High interferon titer and defective NK-cell activity in the circulation of nasopharyngeal carcinoma patients

The interferon (IFN) activity of sera from 19 patients with nasopharyngeal carcinoma (NPC) was determined by the plaque-reduction assay with vesicular stomatitis virus (VSV) in HeLa cells and compared to that of sera from matched healthy controls. High titers of interferon were detected in the sera of the NPC patients with a geometric mean titer (GMT) of 43 +/- 25 U/ml. The interferon activity of the patients' sera was acid- and heat-labile (pH = 2 and 56 degrees C for 1 hr) and could be neutralized by a goat antiserum to human IFN-gamma. Interferon titers of the patients, in contrast, to normal controls, were not correlated with natural killer (NK) activity which was abnormally low in the NPC patients. On the other hand, a high percentage of circulating cells co-expressing the LGL marker (HNK-I) and the OKT8 antigen was detected in parallel with high IFN levels in NPC patients.     

Renal transplantation in the elderly: a survey

For ten years, an increase in the number of elderly patients on renal transplant waiting lists has occured. In an attempt to close the widening gap between supply and demand and because the demand for kidneys for younger patients already surpasses the supply, transplant physicians nowadays accept organs from older donors that might have been deemed inappropriate in the past. Programs of age matching between donors and recipients and of dual-kidneys transplantation have emerged. The initial results of these programs are encouraging with excellent patient and graft survival at one and three years.     

Primary, exclusively gastric localization of alpha-chain disease: anatomo-clinical and immunohistochemical study

We report the first case of heavy alpha-chain disease exclusively located in the stomach and in the perigastric nodes in a thirty year old Tunisian patient. Both the small bowel and the mesenteric nodes were evaluated histologically and immunochemically and were found to be free of disease. Complete remission was obtained using chemotherapy. The reasons for which the small intestinal mucosa and the mesenteric nodes, nearly constantly involved, in alpha-chain disease were spared in our case, are discussed.     

Acute leukoencephalitis in infant treated by high-dose corticosteroid. A case report

The authors report a case of acute post infectious leukoencephalitis observed in a tow-years and a half children admitted to our hospital for fiver with suddent condition deterioration, obnibulation, coma and paralysis of the 6th and 7th cranial nerve. Cerebrospinal fluid study showed lymphocytosis with negative culture. Head magnetic resonance imaging demonstrated diffuse high signals over the white matter on T2 weighted images so the diagnosis was confirmed. High dose corticosteroid therapy was effective.     

Traumatic hyphema due to contusion. 40 cases

PURPOSE: To study the clinical characteristics of traumatic hyphema and to discuss the place of medical and surgical treatment. MATERIAL AND METHODS: A retrospective study of 40 patients hospitalized between 1991 and 1995 for traumatic hyphema was conducted. RESULTS: The average age of patients was 16 years. There were 87.5% males. Sex ratio was 7.1. Dangerous games were responsible for injury in 40% of cases. 60% were grade 2 or less. With medical treatment, outcome was favorable in 67.5% of eyes with hyphema, often within 2 to 5 days. However, complications occurred in 35% of cases: secondary hemorrhage, ocular hypertony, blood staining of the cornea and posterior synechiae. Only 4 cases needed surgical treatment. 3 of them developed secondary hemorrhage after surgery. CONCLUSION: Traumatic hyphema is a diagnostic and therapeutic emergency. More preventive efforts are needed especially in children. Outcome is generally good if medical treatment was quickly instituted. Surgical treatment must be reserved for cases with refractory persistant hypertony, because of the risk of secondary bleeding.     

Diabetic fibrous mastopathy

Diabetic fibrous mastopathy was first described in 1984. This mastopathy usually occurs in patients with autoimmune disorders and often occurs in patients with insulin-dependent diabetes. Little is known about this benign condition. Clinically and radiologically, this entity may simulate malignancy. The presence of an underlying auto-immune disorder or diabetes may suggest the correct diagnosis. The authors report two cases of fibrous mastopathy and suggest that core biopsy could replace surgical biopsy for diagnosis.     

Fetal intra-abdominal tumors: assessment of spectrum,accuracy of prenatal diagnosis,perinatal outcome and therapy at a tertiary referral center

Objective

To describe the varieties and ultrasound characteristics of prenatally diagnosed fetal abdominal tumors and to scrutinize the accuracy of prenatal diagnosis as well as the postnatal outcome and therapy of affected pregnancies.

Study design

Retrospective study of 354 fetuses found to have abdominal tumors on prenatal sonogram, identified from 1993 to 2009 at a tertiary referral center for prenatal medicine. The cohort was classified into subgroups according to the sonographic appearance of the fetal tumor and the affected anatomic structure (urinary, gastrointestinal and genital tracts and other locations). Sensitivity, specificity, positive predictive value and false-positive rate of ultrasonography in identifying the system of origin were calculated. Relationships between relevant outcome domains and the different subgroups were assessed using the chi-square test and Fisher's exact test.

Results

Our cohort comprised 222 urinary tract lesions, 37 genital tract lesions, 80 gastrointestinal lesions and 15 tumors of other origins. The mean gestational age at diagnosis was 26 + 0 wks. The prenatally established diagnosis was exactly concordant with postnatal findings in 88.9%. Sensitivity, specificity, positive predictive value and false-positive rate of ultrasonography in identifying the system of origin (urinary, gastrointestinal, genital tracts and other locations) were 98.3%, 97.6%, 92.6% and 2.4%, respectively. The favorable postnatal outcome rate was highest among fetuses with genital tract lesions (95%) and lowest among those with tumors of the urinary tract (62%, p = < 0.001). Twenty per cent of tumors regressed spontaneously, mostly gastrointestinal tumors (36%, p = < 0.001). In 75/354 cases (21%) the parents opted to terminate the pregnancy: intra-uterine fetal demise and neonatal death were each noted in 4%. Prenatal therapy was performed in 24 of 354 cases (7%) and postnatal surgery in 64 cases (18%).

Conclusion

The majority of fetal abdominal anomalies were accurately diagnosed and the vast majority of affected fetuses had a favorable outcome, some tumors even resolved with advancing pregnancy. Pre- and post-natal invasive surgical interventions were mandatory in only a small number of cases.     

Spouses and bipolar disorder

Objective

To assess the quality of life of a population of spouses of bipolar patients compared with a control population.

Patients and methods

We conducted a cross-sectional study which included two groups: a group of 30 spouses of patients followed for bipolar I disorder according to DSM IV criteria and a second group of 30 subjects from the general population. Both groups were matched by age, sex, marital status and socioeconomic level. This device was designed to limit the differences between the two groups solely those of the bipolar illness. Evaluating the quality of life was achieved using the quality of life scale: SF-36. This is a scale that has already been translated and validated in dialect Arabic.

Results

Regarding sociodemographic variables, the two study groups differed only for: recreation, friendly relations and the couple relationship that included more and better skills among the control group. In the categorical approach, the quality of life was impaired in 60% of spouses and 40% of controls with a statistically significant difference. The following standardized dimensions: mental health (D4), limitation due to mental health (D5), life and relationship with others (D6) and perceived health (D8) and mental component (CM) were significantly altered in patients’ spouses compared to controls. We found significant differences between the two groups for: overall average score (51.1 vs. 68.2), mental health (D4), limitation due to mental health (D5), life and relationship with others (D6), perceived health (D8) and perceived health (D8) standards.

Discussion

The impairment of quality of life of bipolar patients’ spouses is related to the extra responsibility, stress, financial problems and health problems, stigma, and loss of security of the person loved.

Conclusion

Considering the consequences that the appearance of bipolar disorder on the patient's spouse may have, certain measures must be proposed to improve their quality of life.