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Many articles concerning conventional Pap smears, ThinPrep liquid-based cytology (LBC) and Hybrid-Capture II HPV test (HC II) have been published. This study, carried out by the French Society of Clinical Cytology, may be conspicuous for several reasons: it was financially independent; it compared the efficiency of the conventional Pap smear and LBC, of the conventional Pap smear and HC II, and included an economic study based on real costs; for all the women, a "gold standard" reference method, colposcopy, was available and biopsies were performed whenever a lesion was detected; The conventional Pap smear, the LBC (split-sample technique), the colposcopy, and the biopsies were done at the same time. This study included 2,585 women shared into two groups: a group A of a high-risk population, a group B of a screening population. The statistical analysis of the results showed that conventional Pap smears consistently had superior or equivalent sensitivity and specificity than LBC for the lesions at threshold CIN-I (Cervical Intraepithelial Neoplasia) or CIN-II or higher. It underlined the low specificity of the HC II. Finally, the LBC mean cost was never covered by the Social Security tariff.

Stomach angiomatosis is a rare disease. We report an exceptional case of diffuse gastric angiomatosis complicated with severe bleeding; the patient underwent two operations for dramatic haemorrhage with shock. Selective arteriography provided the diagnosis. Total gastrectomy was performed in a third operation providing remission with a 3 year follow-up. The diagnosis of gastric angiomatosis is difficult and is essentially based on the fundamental selective angiography. Histology examination confirms the diagnosis and demonstrates vascular malformations. Cases reported in the literature are usually isolated cases: 47 angiomatoses of the stomach have been reported. Treatment is always surgical with gastrectomy providing complete remission. This case report demonstrates the need for a revision of the classifications of vascular tumours of the stomach.

Granular-cell tumors (GCT), also called Abrikossof's tumors, are generally benign, ubiquitous tumors. An original case of granular-cell tumor of the esophagus is reported. The symptoms included dysphagia and pyrosis. Fiberendoscopy showed a peptic esophageal stenosis with ulcerations confirmed by biopsy. CT showed a round thickening of the esophageal wall, localized in height. This lesion had previously been the object of several dilatation attempts. Esophagectomy with esogastric anastomosis in the thorax was performed. The histological study allowed diagnosing a granular-cell tumor, though one of a very peculiar type: misleading symptoms, tumor infiltrating the whole height of the esophagus and a circular area. Ninety cases of granular-cell tumors are reported in the literature; they are associated with a cancer of the air passages or of the digestive tract in 11% of cases. The cancer often appears secondarily, which requires lengthy surveillance. We do not know if this association is directly related or accidental. We have found no identical case of such a lesion, involving both the whole circumference and the whole height of the esophagus, in the literature.

The use of vascularized, composite and prepared free transplants is a recent technique. Two types of transplants were grafted in rats (150 operated cases). For the prefabricated free transplants, each component remains vascularized by rami of the main pedicle: vessels, nerves, bone, periosteum, cartilage, muscle, skin (50 cases). The graft is transplanted immediately. Neovascularized free transplants are quite different, the various components being laid around the vascular pedicle (100 cases). Neovascularization revascularizes the components. The free graft is transplanted 5 weeks after being prepared. The period of observation ranges from 3 to 12 months. Observation includes macroscopy, arteriography, histology and intravascular dye injections. The results with prefabricated free transplants show normal vascularization of soft tissues. There is bone in all cases, it is normal in 80% of cases. In neovascularized transplants, the bone is normal in 33% of cases only, and totally resorbed in 46%. Prefabricated free transplants produce better results than neovascularized free transplants and must be preferred. The merit of these composite free transplants is that they produce free transplants selectively, using various tissues and chosen vascular pedicles. These transplants are a useful and futuristic alternative for highly sophisticated reconstructive surgery.