[A retrospective study of 93 cases of orbital and eye tumors using tomodensitometry]. / Etude rétrospective de 93 cas de tumeurs orbitaires et oculaires à la tomodensitométrie.

The purpose of this study was to review certain computed tomography (CT) criteria in relation to the histopathologic diagnosis of orbital tumours. One hundred and forty cases of orbital tumour were evaluated by CT between 1979 and 1992 at two tertiary-care hospitals. The radiologic material was available and the histopathologic diagnosis had been clearly established for only 93 of these; these cases were reviewed in detail for the study. The radiologic semiology of the cases was compared with the pathological diagnosis. The characteristics evaluated were tumour localization, attenuation, contrast enhancement, the presence of calcifications, the morphologic features and changes in the neighbouring bony structures. The authors present here the findings for the most commonly encountered tumours: uveal melanoma (observed in 50 cases), lymphoma (in 8), optic glioma (in 6), meningioma (in 6), dermoid cyst (in 5) and metastasis (in 5). Using the current literature for corroboration, the authors suggest an approach to diagnosis on the basis of the CT criteria discussed.

The behavioral medicine service. An administrative model for biopsychosocial medical care, teaching, and research.

The biopsychosocial model has been promoted for its advantages in many important health problems. However, the lack of administrative practice models specifically designed to develop and promote the model hinder the development of systematic clinical applications. This article describes a successful clinical teaching and research practice, The Behavioral Medicine Service, that was conceptualized and developed based on the biopsychosocial model. Systematic planning enabled the service to take advantage of clinical, research, and teaching opportunities and to reduce the constraints imposed on development from within psychiatry and the institution. Advantages of the organizational model include multidisciplinary treatment teams, a systematic method of biopsychosocial assessment and management planning, and continuity of care between several settings: the medical-surgical wards of a general hospital; a behavioral medicine inpatient unit; and outpatient subspecialty clinics for chronic pain, chronic medical illness, anxiety and stress-related disorders, and drug and alcohol abuse. The Human Behavioral Pharmacology Laboratory forms the research arm of the service. Referrals of a diversity of medical and psychiatric problems create a unique learning opportunity for residents. Billing for multimodal team treatment, training residents, establishing clinical research, and managing a plethora of referrals were developmental challenges addressed by the service.

Outpatient treatment of chronic pain groups for couples.

The purpose of this study was to assess the impact of outpatient group treatment for chronic pain patients and their spouses on psychological symptomatology, marital adjustment, and locus of control. There was a significant improvement in mean scores on four of the seven measures pre- and post-treatment. This data suggests that group treatment can significantly reduce chronic pain related problems especially anxiety, depression, and interpersonal sensitivity for the patient as well as for the spouse. It also supports other findings for the effectiveness of brief group therapy programs for chronic pain patients. Although this study has several limitations the results warrant further investigation using control groups and a larger sample size.

Intranasal meningoencephalocele with recurrent meningitis.

Two patients presented with repeated bouts of meningitis. RISA cisternography established the diagnosis in both cases. An intranasal meningoencephalocele was the cause of these infections. Frontal craniotomy and section of the peduncular connection of the meningoencephalocele and sealing of the bony defect was successfully performed in both cases. Postoperative investigations showed complete cure.

Computed tomography of posterior fossa in hereditary ataxias.

Nine cases of Friedreich's ataxia and seven cases of autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) were submitted to neuroradiological procedures to determine the extent of atrophic processes in the central nervous system. All cases had a computerized cerebral tomography and five were studied with pneumoencephalography. The results show a correlation between the two tests and the comparison between Friedreich's ataxia and ARSACS. In Friedreich's ataxia, the radiological signs are variable and discrete in most of the cases. In ARSACS there are constant signs of cerebellar atrophy almost limited to the superior parts of the vermis and anterior lobes.

Preoperative diagnosis of conjoined roots anomaly with herniated lumbar disks.

Twelve cases of nerve root anomalies encountered during investigation for low back pain and sciatica are presented. Most of these patients had a herniated lumbar intervertebral disk and were operated upon with the preoperative knowledge of an associate nerve root malformation. Three patients were found to have a symptomatic nerve root malformation without disk herniation. These patients were conservatively treated. In all cases we found a constant myelographic sign that is described.

Traumatic suprasellar arachnoid cyst.

The case is reported of a suprasellar archnoidal cyst in a five-year-old boy who developed symptoms of hypothalamic involvement. It appears to have been of traumatic origen. It was operated upon, resulting in a remission of symptoms.