[Costal lysis caused by pulmonary histiocytosis X].
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Biomedical subjects
Publications and source records attributed to M Maalej.
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A series of 133 patients, 35 years or less in age (mean: 31.8) presenting with a carcinoma of the cervix and treated at Salah Azaiz Institute from 1969 to 1989 was analysed and compared to a control group of patients older than 35 years (mean: 54). Neither clinical nor epidemiological particularities were found in the younger patients group, except an early sexual life and a high proportion of early stage tumours (33% versus 15.9% in the older women group). Overall survival of the younger women was dramatically worse than that of the older women: 40% and 50% at 5 years, 20% and 40% at 10 years, and 14% and 30% at 15 years, respectively. This difference is statistically significant in stage I-II patients. Young age, non-sterilization of the tumour after brachytherapy, and anemia, are associated with a poor prognosis.
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Within a multifactorial etiology of cancers and a bio-psycho-social approach of patients, considering, among the risk factors, those related to personality in a preventive view, the authors investigate, by an epidemiologic methodology, for a correlation between break-down phenomena and the development of a cancer. The study was carried out at the Salah Azaïez Institute in 1992 and included 707 patients aged from 15 to 82 years, 44% presenting a malignant tumour. For a retrospective evaluation of break-down semiology, the study is based on DSM-III criteria of break-down diagnostic. Search for a clinic/psychic diagnostic relation reveals the difficulty of coexistence between break-down signs and the development of a cancer. That difficulty increases in case of an organised break-down.
Nasopharyngeal carcinoma (NPC) is the primary cancer of the head and neck localisations in the Salah Azaiz Institute (Tunisia). From 1970 to 1987, 80 patients with histologically proven T4 N0 NPC, were treated with exclusive radiation (70-75 Gy to the primary lesion and 50-55 Gy to cervical lymph nodes). The T4 N0 represents 7% of all NPC and 16% of the T4 treated in our Institute. Ninety percent of the patients are over 20 years old with a mean age of 52 years. The sex-ratio was 4:1. Extension to the brain was observed in 55% of the cases. Local control was 70% at 2 months after the end of irradiation. The actuarial survival at 5 years was 47%. Distant metastasis represent 13% (30% of all NPC). The main failure of treatment was local recurrence. The T4 N0 is probably a particular entity concerning the age, the response to radiotherapy and the low rate of distant metastasis.
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Synovialosarcoma is a rare tumor, of difficult diagnosis. Authors report 8 cases diagnosed in the two pathology departments of Salah Azaïz Institute and the Universitary Hospital of Sfax, from 1985 to 1991. This tumor represents 2.96% of all soft tissues sarcomas treated in Salah Azaïz Institute. It occurs in young adults (the average age in our series: 28.8 years) with a male predominance (6 out of 8 cases), localized preferentially in the lower extremity. In the histological study, immunohistochemistry provides a great contribution in the diagnosis and classification of these tumors. The histoprognosis grading of Trojani applied to our cases shows the good correlation between the grade and the prognosis. Treatment is primarily surgical, consisting in wide excision to avoid recurrences that are unfortunately very frequent. Radiotherapy and chemotherapy give very inconstant results. Some authors recommend radiotherapy to sterilize the tumor field, and chemotherapy to prevent metastasis. The clinical course is characterized by a high frequency of local recurrences and pulmonary metastases.
A large body of evidence has suggested that the Epstein-Barr virus (EBV) is strongly associated with undifferentiated nasopharyngeal carcinoma. Immunologically, this neoplasia is characterized by the absence of anti-EBV circulating cytotoxic T lymphocytes (CTL), despite a high number of peripheral activated CD8+ cells, as previously determined in our laboratory. In order to determine whether the absence of anti-EBV CTL is related to a reduced number of circulating anti-EBV effector cells, we attempted to expand these hypothetical specific T cells by induction of proliferation with recombinant interleukin-2 (rIL-2), in the, absence of any stimulator cells. Optimal conditions for stimulation of peripheral blood lymphocytes (PBL) of nasopharyngeal patients were obtained with 100 U/ml rIL-2 during 10 days of culture. PBL treated with rIL-2 induced a selective expansion of CD8+ cells and generated a potent cytotoxicity towards autologous or HLA-compatible lymphoblastoid cell lines, used as target cells in a chromium-release thest. However, this cytolysis was non-MHC-restricted, since, the monoclonal antibodies anti-(HLA class I) and anti-(HLA class II) were inefficient in inhibiting this cytotoxicity. Interestingly, purified CD8+ cells acquired the capacity for non-MHC-restricted cytolysis.
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In this work we separated human blood lymphocytes (PBL) in two populations (A-LAK and NA-LAK cells) by the adherence plastic method. A maximum adherence of cells was obtained after 2 days of PBL incubation in LAK medium containing 500 U/ml rIL-2. The A-LAK cells had LGL phenotype but 40% of them had a macrophage phenotype marker and less than 20% weakly expressed a T-cell marker. This population, when reincubated in culture, produced an increasing titre of interferon. At the same time, a significant NK activity against K562 target cells was measured just after enrichment; these enriched adherent cells also developed an increased LAK activity against DAUDI cell lines, ninefold more at 6 days than when assayed just after enrichment. In contrast, 75% of the NA-LAK enriched cells expressed T-cell marker; these produced two- to threefold less interferon than A-LAK cells at all time-points. The NA-LAK lymphocytes enhanced principally LAK activity measured by 70% lysis against DAUDI target cells tested at 6 days of culture. Further studies are in progress to determine the nature of the effector cells that mediated LAK activity.
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