The fine structure of epithelial cyst in the central nervous system (author's transl)]

The fine structure of three types of cysts within central nervous system, all with a single cell lining, has been examined. The first was in the subarachnoid space of the lumber cord and the lining cells included both ciliated and nonciliated secretory cells. It was considered to be of endodermal origin. The second type was a colloid cyst of the third ventricle and its fine structural features were almost identical to those of the first type. It was, therefore, likewise considered to be of endodermal origin. The third type was an intracerebral epithelial cyst in which the lining cells more closely resembled ependymal cells. The value of fine structural studies for the understanding of the pathogenesis of epithelial cysts within the central nervous system is discussed.     

Preoperative diagnosis of posterior fossa tumors (author's transl)]

The wide-scale use of the CT Scanner has completely modified the radiological approach in the diagnosis of infratorial tumors. In the cerebello pontine angle tumors, computerized tomography offers enough information for surgery (at least in those cases where enlargement of porus is noticeable on the skull film). On the other hand, if clinical picture is incomplete or CT scann atypical (spontaneous hyperdensity), a vertebral angiography is necessary to recognize a meningioma or a neurinoma of the firth nerve. A low density suggesting a cyst (epidermoid or other) is a good indication for pneumoencephalography. In cerebellar tumors of the hemispheres, vertebral angiography should be performed in the case of multiple tumors (except if there is a good chance of metastases) and also with a single tumor showing a high enhancement with contrast; in a solitary cyst, angiography is recommanded when clinical signs suggest hemangioblastoma. Isotopic scanning is only indicated when there is a suspicion of metastases. In midline tumors, one has to consider the relationship with the 4th ventricle; no other radiological exams are necessary if tumor is likely located in the cerebellar vermis; on the contrary, if the ventricular cavity is barely visible positive ventriculography is helpful. In the anteriorly located neoplasms, pneumoencephalography with tomography may precise the exact situation in relation with the brain stem. Regardless of the anteroposterior location, a highly contrasted tumor should be explored by angiography.     

Differential diagnosis of osteoporosis (author's transl)]

This is a review of the diagnostic procedures used in patients with osteoporosis. The differential diagnosis of various forms with recognized etiology is used as a background for the study of postmenopausal osteoporosis with largely unknown pathogenesis.     

The clinical significance of extratesticular originating tumors (author's transl)]

A case of large retroperitoneal metastasis of a seminoma is demonstrated. The primary tumor was impossible to recognize clinically. The extremely scarred primary tumor was at last discovered histologically in the normal appearing testis on the same side. This experience leads to the conclusion that the diagnosis "extratesticular originating testicular tumor" not be accepted unless a "burned-out" tumor can be exluded histologically in the ipsilateral testis.     

Significance of computed tomography in therapeutic diagnosis of brain tumors (author's transl)]

Because of its noninvasive property of direct imaging of the size and shape of the lesion, CT scan is significant not only for the diagnosis of the brain tumors, but also for the assessment of its chronological and/or therapeutic change in size. Contrary to the conventional cerebral angiography and contrast encephalography, CT scan is feasible to detect the tumor repeatedly at short intervals. From March 1976 to October 1977, 197 cases of brain tumors were examined by CT, 6 tumors (1 pineal tumor, 2 cerebellar vermian tumors and 3 supratentorial tumors) of which were radiated after the initial CT scan and re-examined by CT at every 400-1,000 rads radiation, and their grade of radiosensitivity could be evaluated. Immediately after the radiation of 400 rads for five days to the large pineal tumor of a 16-year-old boy, CT exactly showed the markedly diminished size of the tumor, and the tumor disappeared on CT after the 4,000 rads radiation. Cerebellar vermian tumors suspected of medulloblastoma were also diminished in size on CT after the 600 rads radiation. One supratentorial tumor was radiosensitive and disappeared at the end of radiation therapy. Other supratentorial tumors were not changed on CT during the radiation. Procedures for the therapeutic diagnosis, when combined with CT, can easily indicate whether the tumor is radiosensitive or not, without any invasive examination and/or operation.     

Neurophysiological investigation of the central nervous action of the hypnotic agent etomidate in cats (author's transl)]

1. The action of etomidate (0.125-4.0 mg/kg) injected intravenously or into the right atrium (time of injection about 1 sec) was investigated in cats under different central nervous conditions. 2. In decerebrate unanaesthetized animals and in lightly anaesthetized (pentobarbitone) animals with an intact CNS etomidate (0.25-4 mg/kg i.v.) caused a decrease of the spontaneous lumbar fusimotor activity and a strong depression of the fusimotor pinnareflex. Partly a reversal of this reflex from excitation to inhibition was observed. The effects occurred within 20 sec after the injection and lasted for 5-70 min, showing a clear non-linear relationship with the injected dose. 3. In encephale isole preparations etomidate (0.125-1 mg/kg injected intra-right atrially) caused distinct changes of the spontaneous EEB (decrease of frequency, increase of amplitude, occurrence of steeper waves) and a depression of the arousal reactions in the EEB following different stimuli (acoustic stimuli and different stimuli in the area of the face and eyes). These effects occurred within 8 sec after the injection and lasted up to 40 min, dependent upon the injected dose. 4. The character and the principal similarity of the results observed in decerebrate animals and in animals with intact CNS suggest that a considerable part of the action of etomidate consists of a depression of the activity and reactivity of the brain stem reticular formation.