Pleurisy and sarcoidosis. Apropos of 2 cases

Pleural involvement is uncommon in sarcoidosis, observed in less than 5% of cases. We report two cases. Both patients were women. In the first patient, signs of sarcoidosis included pleural, mediastinal node, and multiple joint involvement as well as nasal obstruction, sicca syndrome and subcutaneous nodules. Diagnosis was established on pleural and nasal biopsies. For the second patient, in addition to the pleural involvement, there was interstitial lung disease and cervical, epitrochleal and deep abdominal node enlargement. Diagnosis was established from serial bronchial biopsies, pleural biopsies and peripheral node biopsies. Pleurisy is generally observed in cases with extensive lung involvement with extrathoracic localizations. Blind pleural biopsy is not very sensitive for diagnosis of sarcoidosic pleurisy. Light yellow exsudative fluid with a high lymphocyte count in a patient with a radiological and clinical presentation suggestive of tuberculosis, which must be ruled out, is a characteristic feature.     

Infantile cystinosis. A new Tunisian case]

A case of cystinosis in a three and a half-year-old is reported. Suggestive manifestations included severe rickets, small stature, and complex renal tubule dysfunction meeting the criteria for secondary Fanconi syndrome. Diagnosis was established by the discovery of retinal lesions upon ophtalmologic evaluation and, above all, by the finding that intracellular leukocyte cystine levels were increased to 16 mumol of 1/2 cystine per gram protein. Cystinosis is severe because it inevitably leads to renal failure. Much hope is currently placed in the use of cysteamine to delay this and other complications. At present, early antenatal diagnosis during the first ten weeks of pregnancy is needed in high-risk families to allow elective termination of pregnancy within the legal time limit.     

A platypnea-orthodeoxia syndrome

We report the case of a 68 years old patient with platypnea orthodeoxia syndrome who has been clinically suspected on cutaneous saturation position's variation. It has been confirmed by transthoracic and transesophageal echocardiography (TEE). TEE showed the size of patent foramen ovale (PFO), visualised the right to left shunt. A right heart angiography confirmed echocardiographic data and allowed successful closure by a Cardioseal percutaneous transcatheter button device implantation. Symptom's disappearance and a TEE control after 2 months confirmed the success of the procedure.     

Doppler echocardiography and arhythmogenic right ventricular dysplasia

The aim of this study is to evaluate new echocardiographic modes in diagnosis of arrhythmogenic right ventricular dysplasia (ARVD). Our study is prospective, including ten patients with ARVD and a control group of ten healthy subjects. Transthoracic echocardiography included evaluation of classical criteria's, cross sectional measurements of the right ventricular. M mode and pulsed tissue Doppler techniques were used for quantitative measurement of tricuspid annular motion at the lateral and septal positions. Assessed by M mode, the total amplitude of the tricuspid annular motion was decreased in the lateral and septal positions in the patients compared with the controls. The tissue Doppler velocity pattern showed decreased early diastolic peak annular (Ea) velocity and an accompanying decrease in early (Ea) to late diastolic(Aa) velocity ratio in all positions; the systolic annular velocity was decreased only in the lateral position. Tricuspid annular measurement are valuable, easy to obtain and allow quantitative assessment of right ventricular function. ARVC patients showed an abnormal velocity pattern that may be an early but non specific sign of disease.     

Comparison of idarubicin and daunorubicin regarding intracellular uptake, induction of apoptosis, and resistance

Anthracycline antibiotics are widely used as anticancer agents. Idarubicin (4-demethoxydaunorubicin; Ida), a semisynthetic derivative of daunorubicin (Dnr) is more potent than the parent compound in vitro and in vivo. The equitoxic dose of Ida in patients is about one-fourth of that of Dnr. We compared these drugs regarding cytotoxicity, apoptosis induction, and resistance mechanisms in human leukaemic cell lines. Cytotoxicity was studied by means of the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide assay and drug-induced apoptosis by means of the Annexin V-fluorescein isothiocyanate method at similar intracellular concentrations (extracellular concentrations of 0.35 microM for Ida and 1 microM for Dnr). Ida was at least twice as potent as Dnr in MOLT-4, HL60, CEM, and K562 cell lines. It took 8 h for Ida to induce approximately 20% apoptosis, but at least 22 h for Dnr to reach 20% apoptosis at identical intracellular concentration. Ida induces a faster and higher apoptosis rate compared with Dnr. The human chronic myelogenous leukaemia cell line (K562) was selected for resistance to Dnr and Ida with and without verapamil (Ver). Continuous incubation with Dnr, but not with Ida, led to an increased mdr1 gene expression as assessed by real-time PCR. The development of mdr1 gene expression in Dnr-resistant cells could be reversed by the presence of Ver. Ver also reversed the cytotoxicity to Dnr, but not to Ida, in K562/Dnr cells. The results show that Ida is more effective than Dnr in inducing apoptosis and that there are differences in resistance mechanisms between the drugs.     

Leptin and leptin receptor polymorphisms are associated with increased risk and poor prognosis of breast carcinoma

Background  

Leptin (LEP) has been consistently associated with angiogenesis and tumor growth. Leptin exerts its physiological action through its specific receptor (LEPR). We have investigated whether genetic variations in LEP and LEPR have implications for susceptibility to and prognosis in breast carcinoma.     

Possible correlation between urinary muramidase (E.C.3.2.1.27) and oesophageal cancer

The diagnostic value of determination of low-mass enzymes in urine is very important, especially for early detection of some diseases. There are several investigations about lysozyme (muramidase, E.C.3.2. 1.27) and its correlation with some malignancies, but until now nothing has been reported about the lysozyme, and oesophageal cancer. This study was undertaken for determination of lysozyme concentration in urine of 32 oesophageal cancer patients to evaluate if this enzyme activity changes in oesophageal cancer used for detection of this cancer especially in its early stage. We used high performance liquid chromatography (HPLC) for determination of urinary muramidase after Sep-pac pre-purification of the samples. The mean results of lysozymuria in patients in comparison with the mean of enzyme activity in normal controls were statistically high (12.14+/-0.403 vs. 2.04+/-0.134, P相似文献   

Binaural sensitivity to temporal fine structure and lateralization ability in children with suspected (central) auditory processing disorder

Objective

Previous studies have shown that a subgroup of children with suspected (central) auditory processing disorder (SusCAPD) have insufficient ability to use binaural cues to benefit from spatial processing. Thus, they experience considerable listening difficulties in challenging auditory environments, such as classrooms. Some researchers have also indicated the probable role of binaural temporal fine structure (TFS) in the perceptual segregation of target signal from noise and hence in speech perception in noise. Therefore, in the present study, in order to further investigate the underlying reason for listening problems against background noise in this group of children, their performance was measured using binaural TFS sensitivity test (TFS-LF) as well as behavioral auditory lateralization in noise test, both of which are based on binaural temporal cues processing.

Metastatic breast cancer 49 years after initial treatment

Very late metastases after cancer therapy are not common. We report an exceptionnal case of breast carcinoma associated with pregnancy that reocurred in the form of brain metastasis 49 years after initial treatment.     

Intestinal T cell lymphoma in coeliac disease. A case report

Primary intestinal T-cell lymphomas account for about 5% of all primary gastrointestinal lymphomas and are mostly associated with coeliac disease. Intestinal lymphomas are usually discovered during the 4th to 5th decade and constitute an exceptional complication of coeliac disease. This lymphoma is generally a high grade pleomorphic cell lymphoma with large cells. Our case concerned a 30 year old woman with a history of coeliac disease who developed a gastro-enteromesenteric lymphoma. Anatomopathological and immunohistochemical analysis showed an enteropathy associated T-cell lymphoma. We suggest that patients with coeliac disease unresponsive to a gluten free diet or with deteriorating clinical condition be investigated for complications such as enteropathy associated T-cell lymphoma. It is also important to avoid this complication by detecting asymptomatic form of coeliac disease that needs a gluten-free diet.