[Medulloblastoma].
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Biomedical subjects
Publications and source records attributed to C Raybaud.
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Four cases of clear cell sarcoma of the kidney in children are reported. The specificity of the tumor is examined. The pathologic features, the clinical presentation, and the occurrence of bone metastasis are reasons to distinguish clear cell sarcoma from the Wilms' tumor group. The poor prognosis may be improved in the future by radical resection associated with polyvalent chemotherapy.
Survey of the literature reveals 10 cases of cerebral neuroblastoma in adults. An additional case, confirmed by electron microscopy, is reported here. The patient had a voluminous supratentorial calcified intraventricular tumor with clinical signs dating back more than two years. Despite the size and cellular immaturity of the lesion, surgical removal of the tumor was apparently satisfactory on macroscopic grounds. Treatment also included postoperative radiotherapy of the brain and spinal cord. The present case is discussed in light of the scarce data from the literature.
This study involves 3 children ranging from 10 to 13 years and an eight-month-old infant who received Cis-DDP (30-100 mg/m2) every fourth week by means of a short-term infusion (20-35 minutes). Platinum levels in plasma and urine were determined by flameless atomic absorption spectrophotometry. The decrease in total plasma platinum is triphasic, consistent with the distribution expected for a 3 compartment model. In the elimination phase, the half-life values are high and vary between 149 and 541 hours. The total plasma clearances are extremely low and range from 0.027 to 0.187 litre/hour. The urinary excretion of platinum during the first 5 and 7 days respectively, in two children following administration of Cis-DDP results in large platinum concentrations (40-71 mg/litre) in the first urine excreted from each child. The cumulative urinary platinum excretion in the first twelve hours is high i. e. 27.2 to 32.5% of the administered dose but them it does not exceed 50% even after 5 days. These results confirm that after a short-term infusion of Cis-DDP in a single dose, the kidneys are suddenly subjected to platinum in high concentrations. In order to minimize the nephrotoxicity of this platinum complex, while maintaining sufficient plasma levels to ensure its anti-neoplastic activity, we recommend a schedule consisting of fractionated doses.
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The quasi-elastic scattering of 1 GeV protons permits the three-dimensional reconstruction of the density distribution in extended bodies. Fast multiwire proportional chambers are used to localize the position of every incoming and outgoing charged particle and to determine the coordinates at the interaction vertex. This article describes tests on a human head fixed on formalin. The comparison with computed tomography scans and anatomical sections is encouraging. Slices with a volume element of 5.5 mm3 illustrate the sensitivity of the method. The results also demonstrate the ability of the method to select the density distribution of hydrogen by making use of the kinematic relations specific to elastic scattering. Trials of this method in living humans are being planned.
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About a case in a six year old Negro boy, the existence of a special pattern among the malignant renal tumors in children is emphasized; this tumor is marked from the Wilms' tumor by its peculiar behaviour (frequently poor evolution, high incidence of osseous metastasis in contrast with the rate occurrence of pulmonary involvement) and by a sarcomatous appearance at the pathologic examination. The classification and the suitable therapeutic management are discussed.
An analysis was made of 175 cases of pediatric nontumoral hydrocephalus. CT scan by itself permits a precise diagnosis in only one-third of the cases. However, when the clinical context suggests that hydrocephalus is secondary to certain conditions such as infection, bleeding, or trauma, CT scan may suffice, unless more advanced investigation permits more efficient treatment. When hydrocephalus is associated with brain malformations, however, more complete investigation is needed for a better understanding of the condition. Conventional contrast studies are quite safe, especially ventriculography which is easy to perform in this type of patient, who is usually investigated during the first 12 months of life.
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Nuclear scattering radiographs of a portion of a spine and a sphenoid bone have been obtained using a 1 GeV proton beam. The ability of the method to yield three-dimensional representations is illustrated by three series of adjacent pictures corresponding to the three orthogonal planes (elementary volume: 5.2 mm3 and 0.9 mm3). The sensitivity of the method is discussed. Nuclear scattering radiographs are compared with ones obtained by conventional X-ray tomography and computed tomography. Nuclear scattering radiography also may be used to analyze the partition of hydrogen within the tissures. Hydrogen radiographs obtained in this way are shown.
The intracranial, liquid-containing cysts in children (excluding tumor and parasitic cysts) are relatively frequent in neurosurgical practice. They raise several problems about their nosology, etiology, clinical and radiological diagnosis, and treatment which are analyzed in a series of 36 cases of supratentorial cysts. The most frequent clinical feature is increased head circumference (22 cases) followed by epileptic fits (18 cases), as well as mental and motor retardation (19 cases). Fundi were found abnormal in only one case out of three. Electroencephalogram was abnormal in almost every case, showing either spikes, spikes and waves or localized slow waves, or an asymmetric depression of the electrical activity. Radiological investigation is essential for diagnosis. Plain radiographs of the skull may show an asymmetry (11 cases). Carotid angiogram and pneumoencephalography give the diagnosis of the lesion without accuracy as to the histology. Computerized axial tomography shows the position of the liquid cavity within the head. The surgical approach (simple shunting [6], direct approach [19], or both [7]) should be carefully considered according to anatomical variety and age of the child. An anatomical classification is proposed, based on the radiological, surgical and pathological findings. Three types of cysts are defined: external cysts (cortical or extracortical) which may or may not be communicating with the ventrioles or the subarachnoid space; internal cysts which again may or may not be communicating; and the corticoventricular cysts. The ultrastructural study represents further progress in the attempt to define the exact anatomical type.
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The authors review 54 cases of diffuse bone angiomatosis (one new case and 53 from the literature) and describe the major clinical, radiological and anatomical features. The difficulties of distinguishing between haemagiomata and lymphangiomata are emphasised. The diagnosis is often helped by the presence of visceral or cutaneous lesions and when such lesions are found, a skeletal survey should always be done. These conditions, which may be classified under the general heading of angiodysplasias of bone, are hamartomata and must be distinguished from other bone lesions of vascular origin.
Cerebral tomography allows the delineation of areas modified by edema or necrosis, the visualization of calcifications undetectable by standard x-ray examination, extra- or intra-cerebral blood effusions and neoformations of the cerebrum or of its envelopes. It also reveals slight or localized cerebral atrophies that other neuro-radiologic techniques sometimes failed to detect. It appears therefore worthwhile to reconsider pediatric neurology according to this new type of investigation. Its sole difficulty in young children, is the requirement of a half hour immobility, best obtained by general anesthesia. However, the rapid improvements of this technique will probably permit to overcome this slight drawback.
The authors study the arterial vascularisation of the retro chiasmatic optic tracts in man by means of total or selective arterial injections on 200 brain specimens. They underline the important vascularisation of the optic tracts, the lateral geniculate body and the first part of the optic radiations contrasting with the precarious vascularization of the latero-ventricular part of the optic radiations. The importance of the Sylvian contribution is noted at the origin of the optic radiations and on the occipital cortex level.
On the basis of their experience, the autors report the results obtained after 1500 examinations in the study of space occupying hemispheric lesions and in the study of cerebral atrophy.