Natural position of the head: review of two-dimensional and three-dimensional methods of recording.

Both the correct position of the patient's head and a standard system for the acquisition of images are essential for objective evaluation of the facial profile and the skull, and for longitudinal superimposition. The natural position of the head was introduced into orthodontics in the late 1950s, and is used as a postural basis for craniocervical and craniofacial morphological analysis. It can also have a role in the planning of the surgical correction of craniomaxillofacial deformities. The relatively recent transition in orthodontics from 2-dimensional to 3-dimensional imaging, and from analogue to digital technology, has renewed attention in finding a versatile method for the establishment of an accurate and reliable head position during the acquisition of serial records. In this review we discuss definition, clinical applications, and procedures to establish the natural head position and their reproducibility. We also consider methods to reproduce and record the position in two and three planes.

[Reversible left intraventricular obstruction after treatment of pheochromocytoma and hyperthyroidism]. / Obstruction intraventriculaire gauche réversible après traitement d'un phéochromocytome et d'une hyperthyroïdie.

The authors report an original case of the association of three pathologies: pheochromocytoma, hyperthyroidism and cardiomyopathy with left ventricular outflow tract obstruction. This type of cardiac disease has occasionally been described in cases of pheochromocytoma and are usually induced by the endocrine disturbance because they regress with treatment of the pheochromocytoma. The associated hyperthyroidism observed in this case is very rare and may have increased the left ventricular pressure gradient. Medical treatment before surgery of the pheochromocytoma was unusual in that a triple therapy was used including betablockers, classically contra-indicated in pheochromocytoma alone. In this case, it provided excellent control of the blood pressure and decreased the left ventricular obstruction during the perioperative period.

Trophic effect of human pericardial fluid on adult cardiac myocytes. Differential role of fibroblast growth factor-2 and factors related to ventricular hypertrophy.

Pericardial fluid (PF) may contain myocardial growth factors that exert paracrine actions on cardiac myocytes. The aims of this study were (1) to investigate the effects of human PF and serum, collected from patients undergoing cardiac surgery, on the growth of cultured adult rat cardiac myocytes and (2) to relate the growth activity of both fluids to the adaptive changes in overloaded human hearts. Both PF and serum increased the rate of protein synthesis, measured by [14C]phenylalanine incorporation in adult rat cardiomyocytes (PF, +71.9 +/- 8.2% [n = 17]; serum, +14.9 +/- 6.5% [n = 13]; both P < .01 versus control medium). The effects of both PF and serum on cardiomyocyte growth correlated positively with the respective left ventricular (LV) mass. However, the magnitude of change with PF was 3-fold greater than with serum (P < .01). These trophic effects of PF were mimicked by exogenous basic fibroblast growth factor (FGF2) and inhibited by anti-FGF2 antibodies and transforming growth factor-beta (TGF-beta), suggesting a relationship to FGF2. In addition, FGF2 concentration in PF was 20 times greater than in serum. On the other hand, the LV mass-dependent trophic effect, present in both fluids, was independent of FGF2 concentration or other factors, such as angiotensin II, atrial natriuretic factor, and TGF-beta. These data suggest that FGF2 in human PF is a major determining factor in normal myocyte growth, whereas unidentified LV mass-dependent factor(s), present in both PF and serum, participates in the development of ventricular hypertrophy.

Intraventricular morphine in paraneoplastic painful syndrome of the cervicofacial region: experience in thirty-eight cases.

The authors report their personal experience with the administration of microdoses of morphine hydrochloride by the intraventricular route through a subcutaneous reservoir for the treatment of paraneoplastic painful syndrome of the cervicofacial region in 38 patients. The results obtained are very encouraging.

Microsurgical anterior cervical disk removal without interbody infusion.

A series of 57 patients with root syndromes or compressive myelopathy were operated upon by a modified Cloward technique. No bone grafts were used. The patients were observed for 6 months to 5 years after surgery. Of the 47 patients with radiculopathy, 44 were cured and three complained of minor pains in their arms. Of the 10 patients with myelopathy, three were greatly improved, five were slightly improved, and two remained unchanged. In 100% of these cases, immobilization of the involved interspace occurred within a year. The surgical technique is discussed.

Intraventricular and intravenous use of amphotericin B in a case of non-surgical cerebral aspergillosis.

After a short review of the literature regarding aspergillosis, the authors report a case of a 7-year-old child suffering from cerebral aspergillosis with disseminated lesions. The authors emphasize the use of amphotericin B both intraventricularly and intravenously to obtain a longer survival when surgery is impossible because of the presence of multiple abscessual lesions in central nervous system. Authors' experience shows that the intraventricular administration of amphotericin B is well tolerated and does not cause collateral effects of the parenteral way.

Visual and auditory hallucinosis (the only symptoms in a case of meningioma of the lesser sphenoidal wing).

The case of a woman with absence of neurological deficits, suffering from visual and auditory hallucinosis caused by a meningioma of the lesser sphenoidal wing, is described. The authors discuss the etiology of the hallucinosis that in the reported case is caused by an impairment of the deep temporal structures.

Carcinoma associated with lipomeningocele: case report.

We report the case of a 41-year-old man with an epidermoid carcinoma that had developed on a meningocele with a fistulous tract that chronically drained cerebrospinal fluid. After a review of the literature, we discuss the cause of this rare occurrence. We think that the recurrent discharge of spinal fluid (never complicated by meningitis) may have caused a chronic irritation of the tissues and then the delayed development of a carcinoma, which is similar to a case found in the literature. In our case there was a "flow" of carcinomatous cells along the fistula, which entered the meningocele, invading the subdural space as far as the peduncle. Our patient, who had a benign lesion (meningocele), came under neurosurgical care only after the lesion had degenerated. The malignant degeneration of such a benign lesion emphasizes the need for surgical treatment as soon as possible.