[Infantile acropustolosis: unusual manifestation of scabies in the infant?]

Three pediatric cases of vesiculopustules persisting for several months or years after eradication of Sarcoptes scabiei are reported. This particular course of scabies in infants is underrecognized although probably common. Its clinical manifestations, natural history and histologic features are identical to those seen in infantile acropustulosis, a recently individualized syndrome whose pathogenesis is unelucidated. In the light of these cases and a review of the literature, the possible relationship between scabies and infantile acropustulosis is discussed.

[Psychosocial guidance of nursing home personnel by group therapy. Basic considerations and initial experience]

Support groups for those professional caregivers who work in homes for the aged are seldom. Focussing on occupational stressors in this profession and the burnout research as a conceptual framework, a support group is introduced. To sustain the social competence and the coping skills of the caregivers are the basic aims of this group. Based on role taking and psychodrama as intervention techniques, outcomes from this group are discussed. Recommendations for future groups as a support system for caregivers in homes for the aged are derived.

[Difficulties in demonstrating Hansen's bacillus in lesions. Analysis of a case]

In one case of leprosy, Ziehl's classic staining technic could not demonstrate the bacteriologic evidence. After using a cold-staining procedure, the Lapeyssonie and Causse technic, numerous Hansen's bacilli (B.H.) were detected in the lesions.

Popliteal pseudoaneurysm and arteriovenous shunt following arthroscopic meniscectomy: case report

Arthroscopic procedures have a low complication rate regarding vascular injury. This report describes a pseudoaneurysm of the right popliteal artery with an arteriovenous shunt following arthroscopic resection of remnants of the posterior horn of the medial meniscus, a complication not previously reported.

[Acquired immunodepression syndrome in Guadeloupe]

Guadeloupe is a small Caribbean Island, with racial intermixed population. AIDS prevalence is four time higher than in France. Socio-economical and sanitary levels are similar to those of developed countries. On the other hand, AIDS has epidemiological patterns close to those of under developed countries. This contradiction is discussed. Epidemiological, clinical and psycho-sociological aspects are reviewed.

Magnetic resonance in cartilaginous lesions of the knee joint with three-dimensional gradient-echo imaging

Diagnosis of chondromalacia of the patellofemoral joint using three-dimensional gradient-echo sequences was investigated in 41 patients, with arthroscopic verification in 25 patients. In vitro examinations in human cadaveric patellae were performed in order to determine optimal imaging parameters. FLASH (TR = 40 ms, TE = 10 ms, flip angle = 30 degrees) and FISP (TR = 40 ms, TE = 10 ms, flip angle = 40 degrees) were used in clinical studies. Advanced stages of chrondromalacia could be visualized with high sensitivity. In less advanced disease, overstaging was observed. The therapeutically relevant differentiation of major and minor degrees of chondromalacia seems to be possible. 30 degrees FLASH-images in the axial plane proved to be the most efficacious technique for the diagnosis of chondromalacia.

Effects of tRNA-intron structure on cleavage of precursor tRNAs by RNase P from Saccharomyces cerevisiae

RNase P derived from S. cerevisiae nuclei was tested for its ability to cleave a variety of naturally occurring and selectively altered precursor-tRNA molecules to yield matured 5' termini. Precursors were synthesized in vitro in order to test which aspects of substrate structure are crucial to recognition and cleavage by RNase P. Base modifications in the precursor substrates are not required for cleavage by the enzyme, but deletion and substitution mutations affecting any portion of the precursor tertiary structure reduce cleavage. In particular, a number of alterations in the intervening sequence (IVS) reduce the susceptibility of the substrate to cleavage by RNase P. The significance of these results is discussed in reference to the contribution of the IVS to the structure of the precursor-tRNA.

Chronic learning problems and maturation

An analysis of test scores of a longitudinal sample of normal children, who placed in the lowest quartile of the class on the California Achievement Test and children in the highest quartile yielded significant differences on three perceptual-motor tests and on Piaget's preoperational and precausal tests at Kindergarten level. Although matched for IQ in Kindergarten, significant IQ differences appeared in Grade 1 and continued to increase over 5 yr., as those on other tests. Cattell's Early School Personality Questionnaire indicated that low achievers were significantly less mature and more tense and anxious than high achievers from Grades 1 through 5. Maturational lag is hypothesized for retardation of learning.

Natural resistance to mycobacteria: antimicrobial activity and reactive oxygen intermediate releasing functions of murine macrophages

After infection with Mycobacterium lepraemurium or with M. bovis strain BCG (bacillus Calmette-Guérin), splenic macrophages from mice naturally resistant (NR) to these pathogens (C3H and A/J) spontaneously produced H2O2, whereas splenic macrophages from naturally susceptible (NS) mice (C57BL/6 and Swiss) did not. None of them produced superoxide anion O2-. In addition, NR macrophages had higher levels of superoxide dismutase (SOD) than did NS macrophages. In vivo treatments thought to enhance H2O2 metabolism (phorbol myristate acetate, SOD, Zymosan) decreased M. lepraemurium survival, whereas treatment with diethyl-dithiocarbamate, a potent inhibitor of SOD, had the converse effect. These results favour the hypothesis of a link between natural resistance to BCG (and M. lepraemurium) and H2O2 metabolism, with higher producers being naturally resistant.

Preliminary evidence of natural resistance to Mycobacterium bovis (BCG) in lepromatous leprosy

An assay system has been developed based on radiometric quantification of 3H uracil incorporation into viable BCG in the absence or presence of blood monocytes in cultures from untreated lepromatous (LL) or tuberculoid (TT) leprosy patients. 3H Uracil incorporation into BCG was inhibited when the bacilli were cultivated in the presence of blood-derived macrophages in culture for four days, and that inhibition was always greater with macrophages harvested from LL patients compared to TT patients. The reasons for such an observed difference in humans are discussed according to our knowledge obtained in murine models of mycobacterial infections.

Defect in the generation of cytotoxic T cells in lepromatous leprosy

Cytotoxic T cells are consistently produced in normal individuals after in vitro stimulation by a pool of mitomycin-treated normal lymphocytes. Patients suffering from lepromatous leprosy (LL), presenting with large amounts of Mycobacterium leprae and without a history of erythema nodosum leprosum (ENL) are unable to generate such cytotoxic T cells, while lepromatous patients with ENL which, in the present study were all deprived of M. leprae, react normally.

[Increase in dismutase activity in splenic leukocytes of mice sensitive to BCG and Mycobacterium lepraemurium]

A marked enhancement of superoxide dismutase activity was evidenced when Mice receptive to BCG and Mycobacterium lepraemurium were infected. Such increase was not found in non receptive Mice. This seems related to a genetic factor of the breed of Mice studied.

[Leprosy tests: diagnostic problems (apropos of 2 cases)]

Two cases of reactional leprosy leading to wrong diagnosis are reported. The first one concerns a reversal reaction predominantly neuritic, initially taken for polyarthritis. The second one concerns an erythema nodosum leprosum with extensive cutaneous necrosis (Lucio's phenomenon or ulcerative lazarine leprosy). Main aspects and mechanisms of leprosy reactional states are reviewed. It is emphasized that errors or delays in diagnosis are often caused by failing to recognize cutaneous or neuritic symptoms.

[Red grain mycetomas (A. pelletieri). Apropos of 20 new cases in Dakar]

20 cases of mycetoma A. pelletieri coming from Sénégal are reported. This series confirms the peculiar localisation, extension and severity of this type of mycetoma: 14 cases located outside the foot (buttock, perineum, scrotum, inguinocrural area, abdominal and chest wall); frequency of lymph node involvement; importance of superficial extension; surgical possibilities overreached in more than 1/3 of the cases. Effectiveness of sulfa-methoxy-trimethoprime in the medical management is outlined.

[Ecology of a focus of cutaneous leishmaniasis in the Thies region (Senegal, West Africa). 2. Epidemiological and clinical peculiarities of the human disease]

During their epidemiological survey of a cutaneous leishmaniasis focus, the authors study the epidemiological and clinical aspects of 60 proven human cases observed in the studied area (Thies region). The disease can occur at any age but is more frequently seen in the pre-adolescent (10-15 years), adolescent (15-20 years) and adult (20-40 years) age classes. During the year, 76.5% of the lesions appear between july and the end of november. The spontaneous evolution of the disease seems to have a one year duration. Less than 10 lesions are observed in the majority of the cases (91.5%). The lesions are mainly located on upper and/or lower limbs and are generally of humid ulcerated type, often covered by a deep scar; a lymphatic nodular dissemination from a lesion occurs in 25% of the cases.

[2d case of cutaneous leishmaniasis with mucous involvement in Senegal]

A 6 year-old-girl of a village along the Senegal River presented cutaneous lesions with a nasal nodule, both infected with Leishmania amastigotes. This is the second case of cutaneous leishmaniasis with mucosal involvement described in Senegal (West Africa).