Anatomic correlates of painful tonic spasms in multiple sclerosis.

Painful tonic spasms (PTS) are now regarded as a typical symptom of multiple sclerosis but pathologic or radiologic findings rarely have been described. We report clinical and magnetic resonance imaging records of five original cases. In all of them, lesions likely responsible for unilateral PTS involved the motor pathway at the level of the posterior limb of the internal capsule or the cerebral peduncle on the opposite side.

[Laparoscopic cholecystectomy. Our experience].

This study analysed 90 cases of symptomatic cholelithiasis treated with laparoscopic cholecystectomy. 27% of the cases studied suffered from microlithiasis, 44% from multiple calculosis with calculi measuring 1 to 2 cm in diameter, 25% from single calculi measuring up to 4 cm in diameter, and 4% from a benign proliferative pathology of the cholecystic wall. Calculosis of the main biliary tract was also found in 3 patients and was treated by preoperative endoscopic papillosphincterotomy.

[Intraoperative pancreatic echography].

The US intraoperative diagnostic procedure is useful either for the higher sensitivity rate or for the surgical decision making. The Authors' intraoperative diagnostic experience in pancreatic diseases is reported: 23 exocrine and endocrine neoplasms, 3 chronic pancreatitis and 8 acute pancreatitis cases are discussed.

[Carcinoid tumor in Meckel's diverticulum].

The accidental finding of a carcinoid tumour in Meckel's diverticulum, a very uncommon event, triggered a physiopathological and clinical analysis of this very interesting but very rare association. The value of systematic identification and removal of the diverticulum during laparotomy is underlined.

[Thyroid metastasis of carcinoma of the breast. Considerations on 2 cases].

Two cases of thyroid metastasis from breast cancer are reported, both occurring in patients previously given radical mastectomies. It is emphasised that postoperative follow-up should also monitor rarely affected sites of metastasis from breast cancer.