Tumors of aqueduct of Sylvius. Presentation of 5 cases and review of the literature

The authors reports their experience of 5 cases of intra- and peri-aqueductal tumors. With the exception of 1 case, a subependymoma of the aqueduct discovered at autopsy in a 77 year old woman, the 4 other patients (2 females and 2 males) are relatively young (respectively 14, 23, 14 and 26) at the time when they presented with signs of chronically raised intracranial pressure due to a triventricular hydrocephalus. One patient presented with a partial Parinaud's sign, but the focal and long tract signs were conspicuously absent in the other patients. The diagnosis of a space occupying lesion in the tectum mesencephali or in the aqueduct could only be ascertained with the recent use of M.R.I. The radiological work-up of the cases suggest that theses lesions, presumably of glial origin, are very slowly growing tumors. Four patients have been treated for their symptomatic hydrocephalus, but no treatment of the tumor has been proposed, as the clinical state and the images remain remarkably stable. (Mean duration of follow up from the time of shunting = 3.7 years, extremes = 1.5-8 years). A review of the literature shows that not more than 48 cases of tumors of the aqueduct have been reported. Because of the small number of such observations, there are, until now, no precise informations on the management of such cases to decide if the patient will benefit of an open or stereotactic biopsy associated with radiotherapy or if one can rely on serial clinical and radiological examinations. Further information on the long term follow up is needed.     

Pelvic tilt in neuromuscular diseases

On the basis of a study of the literature and observations in 53 of our own patients, we attempted to establish the cause and best treatment for neuropathic oblique pelvis. In addition, we tried to find out if certain kinds of neurologic dysfunctions coincide with certain kinds of oblique pelvis. It is highly probable that this pelvis malformation is the result of neuropathic spinal deformity. Severe oblique pelvis and scoliosis can be related to the severity of the neurologic dysfunction. Hip dislocation is not the reason for oblique pelvis. It can be assumed that hip dislocation, on the one hand, and oblique pelvis and scoliosis on the other can influence each other. To correct oblique pelvis, the neuropathic spinal deformity must be corrected. Anterior and posterior fusion, including the lumbosacral junction, give the best results.     

Sonographic characteristics of epidermoidcyst of testicle

The ultrasonographic characteristics of an epidermoid cyst of the testicle are presented. Since these, findings are similar to other published case reports, preoperative sonographic diagnosis of this lagon may be possible.     

Wound healing in diabetes mellitus

Diabetes mellitus is a complex metabolic disorder whose components have several direct and indirect effects on the healing of wounds. This article examines how diabetes affects wound healing from the standpoint of alterations in the microvasculature, nerve function, and the immune system.     

Ceruloplasmin activity in blood serum in stomach and duodenal ulcers

An examination of 100 patients with ulcer disease of the stomach duodenum and 20 practically healthy people has shown that the level of extracellular antioxidant enzyme defense (ceruloplasmin) is higher than those in practically healthy people. This dependence was most pronounced in the group of patients requiring surgical interventions. In the process of treatment the level of ceruloplasmin activity gradually decreased, without reaching normal values. The level of ceruloplasmin activity in patients with ulcer disease of the stomach and duodenum are thought to characterize the state of compensatory reactions in these patients.     

Effect of inositol hexaphosphate on retention of zinc and calcium from the human colon

Colonic retention of zinc and calcium was studied after installation during colonoscopy in 11 patients of a solution of 30 mumol zinc, 6.4 mmol calcium and 500 mumol inositol hexaphosphate (phytic acid) labelled with 65Zn and 47Ca. Whole-body retention of the radionuclide at day 13 was 1.0 +/- 1.0 per cent (mean +/- s.d.) for zinc and 4.0 +/- 2.9 per cent for calcium. The retention of zinc but not of calcium was lower than observed earlier under similar conditions from a solution not containing phytic acid and indicates formation of an indigestible complex between phytic acid and zinc. Addition of amino acids to the solution in 3 subjects did not seem to affect the retention of zinc and calcium.     

The comparison of trends in perinatal mortality in small areas

Year to year changes in perinatal mortality rates for small populations are difficult to interpret. Because local rates are based on small numbers of events, they are subject to apparently large fluctuations. A technique for analysing trends in mortality, for detecting changes in trends and comparing variations in trends between areas is described. It is illustrated by an analysis of perinatal mortality rates for Area Health Authorities in the West Midlands Region of England from 1974-1981, but the same techniques could be used to analyse trends at other times and in other places.