[Use of diphenoxalate in cancerology].
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Biomedical subjects
Publications and source records attributed to J M Caille.
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140 patients have been investigated by means of computerized tomography (CT) after contrast injection and radionuclide scan (RN scan). For patients with stroke (56 cases), RN uptake was more frequent (80%) at the 15th day of evolution, enhancement of hypodense images at CT reaches 100% at the 21st day. For the others pathologies (hematoma, tumors), the main difference between both examinations, was the volume of the lesions detected. RN uptake and CT enhancement both show the same blood brain barrier disturbance.
Computerised axial tomography (CAT scan) was performed in 22 children with acute lymphoblastic leukaemia and in 13 the results were normal. In the other nine, various lesions were observed; namely intra-parenchymal lesions of density of (3 cases, one of which was calcified), intra-parenchymal lesions of decreased density (2 cases) and ventricular dilatation (7 cases). The role of the disease and of the treatment (intra-thecal methotrexate, cranial irradiation) in the development of these lesions is discussed. The CAT scan is an excellent method of monitoring the neurological problems in acute lymphoblastic leukaemia.
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After analysis of the results of 142 CT brains scans performed from 1976 to 1982 on children with acute lymphoblastic leukemia, we can propose indications for this exam in relation with the different clinical stages and evolution of the disease. An exam is carried out as soon as possible at the start of the disease without injection of contrast media for use as a reference point. Excepting complications or neurological localisations, a scan will be performed at the end of the third year of treatment, without injection of contrast media, in screening for possible iatrogenic lesions. Neurological complications of unknown origin and leucoblastic meningitis seems to require a scan with injection of contrast media firstly as a mean of diagnosis, and secondly, in case of a cerebro meningeal localisation, in order to judge the efficiency of treatment and to screen for early complications. Computerized tomography however has its limits, particularly in case of purely meningeal leucoblastic infiltration.
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