[Lymphoscintigraphic aspects of the effects of manual lymphatic drainage]. / Aspects lymphoscintigraphiques des effets du drainage lymphatique manuel.

Manual lymphatic drainage is used in physiotherapy of limb lymphedema in combination with other physical techniques. In order to assess the effectiveness of the method, 47 patients with upper limb lymphedema after radiosurgical therapy for breast cancer underwent lymphoscintigraphy. The examination was performed after subcutaneous injection of technetium-labeled colloid via the fourth and first interdigital space on the hand of the limb with lymphedema. The level of the technetium label was compared on scintigraphies performed before and after manual lymph drainage. Results were analyzed as a function of the clinical characteristics of the edema. Manual lymphatic drainage produced an effective progression of the label in 25 cases (53.2%), independent of radiotherapy. Contralateral lymph nodes were reached in 5 cases and the homolateral internal mammary nodes in 2. These nodes were visualized only after manual lymphatic drainage. The visualization of the drainage routes in unexpected areas demonstrated the effectiveness of the technique in stimulating accessory routes useful for resorption of lymphedema. The use of two injection sites on the hand is also discussed. This study demonstrated the effect on a single session of manual lymphatic drainage and should be completed with an assessment of a complete series of manual lymphatic drainages.

[ A comparative lympho-scintigraphic evaluation of manual lymphatic drainage and pressotherapy in edema of the arm following treatment of a breast tumor]. / Evaluation comparative lymphoscintigraphique du drainage lympathique manuel et de la pressothérapie sur l'oedème du membre supérieur secondaire au traitement d'une tumeur mammaire.

Manual lymphatic drainage (MLD) and pressure-therapy are part of the therapeutical gears used in physiotherapy for reducing edema. The solution to the problem of the reduction fo lymphedema of the extremities rests with the evacuation of the liquid phase and the resorption of the stagnant proteins in the interstitial compartment not being collected by the lymphatic system. The injection of a 99 Technetium-labelled colloid substance provides a functional approach to the problem of lymphatic stasis.

[The value of breast lymphoscintigraphy in the definition of axillary staging in cancer of the breast]. / Intérêt de la lymphoscintigraphie mammaire dans la définition du staging axillaire des cancers du sein.

Axillary lymphoscintigraphy (ALS) has been investigated in 51 patients with operable breast carcinoma between July 1982 and February 1984. Pre-operative intra-tumoral injection of 2.5 cm Ci of technetium 99 m antimony sulfide colloid has been performed before axillary dissection. We compared the scans produced by ALS with the results of pre-operative clinical examination of the axilla (UICC criterias) and to the histological status of the nodes surgically removed. We focused on the statistical methodology because, for us, most of the studies use inadequate tests. Axillary lymphoscintigraphy did not predict axillary metastase in breast cancer with precision. Its score was under clinical exam. Today, we are not allowed to abandon axillary dissection for pre-operative ALS. That simple and non traumatic examination appeared to be of no value in order to determine the axillary metastatic nodal status in breast cancer.

[Myocardial tomoscintigraphy with technetium pyrophosphate in the diagnosis of recent infarction]. / Apport de la tomoscintigraphie myocardique au pyrophosphate technétié pour le diagnostic de l'infarctus récent.

Technetium pyrophosphate myocardial scintigraphy has become, together with Thallium scintigraphy, a common diagnostic aid in recent myocardial infarction. However, some cases with moderate diffuse fixation (2+ diffuse in Parkey's classification) are considered equivocal results by many workers. We tried to assess the value of emission tomoscintigraphy in classifying these border-line cases. This non-invasive investigation requires sophisticated equipment, including a rotating gamma camera coupled to a computer. The computer reconstructs tomographic images in the three planes (frontal, sagittal, transverse) at 6 mm intervals. After analysis of 34 coronary patients using classical clinical criteria, standard and tomographic scintigraphy were performed and the results interpreted by a double blind procedure. The following conclusions were drawn: Interpretation of the results of tomography was more reproducible than that of standard scintigraphy (91 p. 100 compared with 79 p. 100). The sensitivity of detection of myocardial infarction was higher (96 p. 100 compared to 80 p. 100) without any loss of specificity (preliminary study in 15 non-coronary patients); this improvement is due to the elimination of the "equivocal" cases observed on standard scintigraphy. The infarcted area was easier to determine as the interpretation was more reproducible. The estimation of the size of the infarcted area and the detection of rudimentary infarcts did not seem to be improved by emission tomography. Our criteria of positivity for the tomographic images were : at least 2+ fixation (significant but less intense than that of the sternum); fixation visible in at least 2 different tomographic planes (e.g. sagittal and frontal); fixation visible on at least 2 consecutive images in each plane.

[Peritoneal splenosis disclosed by infectious mononucleosis in an adolescent. Contribution of scintigraphy]. / Splénose péritonéale révélée par une mononucléose infectieuse chez un adolescent. Apport de la scintigraphie.

This article does not deal with the general problem of splenosis, but with the pathology of splenic nodules implanted in the peritoneum. This condition is uncommon, and chiefly hematological and infectious in the index case. Although this issue is debated, functional activity of these nodules is substantiated, leading to consider therapeutical applications in some exceptional cases.

The carcinogenic effect of a series of petroleum-derived oils on the skin of mice.

Six groups of 30 Swiss mice were treated by application to the skin in the dorsolumbar region two times a week for 12 months of a "white oil" and five samples of petroleum oils derived from the same "crude" (Middle East), which were collected in the same refinery at different stages of "solvent treatment" and which form a homogeneous series with increasing concentrations of polyaromatic hydrocarbons (PAH). The macroscopic and histopathologic examination of the animals (skin and organs) up to 18 months shows the following effects with respect to the 60-mouse control group: --a marked irritating effect for the "aromatic extract," the "distillate," and a "mixture" of intermediary concentration between "distillate" and "raffinate," --a definite tumorigenic effect on the skin (papillomas, kerato-acanthomas, squamous cell carcinomas, and fibrosarcomas) of the "aromatic extract" and the "distillate." The biological answer is in significant association with the PAH concentration of the samples, which is estimated by different analytical methods: viscosity index, percentage of aromatic carbon, "total PAH" according to a gravimetric method, and benzo[a]pyrene concentration.

Scintillation splenoportography: hemodynamic and morphological study of the portal circulation.

The intrasplenic injection of 99mTc-labeled albumin microspheres, followed 30 sec later by an injection of 99mTc-labeled red blood cells with recording of the progression of the two tracers, were performed in 110 patients. This also enabled the plotting of activity versus time curves on splenic, hepatic, cardiac, and pulmonary areas of interest, there by giving access to several hemodynamic variables. Scintillation image demonstrated splenoportal obstruction in 8 cases. Intrahepatic obstruction with reflux via collaterals were observed in 53 cases, 14 with umbilical reflux. In 13 cases, the patency of surgical portacaval anastomoses were verified. The splenoportal blood flow velocity was not significantly different in patients with cirrhosis (V = 10.1 cm per sec +/- 3.0 SD) and in normal subjects (V = 13.2 cm per sec +/- 5.8 SD). The fraction of shunted splenic flow in the case of cirrhosis varied from 0 to 100%; there was no relationship between this percentage and the seriousness of the clinical status. In 3 cases, the presence of intrahepatic shunts was detected. There was a very significant difference between mean transit time (MTT) of red blood cells in patients with cirrhosis (t = 12.2 sec +/- 4.4 SD) and those without cirrhosis (t = 19.9 sec +/- 3.7 SD). Among patients with cirrhosis, those with a history of jaundice had a shorter MTT than those without such a history. On the other hand, the MTT was not significantly different whether the patients with cirrhosis had or did not have hemorrhage, ascites or encephalopathy. There was a positive correlation (P less than 0.01) between MTT and plasma albumin concentration,and between MTT and prothrombin (P less than 0.01). Finally, there was a high negative correlation (P less than 0.001) between MTT and total serum bilirubin. Scintillation splenoportography is a useful technique for assessing hepatic hemodynamics and for demonstrating abnormalities of the intrahepatic circulation.

[Contribution of scintigraphy in acute and chronic pancreatitis. Apropos of 200 examinations]. / Apport de la scintigraphie dans les pancréatites aiguës et chroniques. A propos de 200 examens

The authors report 200 examinations and discuss the role of radio-isotope scans of the pancreas with electronic subtraction of the liver image in acute and chronic pancreatitis. As an emergency, the examination is of definite diagnostic value, the absence of fixation with a suggestive clinical context, is strong evidence of pancreatic disease and normal uptake eliminates the latter. On the other hand, in painful syndromes in which chronic pancreatitis is suggested, the diagnostic interest is very limited for the low uptake on radio-isotope scan occurs at a late stage and is not specific. Radio-isotope scans are worth a place in exploration of the pancreas in acute pancreatitis.

[Not Available]. / Application des courbes de volatilisation-excitation a la determination des conditions de l'analyse spectrochimique de l'oxyde de tantale.

The determination of the optimum conditions for the spectrographic analysis of tantalum oxide is facilitated by consideration of the volatilization curves for the elements sought. The method is applied for the estimation of Cr, Fe, Hf, Ni, Nb, Ti, Y and Zr at the 10-1000 ppm level.