[Pseudotumoral thoracic actinomycosis with lung and brain metastases. Apropos of a case. Review of hundred thirty one cases in the literature]. / Actinomycose thoracique pseudo-tumorale avec métastases pulmonaires et cérébrales. A propos d'un cas. Revue de cent trente et un cas de la littérature.

One particular case of thoracic actinomycosis is reported. The patient presented with a neurological picture mimicking a metastasis, as chest radiogram and CT-Scan indicated a primary pulmonary tumor. Diagnosis of actinomycosis was overlooked and final diagnosis was based on direct microscopy of lung tumor, which required a thoracotomy, without any resection. Antibiotic treatment with penicillin was successful as the cerebral lesion was completely cured within 2 months and the thoracic lesion reduced 2/3rd volume within the same delay. The importance of correct handling of tissue specimens and adequate informations to the microbiologist are emphasized. Another point of interest is that good clinical results can be expected from prolonged antibiotic treatment. Surgery must be reserved for diagnosis if no other means has been effective, for failure of medical treatment or for acute complications.

[Our experience of lumbar chemical sympathectomy in arterial occlusive diseases of the lower limbs]. / Expérience de la sympatholyse chimique lombaire dans les artériopathies des membres inférieurs.

One hundred and sixty two phenol chemical sympathectomy were achieved from 1982 to 1987. After one month and one year, 92 patients get a lasting improvement. The benefit is better for rest pain relief than for intermittent claudication and skin lesions of legs. Diabetic ischaemic disease increased risk of failure of sympathetic block. Results of chemical sympathectomy are similar to the surgical procedure and the incidence of complications is lower. It is concluded that the neurolytic block will be a satisfying experience in patients with obliterative arterial disease not suitable for vascular surgery.

[Thoracic sympathectomy by phenol injection under x-ray computed tomography. Two initial results]. / Sympatholyse thoracique par phénolisation sous contrôle tomodensitométrique. Deux observations préliminaires.

Difficulties in surgical or neurolytic techniques of the sympathetic thoracic chain and the results have been controversial in the upper limbs arteriopathies. A percutaneous technique of neurolytic block under computed tomography in two patients, give evidence of efficacy on pain and skin ulcers.

[Anatomy of the choanae in the newborn]. / Anatomie des choanes du nouveau-né.

The choanal atresia is a congenital malformation and his surgical procedure need to clarified. Ten anatomical specimens have been studied by anatomical measures and CT scan evaluation of the choanal for amend. Our study allow us to predict before surgery the maximum dimension of the choanal opening. A large opening seem to prevent choanal atresia recurrences.

[Anthropometric and biological evaluation of 44 patients with protein-calorie malnutrition]. / Evaluation anthropométrique et biologique de 44 patients présentant une malnutrition protéino-énergétique.

In industrial countries protein-calorie malnutrition (PCM) is a frequent cause of hospital morbidity and mortality. In this study, 88 hospital patients were evaluated: 44 (25 men and 19 women) aged from 20 to 80 years) with PCM, and 44 without malnutrition; the two groups were matched with regard to sex, age and height. The following parameters were determined: arm muscle surface, whole-body muscle mass, proportion of body fat, serum albumin (Alb), prealbumin (PA), retinol-binding protein (RBP), transferrin, thyroxine-binding protein, thyroxine, triiodothyronine, reverse triiodothyronine and total complement. Anthropometric measurements were validated by planimetry of a computerized tomographic section of the arm in 60 patients. There were significant differences between the two sexes in anthropometric values. Alb, PA and RBP values were different in men and RBP only in women; all other biochemical parameters were the same in both sexes. Thus, the group with PCM could be distinguished from the control group by anthropometric values and RBP values. Anthropometric parameters have been reported as being more specific of PCM than biochemical parameters, but since the latter are considered more sensitive, both complement each other and must be taken into account.

[Cancer of the larynx and computed x-ray tomography: exploration of the hypothyroepiglottic area and paraglottic space]. / Cancer du larynx et examen tomo-densitométrique: exploration de la loge hyo-thyro-épiglottique et de l'espace para-glottique.

Twenty patients with laryngeal cancer were explored by tomography and a CT scan. Results were compared between cases and, for operated patients, with histosurgical findings. Results of this study and a review of the literature suggest that the CT scan is the most adapted examination for exploration of the paraglottic and hypothyroepiglottic spaces, but that caution should be exercised when assessing results.

[Bromide encephalopathies (author's transl)]. / Les encéphalopathies aux bromures (à propos de 2 cas).

Bromide encephalopathies are frequently reported in Northern America and Great Britain. There is no characteristic clinical pattern, the neurological symptoms are multiple, this is readily explained by the diffusion of bromide ions to all regions in the central nervous system. An accurate history (bromide intake, followed by the slow onset of digestive and neuropsychiatric symptoms) as well as an apparent hyperchloremia are of the greatest aid in suggesting the diagnosis. The incidence of this type of intoxication is greater in women over 50. The association of a salt free diet to bromide therapy favors the onset of clinical symptoms because of the competition between bromide and chloride at the choroid plexus and at the renal tubule.

[Neurogliale cerebral tumors: test of chemotherapy treatment. Forty five cases (author's transl)]. / Tumeurs cérébrales d'origine neurogliale: surveillance du traitement chimiothérapique. 45 malades.

It is impossible to tell the exact prognosis of the patients affected with neuroglial cerebral tumors which are being treated with cytostatic chemotherapy. This impossibility has made it necessary to repeat the different examinations given before and during the treatment of 45 patients. We contemplate a series of clinical, immunological, biological, hematological tests; then electro-encephalogram, brain scan and a echography reveal the variations in volume of the tumor. If some of the examinations are not conclusive, the others, specifically the electro-encephalogram, the mental state evaluation are accurate in determining the final evolution. Immunological shows modification of cellular immunity with a decrease of T cells (57% +/- 5,9) which are hyporeactive (PHA 1/10: 42% +/- 7,5). EEG pertubations and clinical evolution are in agreement in 80% of cases. The median survival of patients as far as EEG signs are concerned in the third month is 375 days if there is an electival improvement and 188 days in the opposite difference which is significant. Scan ications are not conclusive because of peri tumoral edema evolution and hift of medical structures can be shown by echography.

[Renin plasmatic activity and plasma aldosterone in three cases of pheochromocytoma (author's transl)]. / Phéochromocytomes, activité rénine et aldostérone.

Renin Plasmatic Activity (R.P.A.) was increased in three cases of Pheochromocytoma Plasmatic aldosterone (A), measured in one patient, was high in the supine position and increased considerably in orthostatism. This was not observed with the R.P.A.7. Urine Tetra Hydroaldosterone (T.H.A.) was increased in two of the three patients and this increase corresponded to the Pheochromocytoma in which the V.M.A. concentrations were the highest. P.R.A., T.H.A. and V.M.A. regained normal values after surgery. We suggest that there is a certain parrallelism between the increase in the excretion of A. and the importance of the catécholamine release from the Pheocchromocytoma.