Lymphomatous meningitis: neuroradiological appearances.
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Biomedical subjects
Publications and source records attributed to J L Robert.
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The authors report a case of grade I-II giant-cell tumour of the ribs extending to the thorax and the vertebral column. The tumour was treated by surgical resection followed by vertebral curettage in two stages and adjuvant regional radiotherapy. Giant-cell tumours of the ribs are exceptional and rarely found in the literature. They raise a therapeutic problem (surgery is essential, but radiotherapy is controverted), and a prognostic problem (there is always a potential risk of recurrent malignancy).
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It is exceptional to obtain a cure in multiple myeloma. We report a case of a 54-year old man with stage III, IgA K multiple myeloma in complete remission 12 years after the diagnosis. The patient was treated for 4 years with Melphalan-Prednisone. Eight years after the end of treatment the patient fulfilled the criteria of cure as defined by the "Chronic Leukemia Task Group" (no measurable myeloma protein and normal bone marrow) associated with the disappearance of some osteolytic lesions.
After injection of vinblastine sulfate (VLB) cells of the epithelial root sheath (ERS) showed accumulation of phagosomes lysosomes and, in particular, of exocytosis vesicles facing the basal lamina. An unusual frequency of cell contacts was also noted between pulp mesenchyme and ERS. In the periradicular zone the cells showed accentuated signs of a squamous-like evolution. In addition, numerous mitotic figures were seen arrested at prometaphase all along the tissue: the mitotic arrest index was higher at the tip of the sheath and decreased more coronally. These findings strongly suggest that ERS participates actively to the formation of the basal lamina. They show that heterogenous cell relations frequently occur during root morphogenesis; however they put into question the role of ERS in cementogenesis. The existence of a high mitotic potential in ERS can explain its consistent morphology and might reflect a process of differential mitotic sequences involved in odontoblast differentiation.
The authors present two cases of vertebral chordomas with widespread metastases. The literature is reviewed and the metastatic potential of chordomas is analysed.
In view of negative experience and the disappointing long-term results, most of the classic surgical methods for treating chronic pain are no longer indicated. Only in cancer pain is dissection of the spino-thalamic tract at the cervical or upper thoracic level frequently helpful. In selected cases the same may be said of rhizotomy. Controlled thermocoagulation of the Gasserian ganglion provides the best results in typical trigeminal pain. Other methods of surgical treatment (e.g. commissural myelotomy, thalamotomy) mentioned in this article are things of the past which are no longer used.
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The authors describe two clear-cut cases of hypopharyngeal lateral diverticulum. They have found only 22 published cases. They discuss the nosological limits of the physiological pharyngeal expansions visible under high pressure pharyngography, those of kinetic pharyngoceles which are often forced hernias, finally, the very real but uncommon presence of true lateral diverticula. The passage of barium Therapeutic indications are discussed. The surgical technique is simple.