[Memories of an X-ray bulb. 4: Events, Antoine-Béclère Centre. La Salpêtrière].
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Biomedical subjects
Publications and source records attributed to G Ledoux-Lebard.
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A rarely observed digestive tract disorder, an intraluminal duodenal diverticulum is usually discovered during the course of a barium gastroduodenal follow-through examination. Radiological appearances are characteristic: intraluminal globular opaque image surrounded by a clear border. Clinical signs are absent or non-specific, and surgery is rarely indicated, except when the lesions are poorly tolerated or complications develop.
A case of osteopathia striata is reported, and this rare bone dysplasia reviewed. Normally asymptomatic, diagnosis of the disorder depends upon the finding of characteristic bone striation on radiological examination. A rarely isolated lesion, osteopathia striata is generally associated with other affections, which require systematic investigation in cases demonstrating typical radiological anomalies.
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Double contrast barium enema and colonoscopy are great value in the diagnosis of lesions of the colon, especially polyps. This study involved 73 patients. The results were in agreement in 71,2% of cases and disagreed in 23,3%. In 5,5%, colonoscopy was technically inadequate. Classical barium enema remains indicated for the detection of carcinoma or in elderly or bedridden individuals. By contrast, barium enema should be replaced by double contrast study in the aetiological evaluation of rectal bleeding. In our own series, the diagnosis was positive in 92% of cases as long as both the radiological and endoscopic techniques were used.
Two cases of tuberculosis of the oesophagus serve as an opportunity to review the clinical and radiological features of this rare condition. Generally situated at the junction of the upper and middle third of the oesophagus, the lesion is found opposite the invaded inter-tracheobronchial mediastinal nodes which may give rise to a fistula. Confirmed by oesophagoscopy, direct bacteriological examination, oesophageal tuberculosis is usually cured without sequelae by antituberculous therapy.
From the study of the architectural features of the system connecting the neck to the femoral diaphysis on pelvic radio-grams, osteoporosis can be classified into seven stages (7 to 1) of increasing severity. It is thus possible to estimate the risk of fracture, the latter being over 50 per cent from stage 4 onward. The cortex-diaphysis relationship (RCD) follows a parallel course but is less reliable. The investigation of a control group of 20 subjects and 37 patients with osteoporosis, aged 50 to over 80, shows the value of this method, with which it is moreover possible to check the evolution of the disease and the effects of treatment.
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The administration of a vasodilator substance is followed by the development of a higher contrast gradient in a given film in comparison with a reference X-ray carried out in the same subject under comparable technical conditions. Comparative densitometric measurement of the contrast gradient in the two successive arteriographic series, one with and one without the injection, arterial or venous, of a vasodilator substance (Couramine-Rutine) represents a valuable method for the study in man of the action of the substance in a visceral territory. The present study was limited to the kedney (79 cases), ans the territory of the superior mesenteric (46 cases). The absence of any densitometric difference between the two renal series at too low doses of vasodilator substance leads to the supposition of the possibility of a threshold dose of pharmacological activity.
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The study is based upon 155 cases of Cushing's syndrome and shows the diagnostic value ognosis of the suprarenal lesion responsible was possible. Bilateral suprarenal hyperplasia was always recognised with accuracy. Pneumoretroperituneum is the technique of choice for the surveillance of the therapeutic effects of synthetic anti-cortisols (especially O.P.'D.D.D.).