History Page: Leaders in MSK Radiology.

Born in 1869, Gaston Contremoulins began his career as a painter. Fascinated by photography and discovery of X-rays by Roentgen in 1895, our ingenious self taught engineer joined the laboratory of microphotography in the faculty of medicine in Paris. He published in 1896 studies in the use of X-rays associated with a compass for research and anatomical localization of foreign bodies in the skull.

The first formulation of image-based stereotactic principles: the forgotten work of Gaston Contremoulins.

Although image-based human stereotaxis began with Spiegel and Wycis in 1947, the major principles of radiographic stereotaxis were formulated 50 years earlier by the French scientific photographer Gaston Contremoulins. In 1897, frustrated by the high morbidity of bullet extraction from the brain, the Parisian surgeon Charles Rémy asked Contremoulins to devise a method for bullet localization using the then new technology of x-rays. In doing so, Contremoulins conceived of many of the modern principles of stereotaxis, including the use of a reference frame, radiopaque fiducials for registration, images to locate the target in relation to the frame, phantom devices to locate the target in relation to the fiducial marks, and the use of an adjustable pointer to guide the surgical approach.

[Primary Neisseria meningitidis arthritis of the knee without meningitis: contribution of synovial fluid culture in blood-culture vial].

Introduction: Primary meningococcal arthritis is a rare form of meningococcal disease. It occurs as an isolated acute purulent arthritis without meningitis, and presence of Neisseria meningitidis in articular fluid. We report a new case of typical primary meningococcal arthritis.

[Activated C protein resistance manifested by cutaneous necrosis after interferon alpha injection: case report].

Introduction: Cutaneous necrosis occurring in the course of treatment by alpha interferon is an uncommon side-effect. Its physiopathologic mechanism remains obscure. A local thrombotic action of interferon has been suggested to explain its occurrence.

[Electrolyte abnormalities in elderly people. Prevalence and relation to drug treatment. Multicenter study of 631 subjects aged 70 years and over].

In order to assess the responsibility of medicinal drugs for the disorders in electrolytes observed in elderly people, the prevalence of abnormal natraemia and kalaemia was prospectively established in 631 subjects aged 70 or more on the first day of hospitalization. Among 337 subjects not taking drugs likely to create problems (diuretics, angiotensin-converting enzyme inhibitors, anti-inflammatory agents) 3.6 percent had hyponatraemia (below 130 mmol/l) and 12.

[Anti-hypertensive drugs prescribed to the elderly. Multicenter study at the hospital admission of 631 patients aged 70 plus years].

The anti-hypertensive treatment of 631 patients 70 years old and over was evaluated at the time of their hospitalization in 12 Internal Medicine departments in the western Paris suburbs, in May and June 1990. 49.6 +/- 3.

[Granulomatous hepatitis in cytomegalovirus infection in healthy adults].

The authors report 16 cases of cytomegalovirus (CMV) disease in previously healthy adults. Constant features included pyrexia lasting 3 to 8 weeks and mononucleosis occurring 2-3 weeks after the onset of fever. Moderate hepatomegaly without jaundice, splenomegaly and morbilliform or petechial rush were observed in 30 to 50 p.

Pulmonary lymphangioleiomyomatosis and Bourneville's tuberous sclerosis with pulmonary involvement: the same disease?

The authors studied the ultrastructural morphology of the lung in one case of Bourneville's tuberous sclerosis with pulmonary involvement. The observations in this report are similar to those previously reported in pulmonary lymphangioleiomyomatosis and further emphasize the striking resemblance between the two diseases.

[Digestive manifestations of dermatomyositis (author's transl)].

The principal digestive anomalies detected by radiological examination in dermatomyositis are the motor and functional consequences of the smooth and striated muscle lesions in these tissues. Vascular changes cause ulcerations, located in any part of the digestive tract, but more frequently in the esophagus, duodenum, and small intestine. These ulcerations sometimes develop into pseudodiverticulae.

[Primary intestinal localisation of Hodgkin's disease. One case initially diagnosed as a benign eosinophilic granuloma of the small intestine (author's transl)].

Intestinal lesions in Hodgkin's disease remain relatively rare. Even rarer are forms in which intestinal lesions or mesenteric nodes remain the only manifestations of the disease for a number of years. In these cases, histological findings are usually less typical than in more usual sites and this explains the diagnostic hesitancy which sometimes occurs.

[Scintigraphic appearance and particular arteriographic aspects intrahepatic cholestasis].

Based on one case history, it is reviewed here that prolonged cases of obstructive jaundice can take on deceiving appearences, and all the more so when they fall within the framework of a "biological gap". Extensive distension of the extra and intrahepatic bile ducts are at the basis of images with multiple, radiating hilar gaps on scintigraphy, and of "chicken nests" and "Swiss cheese" at hepatographic times in selective hepatic arteriography. These rather uncommon images should lead to a diagnosis of a surgical cholestatic liver.

[Subacute cytosteatonecrosis of pancreatic origin. Surgical problem in 5 cases (author's transl)].

The authors report 5 cases of subcutaneous cytosteatonecrosis (Weber-Christian syndrome of pancreatic origin) and review 68 cases in the world literature. The skin, bone joint and general manifestations may appear without any clinical or radiological sign of pancreatitis. The rise in blood and urinary amylase and lipase, the skin lesions, the joint pleural and peritoneal effusions, orient the diagnosis towards the pancreas and suggest a full radiological arteriographic and echotomographic investigation.