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Mucositis is an inflammation of the gastrointestinal mucosa resulting from high doses of radio/chemotherapy treatment and may lead to interruption of antineoplasic therapy. Soluble fibres, like pectin, increase SCFA production, which play a role in gut homoeostasis and inflammation suppression. Due to the properties of pectin, the aim of the present study was to evaluate the effect of a high-fibre (HF) diet on chemotherapy-induced mucositis in a murine model. C57/BL6 mice received control (AIN93M), HF, low/zero fibre (LF) diets for 10 d prior to mucositis challenging with irinotecan (75 mg/kg), or they were treated with acetate added to drinking water 5 d prior to and during the mucositis induction. Mice that received the HF diet showed decreased immune cells influx and improved histopathological parameters in the intestine, compared with mice that received the normal diet. Furthermore, the HF diet decreased intestinal permeability induced in the mucositis model when compared with the control group. This effect was not observed for acetate alone, which did not improve gut permeability. For instance, mice that received the LF diet had worsened gut permeability, compared with mice that received the normal diet and mucositis. The effects of the HF and LF diets were shown to modulate the intestinal microbiota, in which the LF diet increased the levels of Enterobacteriaceae, a group associated with gut inflammation, whereas the HF diet decreased this group and increased Lactobacillus and Bifidobacterium (SCFA producers) levels. In conclusion, the results demonstrated the importance of dietary fibre intake in the modulation of gut microbiota composition and homoeostasis maintenance during mucositis in this model.

Introduction La sante mentale est fortement soumise aux determinants sociaux, mais elle est egalement marquee par de forts taux de non-recours aux soins, eux-memes socialement conditionnes. Afin de lutter au mieux contre les inegalites sociales et territoriales de recours dans le champ de la sante mentale, il est indispensable de connaitre les facteurs associes au fait de recourir ou non aux soins de sante mentale. Methodes Une revue systematique de la litterature a permis d’inventorier les facteurs potentiellement associes au (non) recours aux soins de sante mentale. Une fois categorises, ces facteurs ont ete recherches dans les enquetes en population generale. Les bases de donnees francaises identifiees sont le Barometre sante 2005, l’enquete sur la sante et la protection Spsociale (ESPS) 2010, l’enquete Handicap-Sante 2008 (HSM) et l’enquete sante mentale en population generale (SMPG). Une premiere serie d’analyses a porte sur un echantillon d’individus adultes identifies comme porteurs d’un trouble mental grâce au Mini International Neuropsychiatric Interview (MINI) au sein de l’enquete SMPG. Les repondants ont ete selectionnes aleatoirement dans des lieux de passages de 47 sites francais, en plus du MINI ils ont ete interroges sur leurs representations de sante mentale, leurs caracteristiques socio-economiques, leur rapport a leur(s) trouble(s) et leur comportement de sante vis-a-vis de ceux-ci. La base a ete enrichie de variables contextuelles relatives aux sites de l’enquete (secteurs ou agregats de secteurs de psychiatrie) : les densites medicales, l’offre de soin de secteur, l’urbanicite, le fait d’etre en DOM-TOM ou en metropole et le niveau socio-economique du site. Les facteurs associes au fait de recourir au systeme de sante pour raisons de sante mentale ont ete identifies par une serie d’analyses bivariees, les facteurs trouves significatifs au seuil de 20 % ont servi a construire plusieurs modeles de regressions logistiques multi-niveaux inspires du modele theorique de recours aux soins (somatiques) d’Andersen. Resultats Au total, 13 565 individus sur les 39 617 participants a la SMPG ont eu au moins un trouble et/ou un risque suicidaire identifie(s) par le MINI. Parmi eux, 54,3 % n’ont pas recouru au systeme de sante pour leur trouble. En analyses bivariees, on observe que les categories les moins eduquees et ayant un revenu moindre ont un recours significativement plus important. De nombreuses variables demographiques et psychosociales sont egalement fortement correlees au recours. Concernant les variables contextuelles, seul le fait d’etre dans un DOM-TOM influait negativement le taux de recours. Les regressions logistiques mettent en evidence une correlation du non-recours avec le fait d’etre un homme, d’avoir moins de 35 ans, de ne pas se sentir malade ou de declarer de gene, d’etre ou d’avoir une parente (jusqu’aux grands-parents) issu(e) de l’immigration extra-europeenne, d’etre musulman, d’etre resident d’un DOM-TOM, d’avoir recours a la religion pour se soigner, d’avoir un faible soutien social, de ne pas connaitre d’autre lieu que l’hopital psychiatrique pour soigner la maladie mentale et de penser que les porteurs de troubles mentaux sont responsables de leur maladie. Discussion Ces analyses–prenant en consideration un nombre etendu de facteurs potentiellement associes au recours aux soins pour raisons de sante mentale–ne montrent pas d’inegalites sociales de recours bases sur le revenu ou l’activite professionnelle mais revelent plutot l’importance de facteurs culturels, qui pourraient d’ailleurs expliquer l’inegalite territoriale de recours frappant les DOM-TOM. Ces resultats devront etre completes par une recherche d’effets de mediations entre les representations en sante mentale et le statut economique et social. Ils devront egalement etre valides par la decouverte d’associations similaires dans d’autres enquetes en population generale. Par ailleurs, les taux de recours particulierement bas (−20 % par rapport a la moyenne) chez les 18–35 ans sont de nature a alerter les autorites sanitaires.

Various natural chemicals and some contaminants of industrial source present an endocrine activity. Nowadays, many questions related to these compounds are not resolved and the persistent character of these compounds makes it a major problem for future generations. This study concentrated on some specific groups of endocrine disrupting chemicals (estrogens and alkylphenols). In this review, a number of treatment processes will be discussed with regard to their potential on endocrine disrupting chemicals removal.

The effect of phosphorus co-precipitation with ferric chloride ( FeCl3 ) dosing on biological phosphorus (P) along with carbon (C) and nitrogen (N) removal was investigated in a sequencing batch reactor (SBR) for slaughterhouse wastewater treatment. Additional phosphorus removal due to chemical co-precipitation was evaluated as the difference in System P removal between Phase 1 (control—without FeCl3 dosing) and Phase 3 (with FeCl3 dosing). Phase 2 was mainly studied to improve nitrification/denitrification process with acetate addition by Filali-Meknassi et al. in 2004. Both systems (Phases 1 and 3) exhibited high P removal but a co-precipitation with FeCl3 dosing only allowed us to have an orthophosphates (o- PO4 ) concentration below 1 mg P∕L in the effluent. Without FeCl3 addition, the total P concentration was reduced from 85±12 to 14±2 mg P∕L (84% removal), whereas with the addition of FeCl3 an additional 11 mg P∕L was removed bringing the effluent P concentration to 3 mg P∕L (as total P). Although,...

We study the structure of binary monolayers of large (3 μm diameter) very hydrophobic (A) and large (3 μm diameter) hydrophilic (B) or small (1 μm diameter) hydrophilic (C) silica particles at an octane-water interface. By tuning the composition and packing geometry of the mixed monolayer, we find that a rich variety of two-dimensional hexagonal superlattices of mixed A/B or A/C clusters are formed, stabilized by short-ranged electrostatic induced dipole interactions. The cluster structures obtained are in excellent agreement with zero temperature calculations, indicating that the self-assembly process can be effectively controlled.

MAM-3 and MAM-6 antigens were detected immunohistochemically in 34 cases of adenoid cystic carcinomas (ACC) of the salivary glands and these patterns were compared to these of epithelial membrane antigen (EM A) and laminin. ACC was histologically divided into three types; the cribriform pattern, the tubular and trabecular pattern, and the solid cluster pattern. Immunostaining of EMA and MAM-6 antigen had a similar distributions in the luminal borders of luminal tumor cells, whereas the MAM-3 antigen was slight or negative in luminal borders. Myoepithelial derived tumor cells of ACC accompanying hyaline stroma demonstrated positive staining for the MAM-6 antigen (whole cell positive type), and luminal tumor cells of microcysts showed strong staining for the MAM-3 antigen. Laminin staining was confined to the basement membrane and surface borders in pseudocyst cavities. In salivary gland ACC, laminin staining can be used as a marker of pseudocyst surfaces and immunostaining of EMA and the MAM-6 antigen as a marker of luminal borders of cyst. These two histo-chemical markers were useful for discriminating pseudocyst and cyst.

Immunohistochemical studies were performed to explore the distribution of S-100 protein and its alpha, beta subunits in 76 adenoid cystic carcinomas (ACC) of the salivary glands. Histopathologically. ACC was divided into cribriform, tubular, basaloid and trabecular types which could be mixed in the same tumor. S-100 protein was usually positive in tumor cells forming cribriform structures; foci of strongly positive tumor cells were also distributed in the luminal layer of tubular structures, and in areas transitional between cribriform and tubular patterns. S-100 alpha staining was confined to some tumor cells in cribriform areas, to luminal tumor cells in tubular structures and to few tumor cells in basaloid structures. S-100 beta reaction was usually localized to luminal surfaces in a fine granular pattern in tubular and microtubular structures in a distribution somewhat similar to that in the normal salivary gland. Great heterogeneity in the immunohistochemical distribution of S-100, S-100 alpha and S-100 beta proteins was found in the various histologic types of ACC and the pattern was different from that seen in pleomorphic adenomas. It is possible that the ACC tumor cells positive for S-100 protein may be closely related to true or modified myoepithelial cells.

In this study, the occurrence of trace amounts of natural and synthetic steroid estrogens in the aquatic environment was studied using liquid chromatography coupled with electrospray mass spectrometry, following solid-phase extraction (SPE). The SPE was performed with C18 and NH2 cartridges. The first objective was to develop a reliable method for analyzing steroid estrogens (resulting from human and animal excretions) in different matrices. The method developed was then applied to quantify the occurrence of natural and synthetic hormones (estrone [E1], 17beta-estradiol [betaE2], 17alpha-estradiol [alphaE2], estriol [E3], and 17alpha-ethinylestradiol [EE2]) in environmental samples in surface water and wastewater treatment plant (WWTP) influent and effluent. In the WWTP influents, betaE2, alphaE2, and E3 were identified as ranging up to 72.6 ng/L in WWTP influent and to 16 ng/L in WWTP effluent. Analysis o f surface wa ter sampled upstream from the WWTP revealed the presence of all five estrogens, at levels up to 19.8 ng/L. These concentrations of estrogens pose an issue for large and small communities, because they are higher than the recommended guidelines for estrogen-active compounds and because a lot of communities use surface water as drinking-water sources.

Some researches studied the removal of steroid estrogens by enzymatic treatment, however none verified the residual estrogenicity after the enzymatic treatment at environmental conditions. In this study, the residual estrogenic activities of the key natural and synthetic steroid estrogens were investigated following enzymatic treatment with horseradish peroxidase (HRP) and laccase from Trametes versicolor. Synthetic water and municipal wastewater containing environmental concentrations of estrone, 17beta-estradiol, estriol, and 17alpha-ethinylestradiol were treated. Liquid chromatography-mass spectrometry analysis demonstrated that the studied steroid estrogens were completely oxidized in the wastewater reaction mixture after a 1-h treatment with either HRP (8-10 U ml(-1)) or laccase (20 U ml(-1)). Using the recombinant yeast assay, it was also confirmed that both enzymatic treatments were very efficient in removing the estrogenic activity of the studied steroid estrogens. The laccase-catalyzed process seemed to present great advantages over the HRP-catalyzed system for up-scale applications for the treatment of municipal wastewater.

The Trametes versicolor-derived laccase-catalyzed oxidation of natural estrogens (estrone--E1; 17beta-estradiol--E2; and estriol--E3) and a synthetic estrogen (17alpha-ethinylestradiol--EE2) was studied in synthetic water and municipal wastewater to optimize the process for steroid estrogen removal in wastewater. The optimal pH for each studied steroid estrogen oxidation was approximately 6 in synthetic water. This research also focused on the wastewater matrix effect on developed enzymatic treatment. At pH 7.0 and 25+/-1 degrees C, the experiments showed that the laccase-catalyzed system for the removal of steroid estrogens was not significantly affected by the municipal wastewater matrix. Laccase activity of 20 U/ml was sufficient to achieve complete removal of studied steroid estrogens in both synthetic water and municipal wastewater. Moreover, 1-hydroxy-benzotriazole, when used as a mediator, improved laccase-catalyzed system efficiency, thus decreasing the overall cost of the enzymatic system.

Summary Background/Purpose Malignant peripheral nerve sheath tumors (MPNSTs) are rare neoplasms, only sporadically reported involving the maxillo-mandibular region (ten cases with CT or MR data). We present here five additional cases with CT and MR findings along with an extensive review of the literature. Results Accurate diagnosis of MPNSTs is difficult because pathological like radiological criteria are often non specific. Radiological features display a large spectrum of abnormalities from a well-delineated heterogeneous appearance simulating benign schwannoma to extensive erosive patterns. Their development along the mandibular nerve, the absence of any target or central dot sign, their strong predominant peripheral enhancement must suggest the diagnosis of MPNSTs while irregular bone destruction or the detection of poorly defined margins with muscular infiltration are the most reliable criteria of malignancy. Unfortunately, MPNSTs also display a considerably varied histology. Careful clinical and radiological correlation should bring pathologists to examining large samples of the lesion to better evaluate the overall organisation of the lesion and detect some evocative criteria often only present in some areas of the sample as the peculiar curlicue or whorled arrangement of the spindle cells or the alternation of densely cellular fascicles with hypocellular, myxoid zones. Focal, limited immunostaining for S-100 protein is one of the most important additional criterion. Conclusion If accurate early diagnosis often remains difficult, careful correlation of clinical, pathological and radiological data should in most cases suggest a diagnosis of MPNSTs which display a poor prognosis and requires early and adapted treatment.

Steroid estrogens, including both natural estrogens (e.g., estrone - E1; 17beta-estradiol - E2; and estriol - E3) and synthetic estrogens (e.g., 17alpha-ethinylestradiol - EE2), are known as endocrine-disrupting compounds. The objective of this research was to evaluate the feasibility of the enzymatic oxidation of estrogens and to optimize this process in municipal wastewater contaminated with steroid estrogens using horseradish peroxidase (HRP) and hydrogen peroxide. An initial HRP activity of 0.02 U ml(-1) was sufficient to completely remove EE2 from the synthetic solution, although greater HRP doses (up to 0.06 U ml(-1)) were required to remove E1, E2 and E3. The optimal molar peroxide-to-substrate ratio was determined to be approximately 0.45. Based on the Michaelis-Menten kinetics, the HRP had an increasing reactivity with E1, E3, E2, and EE2, in increasing order. In real activated sludge process effluent, an HRP dose of 8-10 U ml(-1) was required to completely remove all of the studied estrogens, while only 0.032 U ml(-1) of HRP was necessary to treat synthetic water containing the same estrogen concentrations.

The primary objective of our research was to establish the technical feasibility of using the horseradish peroxidase (HRP) enzyme for natural and synthetic estrogens-estrone (E1), 17beta-estradiol (E2), estriol (E3), and 17alpha-ethinylestradiol (EE2)-removal. The effects of temperature and pH on enzymatic treatment kinetics were investigated. Residual estrogen concentrations were quantified by liquid chromatography, coupled with mass spectrometry analysis. In a synthetic solution at pH 7 and 25+/-1 degrees C, the HRP enzyme-catalyzed process was capable of achieving 92-100% removal of E1, E2, E3, and EE2 within 1h of treatment with an HRP activity of 0.017 U/ml. The influence of the pH (5-9) and temperature (5-35 degrees C) on estrogen removal was observed to be significant, with the optimum pH near neutral conditions. The results also showed that wastewater constituents significantly impact the HRP-catalyzed estrogen removal. The experimental research proved that the HRP-catalyzed system is technically feasible for the removal of the main estrogens present in the environment at low concentrations.

A case of a maxillary osteolytic tumour is described in a 9-year-old boy. Histological analysis led to an initial diagnosis of benign squamous odontogenic tumour, although this was not straightforward due to swelling, and cellular pseudo-malignant and non-specific signs. Because of the young age of the patient, a local surgical tumourectomy was first chosen with respect to the mixed dentition. For 10 months, the evolution was satisfactory. Then, a very aggressive tumoural recurrence with lip and palate infiltration led to doubts as to the histologic nature of the tumour. Efficient collaboration between several specialized pathologist teams finally confirmed that this was a squamous odontogenic tumour but in a very aggressive form. Radical surgery was then carried out.

Sequencing Batch Reactor (SBR) was used to treat slaughterhouse wastewater which contains average Chemical Oxygen Demand (COD) concentration of 5000 mg l(-1) and ammonium of 360 mgN l(-1). Nitrification/denitrification process was conducted for nitrogen removal. The influent wastewater as internal carbon source and sodium acetate as an external one was used for completing denitrification to achieve the simultaneous organic matter removal (95-96%) and nitrogen removal (95-97%). In addition, the dynamic SBR simulation model for biological nitrogen removal based on the Activated Sludge Model No. 2d (ASM2d) and GPS-X software is presented. The experimental study for the calibration and validation of the model was carried out using laboratory SBR. The study showed that the model provides a powerful tool to reduce the experimental expenditure and time to find the optimum strategy.

In wastewater treatment, the objective of process optimization is primarily to obtain a good treatment efficiency of a specific pollutant. The operational objective of increased productivity has also to be met. This includes a sufficient reduction in the duration of a batch process through batch scheduling. The aim of this paper is thus to find the best cycles for simultaneous carbon, nitrogen and phosphorus (CNP) removal from slaughterhouse wastewater in a sequencing batch reactor (SBR) using GPS-X software and ASM2d model. Simulations with different aeration strategies, residence time, sludge age and feed strategies were carried out to determine the best system performance. The simulation results showed best performance with a system comprised of two equal feeds operated at 48 h hydraulic retention time (HRT) and 20 d solids retention time (SRT). Simulation also showed that addition of metal salts was necessary to reduce the level of phosphorus (P) to meet the requirement (P1 mg l(-1)). The addition of acetate was also necessary to complete the denitrification process. The simulated results were compared against the experimental results obtained from laboratory SBR. The simulated results of COD, nitrates/nitrites and ammonia removal were very close to the experimental results. A diference of 2-4% between the simulated COD and the experimental COD was observed and that could be attributed to the error in evaluation of the inert COD. For ammonia removal, the simulated (99.9%) and experimental (93-100%) results were practically identical. However, a notable difference in o-PO4 concentration was observed (38% removal by simulation against 78% removal through experiments). After metallic salts addition, P removal efficiency was 98% or 1% less than that observed through experimental results.

A total of 31 patients surgically treated for salivary mucoepidermoid tumor had a comprehensive follow-up. Two groups were classified as: 16 with favorable outcome (no recurrence or late recurrences at 5 yr postoperatively and still alive; 15 with poor outcome (local recurrences before 5 yr, metastases, lethal evolution in 11 cases). We evaluated nucleolar organizer in every case, using AgNOR count. The AgNOR count seemed better than histologic criteria for establishing the prognosis of mucoepidermoid tumors. It correlated significantly with the clinical course: a high count was principally found in lethal forms, low counts (less than 1.8) were always detected in patients with a good outcome.

The quality of the tissue-implant interface was evaluated using light and scanning electron microscopy with morphometric analysis. Nine dogs were implanted with 3 types of dental implants (titanium, zirconia, or alumina). A total of 24 dental implants was placed in mandibular bone previously filled with coral carbonate calcium (corail) or hydroxyapatite. The study results in breaking the concept of osseointegration into 2 phases: "osseocoaptation," which concerns only the interface (physical contact between the implants and the bone without interpenetration process), and "osseocoalescence," which relies on an interpenetration of the bioactive material, which almost entirely disappears, being substituted by newly formed bone. There was no significant statistical difference between the 3 types of implants. Both fillings showed good ossecoalescence properties. However, hydroxyapatite led to fibrous encystment, preventing osseocoaptation of implants. In contrast with calcium carbonate filling.

Mesenchymal chondrosarcoma (MCS), described in 1959 by LichtensteinBernstein, is a very rare malignant tumour. Only 46 cases have been previously reported in the jaws. Over a period of 30 years, four chondrosarcomas of mesenchymal type (of which one has already been published in 1987 with a three-month follow up) were treated in our department. Two patients have been followed for more than 17 years, of whom one has died of an intracranial extension and the other is still alive after surgical treatment of numerous recurrences and metastases. The two others are tumour-free with a follow up of 18 months and 11 years respectively. Histological, epidemiological and clinical features and treatment of MCS are discussed relevant to the data published in the literature.

A case of mandibular cystic adenoid carcinoma was observed in a 49-year-old man. After slow progression, the diagnosis was directed to mandibular pseudocystic tumor. The treatment was enucleoresection. Histological findings in this exceptionnal lesion led to a discussion of the radioclinical diagnosis and etiopathogenic features of adenoide cystic carcinoma. The origin of this tumor is hypothesized to be heterotopic salivary inclusion although no histologicaly proof can be provided.

The paradental cyst is an odontogenic inflammatory cyst (WHO classification, 1992). It has been rarely described in the french literature and includes: The inflammatory paradental cyst which occurs on the buccal or distal aspects of an erupted third mandibular molar or of a canine (first description by Main in 1970); the mandibular infected buccal cyst which occurs on the buccal surface of the mandibular second or first molar in children around 6-8 years of age with an associated history of inflammatory signs (Stoneman and North, 1993). The histological features are the same as those of the radicular cyst. Prognosis is excellent after enucleation. This paper present an additional case report of a paradental cyst located on a second mandibular molar.

Paragangliomas are exceptional in the orbit. Among the 47 cases reported in the world literature more than 1/3 has been classified as alveolar soft part sarcoma. Diagnosis of paraganglioma was confirmed on the basis of pathology reports in only 10. We observed a case in a 46-year-old woman who presented with a tumour of the orbit. The histology examination and the ultrastructure determined by electron microscopy confirmed the diagnosis of paraganglioma. Characteristic histologic features are discussed together with a review of the literature.

A malignant xanthogranuloma located in the mandible presented as a tumefaction of the alveolar crest with labiomental hypoaesthesia in a 52-years-old woman. The patient was treated with combined chemoradiotherapy and remained in complete remission for 14 years. Epidemiologic features (age, sex, race) of this tumour are discussed in light of the 24 cases reported in the literature. Histology features and possible treatment protocols as well as observed results are discussed. Five-year survival rate in malignant cervicofacial xanthogranulomas is estimated at 48%.

An unusual case of clear cell sarcoma (CCS) found in the parotid region of a 75-year-old man with a long history of chronic lymphoid leukemia is reported. Treatment of the patient included a total parotidectomy with preservation of the facial nerve. The tumor was pathologically consistent with a clear cell sarcoma. Since CCS originates from the neural crest and is melanin producing, we suggest that this particular tumor originated from the superficial musculo-aponeurotic system (SMAS). To our knowledge, this is the first case of CCS that has been reported in the parotid region.

Histological study is made on labial salivary gland biopsies in three usual circumstances: presence of a sicca syndrome; suspicion of a Gougerot-Sjogren's disease or of another systemic disease (sarcoïdosis; amyloïdosis). Its aim is: to appreciate the accuracy of the biopsy; to analyse elementary lesions and to suggest an etiologic diagnosis. The authors put emphasis on the interest: 1) to use new techniques of immunocytochemistry or molecular biology to appreciate the degree of evolutivity of lesions; 2) to quantify lymphoïd infiltrates, fibrosis and epithelial alterations; 3) to formulate results with regard not only to the etiological Diagnosis but also to the glandular Destruction by means of a double descriptive score: the "D.D." score.

From 228 clinical files of cases with suspected sarcoidosis who had had a biopsy of the accessory salivary glands, 17 cases with both a final diagnosis of sarcoidosis and one or more tuberculoid granulomas. There were 12 women (mean age: 30 years) and 5 men (mean age: 28.5 years) including 3 of Caribbean or African descent. The histopathological examination was performed to determine: 1) the number of granulomas per biopsy, divided into 3 groups: group I, 1 granuloma (n = 1); group II, 2 to 5 granulomas, mean 3.5 (n = 6); group III more than 5 granulomas, mean 12.5 (n = 5); 2) the diffusion of the granulomas within the lobules: 17% of the lobules were involved in groups I and II vs 47% in group III; 3) the size of the granulomas "minimal" (barely identifiable in 3 of 6 patients in group I; rather easily identifiable in all the other patients; 4) the presence of "non-specific" lesions including lymphoid infiltration, epithelial changes. In addition correlations with other clinical parameters of severity and/or duration were evaluated including: involvement of the main salivary glands and/or non-secretory syndrome. The following conclusions were drawn: 1) lesions of the accessory salivary glands is a sign of sarcoid lesions outside the thorax since 16 of the 17 patients had extra-thoracic clinical, biological or anatomic manifestations; 2) there is not however any significant difference in clinical severity between the 3 anatomic "intensity" groups (number of follicules in the accessory salivary glands); 3) both cases of sarcoidosis of recent onset (3 months) with Loefgren's syndrome were in group I; 4) the intensity of the specific lesions in the accessory salivary glands was similar to that of the non-specific lesions and can be correlated with the intensity of the main salivary gland involvement, with or without a non-secretory syndrome.

Rhabdomyosarcoma is a malignant tumour of striated muscles. It is usually encountered in children and rarely in adults. In this study we compared sex ratios, aetiologic factors, different localizations, development stages, modes of extension and treatment as well as prognosis in children and adults with cervicofacial localizations. The differences observed led to the conclusion that cervicofacial rhabdomyosarcomas in children and adults are two very different pathological entities.

Ten undifferentiated thyroid carcinomas detected between 1976 and 1991, were reviewed by means of immunohistochemical techniques. These tumors were highly aggressive with a mean survival rate of three months after the histological diagnosis. They were predominant in women and always occurred in old people (mean age 63.1 years). Four tumours were composed of differentiated trabecular areas. Another one was included in a microvesicular adenoma and a sixth one occurred as a recurrence of a papillary carcinoma surgically treated four months previously. Six tumours were cytokeratin-positive and two of them showed a cytokeratin-vimentin coexpression. These results, like those of an electron microscopic analysis of 1 case, confirm the epithelial origin of these tumours. Undifferentiated carcinomas must be distinguished from poorly differentiated carcinomas and from malignant non Hodgkin lymphomas which have a better prognosis and a different therapeutic approach. The immunohistochemistry and the electron microscopy are useful to identify undifferentiated thyroid carcinomas.

Between 1987 and 1992, thirty-seven heart-lung transplant recipients had a postmortem examination at the Pitié-Salpêtrière Teaching Hospital in Paris, France. Except for three patients who survived 2 months, 4 months and 16 months after transplantation, respectively, most patients died in the early postoperative period (mean survival time = 34.6 days). Autopsy disclosed minor acute heart rejection in four patients and minor acute lung rejection in three patients. Five patients had obliterating bronchiolitis that was the cause of death in two cases. Main causes of death included perioperative pleural bleeding, respiratory infection with or without septicemia, diffuse alveolar lesions (adult respiratory distress syndrome and/or pulmonary edema undergoing organization) and multiple organ failure. Hemodynamic and respiratory complications responsible for multiple organ failure in the perioperative period, as well as pre-existing morbid conditions such as cirrhosis of the liver induced by heart failure, may have a major bearing on the outcome of heart-lung transplantations.

A case of malignant lymphoepithelial lesion of the submandibular gland is reported in a 71-years-old woman. The carcinoma showed a poorly differentiated pattern and its epidermoid nature was obvious after immunohistochemistry and electron microscopy. The epithelial nests were lying in an abundant lymphoid stroma consisting of small lymphocytes. A recurrence occurred ten months after surgical treatment. This observation is compared with those already related in the literature.

Diagnosis of amyloidosis depends on the demonstration of amyloid deposits in biopsies using specific stains. Recently, in addition to classical biopsies (kidney, liver, gum, skin, rectal mucosa), labial salivary gland biopsy has been recommended as safe diagnostic method. In our recruitment, it allowed the fortuitous discovery of amyloidosis in three patients suffering from rheumatoid polyarthritis or spondylarthritis. In five other patients (2 cases of familial amyloidosis, 1 dysglobulinemia, 2 primary cardiac amyloidosis), biopsy was performed for systematic search of amyloidosis. In five of these eight cases, a sicca syndrome was associated with the salivary deposits. These deposits were stained with congo red viewed in polarized light and with T thioflavine. Besides, Wright's method allowed to know the AL or AA type of amyloidosis and thus to guide the treatment. On the whole, labial salivary gland biopsy is a highly sensitive method for diagnosis of primary and secondary amyloidosis.

Twenty one patients surgically treated for acinar cell salivary gland carcinomas were studied retrospectively. Four cases were excluded from the results because of an inadequate follow-up time (less than 5 years). The rest was classified into two groups: eleven patients with a favorable outcome were still alive without any recurrence after a mean follow-up period greater than 10 years; in six other patients, recurrences and metastases occurred followed by death in four cases. Previously for such tumors a high degree of histological undifferentiation usually gave rise to a poor prognosis, although some exceptions were noted. Thus, in an attempt to find a more reliable prognosis criterion, we evaluated by semi-quantitative image analysis nucleolar organizer regions by means of AgNOR count and mean area in all these cases. Our results significantly correlated with the clinical prognosis: a high count (more than 3) and a small mean area were always found in tumors with an unfavorable outcome whereas lower counts and larger mean areas were found in tumors with a favourable clinical course. Thus, this method showed promise as establishing the prognosis of acinar cell tumours.

Among a series of 76 adenoid cystic carcinomas (ACC), 51 cases with cibriform or trabecular patterns were selected for an immunohistochemical study. These tumors were composed of three types of cells: basaloid, myoepithelial and ductal luminal acinous or tubular cells with a variable amount of each cell type from one case to another. Monoclonal antibodies (MoAb) against keratins (PKK1, KL1, K8.12, K8.13, K4.62 anti-cytokeratins antibodies) and against vimentin were used. Tubular cells were characteristically marked by anti-cytokeratins MoAb, but with a great heterogeneity of keratin distribution. In myoepithelial cells, keratin was absent or slightly positive and vimentin was present, with co-expression of the two types of filaments in some cells. Like myoepithelial cells, basaloid cells were positive to anti-vimentin antibody and negative or slightly positive to anti-keratin antibodies, with sometimes a co-expression of vimentin and keratin filaments in the same cell. Histogenesis of adenoid cystic carcinomas was discussed. Progenitor intercalated duct reserve cells may change into ductal luminal and myoepithelial tumor cells. Otherwise, basaloid cells, arising also from intercalated duct reserve cells, are able to acquire some secretory organites.

One case of aggressive intramandibular epithelial tumor is presented. This tumor demonstrated an unusual pattern with areas of follicular ameloblastoma together with undifferentiated trabeculae or lobules composed of basophilic cells and of clear glycogenic-rich cells. The odontogenic nature of this tumour and its analogies with common ameloblastoma were demonstrated by electron microscopy, immunohistoenzymology and immunohistochemistry. The signification of such a neoplasm is discussed.

30 metastases of malignant tumors in jaws were retrospectively studied. They occurred more often in women than in men (17 F/13 H). In 21 cases, the primitive cancer was known and had been treated 1 to 4 years before. In the other cases (9), the bone metastasis led to the discovery of a latent tumor. Clinical signs and symptoms included swelling, pain, loosening of teeth, labio-mental anaesthesia and rarely pathologic fracture. Radiologically, all but two patients had radiolucent lesion. These metastases almost always involved the mandible (95% of cases) and in that bone, most often molar area and angle. Histologically, the majority of lesions were adenocarcinomas from breast (33%) and alimentary canal (stomach, colon). Epidermoid bronchial carcinomas were seen in 5 cases and malignant melanomas in 2 cases. Only one sarcoma of this series was arising from a liposarcoma of the thigh. In all but one patients, evolution was quickly lethal.

Epithelial-myoepithelial carcinoma initially described by Donath in 1972 represents about 0.5% of salivary gland tumors. Total number of reported cases brings to at least 56 cases; we add 15 personal cases. These 71 cases included 46 women and 25 men. The ages range from 23 to 91 years with peak incidence from the 6th to the 8th decades. The majority of tumors (58) arose in the parotid gland. Of the 71 patients local recurrences occurred in 20, cervical lymph node metastasis in 6 and 2 patients died of their disease. Epithelial-myoepithelial carcinoma typically have a multinodular growth pattern with islands of tumors separated by dense fibrous connective tissue. These tumor masses were composed of well-defined tubules lined by two layers of cells: outer cells are large clear with variable amount of glycogen, inner cells are small, cuboidal and eosinophilic. Perineural invasion and necrosis were occasionally seen. In some cases, this biphasic pattern was less apparent with solid masses of clear cells. Electron microscopic and immunohistochemical studies confirmed the epithelial and myoepithelial differentiation. The differential diagnosis included all clear cells tumors of salivary glands (mucoepidermoid carcinoma, acinic cell carcinoma, sebaceous carcinoma) and also metastatic renal carcinoma. Epithelial-myoepithelial carcinoma is a tumor of low-grade malignancy of duct origin which should be differentiated from salivary duct carcinoma.

Twenty-four endomyocardial biopsies performed during surgical correction of valvulopathies were compared with ventricular function. Patients were divided into three groups: group I without anomalies of ventricular function, group II with a slight decrease of the ventricular ejection fraction, group III with a low ventricular ejection fraction. Morphometric analysis was carried out using electron microscopic photographs and an image analyser. The results were correlated with those of functional studies. In patients of the second group, the small number of mitochondria with respect to the increased myofibrillary area seemed to indicate mitochondrial dysfunction. In patients of the third group, alterations of myocontractility expressed a myofibrillary deficiency unable to be corrected by the multiplication and the increased exchange areas of mitochondria.

Among adenoid cystic carcinomas of salivary glands (ACCs), the solid basaloid type has a poor prognosis similar to that of undifferentiated adenocarcinomas. We studied 24 cases in immunohistochemistry using antibodies reactive with keratins of various molecular weights, vimentin, S-100 protein, and its A and B subunits. Our findings were correlated with the histological pattern and with the variable degree of differentiation of these carcinomas. In comparison with other types of ACC, intermediate filament proteins in this group were weakly expressed. The co-expression of cytokeratin and vimentin was noted in some cases. Additional features noted were the presence of cribriform cavities associated with solid lobules and areas of necrosis giving a comedocarcinomatous pattern. In these two variants, cells characterized by the dual expression of cytokeratin and S-100 protein were seen. In the highly malignant anaplastic variety, only a few cells were weakly positive with antisera to cytokeratin and vimentin. This group shows similarities to undifferentiated adenocarcinomas of salivary glands. Such similarities could be explained by the common origin of these tumours from intercalated ducts.

Quantification of number and mean area of NORs was retrospectively studied in six acinic cell tumors with a well-known follow-up by means of electron microscopy without any silver staining. The results were compared with those obtained using silver staining and optical quantification. Mean areas were inversely correlated with the number of NORs. Positive correlations were found between these results and the clinical course: tumors with good outcome were characterized by a low NOR count (less than 2) and by large mean areas (greater than 600 microns 2); on the contrary, tumors with recurrences or metastases always had high NOR counts with small mean areas.

Chronic rejection, the most serious complication in long-term survivors of cardiac transplantation, was studied in 5 cardiac grafts obtained at retransplantation and in 15 post-mortem studies of patients who had survived 3 months to 10 years after transplantation. The usual clinical presentation was cardiac failure. Coronary angiography was performed in several cases and showed narrowing and non-opacification of small arteries often accompanied by thrombosis. Histology showed three types of vascular rejection: the most characteristic one, usually observed after the 6th month, was a stenosing fibrous endarteritis; another type of rejection, occurring earlier, was associated with acute myocardial rejection and presented as an inflammatory arteritis; the third type of vascular rejection was accompanied by widespread atheromatous lesions. The significance and pathogenesis of these lesions are discussed with respect to the clinical context with electron microscopic and immuno-histochemical data.

Thirty-two cases of adenoid cystic carcinoma (ACC) of the salivary glands were examined immunohistochemically by monoclonal antibodies to proteoglycans (PG) such as chondroitin 6 sulfate (C6SPG), chondrotin 4 sulfate (C4SPG), dermatan sulfate (DSPG), heparan sulfate (HSPG) and keratan sulfate (KSPG) in conjunction with specific enzymatic digestion. The cribriform structure of ACC consisted of basaloid, myoepithelium-derived, and luminal tumor cells. The myoepithelial tumor cells were positive for PG, whereas luminal tumor cells were unstained. Occasional pseudocysts also gave positive staining for PG. Tubular structures consisting of modified myoepithelial cells indicated a high intensity reaction for C6SPG and C4SPG, and a slight one for DSPG, HSPG, and KSPG. Immunodepositions in solid and cluster structures were comparatively light in terms of PG. Basement membrane in ACC stained strongly for C4SPG, slightly for C6SPG, and very slightly for DSPG, HSPG, and KSPG. In ACC, immunohistochemical staining of PG was regularly positive in myoepithelium-derived tumor cells, but was irregular in other types of tumor cells.

The purpose of this work was to detect in periductal connective tissue of breast carcinoma in situ changes induced by intraductal tumor cells before any dehiscence in basement membrane. Histological, electron microscopic, immunohistochemical and histoenzymological methods were used in 3 carcinomas in situ, 4 microinvasive carcinomas and 13 control invasive carcinomas. We could demonstrate a high functional activity of fibroblasts with secretion of mucopolysaccharides and type III collagen around intraductal carcinomas. These changes occurred simultaneously to those of the basement membrane which was either thinning or thickening. Any dehiscence in basement membrane secondarily induced in this periductal stroma the usual changes seen in invasive stroma, peculiarly numerous vascular pedicles, myofibroblasts, elastic material. These periductal stromal changes are interpreted according to recent concepts about the possible influence of tumor cells upon their environment: stimulation of mitotic and metabolic activity of fibroblasts: stimulation of angiogenesis by means of an angiogenic factor.

We report 4 cases with neurological disorders due to lethal centrofacial granulomas of unknown origin, and we review the relevant literature. This puzzling disease is characterized by a relentless ulceration of the nose progressing toward the base of the skull, and frequently involving the cranial nerves, the meninges and later the central nervous system. The main clinical point in such situations is to ascertain that no microorganism, no cancer, no specific disease is responsible for the centrofacial lesions, since the microscopic findings may be non-specific. When the entire work-up to exclude all differential diagnoses is completed, the clinician has to deal with lethal centrofacial granuloma. This seems to be a heterogeneous disease, in most of the cases close to malignant T lymphomas. Management is based on radiotherapy, chemotherapy and renutrition with treatment of frequent infectious complications. The prognosis is poor.