Otogenic thrombosis of the lateral sinus: report of a case in a child.

A case of thrombosis of the lateral sinus complicating the mastoiditis in a five year old boy is presented. This intracranial complication of suppurative otitis media which has become rare since the use of antibiotics, still raises diagnostic and therapeutic problems. The various clinical and paraclinical elements of this rare pathology, its diagnosis and treatment are reviewed.

The complementary contribution of the rhinologist and the neurologist at the clinical study and treatment of the cluster headache.

New neurophysiological techniques and pluridisciplinary approach contribute to progress in the diagnosis and medico-surgical treatment of headaches.

[Diagnostic and therapeutic management of the patient with headache]. / Prise en charge diagnostique et thérapeutique du patient céphalalgique.

The different diagnostical and therapeutical approaches of cephalalgia are described. The importance of a pluridisciplinary management is stressed.

[The cavernous sinus: development, anatomy, radio-anatomy and clinical implications]. / La loge caverneuse: développement, anatomie, radio-anatomie et implications cliniques.

Cavernous sinus is an important region rich in neurological structures. Its development and its anatomy are very complex and the purpose of our work is to correlate embryology, anatomy and semiology of this region and its content. Interest of medical imaging of cavernous sinus and referred structures is enhanced.

[Dermoid cyst of the tongue]. / Le kyste dermoïde de la langue.

An epidermoid cyst of the tongue with sinus tract is discussed. Its interest comes from the fact that histologic sections show sinus tract wall and epidermoïd cyst wall made with the same major characteristics of skin structures. Both have therefore the same embryologic origin. Adequate treatment is surgical excision.

[Colovesical fistula of diverticular origin. Diagnostic and therapeutic aspects. 17 cases]. / Fistules colo-vésicales d'origine diverticulaire. Aspects diagnostiques et thérapeutiques. Dix-sept observations.

Seventeen patients presenting with diverticular colovesical fistula were treated surgically between 1975 and 1979. Any treatment of the fistula must aim at the cause--colonic diverticulitis--by resection of the colon and colorectal anastomosis. Colostomy was performed in two cases. The bladder was closed by simple suture and a urethral catheter was left in place for ten days. There were few complications, though one patient died. Pneumaturia and fecaluria are specific symptoms. Intravenous pyelography and cystoscopy are of little assistance and only a barium enema should be performed for preoperative diagnosis.

[Automatic screening tympanometry in school medicine]. / La tympanométrie automatique de dépistage en médecine scolaire.

The authors have tested 1690 ears of kindergarten and schoolchildren aged between 2 1/2 and 13 with a completely automatic tympanometer Model 85 AR American Electromedics whose most interesting characteristic is a supple eartip which adjusts to the concha without penetrating the external earduct. That technical advantage makes it a very non-aggressive instrument, easy to use for school medical screening. The results obtained are quite the same as those mentioned in the literature: 23% of the children tested have a pathological tympanogram. Three to 6 weeks later, 50% of these tympanograms remain abnormal. The breakdown by age group analysis shows a larger frequency of middle ear pathology between the ages of 2 1/2 and 6. The use of an automatic tympanometer for the screening of suspect cases seems to not only be highly suitable but needed for kindergarten children before beginning primary school.

Noninvasive measurement of nutrient portal blood shunting: an experimental study with [14C]ursodeoxycholic acid.

All of the methods proposed for measuring portal blood flow are either invasive, estimate total rather than nutrient flow, and none has proved reliable in cirrhotic patients. A method has been derived from pharmacokinetic principles used for the calculation of bioavailability of drugs according to the route of administration (i.v. or p.o.) and tested experimentally in 20 pigs. A tracer dose of [14C]ursodeoxycholic acid, a biliary acid with a high-liver first-pass effect, is administered in the duodenum, and serial peripheral blood samples are taken. Later, the same dose of the same drug is administered i.v. The shunt fraction of portal blood F is obtained by the ratio of the areas under the plasma level vs. time curves ("AUC") after p.o. and i.v. administrations: (see formula in text). The pigs were divided into three experimental groups. (i) Group I: undisturbed portal flow; (ii) Group II: total diversion of portal blood with an end-to-side portacaval shunt, and (iii) Group III: partial diversion of portal blood through a side-to-side portacaval shunt. Portal flow was measured during surgery with an electromagnetic flowmeter above and below the shunt and the degree of shunting calculated. Results show that the shunt fraction measured with ursodeoxycholic acid is well-correlated with hemodynamic data. No overlap between Groups I and III is observed. It is concluded that the shunt fraction of nutrient portal blood can be measured with this noninvasive method. Minute amounts of ursodeoxycholic acid were used in order to be completely metabolized by the liver, even in spite of hepatocellular dysfunction. Therefore, this method should be valid in cirrhotic patients and be useful to decide the type of portasystemic shunt to propose for the decompression of gastroesophageal varices.

Cutaneous angiosarcoma arising in a mastectomy scar after therapeutic irradiation.

A cutaneous angiosarcoma developed in a mastectomy scar four years after post operative irradiation. Clinical and histological data are presented. The authors believe that radiotherapy was determinant in the genesis of this rare type of tumour.