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INTRODUCTION: Netrin-4 is a secreted member of the laminin-related protein family, known to be involved in axonal guidance and endothelial cell survival, proliferation, and migration. We have recently reported the cellular localization of netrin-4 and its receptor neogenin in human first trimester and term placenta. A strong expression of netrin-4 was observed in trophoblast and in endothelial cells, suggesting a potential role of this protein in placental angiogenesis. In relation to human pregnancy, it has been reported that circulating netrin-4 were increased in fetal umbilical cord blood of intrauterine growth restriction IUGR compared to normal pregnancy suggesting an adverse effect of this protein on placental and fetal development. The aim of this study was to determine the role of netrin-4 in placental angiogenesis. METHODS: The effects of netrin-4 on proliferation, migration, tube-like organization, and spheroid sprouting of human placental microvascular endothelial cells (HPEC) were studied. RESULTS: We demonstrated that netrin-4 inhibits HPEC proliferation, tube-like formation, migration and spheroid sprouting, suggesting a direct role of netrin-4 in the regulation of intra-villus angiogenesis. DISCUSSION: This is the first report of an anti-angiogenic activity of netrin-4 in human placenta. This study brings new insights into netrin-4 roles in placental angiogenesis and suggests possible involvements of netrin-4 in angiogenesis-related pathologies such as IUGR.

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Gamma scintigraphy plays an important role in the topographic diagnosis of focalized cerebrovascular insufficiency. Furthermore, sequential imaging allows a comparative study of arterial distribution while studying the "transit time" of the radioactive tracer. In this work, the authors attempted to quantify transit time in patients with chronic cerebrovascular insufficiency while comparing the radioactivity in the hemispheres with that of the various arterial territories. The study of the arca and slope of the various arterial territories. The study of the area and slope of the tracer profile indirectly gives information about the cerebro-correlation between cerebrovascular resistance and the clinical state, there was, however, an interesting relation during vasodilator treatment (ifenprodil tartrate) in which promising clinical results were preceded by an increase in the arterial inflow component of the radioactivity curve.

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A forty-two-year-old man presented with erythema nodosum of undeterminated etiology and pancytopenia. A bone marrow biopsy revealed extensive hairy-cell infiltration. Four months later, the diagnosis of pulmonary tuberculosis was suggested by the appearance of a pulmonary infiltrate in the left upper lobe. Despite antituberculous chemotherapy, the patient died. Post-mortem bacteriologic confirmation was given by sputum culture.

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Two cases of biliary peritonitis by perforation of intra-hepatic biliary ducts are presented. In both cases there is a perforation from a gallstone. In the first case the perforation is located at the proximal part of the left hepatic bile duct, in the second case it is at the proximal and distal portion of the third segment bile duct. Those peritonitis are rare and their diagnosis is difficult. Gallstone is the main cause. Removing bile duct obstruction is the treatment.

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The authors report on a patient with hereditary osteo-onychodysplasia (HOOD). Osteoporosis was demonstrated upon histomorphologic bone examination. HOOD is a rare inherited disorder. Typical features include dysplasia of the nails, patellae, elbows and ilium. Nephropathy occurs in 48% of patients. Numerous renal histologic studies have led to the concept that the nail-patella syndrome is an inherited metabolic disorder affecting the connective tissue. Our findings from histomorphologic bone assessment bring further evidence in support of this hypothesis.

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The authors report on two patients in whom Hodgkin disease was revealed by renal complications: nephrotic syndrome in one patient and renal failure with enlarged kidneys secondary to malignant infiltration in the other. In comparison to other lymphomas, renal infiltration is infrequent in Hodgkin disease. Clinical manifestations of renal infiltration are delayed. Renal failure with enlarged kidneys, which is very uncommon, carries a poor prognosis and is often associated with involvement of the lungs. Nephrotic syndrome in Hodgkin disease may be secondary to one of the three following causes: renal vein compression, renal amyloïdosis, or a paraneoplastic syndrome. The latter is the most common cause and is probably ascribable to immunologic disturbances. Among the other complications, infection and the renal consequences of metabolic disorders are mentioned.

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Prolymphocytic leukaemia (PL) is a rare variant of lympho-proliferative disorder, defined by Galton [21], which differs clearly from CLL by clinical, haematological and immunological features. Nevertheless like CLL, PL appears to represent predominantly a B cells monoclonal proliferation and cases of T-PL are rare. We report about another case of PL which was found to have T-lymphocyte characteristics and some clinical and immunological particularities.

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We used intravenous synthetic somatostatin to stem severe bleeding from oesophagites and oesophageal ulcer associated with renal failure hyponatremia and mental confusion. The ability of somatostatin to reduce splanchnic blood flow and portal pressure and to inhibit both gastrin release and the pentagastrin-stimulated secretion of gastric acid and pepsin provides its therapeutic use in multiple alimentary bleeding. When patients is considered poor candidate for surgery, somatostatin may prove a particularly valuable alternative to conventional medical treatments. We observed no side effects, with somatostatin, during a 72 h period of treatment. Since cimetidine give rise to mental confusion in ureamia or hyponatremia, somatostatin should be looked upon with particular interest in cases of gastro-intestinal bleeding associated with renal insufficiency.

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The authors report a case of Ph 1 positive chronic myelocytic leukemia associated with cutaneous mastocytosis, occuring lately in a 75 years old man. 12 similar cases (associations mastocytosis chronic or acute leukemia) are described in the literature.

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A case is reported of a 49 years-old man who presented with cutaneous and muscular manifestations revealing periarteritis nodosa. Two years after detection of this disease occured a preleukemic condition and four years later a chronic lymphocytic leukaemia is discovered. In clinical course appeared a tuberous infiltration of the face and a sudden bilateral deafness. Regression of these two abnormalities is obtained after administration of prednisolone. The patient died of generalized infectious process postoperatively. From these clinical and pathological findings relations between periarteritis and CLL, occurence of deafness and cutaneous lesions are discussed. The relationship between the development of CLL and the immunosuppressive treatment is considered.

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