[Double gastric leiomyosarcoma revealed by a hemoperitoneum]. / Double léiomyosarcome gastrique révélé par un hémopéritoine.

The authors report a complicated leiomyosarcoma gastric case with hemoperitoneum. The exploratory laparotomy reveals an hemoperitoneum constituted from both gastric tumors. One was localised in the antrum and was encapsulated, the other in the cardia and had an encephaloid and necrotized core. The pathological examination of the total gastrectomy piece is consistent with a double gastric localisation of a leiomyosarcomosis. 5 years after the initial operation, the patient developed hepatic metastases. A review of literature allows the authors to make the point of this disease.

[Cancer of the stomach: an epidemiologic, diagnostic and therapeutic study]. / Les cancers de l'estomac. Etude épidémiologique, diagnostique et thérapeutique.

The authors report 203 cases of gastric cancer collected between 1974 and 1987 without prior selection. Analysis of these records provided the following information: From an epidemiological viewpoint, there was no predominance of blood group A; a certain number of gastric lesions preceded or coexisted with the cancer. From a clinical viewpoint epigastric pain and general physical deterioration were the most frequent presenting signs. Physical examination was normal in 32.5% of patients, while 34.4% presented a palpable epigastric mass. Diagnosis was confirmed by a combination of radiology (transit studies of oesophagus, stomach and duodenum) and endoscopy with multiple biopsies. These procedures were carried out in 88% and 72% of patients respectively. 87% of patients were operable and resection was possible in 50%. Subtotal gastrectomy was performed in 61% of cases where resection was possible. The overall operative mortality was 8.5% and 20% for extended total gastrectomy. Actuarial survival was only correctly evaluated in 42% of operated patients. It was estimated to be 5%.

[96 cases of spontaneous medical cerebral hemorrhage. Diagnostic and therapeutic experience]. / Quatre-vingt-seize cas d'hémorragie cérébrale médicale spontanée. Expérience diagnostique et thérapeutique.

Prognosis in a homogeneous series of 96 cases of non-traumatic cerebral hemorrhage admitted to a neurosurgical department within 6 to 24 hours of onset was assessed by studying possible correlations between clinical condition (grade I: conscious; grade II: somnolent; grade III: comatose; grade IV: comatose with signs of brain stem involvement) and computed tomography findings (site, extension, size of hemorrhage; degree of edema and of mass effect; presence of hydrocephalus or ventricular hemorrhage). It was possible to distinguish effects due to destruction and/or compression of functional cerebral regions for a given clinical picture, and to apply these data to determine types of therapy and surveillance according to 3 time-periods. During the first 48 hours there was almost perfect agreement between the severity of the clinical picture and the degree of cerebral destruction (62,6 p. 100 of grade IV, 27,7 p. cent of grade III died). Only patients in grade III with temporal hemorrhage directly menacing the brain stem were operated upon. From the 3rd to the 7th day surveillance was based on clinical findings and computed tomography, repeated in principle on the 3rd and 7th days. Patients operated upon during this period were those in whom clinical signs and/or effects due to mass effect as seen on the CTscan were becoming worse. The third period, lasting from the 8th to the 21st day, was that during which the vital prognosis was generally no longer affected, and indications for surgery were functional in nature. The prognostic value of measurements of intracranial pressure is discussed.

[Typology of the cells of the bulbopontine reticular formation]. / Typologie des cellules de la réticulée bulbo-pontique.

The network analysis methods have been applied to study the neurons of the medial bulbo pontine reticular formation in the cat. The bifurcation ratio allows isolation of two different cellular patterns: collateral branched cells or CB type, and at random pendant vertices dichotomously branched cells or DA type. The morphologic features of CB cells lead to the assumption that these cells have an integrative function. The topographic distribution of the two cells types seems to vary in the different parts of the reticular formation and should argue for the fact that the reticular formation represents an aggregation of several discrete anatomical units.