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The interstitial nephritis associated with sicca syndrome is usually symptomless or responsible for mild renal impairment. The authors report five cases in which renal failure was severe, requiring haemodialysis in two patients. The physiopathological mechanisms and the treatment of interstitial nephritis in sicca syndrome are discussed. Corticosteroids improved renal function in three of these five patients.

The depicted procedure minimizes the hazards of aggressive manipulations, and excludes any possibility of so-called "warm ischaemia". The kidneys are flushed out in situ with cool pulsatile perfusion through an aortic cannula. Kidneys, aorta and inferior vena cava are then removed en-bloc without interrupting the perfusion, and preserved in Collins' solution at 4 degrees C. After a 6 to 19 hour storage time, one of the kidneys is transplanted on another dog, while the second one is submitted to histological examination. Nine transplantations were carried out, followed in 7 cases with a most satisfactory diuresis resuming, and with urinary ionic levels, as well as daily urea output, normalization within 48 hours. Histologic examination showed an unaffected glomerular apparatus, but some mild tubular lesions.

The effects of nifedipine (20 mg), propranolol (80 mg), the nifedipine (20 mg) + propranolol (80 mg) combination and a placebo on cardiac [heart rate (HR), cardiac output (CO, Doppler determination)] and systemic [mean arterial pressure (MAP), systemic vascular resistance (SVR)] and regional hemodynamic [brachial blood flow (BBF) and arterial diameter (BAD) (pulsed Doppler), forearm vascular resistance (FVR)] parameters were investigated during the 3 hours following their random administration in a double blind and cross over study performed in 6 healthy subjects. At their peak effects, (a) nifedipine decreased SVR (-17 p. 100, p less than 0.01), increased HR (+ 12p. 100, p less than 0.001) and CO (+ 18 p. 100, p less than 0.001), did not change MAP and increased BBF (+31 p. 100, p less than 0.001) with a vasodilating effect which affected both large and small arteries; (b) propranolol decreased HR (-14 p. 100, p less than 0.05) and CO (-25 p. 100, p less than 0.01), increased SVR (+25 p. 100, p less than 0.01), did not change MAP and decreased BBF (-28 p. 100, p less than 0.05) with a vasoconstrictor effect which affected both large and small arteries; (c) in the nifedipine-propranolol combination, nifedipine neutralized propranolol-induced systemic and regional vasoconstrictor effects while propranolol antagonized nifedipine-induced increases in HR and CO. Thus, the favorable synergistic effects of the nifedipine-propranolol combination in hypertensive patients could be demonstrated in healthy subjects inasmuch as MAP was decreased and peripheral vascular blood flows were preserved.(ABSTRACT TRUNCATED AT 250 WORDS)

Ultrastructural study of a case of granulomatosis disciformis occurring on the legs of a 62-year-old woman. The diagnosis is based upon the contrast between the clinical aspect of necrobiosis lipoidica and the histologic aspect of inflammatory granulomatous infiltrate of dermis without necrobiosis nor palisading. Electron microscopic findings are: perivascular mixed cell infiltrate and histiocytic granuloma with lysosomial and phagocytic activity; degenerative and necrotic cellular alterations; modifications of collagen fibres with two types of fibres: the thinnest are the most numerous and have a mean diameter of 50 nm, the thickest of 110 nm; no significant lesions of capillary walls. These findings suggest the following succession of pathological events: cellular necrosis, lysosomial and phagocytic activity, scarring. Some descriptions of necrobiosis lipoidica and granuloma annulare seem to be quite similar and our findings are in favour of the unity of these three illnesses.

The authors report three cases of palmo-plantar pustulosis associated with articular signs: erosive arthritis of the right first sternocostal joint in 2 cases (without hypertrophy of the clavicle or the sternum) and atlanto-occipital arthropathy with marked neck stiffness in another case. The HLA phenotype of one case was: A2 - A9 - B14 - X - DR3 - DR4. A surgical sterno-costal biopsy revealed non-specific inflammatory lesions in 2 cases. In one of these cases, a Corynebacterium sp. was isolated. The clinical course was favourable in response to local antibiotic therapy in one case (follow-up of 8 years) and after treatment with non-steroidal anti-inflammatory agents in 2 cases (follow-up of one to two years). The skin biopsy revealed non-spongiform (and therefore non-psoriatic) unilocular pustulosis, distinguishing this non-bacterial pustulosis from pustular palmo-plantar psoriasis with which it is frequently confused. These cases are similar to the cases of "pustulotic arthro-osteitis" reported by Japanese authors (Sonozaki et al.), which appear to be rare in Europe. They seem to be an early form in a vast range of spondylo-arthropathies including rheumatism and acne conglobata. The aetio-pathogenesis of this syndrome is discussed; one of the cases is strongly suggestive of an infectious origin (Corynebacterium). These lesions do not appear to be a form of reactive arthritis, as the presence of HLA B27 is rare in both the European and the Japanese cases.

Primary Aldosteronism may be due to adenoma or hyperplastic adrenals. Such a distinction can be obtained from biochemical studies. In our observation, a man with recurrent aldosteronism after right adrenalectomy was studied. Radiological and surgical data might indicate an adenoma. This opinion was modified by pathological studies. This absence of capsule and the presence of microadenomatous hyperplastic lesions indicated pseudo-adenomatous hyperplastic glands. On the other hand, high blood pressure remained after adrenalectomy. A treatment with beta-blocking substances corrected this hypertension.

A new case of carcinoma involving Caroli's disease in a 51 years old woman is reported. This papillary carcinoma is developed in left hepatic duct. The type is quite different from the previous cases already described. It is not a cholangiocarcinoma but a papillary mucoid carcinoma.

One case of atresia of the common pulmonary vein is discussed at the light of the few reports found in the literature. The presence of criteria distinguishing this type of obstacle to pulmonary venous return from the other cases, is of practical diagnostic interest; indeed, its diagnosis leads to surgical intervention, theoretically curative.

Administration of a single oral dose of oltipraz (5-(2-pyrazinyl)-4 methyl-1,2 dithiol-3-thione) to mice infected with Schistosoma mansoni resulted in the elimination of the parasites. Oltipraz is a slow-acting drug and approximately 2 months are required until its full schistosomicidal effect becomes evident. One of the earliest effects of the drug is a reduction of the glutathione stores of the worms. The antischistosomal activity of oltipraz is lowered when drug metabolism is stimulated by pretreatment with phenobarbital or butyl-hydroxyanisole (BHA). By contrast, administration of L-cysteine is synergistic with the antischistosomal effect of oltipraz. Evaluation of a limited number of oltipraz analogs revealed among dithiolthiones rather stringent structural requirements for antischistosomal activity.

Primary Sjogren’s syndrome is a chronic inflammatory autoimmune disorder that is characterized by a mononuclear cell infiltration of the exocrine glands. Similar lymphocytic infiltrates may invade visceral organs, and this results in several extra glandular manifestations, including renal disease.

We present a study of the heavy-light spectrum and of the D- and B-meson decay constants. The results wer e obtained in the quenched approximation, by using the non-perturbatively improved Clover lattice action at beta=6.2, with a sample of 100 configurations, on a 24^3 x 64 lattice. After a careful analysis of th e systematic errors present in the extraction of the physical results, by assuming quite conservative discretization errors, we find f_Ds=231 +/- 12^{+6}_{-1} MeV, f_D = 211 +/- 14^{+0}_{-12} MeV, f_Ds/f_D=1.10(2), f_Bs = 204 +/- 16^{+28}_{-0} MeV, f_B = 179 +/- 18^{+26}_{-9} MeV, f_Bs/f_B=1.14(3)^{+0}_{-1}. Our results, which have smaller discretization errors than many previous estimates at fixed value of the lattice spacing $a$, support a large value of f_B in the quenched approximation., 26 pages, 9 Postscript figures

We present the results for light hadron spectrum, decay constants and the quark masses obtained with non-perturbatively improved Wilson fermions. We also give our preliminary results for the heavy-light decay constants., 3 pages, 2 figures, corrected some typos and one reference added, LATTICE98(spectrum)