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[Tomodensitometry in stereotaxic conditions (possibilities and limitations in the diagnosis and treatment of brain lesions)].

The stereotaxic approach of cerebral lesions for diagnostic (biopsies) and/or therapeutic purposes (interstitial radiotherapy) has been well documented. These techniques depend on an exact spatial definition of the tumoral volume, which is often difficult to obtain through conventional neuroradiology, stereoencephalography, rheography... The use of tomodensitometry in this context is obviously of upmost interest if, and only if, the scan itself is obtained in stereotaxic conditions. The authors present a stereotaxic system with which all the diagnostic data, including CT scan itself, are recorded and matched within the same stereotaxic space. This method achieves an exact mapping of lesions within the actual stereotaxic brain space. Hence any further stereotaxic gesture can be calculated and controlled with a suitable accuracy. The interest of these procedures in the management of brain lesions is demonstrated through an experience of 52 supra tentorial tumors. 13 cases of lesions under 20 mm in diameter are especially discussed.

Brain Abscess↗

[Peripheral vascular complications of beta-blocking agents].

Beta-blocking agents may induce vascular syndromes related to environmental temperature, accentuation of arterial diseases, gangrene of the extremities. Incidence and severity are variable with beta-blocking agent's properties: cardioselectivity, intrinsic sympathomimetic activity, cardiac depression, and with the patient's disease. The risk of complication is greater with hypertension disease because of the reduction of arterial compliance and quantitative and qualitative alterations of adrenergic receptors.

Adrenergic beta-Antagonists↗

[Laparoscopy in the detection of hepatic metastasis of early bronchial cancer (100 laparoscopies)].

Staging 125 cases of primary lung cancer, peritoneoscopy for detection of liver metastasis was done each time it was possible. 100 peritoneoscopies were done, 92 were available. Tolerance was excellent. First investigation showed 16,3% liver metastasis. Higher frequency (35,3%) is found in oat cells carcinomas and lower in epidermoids (13,1%) and adenocarcinomas and/or undifferentiated (7,1%). Above all, in 7,6% of cases, peritoneoscopy alone was able to give diagnosis of liver metastasis not detected by other means. Peritoneoscopy shows no false positive, is safe and more effective than scans of biologic tests, can be repeated, and must become part of staging of lung cancers.

Carcinoma, Bronchogenic↗

[Contribution of iodinated cisternography to craniocerebral computed tomography].

Computerized tomography is usually adequate to explore supratentorial lesions of the skull and brain. However, it is often inadequate for a detailed analysis of lesions of the base of the skull and their anatomical rapports. Opacification of the subarachnoid spaces by means of a contrast medium (computerized cisternography) has proved extremely useful in such cases. The contrast media utilized are tri-iodized, water-soluble compounds which are well tolerated. The technique and anatomical data of the method are described, and its applications in different fields of tumoral and non-tumoral pathology are discussed.

Arachnoid↗

[Blood and bone marrow abnormalities in primary lung cancers (author's transl)].

Blood and bone marrow abnormalities accompanying cancers have been known for a while, without yet being understood. The study of 89 patients having lung cancers leads to the following observations: thrombocytosis is frequent and should be considered as a diagnostic criterion; anemia is often associated and we have noticed a correlation between the two. The bone marrow abnormalities shown on biopsy are also frequent, presenting mainly (54/104) as irritative type. This histological pattern becomes a criterion of prognosis, since one should interpret it as a bone marrow reaction to the implantation of cancerous cells. Lastly, no relationship has been found between the blood count and the bone marrow pattern.

Anemia↗

[Crystallographic and molecular structure of trihexosyl-ceramide deposits characteristic of Fabry's disease (particularly the rheumatic form). Digital imaging processing].

The ceramide trihexoside inclusions, which characterize Fabry-Anderson disease, have been studied using electron microscopy and digital image processing. Results are given showing the various apparent periodicities of the inclusion lamellae and the orientation, perpendicular to the lamellae or oblique, of the ceramide molecular component.

Adipose Tissue↗

[Meningeal carcinomatosis in adults (author's transl)].

Twenty cases of carcinomatous meningitis in adults, treated in the Gustave Roussy Institute between 1970 and 1980, are reviewed. In fourteen cases meningitis was secondary to breast cancer. Initial inflammation was present in 90% of the mammary tumors. Clinical features as well as biochemical and cytological findings in cerebrospinal fluid are described. The various therapeutic regimens using radiotherapy and intrathecal chemotherapy are analyzed in terms of survival and compared with other published studies. The most significant point is the necessity for early diagnosis which improves survival. However, prognosis for this metastatic disease is always very poor.

Adenocarcinoma↗

[Antinuclear antibodies: analysis of images and classification of immunofluorescence aspects on nuclei isolated from rat hepatocytes].

Image analysis and Fourier transformation of the various nuclear immunofluorescence patterns observed while detecting antinuclear antibodies allow an objective and quantitative definition of the fluorescence. They also point out various IF types hidden by the main pattern, without having to dilute the test serum. They make obvious the difference between speckled and reticular patterns, and reveal the existence of intermediate states. The usual nuclear IF patterns (homogeneous, ring, nucleolar, reticulated, speckled and diffuse) may be grouped, according to their photo emission, into nuclear and subnuclear patterns. The first group includes homogeneous, annular and passive nucleolar IF. The second group is composed of speckled, reticulated, mixed, and active nucleolar IF. Alternatively, these aspects may be grouped into three types: homogeneous nuclear IF (homogeneous and ring), heterogeneous nuclear IF (speckled, reticulated and mixed) and nucleolar IF (active or passive). Diffusion can affect or not these aspects and does not apply to a special type or pattern. Image analysis and the study of the image spatial spectrum lead to automated recognition of the IF types, and later on, to the discrimination of antinuclear antibodies.

Animals↗

[Value and limitations of the use of CO2 laser in neurosurgery. Reflexions from a French experience].

The authors have been using routinely since February 1983 a french 80W. CO2 Laser unit. They discuss the advantages and limits of this technic in the light of the first 26 intracranial and intraspinal operations carried on with it. The main and wellknown qualities of CO2 Laser are: the easiness of the hemostasis of the tumor and of the surgical cavity; and the absence of traction on the same tissue. The coupling of CO2 Laser with the operating microscope appeared very useful and made safer deep tumor excision, particularly that of the posterior fossa such as neurinomas and meningiomas. It was also quite efficient for intra-orbital tumors. The maniability of the hand piece was increased by the use of oblique mirror (45 degrees and 60 degrees) fixed at its extremity. The incision of skin, subcutaneous and muscular layers was not simplified by CO2 Laser; indeed this apparatus increased the operatory duration and was responsible of a healing time extension.

Adolescent↗

[Frontal osteoma with orbital extension. Apropos of a case].

Fronto ethmoidal osteoma are rare slow growth benign tumors. Exceptional ophthalmological and neurological complications can occur. The authors report a case of 32 years old man with eye compression by a giant frontal sinus osteoma. This lesion was responsible for a vertical diplopia and moderate proptosis. Plain skull X-Ray show a well defined opacity filling the whole left frontal sinus and C.T. scan delimited precisely orbital extension. Neurosurgical exposure enabled a complete extraction of the tumor and satisfying recovery. The authors have compared this case to those described in literature and insist on the importance of the pre-operative C.T. scan.

Adult↗

[The intercapital metatarsal space. Anatomical and pathological aspects].

The metatarsal intercapital space is located in the forefoot, between two metatarsal heads and above the transverse inter-metatarsal ligament. The 2nd space is the narrowest, the 1st is the widest and the 3rd is the most mobile. It contains a connective tissue bursa which facilitates the sliding of the metatarsal heads. The existence of this bursa was confirmed in two cases of rheumatoid arthritis (at operation). As the bursa hypertrophies, it gradually extends beyond its normal site towards the dorsal or plantar region of the foot. The metatarsal intercapital space, like the metatarso-phalangeal joint, warrants thorough clinical investigation.

Arthritis, Rheumatoid↗