L’atteinte diaphragmatique au cours du lupus érythémateux disséminé (LED) est une entité rare et le plus souvent méconnue. Nous présentons l’observation d’une patiente âgée de 34 ans qui a présenté, 15 jours avant son hospitalisation, des douleurs basithoraciques bilatérales, sans syndrome bronchique, avec une dyspnée stade II de NYHA évoluant dans un contexte de conservation de l’état général. L’examen clinique était sensiblement normal, en dehors de polyarthralgies diffuses de type inflammatoire avec une photosensibilité cutanée. La radiographie thoracique a objectivé un aspect d’ascension des deux coupoles diaphragmatiques réalisant des petits poumons rétractés, associé à des atélectasies planes basales bilatérales. Le diagnostic de LED avec atteinte diaphragmatique a été retenu sur les polyarthralgies, la photosensibilité cutanée à type d’érythème du visage, la présence d’un épanchement péricardique, un titre élevé d’anticorps antinucléaires et une lymphopénie à 1 100 éléments/mm3 contrôlée. Les épreuves fonctionnelles respiratoires ont montré un syndrome restrictif. Sous corticothérapie orale à la dose de 1 mg/kg/j, l’évolution était marquée par une nette amélioration clinique et fonctionnelle. A la lumière de cette observation, les auteurs soulignent la rareté de l’atteinte diaphragmatique au cours du LED, la difficulté du diagnostic positif et rappellent les mécanismes physiopathologiques de cette atteinte.The diaphragm is an unusual localization for disseminated erythematous lupus and is generally not recognized. We present the case of a 34-year-old woman who developed bilateral pain in the base of the thorax 15 days before hospitalization without any bronchial signs and NYHA stage II dyspnea. The patient's general health status remained satisfactory and the physical examination was normal except for diffuse inflammatory joint pain and cutaneous photosensitivization. The chest x-ray disclosed ascension of both hemidiaphragms with retracted lungs associated with bilateral basal atalectasia. The diagnosis of lupus with diaphragmatic involvement was retained due to the clinical presentation with diffuse joint pain, photosensitization with facial erythema, pericardial effusion and elevated antinuclear antibody and lymphopenia (1 100/mm3). Lung function tests revealed a restrictive syndrome. Oral corticosteroids 1 mg/kg/d enabled clinical and functional improvement. In light of this observation we discuss the pathogenic mechanisms of this uncommon localization of lupus and the difficulty of establishing a sure diagnosis.

Central nervous system involvement in systemic lupus erythematosus (SLE) is frequent and severe, however, myelopathy is rarely reported (0.8 p. 100 of SLE cases). We describe two SLE-young women. They were 21 and 37 year old, presented with acute paraplegia. CSF study showed pleocytosis and moderately elevated protein. Antinuclear, anti-DNA and anticardiolipin were positive. High dose steroids therapy induced marked improvement The pathogenesis of myelopathy in SLE remains unclear. Anti-phospholipid antibodies may cause thrombosis and ischemic myelopathy. However, auto-antibodies directed against central nervous system constituents may be involved.

With recent advances in medicine, uremic patients are living longer with an improving quality of life. Several skin diseases have been reported in patients with chronic renal failure, and the opportunity has been offered to elucidate newer cutaneous abnormalities among patients undergoing long-term hemodialysis. Hyperpigmentation was the most prevalent cutaneous abnormality observed in these patients, but hypopigmentation remains an exceptional event. We report here a case of a maintenance hemodialysis patient with an acquired hair and skin fairness. Although the true mechanism involved in this entity remains obscure, it can be correlated with a disturbance of phenylalanine metabolism on the basis of the current knowledge.

The spectral and temporal behavior of absorption bleaching due to band- and state-filling processes in Cd1−xZnxTe polycrystalline layers with a nominal composition x=0.17 are investigated. The absorption bleaching due to band-filling effects has a decay time in the range of 35 and 90 ps which depends on the photon energies of the pump and test beams. It is attributed to the relaxation of quasi-Fermi levels through the bottom (top) of the conduction (valence) band and corresponds to the lifetime of nonequilibrium charge carriers. The absorption bleaching due to state-filling processes corresponds to the nonthermal part of the energy distribution of free carriers and therefore depends on the photon energy of the pump beam. A hole burning is found which peaks near the photon energy of the pump laser and which follows the temporal shape of the laser pulses (20 ps). The asymmetry of the hole-burning spectrum is attributed to the energy dependence of the density of states which is important for electron–electron scattering processes.

Septic thrombosis of the cavernous sinuses most commonly follows staphylococcal infections of the middle third of the face. Orbital symptoms are constant. We report six cases diagnosed only by CT. At present, MR imaging is the diagnostic procedure of choice. Its findings are thought to reflect the septic nature of the thrombosis.

To define, the prevalence and risk, factors of hepatitis C virus (HCV) a prospective and multicentre study was performed in 235 patients undergoing haemodialysis, the anti-HCV antibodies a ere evaluated using an immuno-enzymatic method (wellcozyme anti-HCV), The following parameters were obtained for all patients : time on haemodialysis, blood transfusion, liver enzymes (ALT, AST), others virus markers: HBV (HBs Ag, HBs Ab, HBc Ab) and HIV, Anti-HCV was positive in 86 patients (42 %), There was a significant (p < 0.05) relationship between presence of anti-I-ICV antibodies and duration of haemodialysis (33 +/- 24 vs 20 +/- 19 months), No statistically significant difference was found with blood transfusion and the others parameters, In conclusion, the prevalence of HCV in our centre of dialysis was high, The duration of dialysis seems to be the main risk factor HCV infection.

We study the optical nonlinear properties of bulk Cd0.13Zn0.87Te monocrystals at room temperature near the band gap. In time-resolved test and pump experiments, they manifest themselves by a defocalization and an induced absorption of the test beam in the presence of the pump beam. By measuring the spatial intensity profile of the test pulse transmitted through the sample, we determine the real and the imaginary parts of the refractive index as functions of the photon energy and time delay between pump and test pulses.

Histiocytosis X is an uncommon disease. Temporal bone involvement is a frequent head and neck manifestation. Most patients are under fifteen years of age. The authors report a case of a bilateral extensive temporal involvement complicated with vertigo and peripheric facial palsy. CT plays a dominant role in the diagnosis because of the ability to identify bone destruction, soft tissue involvement and intra-cranial histiocytosis more accurately.

Bulk Cd0.13Zn0.87Te monocrystals are studied by nonlinear optical experiments at room temperature near their absorption edge. Time-resolved test and pump experiments allow us to determine separately the refractive index and absorption changes induced by the pump pulse by measuring the spatial intensity distribution of the test pulse.

The aim of this study was to compare the renal tolerance of cisplatin and carboplatin in euvolemic and dehydrated rats. A total of 79 euvolemic or dehydrated male rats were randomly assigned to receive cisplatin (5 mg/kg body weight, i.p.), carboplatin (40 mg/kg body weight, i.p.) or vehicle. Body weight, serum creatinine, creatinine clearance, fractional excretion of sodium and urinary NAG excretion were recorded on days 1 and 5. Glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and renal histology were determined on day 5. In the euvolemic and dehydrated control and carboplatin groups we observed no change in serum electrolytes, serum creatinine, creatinine clearance, GFR and ERPF. In the euvolemic and dehydrated control groups we observed no change in urinary NAG excretion. Carboplatin induced a slight but significant increase in urinary NAG excretion. In dehydrated rats carboplatin induced a significantly higher increase in urinary NAG excretion than in euvolemic rats. Cisplatin induced a marked and significant decrease in GFR and ERPF, and a significant increase in NAG. Dehydration markedly potentiated cisplatin nephrotoxicity. Euvolemic rats treated with cisplatin exhibited, slight renal lesions with a mean score which was similar to the control group. The most extensive lesions were observed in euvolemic and dehydrated cisplatin treated rats with tubular necrosis in the outer stripe of the medulla. The mean total nephrotoxicity score of dehydrated cisplatin treated rats was significantly higher than that of the euvolemic cisplatin treated rats. The results in this study indicate that carboplatin is a promising second generation platinum analog with respect to decreased renal toxicity as compared with cisplatin and may be particularly useful in patients with risk factors such as chronic renal failure or in patients who cannot bear hyperhydration.

Renal tubular acidification function was studied in 12 patients treated with cyclosporine (Cy) for idiopathic uveitis (IU) and in 5 patients with IU not treated with Cy. After intravenous bicarbonate loading fractional bicarbonate excretion was similar in both groups indicating normal proximal tubular acidification function. Plasma renin activity, plasma aldosterone and transtubular potassium gradient were similar in both groups. Distal hydrogen ion secretion evaluated by the ability to increase urine-blood (U-B) pCO2 in a highly alkaline urine was impaired in Cy-treated patients (31.8 +/- 3.2 mm Hg) as compared to controls (47.9 +/- 0.5 mm Hg) (p < 0.005). We conclude that Cy therapy is associated with a distal acidification defect with a low U-B pCO2 gradient during sodium bicarbonate loading. Because none of our Cy-treated patients spontaneously developed over metabolic acidosis one could classify them as having an incomplete form of distal tubular acidosis.