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[Stereotaxic biopsies (SB) of intracranial neoplasms. Considerations apropos of 3,052 cases].

On May 12th 1984 a meeting on stereotactic biopsies of intraencephalic lesions has been held in Marseilles. All French Neurosurgeons and Neuropathologists involved with this technique were present. This report presents, in one hand, the result of an investigation on 3 052 BS and, in the other hand, the synthesis of discussions held on the limits and dangers of the BS, morphology of the biopsy instrument, means of the definition of the target and the microscopic histologic technics and results.

Biopsy, Needle↗

[Pierre Masson. A precursor and re-discoverer (1880-1959)].

Pierre Masson, born in Dijon in November 1880, intended to be a clinician doctor. After being seriously troubled with bad health and following the advice of his master Eugène Bataillon, a researcher who found out the parthenogenesis of batrachian ova, he turned towards a scientific carrier as a biologist. Appointed Chairman in Strasbourg where he held the chair of pathology as early as the first world war, he left France in 1927 to assume the same functions in Montreal. There, he died in May 1959, after creating one of the most brilliant schools of pathology of the XXth century. Most of Pierre Masson's works are precursory as regards the scientific conceptions of his period. He gave them two predominant orientations: on the one hand, works of pure technical histology, resulting in original processes of fixation, coloration and argentation which are still used today; on the other hand, numerous works of oncologic pathology, which allowed him to individualize new tumors, such as the "spermatocytoma" or the "glomus tumor". An observed endowed with a vast culture in biology, Pierre Masson considers the pathologic fact as a real "natural experience" which reveals unsuspected properties of the tissues or allows to discover normal structures which could not be found out easily without it. In this regard he gave pathology a renewed vitality.

France↗

[Angiodysplasias or vascular ectasias of the intestine. Report on 8 personal cases].

Angiodysplasia or vascular ectasia of the intestine is a new pathological entity which was initially revealed by arteriography. More recently it has been found by coloscopy and is considered to be responsible for many cases of intestinal bleeding, especially in older patients The present study is based on eight patients including 2 cases of microscopic bleeding, 4 of massive hemorrhage, and 2 asymptomatic cases. There is a clear difference between intestinal angiodysplasia and other forms of vascular malformations, even though its pathogenesis is still in question. Whereas in older patients it is acquired, typically in the caecum. It can also exist congenitally in younger patients and in other locations. However, identical lesions may be observed at all levels of the digestive tract in association with certain diseases, most often vascular atheroma, but also diverse intestinal diseases (diverticulitis, colitis, polyps, cancer) and even iatrogenic diseases. Even though these malformations are frequent, the lesions often go unrecognized because special histological technics are required to reveal the arteriovenous fistulas. The major circumstance leading to this diagnosis is anemia due either to occult intestinal bleeding or massive hemorrhage (after exclusion of prevalent associated disease such as diverticulosis). Occasionally latent angiodysplasia is revealed during studies undertaken for associated disease. Positive diagnosis is based on selective angiography during massive bleeding and on endoscopic examination in case of anemia from occult bleeding. Surgical treatment should be undertaken in case of major blood loss. This usually consists of resection of the ascending colon, the most frequent site of the lesion. It is recommended that an even longer colonic segment be resected in case of associated diverticulosis. The preferred treatment of limited forms with few symptoms depends on more recent technics such as endoscopic electrocoagulation. In conclusion, many cases if occult intestinal bleeding can be explained by angiodysplasia which thus deserves better understanding and recognition.

Aged↗

[Liver biopsy : its indications in pathology (author's transl)].

One might expect several data from the study of liver biopsies : a diagnosis, an evaluation of the prognosis and the follow-up of therapy in patients with liver disease. The authors precise the most important lesions encountered in liver biopsy : diseases in which hepatic and or biliary manifestations are predominant (alcoholic liver disease, viral hepatitis, drugs and chemicals induced lesions, cirrhosis, biliary disease), liver alterations due to metabolic, cardio-vascular, haematological or systemic disorders. The prognosis and the evolution of the disease may be evaluation by the pathologist. The liver biopsy interpretation provides the basis on which the management of the patient with liver disease is founded. An important part of the study is related to the conditions necessary to obtain a final diagnosis. Clinical and biological data (and good samples) must be provided by the physician who must have a critical understanding of the pathological report. On the other hand, the pathologist with a good knowledge of histological technics has to analyse the lesions taking into account these informations. The best conditions are obtained in the closest possible collaboration between the pathologists and the clinicians providing the samples. The limits of the liver biopsy interpretation are also emphasized. The paper is followed by a glossary and 12 references.

Biopsy↗

[The mode of action of bleomycin-cell kinetic investigations (author's transl)].

Chemotherapy of malignant ENT tumours with Bleomycin (BLM) alone is not very successful. In the last time however several authors pointed out much better therapeutic results when BLM therapy has been combined with radiation treatment It is farly unknown why this combination should cause a greater therapeutic effect. Therefore we investigated the following questions: 1. In what manner does BLM influence the kinetics of cell proliferation of malignant tissues? 2. Does BLM synchronize the tumour cells or is the greater therapeutic success of a combination of BLM and X rays only depending an an additional effect? 3. Can we find a connection between the effect of BLM and the histology of the tumour? With cell kinetic methods (authoradiography, cytophotometry, mitotic index) and histological technics we examined these problems in 5 human ENT tumours and got the following results: 1. BLM initially causes a partial synchronization of the tumour cells (blockade in the S-phase). During a continuous therapy with BLM however the tumour cells will be collected in the late S- and mainly in the G2-phase. But this peak of cells in G2 is not the expression of synchronization because a lot of these cells are blocked irreversible and will leave the cell cycle (hyperceratotic cells). Ffrom those cells which thereupon have entered the mitotic phase a further part of them will by endomitosis or endoreduplication. Only a small group of the cells originally collected in the G2-phase will devide and enter the G1-phase again. Furthermore we observed a distinct recruitment of G0-cells back into the cell cycle (for details see fig. 9). 2. The greater effect of radiation therapy following the application of BLM is not the result of synchronization but of an additional destruction of premitotic G2-cells which properly would have undergone mitosis. BLM and X rays therefore act additionally. 3. The greater therapeutic success of the combination of BLM and radiation treatment comes true only in keratinizing squamous cell carcinoma. The reason is that BLM destroys the tumour cells by hyperkeratosis and polyploidy. Thus BLM must be ineffective in carcinoma without the ability of keratinizing.

Bleomycin↗

[Meningiomas: present and future].

The article describes the most recent advances in the field of the embryology, physiopathology, therapy, and prognosis of meningiomas. It is assumed that the future of our knowledge of these neoplasms will be based upon the present basic and clinical research. The well known arachnoid cell origin of meningiomas is emphasized, the ultrastructure of the arachnoid villi is mentioned and the double embryological origin of the meningeal membranes--neuroectodermal and mesodermal--is stressed. Based upon personal ultrastructural and immunohistochemical studies, the probable pericytic and arachnoid origin of the so-called hemangiopericytic and sarcomatous meningiomas respectively, is reported. The several possible physiopathological mechanisms of the peritumoral oedema are summarized. Concerning the biological behaviour of meningiomas, the relevance of complete surgical resection is stressed, although new imaging or histological technics are also important in the prediction of recurrences. Lastly, regarding the management of these kind of tumors, other therapeutic procedures beyond surgery are also considered.

Humans↗

[Experimental kidney transplantation in rats. Technical, functional, and histologic aspects].

In recent years, different experimental transplantation techniques have been developed in animals to gain further insight into the immunologic and non-immunologic processes occurring in grafts. Microsurgery permits the application of these procedures to small animals, as the rat. We present our experience in experimental transplantation in rats, with special reference to isogenic transplantation (inbred animals), leaving solely the graft in the receptor. The technical characteristics, the analytic and histologic findings after transplantation are described.

Animals↗

Freezing of neural tissues and their transplantation in the brain of rats: technical details and histological observations.

Embryonic neocortical and brainstem tissues were frozen, stored for variable periods, thawed and transplanted into the cerebellum of neonatal host rats. Various conditions related to freezing, media for freezing, DMSO as the cryoprotectant, and thawing were analyzed. The findings indicated that the following conditions yielded best results for neocortical transplantation: freezing at a rate of 1 degrees C/min, using rat amniotic fluid as the medium for freezing, using 10% DMSO as the cryoprotectant, storing the frozen tissues at -90 degrees C, thawing the tissues fast just prior to transplantation, and transplanting them in the host brain with little or no delay. Other conditions having adverse effects on the neural tissues were considered. Issues pertaining to transplantability and retainability of the neural tissues inside the host brain, and effects of freezing and thawing on the long-term viability of the neural tissues and their growth are discussed.

Animals↗