Technetium-99m HMPAO SPET in acute supratentorial ischaemic infarction, expressing deficits as millilitre of zero perfusion

A comparative interim analysis was performed of clinical parameters, computed tomographic (CT) scan results and technetium-99m hexamethylpropylene amine oxime single-photon emission tomography (SPET) findings obtained within 12 h of acute supratentorial ischaemic infarction. First, the applicability for SPET semiquantification in this study of the "method of Mountz", simultaneously accounting for extent and degrees of hypoperfusion by expressing deficits as millilitre of zero perfusion, was considered. Next, the relative contributions of perfusion SPET and CT scan in the acute stage of ischaemic infarction were compared in 27 patients (mean age 68.8 years). Finally, the correlation of SPET lesions with clinical parameters at onset was evaluated. The method of Mountz represents a workable, accurate virtual parameter, with the assumption that the contralateral brain region remains uninvolved. Interobserver reproducibility in 12 SPET studies, with lesions varying between 6 and 369 cc, showed a correlation coefficient r of 0.99. In practice, because of inconstant distribution of activities in the brain, the method can only be applied slice by slice and not on the total global volume. While the mean delay since the onset of symptomatology was approximately 7 h for both SPET and CT scan, SPET showed lesions concordant with the clinical neurological findings in 100% and CT scan in only 48%. One could hypothesize that SPET examinations performed later would show larger functional defects, because of the development of additional functional changes secondary to biochemical alterations. However, in this regard no statistically significant differences were found between two subproups, taking the median of delay before SPET examination as cut-off.(ABSTRACT TRUNCATED AT 250 WORDS)

[Immediate allergy to latex in urological practice]

Five cases of acute allergic reaction to latex are reported. Four of those were diagnosed during surgery and presented anaphylactic shock. One was suspected before surgery by systematic screening and dramatic presentation was avoided. Increasing frequency of latex allergy is reported in the literature and is usually seen in patients with extensive neurosurgical or urological histories, or by peoples currently exposed to natural rubber products (medical staff). Systematic screening in history before surgery is important so that exposure to latex should be avoided in suspected cases.

[Appendicular mucocele. Report of 2 cases]

We report two cases of mucocele of the appendix produced by a cystadenocarcinoma, with pseudomyxoma peritonei in one. The treatment consisted in appendectomy with partial resection of the caecum, for the first patient. It consisted in wide resection and in local chemotherapy for the second.

[Actinomycosis of the abdominal wall. Report of a case]

We report a primary case of Actinomycosis of the abdominal wall. The diagnosis is obtained on the basis of the CT-scan and the pathological examination. The treatment is a surgical excision and a long term administration of antibiotics.

[First elements of comparison between blood-tissue barriers at cerebral, genital and urinary levels]

Fluorescence microscope observations of Trypan Blue distribution gives the demonstration of the blood-tissue barriers. It reveals the similitude between the barriers in choroid plexus, in testis, epididymis and bladder and the difference with the blood-brain barrier. Electron microscope investigations afford a statistical view of relations between structure and vascular permeability and stress the opposition reported above. Membrane specializations of each epithelium often bring forward those which are involved in the barrier. This function is principally assigned to thight junctions. The different morphological aspects encountered lead to the problem of dynamic variations in the configuration of the junctions.