[Role of radiotherapy in the treatment of plantar fasciitis]. / Place de la radiothérapie dans le traitement de la fasciite plantaire.

Plantar fasciitis is the most common cause of talalgia in adult. It can affect a variety of individuals and its etiology is still unknown. Several factors are probably involved (repeated micro-traumatisms excessive tension, chronic inflammation…). In plantar fasciitis bone exostosis can be observed. The latter may also result into a functional incapacity due to major pain and therefore has a major impact on the quality of life. Several treatments with different efficacy are proposed to the patient. The role of radiotherapy is very limited, even if it's more frequently applied in Germany. The main goals of this article are to evaluate the place of the radiotherapy in the therapeutic approach, to confirm its efficacy and to assess the associated risks.

La fasciite plantaire est la cause la plus fréquente de talalgie chez l'adulte. Elle affecte une population hétérogène et son étiologie reste inconnue, même s'il existe probablement une origine multi-factorielle (contraintes répétées, tension excessive, inflammation chronique…). La talalgie peut être associée à une exostose osseuse ou éperon calcanéen inférieur. Elle peut être source d'incapacité fonctionnelle en raison de douleurs importantes associées qui peuvent entraîner une altération majeure de la qualité de vie. De multiples traitements peuvent être proposés aux patients. La radiothérapie a une place très restreinte dans l'arsenal thérapeutique, même si elle est plus fréquemment utilisée chez nos voisins germaniques. Notre article a pour but de discuter de la place de la radiothérapie dans le schéma thérapeutique, d'en confirmer l'efficacité et d'en évaluer les risques associés.

Automated cytopathologic diagnosis of bronchial carcinoma. II. Preliminary results of classifying cytocentrifuged bronchial brushings.

An automated discrimination between healthy and neoplastic bronchial cells was performed on eight bronchial smears prepared by cytocentrifugation. An image analyzer was used to examine 415 cells in these smears. The nuclear surface of each cell was measured, as was the total integrated optical density for 25 programmed thresholds. The results show that it is possible to distinguish healthy from cancerous cells in a given subject using these two measured parameters and two new parameters deduced mathematically. It appears difficult, however, to demonstrate a typical healthy and typical cancerous bronchial cell that could be used as a reference for all subjects. It is thus the presence of cell heterogeneity in a given subject that enables him or her to be characterized as healthy or having cancer.

Automatic cytopathologic diagnosis of bronchial carcinoma. I. Cytocentrifugation of bronchial brushings for image analysis.

A cytocentrifugation technique for the preparation of monodispersed preparations of bronchial cells collected by brushing is described. First developed with the aim of obtaining slides suitable for automated analysis, it was found to be useful for routine morphologic examinations. This technique requires careful preparation as well as "education" of the pathologist/screener in the appearance of the cellular elements in its samples. However, it is reliable and reproducible and, above all, eliminates a certain number of artifacts found in conventional preparations.

[New trends in the cytodiagnosis of bronchial carcinoma (author's transl)]. / Nouvelles orientations du cytodiagnostic des cancers bronchiques.

Cytological examination of the sputum is nowadays mainly used for mass surveys among high-risk populations and in suspicious cases with normal X-ray films. In all other cases, bronchial brushing and percutaneous puncture-biopsy of the lung are preferred, being much more reliable. Several new bronchial cytology techniques have recently been developed but are not yet widely used. Their respective indications are governed by the facilities available and by the volume, site and characteristic features of the tumour.

[Application of cytocentrifugation to routine cytological diagnosis of solid pathologic tissues (author's transl)]. / La cytocentrifugation appliquée à létude cellulaire des tissus cohérents.

Cytocentrifugation (Watson, 1966) was first proposed as a better cell concentrating technique; more recently, it appeared that the samples, thanks to the "monodispersion" of the cells, are quite suitable for A.L.A. *Automated Image Analysis); this property may be applied to routine microscopic cytodiagnosis of several lesions. This paper is an attempt to discuss the different technical problems to obtain suitable cells from solid pathologic tissues: first, a sufficient quantity of cells must be obtained and a correct medium must be adopted; a special care must be taken for the collecting of the samples; the mediums must be chosen as the most convenient to fix cells, to solve mucous, to permit monolayer spreading to stick unto the slides; a method of cytocentrifugation is described. The characters of the smears are reported about cell concentration, evaluation of cell loss, control of monolayer dispersion, signification of clumps and agregates. The techniques of fixation and staining of such samples are precise for the two chosen mediums: after using PBS-albumin, the slides have to be air-dried and stained according to Papanicolaou or May-Grunwald Giemsa technique; after BABS solution, the slides may be fixed with spray and have to be stained according to Papanicolaou. Technical results applied to 97 cases of bronchial, breast and liver samples are discussed. The advantages of the method are: rapid examination, easy storage of slides, satisfactory preservation of cells, even for the most delicate ones (ciliated bronchial cells, for instance), absence of mucous background, minimal cells loss, possibility of enzymologic studies. Moreover the method happens to be inexpensive.

[Morphological aspects of non-tumoral bronchial cells recovered by brushing (author's transl)]. / Aspects morphologiques des cellules bronchiques non tumorales recueillies par brossage.

A series of 132 bronchial brushings studied according to a strict protocol, both in obtaining the specimens and their subsequent laboratory preparation, has allowed us to study the cells of the bronchial mucosa in greater detail. Until now the greater part of the work in this field has been on the characteristics of tumour cells and the variability in detecting cancer, slightly neglecting the analysis of normal, inflammatory or dystrophic cells. The brushings were compared to the cytology requests on sputum and/or corresponding aspirations by conventional methods. This work has shown that the different types of normal epithelial cells so recovered, as well as dystrophic cells, have a very different appearance than those same cells when observed using classical cytological methods (on sputa and aspirations). The cyto-pathologist ought to adjust the technique before interpreting the specimens. The differences are due to a better state of conservation of the recovered cells, thanks to improvement in current endoscopic technique. We infer that certain cytological appearances considered pathological until now, using classical expectoration or aspiration, may in reality only be artefacts.