[The compression syndrome: A revaluation of the value of postural angiography (author's transl)]

A total of 136 patients with a compression syndrome of the upper limb were examined systematically by selective dynamic angiography as developed by the Hôtel-Dieu Hospital in Montreal. The method consists of given multiple injections of a contrast medium with the patient's arm in thirteen different positions. This retrospective study demonstrated that this method carries very little risk and is well-tolerated by the patients. Conclusions are drawn from a comparative statistical analysis of the angiographic results and the therapy chosen. The practical value of the examination is not to confirm the anatomical site of the compression but to evaluate the characteristics of the stenosis before a decision is made whether to operate. In this respect, the positions in which the patient is sitting down and the arm is in abduction are those in which a difference is found between those patients operated upon and those given medical treatment, which is a point in favour of this particular procedure.

Vulnerability of keto bile acids to alkaline hydrolysis

Rigorous alkaline hydrolysis of the two primary (cholic and chenodeoxycholic) and of the two preponderant secondary (deoxycholic and lithocholic) bile acids found in bile led to excellent recoveries. Such was not the case with 11 different keto bile acid standards. Recoveries for a number of standards were unacceptably low and a variety of artefactural products were tentatively identified by gas-liquid chromatography. Keto bile acids bearing a keto gropu on C-3 were particularly vulnerable. In view of thee findings, quantitative and qualitative data reported on biological specimens submitted to saponification in ethanol, methanol, or even in water are of questionable significance.

[Semiology of benign diseases of the breast in mammography (author's transl)]

Mammography is a basic examination which must never be dissociated from the clinical background. A statistical blind study of 330 cases shows that only well definite syndroms are reliable. The presence of absence of a single sign has no value. Difficulties arise in the diagnosis of suspect nodule in a dense dystrophic breast. Hydratation of the connecting tissue is a fundamental concept for analysis of mammographic pictures. The densities change according to hormonal influence, growth of dystrophy and specific signs of fibrillary or hyalin fibrosis. A histological study of serial cuts of the breast shows that the must reliable signs are found in the center of the nodule ande immediately around it. As in the histological study, serial cuts are indispensable in X-ray examination. Tomography improves the examination of dystrophies.

Plasma lipids and lipoprotein patterns in angiographically graded atherosclerosis of the legs and in coronary heart disease

The prevalence and type of plasma lipoprotein abnormalities were determined in 114 French-Canadian patients with angiographically proven peripheral vascular disease (PVD). The severity of atherosclerosis was positively correlated with plasma triglyceride concentration, especially in the younger patients (r = 0.29, P less than 0.05), and (not significantly) with plasma cholesterol concentration. Of the risk factors believed to predispose individuals to atherosclerosis, cigarette smoking was the most frequently found in the PVD patients (72.8%), especially among the men. Combination of two or more risk factors was the rule. Findings were compared with those in 114 patients who had undergone coronary angiography for suspected coronary heart disease (CHD). The CHD patients were, on average, younger by 10 years. Hyperlipidemia was present in 58.8% of CHD patients, compared with 43.9% of PVD patients. A far higher proportion of CHD patients showed the type II plasma lipoprotein pattern (24.6% v. 7.9%), although the type IV pattern was more common in both groups (31.6% and 28.9%, respectively). A high proportion of all patients (56.1% with PVD and 41.2% with CHD) showed a normal lipoprotein pattern on paper electrophoresis.

[Mammotomography, a new technic of breast examination]

The authors present the first results of a new technique of breast examination: tomo-mammography. This new method allows a complete study of the whole gland without any compression and any modification of histological and anatomical structures, and an analysis of the center of breast lesions in which are rassembled the most reliable radiological signs. These first results enable to hope a large increase of possibilities of diagnosis of breast lesions in the most difficult anatomical and clinical cases.

[Anatomical and histological approach to the radioraphic appearance of the breast (author's transl)]

The authors present first correlations between histology, anatomy and serial radiography of the breast, in order to establish a new understanding of the mammographic picture, with respect to the tridimensional histological structures. Several essential points are considered: - Mammographic pictures only show fibrous, connecting and fatty tissues. The epithelium of the galactophores is not shown, because of its low radio-opacity. Mammographic densities are due above all to fibrous connecting tissue, which has a high percentage of water. Benign or malignant breast tumors present with a proliferation of epithelium and connecting tissue, but only connecting tissue, more or less hydrated is shown on the mammographic picture. Many mammographic patterns are related to various superimposed fibrous strands, appearing as pseudotumoral opacities. The benign or malignant tumoral opacities are hidden or modified by multiple superimposed adjacent structures. - The mammographic patterns is related to the degree of hydratation and components of the connecting tissue.