The development of necrosis and macrophage infiltration increases the risk of renal graft rejection. But the macrophages secrete the alpha form of the tumour necrosing factor (TNF) which is also involved in several immunologic and inflammatory phenomena. We therefore studied the expression of the gene TNF alpha by in situ hybridization during advanced stage rejection after renal transplantation: the grafts were infiltrated with macrophage-like cells expressing the mRNA of the TNF alpha gene, particularly deep in the cortex and in the medulla. These cells then secrete the TNF alpha molecule since they are recognized by anti-TNF alpha antibodies. These antibodies also recognize certain other glomerular endothelial and tubular epithelial cells which do not express the TNF alpha gene: these cells are undoubtedly the TNF target cells. These findings confirm the synthesis of TNF alpha in advanced stage renal graft rejection.

Hepatocellular carcinoma in woodchuck were characterized for woodchuck hepatitis virus integration nea c-myc oncogene. In one tumor, viral integration resulted in overexpression of a c-myc viral cotranscript. In a second tumor, viral insertion, 600 bp upstream of c-myc exon 1, was associated with increased levels of normal c-myc mRNA. These results demonstrate that integration of woodchuck hepatitis virus near a proto-oncogene can contribute to the genesis of liver tumors. From a comparison of a single hepatitis B virus (HBV) integration site in a human hepatoma with the corresponding unoccupied site have shown HBV DNA insertion in a putative cellular exon. This exon presented striking similarity to the DNA-binding domain of the thyroid/steriod hormones receptors. The corresponding cDNA has been isolated (hap gene) as shown to encode the retinoic acid receptor. It is most probable that consequent to HBV insertion, hap gene became inappropriately expressed as an altered chimaeric gene retinoic acid receptor, thus contributing to the cell transformation. As for woodchuck these results strongly support the possibility that HBV, may play a direct role in liver carcinogenesis by insertional mutagenesis.

The Currarino triad consists of an anorectal malformation, a presacral tumor and a sacrum defect. A new case is reported in a female neonate. The diagnosis was suspected because of delayed emission of meconium associated with an occlusion syndrome. It was confirmed by bone imaging, ultrasonography and magnetic resonance imaging. A colostomy was performed on day 7 then closed on day 43 after several rectal dilation were carried out. A presacral lipoma was operated on at 10 months. The 56 cases reported in the literature are reviewed.

A thorough study of the genetic aspects of Klippel-Trenaunay syndrome revealed two further cases of K.T. in the family 2 of the 86 patients questioned. In addition, 7/4,000 first degree relatives had flat angiomas. The authors suggest that these individuals are in fact "mini-Klippels". "Formes frustes" of the syndrome can be explained by variable expression of the genetic defect. In all, 7/86 families were of particular genetic interest: - two families with two individuals suffering from KTS; - five families with several individuals with flat angiomas on one or more limbs. All these findings suggest multifactorial inheritance of the syndrome. It is not possible to calculate the precise probability of inheritance of the syndrome on the basis of our figures but we consider it to be of the order of 1 to 2%.

A new cell line derived from a thyroid anaplastic carcinoma, CAL 62, has been established in culture. This line is constituted by highly tumorigenic cells. Their epithelial phenotype is stable in culture. Immunochemical staining for human thyroglobulin is negative. Cytogenetic analysis showed a gain of chromosome 20, the translocation i (14q), and breakpoints of centrometric chromatine. These results are similar to those previously reported by other investigators. CAL 62 radiosensibility has been studied. The survival curve of the in vitro irradiated cells has been adjusted with a linear-quadratic model. This cell line is thus showed to be radioresistant. Cell line CAL 62 constitutes an appropriate model for in vitro studies of thyroid anaplastic carcinoma.

Two cases of acute megakaryoblastic leukemia in a 4 month-old and a 13 year-old girl are described. In the first case who presented with a large hepatomegaly and portal fibrosis, the diagnosis was made from the surface phenotyping of megakaryoblasts; a trisomy 13, 14 and 19 and an extra chromosome X were present in the bone marrow. An electron microscopy study of megakaryoblasts was necessary to identify the second case. Both children died shortly after treatment (cytosine-arabinoside at low dosage in the first case and polychemotherapy in the second). The 51 other cases reported in the literature are reviewed.

Through flow cytometry, we have analysed DNA content of cervical cells recovered by scrapping the uterine cervix in 1) 103 women without human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN), 2) 42 patients with HPV infection without CIN, and 45 patients with CIN. We have observed four different DNA patterns: 1) normal DNA pattern, 2) increased and heterogeneous DNA pattern (IH), 3) increased S G2 + M phases, and 4) DNA aneuploid pattern. Statistical calculation has emphasized the significant correlation linking flow cytometric DNA pattern with cytologic diagnosis. HPV infection without CIN was associated with IH DNA pattern and CIN with increased S G2 + M phases or DNA aneuploid pattern. These results point out the interest of flow cytometric analysis of DNA content in uterine cervix pathology and in more extend in infectious or preneoplastic pathology.

We have studied the configuration of genes encoding for the heavy and light chains in the tumoral cells of 6 patients affected by alpha heavy chain disease (alpha HCD). The results showed the presence of rearrangement of the alpha heavy chain as well as the kappa light chain genes whereas the lambda genes were in germinal configuration. Thus, these results suggest the presence of a monoclonal compound in the tumoral cells in the alpha HCD.

A variety of clinical, topographical, histological, epidemiological and geographical arguments attribute to the effects of solar radiation and to ultraviolet rays (UV) in particular, a decisive role in the processes of cutaneous carcinogenesis. This carcinogenicity is part of a series of chronic changes affecting the integument which constitute heliodermatitis or photosenescence. The effects of UV are cumulative. DNA is the main target of UV rays. Man possesses several DNA repair systems. The hereditary malfunction of part of these systems result in xeroderma pigmentosum, which constitutes a pathological model of photocarcinogenesis. Intrinsic skin ageing (non-photodependent) appears to promote this process of photocarcinogenicity by several mechanisms: summation of DNA changes, progressive deterioration of repair systems, dermal-epidermal atrophy, melanocytic changes, immuno-surveillance deficit.

Activity and phenotype of red blood cell esterase D were systematically determined in a population of 128 retinoblastoma patients from 99 families and compared to 158 controls, in order to detect a chromosome 13q14 deletion. Among these patients 12 were healthy carriers and 116 affected carriers of a mutant allele of the retinoblastoma susceptibility gene (110 retinoblastoma, 5 retinoma, 1 phtisis bulbi). 4 patients were found to have decreased ESD levels in connection with 13q14 deletion which was confirmed by chromosome analysis. The data presented here suggest that ESD quantification has a high specificity and sensitivity for the detection of homogenous chromosome 13 deletions in retinoblastoma patients.

In primary hyperparathyroidism, hypercalcaemia is due to inappropriate hypersecretion of parathormone (PTH). Yet, the intestinal or osseous origin of the excess in plasma calcium and the symptoms of the disease are largely conditioned by vitamin D reserve and metabolism. In cases with sufficient vitamin D reserve and normal metabolism, the primary disorder is hyperabsorption of calcium by the intestine, and there is a risk of renal stone formation. In patients with vitamin D deficiency, there is a significant increase of bone resorption accompanied by osteoarticular symptoms. In addition, other factors, as yet unidentified, seem to intervene in the reabsorption of calcium by the renal tubule, which commands the degree of hypercalcaemia. Hypersecretion of parathormone may be due either to a reduced sensitivity of parathyroid cells to calcium (as in adenomas) or to an increase of the PTH-secreting thyroid mass (as in hyperplasia and some adenomas).

Nucleolar Organisers (NORs) are intranucleolar segments of DNA coding for ribosomal RNA. The agyrophilic proteins (AgNOR) associated with NORs allow them to be cytolabelled on paraffin sections. The number of NORs (NOR index) is correlated with cellular proliferation and has a diagnostic and prognostic value in neoplastic disease. The AgNOR method was analysed in a series of 37 superficial bladder tumours with different clinical courses. The NORs were counted in normal urothelium, on superficial tumours used to establish the diagnosis of the disease and on recurrent superficial tumours. The NOR index was 4.54 for normal urothelium, 5.89 for non-invasive superficial tumours, 7.33 for invasive superficial tumours, and 9.75 for invasive recurrences. These results demonstrate an increase in nucleolar argyrophilia with invasion and invasive potential of superficial bladder tumours which were initially homogeneous for stage and grade. The AfNOR method could constitute a new method of early histoprognostic evaluation for urothelial tumours.

During the natural history of a tumor, cancer cells become more and more aggressive and their increasing malignancy leads usually to the patient's death. The expression of malignant properties by tumor cells is manifested by the occurrence of metastases and is the result of an overexpression of molecules that are normally or barely non expressed by the normal cell progenitors. These molecules can be involved in cell attachment (receptor to the extracellular matrix), in proteolysis (collagenases), in angiogenesis (b FGF), in adhesion to endothelial cells, in resistance to the immune system. The genetic instability of tumor cells favors the amplification, mutation and gene translocation events, resulting in the activation of some genes or/and oncogenes which might direct the expression of the malignant properties. Finally, metastatic cells have been shown to have a growth advantage over non metastatic cells, so that metastatic cell population becomes ultimately numerously dominant in the primary tumor. The current knowledge about the malignant cell properties allow us to begin to understand how a cancer cell becomes metastatic and how the metastatic dissemination is usually an ineluctable process.

The prognosis of chronic myelocytic leukemia is a current topic owing to the new treatments that have been proposed for this malignant blood disease which, a few years ago, was lethal within 3 to 4 years due to the inescapable occurrence of the terminal acute transformation. Beside bone marrow allograft, which is known to have cured a non-negligible number of patients, the most recent use of interferons offers a reasonable therapeutic alternative to those patients who cannot be allografted. The identification of prognostic variables at the time of diagnosis has become necessary for a better determination of therapeutic indications. The analysis of large published series has made it possible to construct mathematical models which have proved efficient and have been confirmed by prospective studies. The value of new techniques, such as molecular biology, to refine the mathematical models remains to be demonstrated.