 0.001), Eact-RFC were found to be depressed in head and neck as well as esophagus cancer (p less than 0,05 and p less than 0,01 respectively) and auto-RFC were found to be depressed in lung and esophagus cancer (p less than 0,01). Mean survival times of patients with RFC over and under 1 SD below the average value were compared. Significant differences were demonstrated in E-RFC and auto-RFC for head and neck cancer and in Eact-RFC for lung cancer.

[Prognostic significance of lymphocytes forming "active rosettes" in lung cancer]. / Intérêt pronostique des lymphocytes formant des "rosettes actives" dans le cancer du poumon.

Lymphocytes forming E rosettes, active E, autologous and EA antibodies were studied in 66 subjects (56 men, 10 women, mean age 59, range: 40-85 years) who presented with lung cancer classified on the TMN scale in stages I and II: 19; stage III: 20; stage IV: 27. In comparison to the controls, there was a significant reduction (p less than 0.01) in E, autologous and EA rosettes in the patients. A reduction in E active rosettes (compared to controls) was noted for stage IV cases (p less than 0.01) and rose with the stage. The formation of rosettes was reduced in 50 squamous carcinomas compared to 12 anaplastic carcinomas for E rosettes (p less than 0.01) and E active (p less than 0.02). If one compares the actuarial survival curves of 37 patients with E act rosettes greater than or equal to 23% and of 29 with a level of less than 23%, the mean survival for all stages combined was 14.1 months in the first group and 8.2 months in the second group. Associated with an extension of the tumour, the immunological system has a role in determining outcome and lymphocytes forming active E rosettes appear to be the subpopulation most closely correlated with survival.

[Branchiomeric mediastinal chemodectoma: a case report and literature review]. / Chémodectomes médiastinaux branchiomériques. A propos d'un cas et revue de la littérature.

Among non-chromaffin paragangliomas, the so-called aorticopulmonary or branchiomeric mediastinal chemodectomas are very rare tumors. A case is reported, and 57 similar cases described in the literature are reviewed. As recommended by Olson, a separate group was instituted of 21 cases of the so-called posterior mediastinal or aorticosympathetic group of the costovertebral groove. In principle, aorticopulmonary chemodectomas are non-functional, and in 9 out of 10 cases follow a slow and benign course extending over many, or even tens of years. In contrast to carotid and jugular paragangliomas they are rarely multifocal: when this is the case it is difficult to confirm the presence of metastases, this being however the most reliable criterion of their malignancy. The fortuitous discovery on a radiography of a tumor of the anterior and middle compartments of the upper mediastinum should invoke the presence of an aorticopulmonary chemodectoma, and lead to arteriography of the aortic arch region. Diagnosis is made essentially by pathological examination. Treatment is exclusively by surgical excision, and this was complete in nearly half of the cases treated. Prognosis is not hopeless after partial removal, however, and a relatively comfortable survival can be obtained extending over many years.

[Spontaneous abortion after intra-uterine transfer of an ovum fecundated in vitro (author's transl)]. / Transfert utérin d'un oeuf fécondé in vitro: avortement spontaneé.

Spontaneous expulsion of a human ovum fecundated in vitro and transferred into the uterus occurred after 10 1/2 weeks of amenorrhoea. The oocyte had been collected after stimulation by human menopausal and chorionic gonadotrophins (hMG and hCG). The techniques of pre-ovulatory oocyte collection, fecundation, in vitro culture and of reimplantation of the embryo are briefly described.

[Acquired ichtyosis and bronchial cancer; report on two cases (author's transl)]. / Ichtyose acquise et cancer bronchique. A propos de deux nouvelles observations.

Acquired ichtyosis appears to be a rather rare paraneoplasic syndrome, mainly observed during the course of Hodgkin's disease, but also accompanying visceral cancers. Two cases of generalised ichtyosis in patients with bronchial carcinoma are reported, emphasis being placed on the need for systematic investigations to determine this possible aetiology. Diagnostic problems are discussed, as well as hypotheses concerning the pathogenicity of these affections, which is still obscure, emphasis being placed on the secretory potential of these tumours and the role of immunological phenomena.

[Treatment of the syndrome of inappropriate secretion of antidiuretic hormone with demethylchlortetracycline. Apropos of 2 cases]. / Traitement du syndrome d'antidiurèse inappropriée par la déméthylchlortétracycline

Two cases of inappropriate antidiuresis are reported, one associated with small cell anaplastic bronchial carcinoma, the other secondary to acute hydrocephalus. ttreatment with demethylchlortetracycline proved effective in both cases. Treatment of the inappropriate antidiuretic syndrome is discussed and the advantages of demethylchlortetracycline emphasised. This antibiotic seems to represent the treatment of choice of the chronic syndrome of inappropriate antidiuresis.

[Spontaneous pneumothorax in the adult. Problems of its development and treatment (apropos of 124 cases)]. / Le pneumothorax spontané de l'adulte. Problèmes évolutifs et thérapeutique (a propos de 124 cas)

The authors report their experience of the evolution and treatment of spontaneous pneumothorax in the adult, in a series of 124 cases, starting from January 1965 to May 1975. Recurrences occur in 27% of cases whatever therapeutics are used. They discuss frequency and modality in relation to the etiology and the proposed treatment of pneumothorax.