A prospective study of the value of bone marrow erythroid progenitor cultures in polycythemia.

The diagnostic value in polycythemia of the presence of endogenous erythroid colonies derived from bone marrow cells (EECs) was assessed in a prospective study on 108 patients referred for polycythemia (Hb greater than g/dL in men, greater than 16 g/dL in women) with normal plasma volume by comparison with the standard criteria, the bone marrow grade, and the serum erythropoietin (Epo) level. Total red cell volume (TRCV) was high (greater than 36 mL/kg in men, 32 mL/kg in women) in 87 cases (group A) and slightly increased in 21 cases (group B). Standard criteria were applicable in 63 of 108 cases (57%); 46 were PV and 17 were secondary polycythemia (SP).

Phenotype of early erythroblastic leukemias.

Nine cases of early erythroblastic leukemia, unidentified by usual criteria, have been diagnosed using a panel of antibodies. Three cases arose in patients with Down's syndrome, one in a patient with therapy-related leukemia, and four patients were in blast crisis of chronic myeloid leukemia; only one case arose de novo. Blast cells could be assigned to two main stages of erythroid differentiation: presence of all erythroid-specific proteins in two patients, a phenotype corresponding to an immature erythroblast; absence of the erythroid markers such as glycophorin A and spectrin in the presence of carbonic anhydrase isoenzyme I, ABH group antigens, and the antigen defined by FA6 152 monoclonal antibody in six patients, a phenotype related to a late erythroid progenitor (CFU-E).

[Acute colectasia in patients on artificial respiration. 10 cases].

Acute colectasia may occur in patients under mechanical ventilation. Causative factors include haemodynamic changes, potassium loss, underlying pathology (chronic respiratory failure, cirrhosis) and especially morphine-like compounds used for sedation. Analysis of the results obtained with various treatments suggests that surgery is not justified: caecal perforation is extremely rare in a previous healthy colon; any surgical procedure is hazardous in this type of patient, and colectasia frequently regresses under appropriate medical treatment, even though mechanical ventilation is pursued.

[Morphometric study of hepatocytes in steatosis].

By morphometric analysis of fatty liver, we propose to value volume density of fat vacuoles and liver hypertrophy. By this method we appreciate liver cell modification in malnutrition.

Vindesine-prednisone in the treatment of blast crisis of chronic myeloid leukemia.

Eight patients with chronic myeloid leukemia in blast crisis were treated with a combination of vindesine and prednisone. Complete remission was achieved in three patients; partial remission was achieved in three. All six responders received maintenance treatment with hydroxyurea and 6-mercaptopurine.

[Metastatic malignant thymoma].

Three cases of metastatic malignant thymoma are reported. In all three cases the tumour was invasive and excision was only partial or impossible. Histologically, these tumours were of epithelial origin with a variable lymphocytic component.

High density lipoprotein cholesterol and apoprotein A1 in healthy volunteers during long-term moderate alcohol intake.

Moderate alcohol consumption is associated with lower cardiovascular mortality. The effect of moderate alcohol intake during 5 weeks on lipoproteins, especially on the high density lipoprotein (HDL) cholesterol total (of which the levels are inversely predictive of coronary heart disease) and apoproteins A, A1 and B, was studied in 7 normal men. HDL cholesterol total appreciated by the heparin manganese precipitation method and phosphotungstate magnesium method increased (p less than 0.

Prognostic index for clinical Stage I cutaneous malignant melanoma.

Thirteen variables were evaluated for their significance in predicting the survival of 148 patients in a retrospective study with clinical Stage I cutaneous malignant melanoma. The variables studied were histological type, tumor thickness, level of invasion, mitotic activity, pigmentation type, existence of ulceration, presence of lymphocytic infiltration, cell type, sex and age of the patient, site of melanoma, and wide local excision preceded or not by contact radiotherapy and associated or not with lymphadenectomy. When these variables were individualized, only seven were significantly related to survival: histological type; tumor thickness; level of invasion; mitotic activity; pigmentation type; existence of ulceration; and sex of the patient.

[Value of captopril in the treatment of systemic arterial and pulmonary hypertension with increased plasma renin in scleroderma].

The effects of the converting enzyme inhibitor captopril (Lopril) were studied in a 53 year old woman with acute exacerbation of scleroderma. In addition to her chronic symptoms of Raynaud's syndrome, the patient presented with severe hypertension, cardiac failure and oligoanuria. Right heart catheterisation with a Swan-Ganz catheter confirmed the systemic hypertension with cardiac failure, and also demonstrated precapillary pulmonary hypertension with raised pulmonary arterial resistance.

[Proposal for a surgical evaluation index card for ovarian cancers].

The authors propose a computer card for registering the main information required in the management of ovarian cancers. The data include a detailed description of the lesions noted at operation, the surgical procedure, and postoperative lesions. They concern both the initial laparotomy and any second-look operations.

[Acute haemorrhagic pancreatitis. Criteria of letality (author's transl)].

A retrospective study of severity symptoms in a series of 102 patients operated upon for acute haemorrhagic pancreatitis showed that the risk of death was much significantly higher when shock (p less than 0,00001) and renal failure (p less than 0,0001) were present. The association, during the post-operative period, of shock and renal failure with one of the following symptoms: digestive haemorrhage, psychic disorders, pulmonary oedema, post-operative peritonitis and evisceration invariably proved fatal. It is suggested that controlled therapeutic trials should be carried out in patients presenting with these complications.

[Pull-through procedure for carcinoma of the rectum. Results of 65 operations (author's transl)].

These sixty five cases of abdomino-trans anal excision account for approximately one third of 210 operations performed for carcinoma of the rectum. In the context of curative surgery, indications for preservation of the sphincter must be strict in order to permit satisfactory excision inferior to the tumour and to avoid the risk of local recurrence. Post-operative care and early complications involve the segment of colon which must be brought down.