La pneumopathie chronique idiopathique à éosinophiles (PCIE) ou maladie de Carrington correspond à une infiltration du parenchyme pulmonaire par des polynucléaires éosinophiles sans cause mise en évidence. Le diagnostic de PCIE repose sur des caractéristiques cliniques et radiologiques bien définies associées à une éosinophilie sanguine et/ou alvéolaire. L'hyperéosinophilie alvéolaire est forte et décrite comme constante. Nous rapportons le cas d'un homme de 57 ans consultant pour une toux et altération de l'état général avec à la radiographie pulmonaire des infiltrats périphériques, une hyperéosinophilie sanguine mais sans hyperéosinophilie au lavage broncho-alvéolaire (LBA). Le diagnostic de PCIE a été porté après étude histologique d'une biopsie pulmonaire chirurgicale. L'absence d'hyperéosinophilie alvéolaire dans une PCIE reste exceptionnelle et l'affirmation du diagnostic peut reposer dans ce cas sur l'examen d'une biopsie pulmonaire. Idiopathic chronic eosinophilic pneumonia (ICEP) or Carrington's disease is an infiltration of the lung parenchyma by eosinophils without known cause. The diagnosis of ICEP is based on well defined clinical and radiological characteristics associated with blood and/or alveolar eosinophilia. Alveolar hypereosinophilia is marked and regarded as a constant feature. We report the case of a 57 year old man seen on account of a cough and deterioration of general health associated with radiographic peripheral pulmonary infiltrates, blood hypereosinophilia but no hypereosinophilia in the bronchial lavage (BL). The diagnosis of ICEP was made after histological examination of a surgical lung biopsy. Absence of alveolar hypereosinophilia in ICEP remains exceptional and in this case confirmation of the diagnosis may depend on examination of a lung biopsy.

INTRODUCTION:Idiopathic chronic eosinophilic pneumonia (ICEP) or Carrington's disease is an infiltration of the lung parenchyma by eosinophils without known cause. The diagnosis of ICEP is based on well defined clinical and radiological characteristics associated with blood and/or alveolar eosinophilia. Alveolar hypereosinophilia is marked and regarded as a constant feature.CASE REPORT:We report the case of a 57 year old man seen on account of a cough and deterioration of general health associated with radiographic peripheral pulmonary infiltrates, blood hypereosinophilia but no hypereosinophilia in the bronchial lavage (BL). The diagnosis of ICEP was made after histological examination of a surgical lung biopsy.CONCLUSION:Absence of alveolar hypereosinophilia in ICEP remains exceptional and in this case confirmation of the diagnosis may depend on examination of a lung biopsy.

The authors have made an histological study of the evolution, after 120 days, of coral implant and tricalcic phosphate ceramic implant in each femur of 12 rabbits. The results have shown on the one hand that ceramic is resorbed faster than coral, on the other hand that for both types of biomaterials the resorption was much faster for the implants in contact with the bone-marrow than for those which were not.

Activated human polymorphonuclear neutrophils at inflammatory sites release the chymotrypsin-like protease cathepsin G, together with elastase and proteinase 3 (myeloblastin), from their azurophil granules. The low activity of cathepsin G on synthetic substrates seriously impairs studies designed to clarify its role in tissue inflammation. We have solved this problem by producing new peptide substrates with intramolecularly quenched fluorescence. These substrates were deduced from the sequence of putative protein targets of cathepsin G, including the reactive loop sequence of serpin inhibitors and the N-terminal domain of the protease-activated receptor of thrombin, PAR-1. Two substrates were selected, Abz-TPFSGQ-EDDnp and Abz-EPFWEDQ-EDDnp, that are cleaved very efficiently by cathepsin G but not by neutrophil elastase or proteinase 3, with specificity constants (k(cat)/K-m) in the 10(5) M-1 (.) s(-1) range. They can be used to measure subnanomolar concentrations of free enzyme in vitro and at the surface of neutrophils purified from fresh human blood. Purified neutrophils express 0.02-0.7 pg of cathepsin G/cell (n = 15) at their surface. This means that about 10(4) purified cells may be enough to record cathepsin G activity within minutes. This may be most important for investigating the role of cathepsin G as an inflammatory agent, especially in bronchoalveolar lavage fluids from patients with pulmonary inflammatory disorders.

In order to analyse human papillomavirus (HPV) infection in the Senegalese population, HPV DNA was sought in 65 women with evidence of cervical cytological abnormality and in 72 pregnant women. Ninety-four percent of the patients were positive for HPV DNA as compared to 24% of pregnant women. HPV 16 was detected in cervical smears in 42% of cases, HPV 18 in 39%, HPV 6 in 26%, HPV 11 in 15%, HPV 45 in 10%, HPV 52 in 3%, and HPV 31, HPV 33 and HPV 68 in 1.5%. HPV 16 and HPV 18 were detected in 16% and 7% respectively of pregnant women. HPV DNA of unknown type was detected in 6% of cases, and multiple HPV infections were observed in 28% of cases. Low risk genital HPVs (6/11) were detected in smaller proportions (17%) among high grade squamous intraepithelial lesions (SILs) than the low grade SILs (43%). High risk HPVs (16/18) were detected in high proportions both in low and high grade SIL lesions, though the highest frequency (70%) was observed among patients with high grade lesions. In conclusion, the results confirm that HPV infections are frequent in Senegal and that HPV 18 and 45 are detected in a high proportion of patients in Africa. © 1996 Wiley-Liss, Inc.

One hundred ninety-six cervical scrapings were obtained for simultaneous research of cell abnormalities in Papanicolaou smears and detection of genital human papillomavirus (HPV) genotypes by polymerase chain reaction in extracted DNA from each clinical sample. The samples described by six discriminant cytologic parameters, and a synthetic HPV-presence/absence parameter provided an efficient matrix for multiple correspondence analysis. This statistical analysis displayed a plurality of HPV-related cell abnormalities in squamous intraepithelial lesions, and a high correspondence between HPV infection and the presence of multinucleated squamous cells, morphologically transformed keratinocytes (dyskaryotic cells), koilocytes, and cellular changes related to epithelial maturation. Because of the low proportion of detectable koilocytes in the HPV-infected scrapings, the authors also inferred that cellular changes related to epithelial maturation and morphologically transformed keratinocytes are the most accurate and efficient cell abnormalities, in terms of frequency and correlation, for cytodiagnosis of HPV-induced or associated squamous intraepithelial cervical lesions.

Discrepancies have been reported in differential cell counts according to the diverse processing methods used in bronchoalveolar lavage (BAL) fluid management. The differences have proved to be mainly the result of selective lymphocyte loss, while the exact mechanisms of the phenomenon remain controversial. Observing a similar variation in differentials from differently stained identical smears, we quantified the cell loss due to staining procedures from 45 consecutive satisfactory BAL procedures. To do this, we compared relative lymphocyte recovery on neat pooled lavage in a hemocytometer with that from smears and cytopreps fixed and stained in different ways. We found (1) A significant lymphocyte loss (p < 0.05) whatever the staining method. (2) Different methods of fixation and staining lead to considerable variation in differentials from slides otherwise identically managed. The loss is higher during air-drying fixation followed by staining with an aqueous medium such as Diff-Quik than on spray-fixed slides stained in an alcohol medium such as Papanicolaou stain. (3) The effect of lymphocyte loss on differentials is more important when the initial lymphocytosis is less than 35%, and decreases to nonsignificance when it exceeds 70%. The role of cytocentrifugation or other manipulations in cell loss probably has been overestimated because unknown effects of staining methods were also attributed to these manipulations. We suggest that lymphocyte loss could arise from poor adherence on slides, which is exacerbated during aqueous staining if no artifice (e.g., spray fixation), is used to hold them. Thus, the definition of the long-awaited standard procedure for an accurate differential count of BAL fluid must take into account fixation and staining methods.

We report a case of pulmonary malakoplakia in a patient suffering from AIDS secondary to a Rhodococcus equi pneumonia. The association between these two pathologies only occurring in the immunodepressed does not seen fortuitous. Deficiency in cellular immunity and macrophage cellular activity as well as failure of intracellular bactericidal and phagolysosomal function are very probably the links. The treatment of this opportunistic germ rests on prolonged poly-antibiotic therapy or indeed surgical excision.

360 consecutive bronchoalveolar lavage fluids (BAL) were studied using semi-quantitative method described by GOLDE (GOLDE score). 44 hemosiderosis were detected (12%). Most of them corresponded to massive alveolar hemorrhage (AH). Depending on pathological contexts, we distinguished three main groups of AH frequency: a group of high frequency (around 40%), an intermediate group (10%) and a low frequency group with less than 5%. Matching cytological results with clinical and radiological data, revealed that AH was often too late diagnosed because inconstancy of typical clinical and radiological signs. Even with a variable prognosis related to different physiopathological mechanisms, AH evolution is unpredictable. The authors suggest thus BAL cytological examination may systematically include a research of hemosiderosis in AH high frequency groups.

360 consecutive bronchoalveolar lavage fluids (BAL) were studied using semi-quantitative method described by GOLDE (GOLDE score). 44 hemosiderosis were detected (12%). Most of them corresponded to massive alveolar hemorrhage (AH). Depending on pathological contexts, we distinguished three main groups of AH frequency : a group high frequency (around 40%), an intermediate group (10%) and a low frequency group with less than 5%. Matching cytological results with clinical and radiological datas, revealed that AH was often too late diagnosed because inconstancy of typical clinical and radiological signs. Even with a variable prognosis related to different physiopathological mechanisms, AH evolution is unpredictable. The authors suggest thus BAL cytological examination may systematically include a research of hemosiderosis in AH high frequency groups.

We report on proximal symphalangism of the four last fingers, transmitted through five generations of an African family. Intrafamilial variations of the disorder are due to the heterogeneity of associated anomalies. This familial trait resembles multiple synostosis disease, however, it is not restricted to synostoses and appears to be more generalised. To our knowledge this is the first report of a familial trait associating proximal and distal symphalangism. The distribution of elementary anomalies in this family suggests a link in their pathogeny and raises the question of embryological equivalence for some of them. Symphalangism seems to be a symptom of a more generalised disorder, the comprehension of which requires a better coordination of clinical, embryological and genetic data.

Cervical cells obtained by scraping from 126 women living in the Tours area, France, were tested for the presence of HPV 16 infection, using the PCR method. In all samples analysed no evidence was found of HPV 16 b subtype. The incidence of HPV 16 infection ranged from 4% in women without history of genital HPV infection to 48% in women with high-grade squamous intraepithelial lesions (SIL). It must be noted that HPV 16 infection is twice as frequent in women with a history of HPV-induced cervical lesions as in those without this history. Thus, a normal cytology does not always mean an absence of HPV infection of the uterine cervix. It may be concluded from these results that detection of cervical HPV 16 infection by the PCR method makes it possible to identify a group of women at high risk of developing SIL or cervical cancer. Regular cytological surveillance of these women who are healthy carriers of HPV 16 without detectable squamous cell abnormalities must be implemented.

Cervical cells obtained by scraping from 126 women living in the Tours area, France, were tested for the presence of HPV 16 infection, using the PCR method. In all samples analysed no evidence was found of HPV 16 b subtype. The incidence of HPV 16 infection ranged from 4 % in women without history of genital HPV infection to 48 % in women with high-grade squamous intraepithelial lesions (SIL). It must be noted that HPV 16 infection is twice as frequent in women with a history of HPV-induced cervical lesions as in those without this history. Thus, a normal cytology does not always mean an absence of HPV infection of the uterine cervix. It may be concluded from these results that detection of cervical HPV 16 infection by the PCR method makes it possible to identify a group of women at high risk of developing SIL or cervical cancer. Regular cytological surveillance of these women who are healthy carriers of HPV 16 without detectable squamous cell abnormalities must be implemented.