Breast specimen lumpectomy orientation: which technique is the best?

The authors report a cheap, simple, reliable and reproducible technique of breast specimen lumpectomy orientation.

Assessment of response by breast helical computed tomography to neoadjuvant chemotherapy in large inflammatory breast cancer.

Breast helical computed tomography (CT) was evaluated for use in assessing response to neoadjuvant chemotherapy and residual tumor volume. Forty-three patients with large, inflammatory breast cancers (stage IIA, 12; IIB, 13; IIIA, 9; IIIB, 9), all histologically confirmed by core biopsy, were evaluated prior to and following neoadjuvant chemotherapy. The breast helical CT procedure involved patients in the prone position using single acquisition during quiet respiration following intravenous injection of nonionic contrast material.

Uterine metastases from primary breast-cancer - report of 2 cases.

The authors report on 2 cases of uterine dissemination from primary breast carcinoma. Special emphasis is made on this atypical site of metastases and on the necessity of a gynecological work-up in patients previously treated for breast cancer.

[Validation of the measurement of hepatic volume by three-dimensional computed tomography].

The aim of this work was to verify experimentally the reliability of 3D CT scan in measuring hepatic volumes. Eight livers were dissected from corpses. The referring liver volume was determined by measure of its hydric shift.

[190 cancers of the thyroid with a follow-up of more than 5 years].

Outcome in 190 patients operated upon by first intention for thyroid cancer is analyzed after follow up over more than 5 years. No deaths due to cancer occurred in 57 cases of papillary cancer, but 7 cases presented pulmonary metastases, while the global-5-year survival rate in 63 cases of vesicular cancer (including 25% with preoperative metastases) was 60%. In the absence of preoperative metastases, ans if well differentiated forms are separated from moderately differentiated forms, the respective 5-year survivals were 88 and 45%.

[Study by radioactive microspheres of bone microcirculation in aseptic osteonecrosis of the femoral head].

Thirty-two hips affected by aseptic necrosis, four of them post-traumatic and 12 contralateral hips thought to be healthy have been studied by combining superselective arteriography with the injection of radioactive microspheres. It has been possible to show that aseptic necrosis begins with a global ischaemia and is followed by an incomplete revascularisation leaving a necrotic area. On the border between the two areas hypervascularity produces a zone of fragility where microfractures develop with detachment of a sequestrum.

Detection of right ventricular pressure overloading by thallium-201 myocardial scintigraphy. Results in 57 patients with chronic respiratory diseases.

The diagnostic value of thallium 201 (201Tl) myocardial imaging was studied in 57 patients with chronic respiratory diseases, most with COPD (n = 46), by comparing the results to hemodynamic findings. In healthy subjects, the right ventricle (RV) is not visualized; therefore, any recorded activity of the RV was considered as indicating RV hypertrophy due to RV pressure overloading (RVPO). RV activity was graded from 0 (no activity) to 3 (activity greater than or equal to that of the left ventricle).

Relationship between pulmonary artery mean pressure and the vertical gradient of perfusion in chronic respiratory diseases.

The relationship between mean pulmonary artery pressure (PPA) and the regional distribution of perfusion, investigated with 133Xe, was studied in 67 patients with chronic respiratory diseases, including 57 patients with chronic obstructive pulmonary disease. The vertical gradient of perfusion, assessed by the ratio upper/lower perfusion (RQ), was considered as normal when RQ was less than or equal to 0.85.

[Regional pulmonary function in unilateral sero-fibrinous pleural effusions and changes under the influence of treatment (author's transl)].

The regional distribution of ventilation (Vr), perfusion (Qr) (expressed in absolute values) and the regional distribution of ventilated lung volume, of ventilation and of perfusion (expressed as %) were studied using Xenon 133 in 13 subjects with a unilateral pleural effusion of proven or presumed tuberculous origin. The examinations were performed in a sitting position. The initial examination was carried out after as complete an evacuation as possible of the fluid effusion.

[Recent advances in isotopic exploration of the skeletal system in prostate cancer (author's transl)].

Skeletal isotopic exploration is fundamental in patients with prostatic cancer. Bone scintiscan is reliable. Its sensibility can be increased by using new radioactive isotopes and quantitative isotopic explorations.

Radionuclide computerized ventilation studies.

Studies of regional lung function have developed rapidly in the last few years. Xenon -133 is the most frequently used isotope because of its physiocochemical and biologic properties. Fixed counters are being replaced by the scintillation camera interfaced to a computer allowing easy acquisition and interpretation of results and numerical data.

[The regional exploration of pulmonary function using xenon 133. Value of the gamma camera connected to a computer (author's transl)].

Regional isotopic exploration of ventilation and pulmonary perfusion is not yet widely applied in clinical practice, by virtue of the complexity of the equipment required, but also because of the complicated and lengthy analysis of the results. In this respect, connection of the scintillation camera to a computer represents a major advance which other authors have already emphasized. Our own experience in this area and our method of exploration are described.

[Regional pulmonary function in hemidiaphragmatic paralysis (author's transl)].

Gaseous exchange and regional pulmonary function (using 133Xe) were studied in 10 subjects with hemidiaphragmatic paralysis; the paralysis was presumably idiopathic in nine subjects. Global and regional investigations were performed on the same morning, the subjects being studied in the sitting position. Six subjects were obese; nevertheless overweight was moderate except in one case.

Regional pulmonary function in sarcoidosis.

In 26 subjects with a confirmed histological diagnosis of thoracic sarcoidosis regional lung function was studied with Xenon 133. All subjects also underwent overall lung function studies including CO steady state (TCO SS) and single breath (TCO SB) diffusing capacity. Regional ventilation (Vr) was on the average increased in stages I (isolated hilar adenopathies) and II (pulmonary infiltration) and appeared normal in stage III (pulmonary fibrosis).