[2 cases of double pylorus with ulcer].
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Biomedical subjects
Publications and source records attributed to M Chousterman.
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Both of these arterial diseases may involve the aorta and the major arterial trunks. Two cases of subclavian involvement are used to contrast them from a histopathological standpoint. In giant cell arteritis, the lesions affect above all the internal elastic layer and the inner part of the media, destroyed by an inflammatory infiltrate with giant cells. In Takayasu's disease, the lesions involve the adventitia, the site of fibrosis and of inflammatory islets with the vasa vasorum at the centres. Involvement of the media is predominantly in its outer part, the internal elastic layer being intact. A histopathological definition of these arterial diseases may be envisaged on the basis of these facts.
Recent observation of a case of idiopathic chronic intestinal pseudo-obstruction and the relationship sometimes suggested in this context with certain systemic diseases, such as scleroderma, led the authors to compare the changes seen in the myenteric plexuses in these different groups of disorders. The intramural plexuses were studied using the technique of B. Smith, in thick frozen section parallel to the lumen and stained using Bielchowsky's method. Plexus innervation was normal in a case of digestive amyloidosis and a case of myxoedema. There were secondary changes in the plexuses in scleroderma. The lesions were very different in our case of idiopathic chronic intestinal pseudo-obstruction (marked decrease in the number of neurones with degenerative changes in the neurones and dendrites, marked schwannosis). A decrease in the number of neurones was seen in a case of severe diabetes. Various mechanisms are discussed. These cases emphasize the great value of B. Smith's technique in the fine study of the intramural plexus innervation of the digestive wall.
A series of 180, Bouin-fixed and paraffin embedded liver biopsies obtained from 147 patients was investigated for the presence of hepatitis B surface antigen (HBs) by histochemical and indirect immunofluorescence techniques. A comparison between orcein staining and Masson's trichrome preparations for ground glass hepatocytes, showed that immunofluorescence was both the more reliable and the more specific method for detection of HBsAg in liver tissue. The ability to perform this technique on paraffin sections facilitates systematic studies and allows retrospective work-up. IF-HBs positive hepatocytes were found in approximately two thirds of all HBs-positive patients in their serum, but never seen in HBs-negative patients. HBs-positive cells were observed in healthy chronic carriers and in all forms of chronic hepatitis, but never in acute HBs-positive hepatitis. In patients treated with chronic hemodialysis and in renal homograft recipients, the incidence of positive cells was higher than in the chronic hepatitis groups; this could be correlated with the duration of antigenemia at the time of biopsy.
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This paper describes a case of disseminated gonococcal infection, a rare disease in France. A 41 year-old woman was hospitalised with acute polyarthritis and characteristics skin lesions. Jaundice and liver function abnormalities are difficult to interpret due to a preexisting alcoholic cirrhosis. The possibility of an endocarditis is raised because of a systolic murmur heard at the base of the heart. Bacteriological identification of N. Gonorrhoeae is carried out in blood culture; it has also been recovered by scrapings of a cutaneous bullae by staining only. Therapy was instituted by daily intravenous penicillin G sodium 50 000 000 u. and intramuscular gentamicin 160 mg for 45 days. There resulted good clinical and bacteriological response. The elements of clinical and bacteriological diagnosis, as well as the therapy are discussed.
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