[Contribution of mammography and echography to the diagnosis of breast cancer in Dakar: apropos of 25 cases]. / Apport de la mammographie et de l'échographie dans le diagnostic du cancer du sein à Dakar: à propos de 25 cas.

The authors studied mammographic features of 25 patients with malignant breast disease. 24 of them had ultrasonographic (US) exploration. The study appreciates epidemiological, mammographic and US aspects; It also appreciates the correlation between images and histology. The mean age is 40. Six women (26%) had family history cancer. The mean reason of the exploration is a mass in 76%. At mammography, contours of cancerous opacities are irregular in 56%, regular in 16%. In 20%, the cancer showed no opacity. At US, we find a lack that appears irregular in 48%, regular in 24%, without traduction in 4%, non precised in 24%. Mammography sensitivity was 80%, false negative rate 28% and false positive rate 8% against respectively 96%, 32% et 12% for echography. This study shows that US is more sensitive but less specific than mammography. However, we recommend the use of mammography and echography together because in Senegal, cancer happens at an earlier age at with breast is easier to analyze at US.

[Pterygo-cavernous thrombophlebitis and temporo-mandibular ankylosis in dental infections]. / Thrombophlébite ptérygo-caverneuse et ankylose temporo-mandibulaire au décours d'une infection dentaire.

The authors report the complications of a case of cellulitis from dental origin. A cavernous sinus thrombophlebitis and a temporo-mandibular ankylosis succeed, pointing on the importance of a precocious treatment of dental phlegmons, in order to prevent occurrence of local or regional complications.

[Echoguided renal needle biopsy. Technique and results. Report of 413 examinations]. / La ponction-biopsie rénale échoguidée. Technique et résultats. A propos de 413 examens.

Blindly executed for a long period with only X- Ray detection, renal biopsy benefits nowadays of precision and security of real-time echoguiding. The authors describe their technique without bondage between needle and transducer and comment their results about 413 examinations.

[Renal needle biopsy under echography. Apropos of 413 examinations]. / Ponction-biopsie rénale sous échographie. A propos de 413 examens.

Blindly executed for a long period with only X-ray detection, renal biopsy benefits nowadays of precision and security of real-time echoguiding. The authors describe their technique without bondage between needle and transducer and comment their results about 413 examinations.

[Doppler sonographic determination of specific hemodynamic changes in fetal circulation during the last four weeks before birth]. / Doppler-sonographisch ermittelte spezifisch hämodynamische Veränderungen im Kreislauf von Feten in den letzten 4 Wochen vor Geburt.

The observation of characteristic flow changes measured by Doppler ultrasound in the fetal descending aorta a short time before delivery led us to systematically analyse our measurement data. For the retrospective analysis, records with a total of 115 measurements taken in the last four weeks prior to spontaneous onset of labour from 90 women with normal pregnancies were used. For each of the four weekly periods there were between 15 and 50 measurements. Both qualitative and quantitative flow parameters were evaluated. The findings showed: 1. No significant changes in the blood flow characteristics of the uteroplacental and fetoplacental vessels; 2. A clear widening of the diameter of the aorta; 3. A decrease in the mean flow velocity in the descending aorta; 4. A steep decrease in maximum velocity during late systole, sometimes so pronounced that a notch in the flow envelope was observed. The time when the changes occurred was found to be 2 weeks prior to spontaneous onset of labour. These changes in the fetal circulation, which can be called "term effect", occur along with other developments taking place towards the time of birth. They are probably related to the beginning of spontaneous contractions and indicate an adaptation to the changing supply conditions occurring a few days before the onset of labour.

[Doppler velocimetry of the aorta in materno-fetal blood incompatibility]. / Vélocimétrie Doppler de l'aorte lors d'incompatibilité sanguine materno-foetale.

The underlying pathogenesis of erythroblastosis fetalis is hemolysis of fetal red blood cells mediated by maternal antibodies. The resulting destruction of erythrocytes leads to progressive fetal anemia, and a hypervolemic condition develops in the fetus. The amount of maternal antibodies, real-time ultrasound, amniocentesis and/or cordocentesis can all be used to evaluate the degree of fetal anemia. The work presented here attempts to show that Doppler ultrasound can be used to detect the hypervolemic condition of anemic fetuses. One hundred fifty Doppler examinations were carried out on the aorta in 37 fetuses to evaluate the blood flow velocities and compare these with the fetal hematocrit. For the Doppler analysis, along with bidimensional echography, a Kranzbühler duplex scanner was used. In addition to the usual indices, the ratio of the median velocity to the maximum systolic velocity and an index of resistance using the maximum velocities 1/2 and 2/3 of the way through the cardiac cycle were calculated. Our examinations showed a significant increase in the temporal average of spatial average velocities (TASAV) and in the temporal average of maximum velocities (TAMV or M). The appearance of a spectral window was characteristic and a dicrotism in the curve was often observed. Much experience with the Doppler technique as well as a knowledge of factors influencing the blood flow velocity (caffeine, theine, nicotine, beta-sympathicomimetics) are necessary before attempting an interpretation of Doppler ultrasound results. Although the use of Doppler ultrasound does not yet permit a reduction in the number of invasive examinations, it does allow an improvement in the quality of surveillance of the fetal condition.

[Nongynecological occult cancers diagnosed in the course of their ovarian metastases. A clinical and anatomicopathological study of 8 cases]. / Carcinomes non gynécologiques, occultes, diagnostiqués au travers de leurs métastases ovariennes. Etude clinique et anatomo-pathologique de 8 cas.

Malignant non-gynecological diseases manifested through ovary metastases are rare but not exceptional. In routine histological examinations of the ovary within the last 6 years we have found an unknown non-gynecological disease in 8 patients undergoing surgery in the gynecological clinic in Zurich. One lobular bilateral breast cancer, one pancreatic cancer, three stomach cancers and three lymphomas were diagnosed. The symptoms, treatment, prognosis and anatomo-pathological aspects are discussed.

[Obstructive endometriosis of the efferent urinary tract]. / Obstruktive Endometriose im Bereich der ableitenden Harnwege.

Even though, in every 7th to 8th patient with endometriosis, it occurs in the efferent urinary tract, little attention has been paid this fact, generally speaking. This may be due in part to the atypical symptomatology of ureteral or respectively vesical endometriosis. However, its consequences can be serious in both younger patients as well as postmenopausal women. On the basis of two of the authors' own cases and the literature, the clinical symptoms and treatment of vesical endometriosis and ureteral obstruction associated with pelvic endometriosis are discussed.

[Neurinoma of the abdominal pneumogastric nerve. Apropos of a case]. / Neurinome du pneumogastrique abdominal. A propos d'un cas.

Neurinomas of the vagus nerve are rare occurrences, and their localization to the abdominal portion of the nerve are even more exceptional events (two cases published). A case is reported where presenting symptoms were post-prandial abdominal pains of the pancreatic type. The lesion was of the necrotic hemorrhagic type. Radiological examinations confirmed the site and mixed nature of the mass but not its departure point. These patients must be kept under medical observation because of possible development of a non-systematized neurocristopathy.