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Introduction Despite the fact that hydatid disease is endemic in some countries, its cervical location remains very rare. Presentation of case We report two cases of primary cervical hydatid disease in two children from rural areas. The imaging was not specific, since the location is rare; the diagnosis was only confirmed after surgery. Discussion Hydatid cyst is a rare pathology. Thus clinical presentation, radiological examinations, fine needle aspiration and serology can be useful to suspect the diagnosis. Conclusion Hydatid disease should be considered when dealing with slow-growing renitent neck swelling in endemic countries., Highlights • Hydatid disease mainly affects liver and lung in endemic countries • Neck hydatid disease is exceptional and quite challenging for physicians • Imaging, fine needle aspiration cytology and serology can help guide the diagnosis but are non-specific • In-bloc surgical resection is the treatment of choice, however PAIR technique and antiparastic drugs can be an alternative in some cases

Myiasis is the infestation of humans and vertebrate animals with dipterous larvae. It is a rare clinical condition, mainly observed in vulnerable people living in tropical and subtropical regions.We reported a 2-year-old boy, with history of anemia and psoriasis who was admitted to our department after discovering larvea coming out from the left ear 6 weeks ago. Ear examination revealed a few maggots in the left concha and external auditory canal. A larvea was removed and identified as Musca domestica. Management of this otomyiasis was based on manual maggot removal and regular auditory toilets with povidone iodine.Although rarely reported, clinicians should still suspect aural myiasis in the event of an unexplained otalgia in children, mainly if they are from rural area with poor hygienic conditions.Otomyiasis is mainly reported in tropical rural location in debilitated individuals with low socioeconomic conditions and poor hygiene. Thus prophylactic measures are the most effective means to reduce its incidence.

Lipoma arborescens is a rare intra-articular benign tumor. It affects mostly the knee and the diagnosis is usually difficult due to resembling symptomatology of osteoarthritis.We report herein 3 new cases of lipoma arborescens of the knee in which a patient has synovitis associated. In 2 cases, the discovery was intraoperatively. We also report a tumor relapse 2 years after surgery.

The identification essentially of hMSH2 and/or hMLH1 alterations has clinical implications for recognition and prognosis of MSI phenotypes cases. In this study, we tried to identify instability by immunohistochemical expression pattern analysis, compared the results with molecular investigation and shown their usefulness as predictive factors for determination of Microsatellite Instability in patients with colorectal carcinomas in routinely.Forty seven colorectal cancers and their adjacent colonic mucosa were selected retrospectively for this study. We first studied the potential value of molecular investigation to identify microsatellite instability in which a NCI panel (or Bethesda panel) of five microsatellite was analyzed (Bat-25, Bat-26, D2S123, D5S346 and D17S250). Secondary, we evaluated the immunohistochemical assessment of hMLH1, hMSH2, hMSH6 and PMS2 proteins in tumor and adjacent normal colorectal mucosa tissues.Fourteen cases were scored as MSI and the remaining MSS. Moreover, we found loss of expression for hMLH1, hMSH2, hMSH6 and PMS2 respectively in 9, 10, 6 and 9 of cases. The MSI patients were less than 45 years old, have right localization and mucinous histological type. We found an association between MSH2, age (P=0.03) and staging (P=0.02). MLH1 is associated only with age (P=0.02) while MSH6 with tumor grade (P=0.01).We found an association between MSI molecular investigation and MMR immunohistochemical expression which may allow one to specifically identify MSI phenotype of patients with colorectal carcinomas. Furthermore, immunohistochemical analysis of MMR protein can be used in routinely for detection of microsatellite instability without occurs to molecular investigation.

Objectives Mutations in GJB2 are found to be responsible for 50% of congenital autosomal recessive non-syndromic hearing loss, one of the most important mutations in this gene is the c.35delG, which is responsible for the majority of GJB2 related deafness in the Tunisian population. The aim of this study was to determine the molecular etiology of hearing loss in two Tunisian individuals. Methods We screened two Tunisian individuals affected by congenital, bilateral, profound, sensorineural hearing loss for mutations in GJB2 gene using PCR and direct sequencing. Results We identified a novel frameshift mutation in the GJB2 gene, the c.405delC resulting in a truncated protein (p.Tyr136Thrfs*32). It was found in compound heterozygosity with the c.35delG in two non-consanguineous unrelated families from Tunisia. One patient underwent a cochlear implant at 4 years. Initial evaluations post-implantation indicate a successful cochlear implant outcome since the patient began to acquire language abilities and auditory sensation. Conclusions With this novel GJB2 mutation, the mutational spectrum of this gene continues to broaden in our population. The occurrence of biallelic GJB2 mutations for the other deaf girl, despite the neonatal pain and hypotension due to complicated delivery, led us to confirm the importance of GJB2 screening for cochlear implant candidates regardless of the etiology of deafness in populations with a relatively high frequency of GJB2 mutation carriers.

To evaluate the effects of ethanol-water (80:20) extract of Marrubium vulgare (M. vulgare) on the hematological parameters, macroscopic and histological aspects of the uterus and fetus in non-pregnant and pregnant rats.Female rats were divided into 4 equal groups (n = 9), group N (normal rats) and group G (pregnant rats) considered as control groups, group NE (normal rats treated with the ethanol-water (80:20, v/v) extract of M. vulgare) and group GE (pregnant rats treated with the extract). The ethanol-water (80:20) plant extract was administered in a single daily dose 1 g/kg at the morning, during 19 d. On the 19 day of the experiment, animals were sacrificed, the uterus and fetuses were removed for the morphological and histological studies and the blood was collected in EDTA tubes for the measurement of hematological parameters with the use of an automate 'HORIBA ABX Micros 60 Hematology Analyzer'.Our results showed, in group NE and GE, a significant decrease on hematological parameters: red blood cells (NE: 18.6%; GE: 38.4%), hematocrit (NE: 13.8%; GE: 20.4%), hemoglobin (NE: 12.1%; GE: 8.3%) and mean corpuscular volume (NE: 6.4%; GE: 2%) with P more less a 0.05. Indeed, the extract of M. vulgare caused a significant decrease on the mean implantations of fetuses (82.5%, P 0.001) and their size (47.2%, P 0.01). As for the macroscopic and histological appearance of uterus, our data showed no change in normal treated rats. In contrast, the treated pregnant rats showed a severe histological change characterized by the existence of location of stopped gestation. Furthermore, it was also found in the uterus of these rat lyses placental and embryo tissue.All these results support the hypothesis of an abortifacient effect of M. vulgare.

Resume Introduction Le syndrome de Kindler est une genodermatose autosomique recessive rare appartenant au groupe des maladies poikilodermiques bulleuses. Nous rapportons trois nouvelles observations chez trois sœurs. Observations Il s’agissait de trois sœurs âgees de 20, 16 et 12 ans, issues d’un mariage consanguin de premier degre sans antecedents familiaux de syndrome de Kindler. Les trois patientes presentaient des lesions bulleuses spontanement regressives, une poikilodermie d’aggravation progressive, une atrophie cutanee importante du dos des mains et des pieds, une photosensibilite et une hypertrophie gingivale. L’examen histologique en microscopie optique et en microcopie electronique avaient montre un clivage intra-epidermique. Discussion Le syndrome de Kindler appartient au groupe de maladies bulleuses congenitales poikilodermique. Son diagnostic est clinique. L’examen en microscopie electronique met en evidence un clivage epidermique, jonctionnel et dermique. Le diagnostic peut preter a confusion avec l’epidermolyse bulleuse congenitale, le syndrome de Weary et les autres maladies bulleuses congenitales poikilodermiques.

The Corynebacterineae represent a distinct group within Gram-positive bacteria, with prominent members being the human pathogens Mycobacterium tuberculosis, Mycobacterium leprae, and Corynebacterium diphtheriae. A common feature of the Corynebacterineae is that they possess an unusual cell wall architecture rich in mycolic acids that is responsible for host pathogenesis and antibiotic resistance. The present study was carried out to evaluate the effects of garlic extract (GE) on the viability, cell wall ultrastructure and fatty acid composition of extractible lipids of Corynebacterium glutamicum. We found that C. glutamicum is inhibited by 44.25 mg ml−1 GE. Observations by electron microscopy revealed that GE alters the cell wall. In addition, GE-treated bacteria (23.6 mg ml−1) showed an increase (from 6.9% to 18.8%) in the extractible lipids released. The fatty acid composition of these lipids was also significantly perturbed, especially C16:0, C18:0, C18:1 and C18:2. These data indicate that the integrity of the cell wall, the most effective target of antimycobacterial drugs, is affected by GE. This knowledge could contribute to improving the treatment of pathogenic Corynebacterineae.

Three different tumour-like lesions within the infrapatellar fat pad, an osteochondroma, a localised pigmented villonodular synovitis and a synovial cyst are reported. The osteochondroma and the pigmented villonodular synovitis were treated by marginal excision, and the synovial cyst was resected using arthroscopy.

To evaluate the contribution of electron microscopy to the final diagnosis of glomerulopathies, the authors established a prospective study during the first semester of 2006. A total of 52 kidney biopsies were performed with 3 samples for light microscopy, immunofluorescence, and electron microscopy. Among these renal biopsies, only 20 were examined with electron microscopy because the diagnosis made on the basis of conventional methods had remained unclear or doubtful. In 18 cases, electron microscopy was undertaken for the investigation of primary kidney disease. The 2 remaining cases were transplant biopsies. In this series of 20 patients, there were 3 children with an average age of 9 years and 17 adults with an average age of 35.5 years. Fifteen patients (75%) were nephrotic. The study revealed that electron microscopy was essential for diagnosis in 8 cases (40%) and was helpful in 12 cases (60%). In conclusion, the results showed that the ultrastructural study provides essential or helpful information in many cases of glomerular diseases, and therefore electron microscopy should be considered an important tool of diagnostic renal pathology. As was recommended, it is important to reserve renal tissue for ultrastructural study unless electron microscopy can be routinely used in all biopsies. Thus, this technique could be performed wherever a renal biopsy has to be ultrastructurally evaluated.

Phosphates are very important basic materials in agricultural and other industrial applications. The removal of phosphates from surface waters is generally necessary to avoid problems, such as eutrophication, particularly near urban areas. This paper is focused on the sorption of PO 4 3− ions from aqueous solution onto date palm fibers as a raw, natural and abundantly materials. A series of batch tests were conducted and the influence of contact time, initial phosphate concentration, pH of the solution and adsorbent dosage on PO 4 3− specie removal was investigated. FT-IR spectroscopy, scanning electron microscopy (SEM)/energy dispersive spectroscopy (EDS), transmission electron microscopy (TEM) analysis of the date palm fibers before and after phosphates biosorption and desorption studies were investigated to confirm the mechanism of the retention of phosphates. Results indicate that PO 4 3− uptake increased with increased initial phosphate concentration and decreased with increased pH values. The results showed that the highest phosphates adsorption capacity (4.35 mg/g) was found at pH 6.8, for an adsorbent dosage of 6 g/L, initial phosphate concentration of 50 mg/L, under a constant temperature of 18 °C ± 02, and the equilibrium state was reached within 120 min of exposure time. The relatively low cost and high capabilities of date palm fibers make them potentially attractive adsorbents for the removal of phosphate from aqueous solution.

International audience; Male infertility is the cause in half of all childless partnerships. Numerous factors contribute to male infertility, including chromosomal aberrations and gene defects. Few data exist regarding the association of these chromosomal aberrations with male infertility in Arab and North African populations. We therefore aimed to evaluate the frequency of chromosomal aberrations in a sample of 476 infertile men with non-obstructive azoospermia (n=328) or severe oligozoospermia (n=148) referred for routine cytogenetic analysis to the department of cytogenetics of the Pasteur Institute of Tunis. The overall incidence of chromosomal abnormalities was about 10.9%. Out of the 52 patients with abnormal cytogenetic findings, sex chromosome abnormalities were observed in 42 (80.7%) including Klinefelter syndrome in 37 (71%). Structural chromosome abnormalities involving autosomes (19.2%) and sex chromosomes were detected in 11 infertile men. Abnormal findings were more prevalent in the azoospermia group (14.02%) than in the severe oligozoospermia group (4.05%). The high frequency of chromosomal alterations in our series highlights the need for efficient genetic testing in infertile men, as results may help to determine the prognosis, as well as the choice of an assisted reproduction technique. Moreover, a genetic investigation could minimize the risk of transmitting genetic abnormalities to future generations.

The subcellular behavior of several mineral elements was studied using modern techniques of observation like transmission electron microscopy and analysis like electron probe microanalysis and secondary ion mass spectrometry. In the present ultrastructural and analytical investigations, we undertake to compare the intracellular behavior of a heavy metal, gold, and a III-A group element, indium, on rat testicular tissues after their parenteral administrations. Our ultrastructural results showed that while gold was found only in the lysosomes of Leydig cells under electron dense needles, indium was observed as electron-dense deposits in the lysosomes of both Leydig and Sertoli cells. No ultrastructural modifications were observed in the testicular tissues of the control rats. The microanalytical study showed that gold was concentrated in lysosomes with sulfur as a sulfate crystalline structure whereas indium was concentrated in the same organelle as insoluble phosphate salt. These results demonstrated that testicular Leydig and Sertoli cells have the ability to selectively concentrate indium but gold was concentrated only in the first kind of cells. The mechanism implicated in this concentration phenomenon is a biochemical one involving intralysosomal hydrolytic enzymes, the acid phosphatase and the arylsulfatase. This mechanism occurs in order to protect the organism and to avoid the presence of toxic metals under soluble and free form.

A 41-year-old man was admitted for evaluation of nephrotic syndrome associated with microhematuria, hypertension, and moderate renal failure. In serum and urine samples, monoclonal IgG-lambda was detected. Bone marrow examination showed normal representation of all cell lines with normal range of plasma cells. Renal biopsy demonstrated diabetes-like nodular glomerulosclerosis. Immunofluorescence failed to demonstrate the presence of kappa or lambda light chains in the kidney. Electron microcopy showed granular electron-dense deposits along the glomerular basement membranes and in the mesangial nodules. The patient was diagnosed as having light-chain deposition disease (LCDD) without evidence of plasma cell dyscrasia. This report was designed to stress the significant challenges that remain in the diagnosis of LCDD-related glomerulopathy. The salient morphological features that help in making an accurate diagnosis are discussed.

Primary small intestinal lymphoma (PSIL) is the second Non-Hodgkin lymphoma (NHL) of the digestive tract (after gastric NHL).To evaluate during the past 28 years the epidemiological, anatomoclinical and therapeutic changes of PSIL in Tunisia through an acquired experience of more than a quarter of a century.Our retrospective study included patients with histologically confirmed small intestinal lymphoma from 1981 to 2008 in Tunisia at Salah Azaiz Institute. The cohort of 210 patients was divided into two groups: A group from 1981 to 1992 (152 patients) and B group from 1993 to 2008 (58 patients). We analysed the epidemiological, anatomoclinical, histological, and therapeutic characteristics.We observed a significant decrease in the annual incidence of PSIL but also a significant transition of diffuse immunoproliferative small intestinal disease (IPSID) also known as "Mediterranean" PSIL, which were progressively replaced by "Western" lymphomas. Laparotomy with or without a debulking surgery, largely performed in group A, has disappeared at the cost of a primary chemotherapy (p0.001). Five-year actuarial global and relapse free survivals were respectively 60.5 and 57.3%.PSIL in Tunisia were subjected to a triple transition: epidemiological, histological and therapeutic.

Obesity-related glomerulopathy (ORG) is a secondary form of focal segmental glomerulosclerosis (FSGS) occurring in obese patients with a body-mass index higher than 30 kg/m(2). It is typically manifested by nephrotic-range proteinuria without full nephrotic syndrome, and progressive renal insufficiency. Characteristic morphologic features include the consistent presence of glomerulomegaly, predominance of perihilar variant of FSGS, and the relatively mild fusion of visceral epithelial cell foot processes. The concept of podocyte depletion as a driver of the glomerular scarring in obesity-associated FSGS is well documented. The underlying mechanisms are likely to be related in part to the oxidative stress and the impairment of the integrity of the slit diaphragm and cell adhesion resulting mainly from angiotensin II and transforming growth factor-β. These proapoptotic cytokines are upregulated in obesity in response to insulin resistance, compensatory hyperinsulinemia and glomerular hyperfiltration-hypertension mediated mechanical stress. This review is designed to discuss the clinicopathologic features of obesity-associated FSGS, with a focus on the podocyte injury, which is involved in the onset and progression of the glomerulosclerotic process. Ultrastructural glomerular lesions are documented.

Membranoproliferative glomerulonephritis with isolated C3 deposits (MPGNC3) is an uncommon condition characterized by overt glomerular C3 deposits in the absence of immunoglobulins and intramembranous dense deposits. Here the authors describe the clinical and morphological features of primary MPGNC3 in a 13-year-old boy and critically review the previously published cases. The patient presented with nephrotic syndrome and microscopic hematuria. Blood tests revealed very low circulating C3 levels. The renal biopsy exhibited subendothelial, subepithelial, and mesangial deposits, with C3 but not immunoglobulins seen on immunofluorescence. This case and the review of the literature indicate that the serum complement profile with decreased levels of C3 and normal levels of classical pathway components together with glomerular deposits containing exclusively complement C3 is highly suggestive of alternative pathway activation. The diagnosis of acquired and/or genetic complement abnormalities in some cases supports that complement dysregulation is implicated in the pathogenesis of MPGNC3. Such data show great promise to provide new therapy strategies based on modulation of the complement system activity.

Kindler's syndrome is a rare type of genetic skin condition belonging to the class of bullous poikilodermia. We report three new sibling cases of this rare syndrome.The condition was seen in three sisters aged 12, 16 and 20 years, born of a first-degree consanguineous marriage with no family history of Kindler's syndrome. The three patients presented spontaneously regressive bullous eruptions, poikilodermia of gradual onset, major cutaneous atrophy on the back of the hands and the feet, photosensitivity and gingival hypertrophy. Electron microscopy examination of poikilodermic skin showed normal anchoring filaments and intraepidermal cleavage.Diagnosis of Kindler's syndrome is based upon clinical evidence. Kidler's syndrome is a well defined clinical entity. Ultra-structural studies show intraepidermal, junctional, and dermal cleavage. This syndrome must be differentiated from congenital epidermolysis bullosa, Weary's syndrome, and other bullous hereditary poikilodermas.

Mc 2009. Microscopy Conference, Graz, Austria. 30 August - 4 September 2009. First Joint Meeting Of Dreiländertagung And Multinational Congress On Microscopy.

Epithelial odontogenic tumors are rare jaw pathologies that raise clinical diagnosis and prognosis dilemmas notably between ameloblastomas and clear cell odontogenic carcinomas (CCOCs). In line with previous studies, the molecular determinants of tooth development—amelogenin, Msx1, Msx2, Dlx2, Dlx3, Bmp2, and Bmp4—were analyzed by RT-PCR, ISH, and immunolabeling in 12 recurrent ameloblastomas and in one case of CCOC. Although Msx1 expression imitates normal cell differentiation in these tumors, other genes showed a distinct pattern depending on the type of tumor and the tissue involved. In benign ameloblastomas, ISH localized Dlx3 transcripts and inconstantly detected Msx2 transcripts in epithelial cells. In the CCOC, ISH established a lack of both Dlx3 and Msx2 transcripts but allowed identification of the antisense transcript of Msx1, which imitates the same scheme of distribution between mesenchyme and epithelium as in the cup stage of tooth development. Furthermore, while exploring the expression pattern of signal molecules by RT-PCR, Bmp2 was shown to be completely inactivated in the CCOC and irregularly noticeable in ameloblastomas. Bmp4 was always expressed in all the tumors. Based on the established roles of Msx and Dlx transcription factors in dental cell fates, these data suggest that their altered expression is a proposed trail to explain the genesis and/or the progression of odontogenic tumors. (J Histochem Cytochem 57:69–78, 2009)

Michelin tire syndrome is a rare syndrome characterized by excessive folding of the skin. The diagnosis is mainly clinical. It has been found to be associated with noncutaneous anomalies, and probably reflects multiple underlying disorders. We report two siblings with Michelin tire syndrome, a 5-year-old boy and his sister both of whom had marked skin folds and facial anomalies. Histologic study found an increase in smooth muscle fibers of the dermis. Electron microscopy showed details of smooth muscle cells. We also review reported cases in the literature to contribute to a better understanding of this syndrome.

Neurofibrosarcoma is a rare malignant peripheral nerve sheath tumour. It's the consequence of degeneration of neurofibroma in patients with neurofibromatosis. In the absence of clinical symptoms of malignancy, imaging is of prime importance. The observed new case of cubital neurofibrosarcoma stimulated the researchers to give more importance to MR imaging in distinguishing from the benign tumors.

Background: In previous studies, we reported that green tea decoction (GTD) cooked in boiling water for 15-min (15-min GTD) reduced body weight gain (BWG), glucose and lipid absorption and improved total antioxidant status (TAS) of rats fed normal or high-fat diet (HFD). However, the long-term effect of a mixture: 15-min GTD + lemon juice (LJ) on BWG, liver steatosis (LS), TAS, blood glucose and lipids is still unknown. Purpose The aim of the present study is to examine the long-term effect of 15-min GTD + LJ mixture on above parameters in rats fed HFD induced-obesity and LS. Methods Twenty-eight male rats were assigned to four groups with comparable body weights. During 9-weeks treatment, rats were given ad-libitum a basic diet (BD) or HFD to promote obesity and LS. The group 1 received the BD (BD group), the group 2 received HFD (HFD group), the group 3 received HFD + 15-min GTD (GTD group) and the group 4 received HFD + a mixture: 15-min GTD and LJ (GTDLJ group). Results The rats fed HFD had the highest BWG associated with an abundant LS spread than rats consumed BD. However, 15-min GTD significantly reduced the BWG and LS spread (p

Biopsy specimens taken during exploratory laparotomy provided the material for a pathological study of 23 cases of nonsecreting immunoproliferative small intestinal disease (Mediterranean lymphomas without a-chain disease). The distinctive pathological feature of immunoproliferative small intestinal disease, i.e., a diffuse lymphoid infiltration, was present in the mucosa and submucosa of all or a major part of the small intestine. It was composed of a low- or intermediate-grade malignant lymphoid proliferation associated in 19 of 23 cases with benign-appearing follicular lymphoid structures. These follicular figures were surrounded and partially destroyed by the lymphoma cells. This association strongly resembles the newly described nonHodgkin's lymphoma entities of perifollicular or parafollicular cell origin. Gross tumors of the small intestine were found in association with the diffuse lymphoid infiltration in 10 cases. They often constituted foci of lymphoma with a higher grade of malignancy. Mesenteric lymph node involvement was frequent and generally in direct ratio to the severity of intestinal involvement. A comprehensive study of the lesions observed in these cases led to the hypothesis that nonsecreting immunoproliferative small intestinal disease could result from the malignant change of perifollicular B cells; during an initial period the tumoral cells retain circulating and homing properties that explain their infiltrative and extensive method of spreading. The possible subsequent emergence of more aggressive subclones of noncirculating malignant cells could then explain the associated inconstant fungating tumor foci. Further studies using more sophisticated immunohistochemical techniques are necessary to establish the meaning of the hyperplastic lymphoid follicles, the possible etiologic role of benign nodular hyperplasia, the exact identification of the tumor cells, and the relationship of nonsecreting immunoproliferative small intestinal disease to closely related a-chain disease.

Between 1981 and 1985, the authors studied 21 Tunisian patients with alpha chain disease. Twenty of 21 underwent laparotomy. According to Galian et al. six patients were classified Stage A, two Stage B, and 13 Stage C. The therapeutic regimen included the following: (1) Antibiotics: In the case of intestinal bacterial overgrowth (IBO), antibiotics selected by their antibiograms were delivered; in absence of IBO, metronidazole plus ampicillin were first given. The antibiotic treatment was changed in case of therapeutic failure. (2) Chemotherapy: From 1981 to 1983 a cyclophosphamide, Adriamycin (doxorubicin), teniposide (VM-26), prednisone (CHVP) protocol (Adriamycin 35 mg/m2, teniposide 50 mg/m2 day 2, cyclophosphamide 300 mg/m2 days 2 through 4, prednisone 40 mg/m2 days 1 through 10) was used. After 1983 bleomycin 15 mg, Adriamycin 30 mg, vinblastine 10 mg were given on day 15. Serum immunoelectrophoresis and immunohistochemical study of duodenojejunal specimens were made on a 3-month and 6-month basis, respectively. Survival curve analysis was made according to Kaplan and Meier. Results were as follows: (1) Stage A: Six patients were first treated by antibiotics alone; two complete responses (CR) persisting 42 and 55 months later were observed, respectively. The four antibiotic failures were submitted to further chemotherapy with four subsequent failures and two deaths. (2) Stage B-C: Chemotherapy led to nine CR with one precocious relapse, a salvage chemotherapy allowing to one more CR. (3) All stages mixed, percentage of survival reached 90 +/- 12% at 2 years and 67 +/- 25% at 3 years, all patients alive beyond 3.5 years being disease-free.

We describe the case of a 46-year-old man with an isolated superior vena cava syndrome, which was relieved by surgery. Pathologic examination revealed segmental involvement of the superior vena cava with dense collagen sclerosis. Histiomonocytic inflammatory transmural infiltration of all layers was histologically compatible with lesions described in Takayasu's disease. Although not previously described, this pathologic aspect suggests the possibility of venous involvement in this disease.

To assess the diagnostic value of upper intestinal fiber endoscopy in primary small intestinal lymphomas observed in an underdeveloped Mediterranean country, the endoscopic records of 40 patients (Group A) offering histologic evidence of lymphoma were compared with those of 80 patients (Group B) displaying clinical findings of small intestinal disease, but who eventually proved to be free of lymphoma after a complete work-up. The endoscopic procedure reached the jejunum in 91% cases and was well tolerated with only one reversible complication. Five primary endoscopic patterns could be defined, occurring either alone or in various combinations. The infiltrated pattern was the most sensitive (0.80) and specific (0.96) finding with predictive positive and negative values reaching 0.88 and 0.93, followed by the nodular pattern (sensitivity 0.60, specificity 0.84). Other primary lesions (ulcerations, mosaic pattern, mucosal fold thickening alone) were either nonsensitive or nonspecific or both. The infiltrated pattern proved to be more valuable than any association of primary lesion. Per endoscopic biopsies were diagnostic of lymphoma in 85% cases. These findings strongly suggest that upper intestinal fiber endoscopy, using long ending view instruments should be the first investigation in patients suspected of small intestinal lymphoma in developing Mediterranean countries.

For the purpose of using the nacreous layer of the pearl oyster Pinctada radiata shell in biomedical applications, its mineralogy, microstructure, thermal properties, water and organic matrix content and elemental composition of mineral and organic phases were investigated. P. radiata shell consisted of two mineralized layers: an outer calcitic prismatic layer and an inner aragonitic one exhibiting a "Brick and mortar" micro-architecture. Thermal and elemental analyses revealed that nacre of P. radiata was composed of 4.28% weight (wt) of organic matrix consisting of 1.01% of carbon, 0.49% of hydrogen, 0.39% of nitrogen and 0.08% of sulphur. FTIR analyses showed that the nacreous organic matrix contained functional amine, amide, sulfate and carboxylic acid groups and sugars. The presence of water in nacre was confirmed and measured at 0.34% wt. These results showed that the nacreous layer of P. radiata had comparable microstructure, composition and thermal properties to those of other pearl oysters nacres which exhibited osteogenic and osteoinductive properties. However, its higher organic matrix amount could make it more interesting for biomedical applications considering the significant role of the organic part in the mechanical and osteoinductive properties of a biomedical material.