[MRI in the early diagnosis of spinal metastases of bronchial cancer]. / IRM dans le diagnostic précoce des métastases vertébrales du cancer bronchique.

MRI of the whole spine and radionuclide bone scan were performed prospectively on 50 consecutive patients with newly diagnosed non small-cell lung carcinoma. The final diagnosis of vertebral metastasis was made by means of follow-up studies. The prevalence of vertebral metastasis was 24% (12/50 patients). The sensitivity of MR imaging (92%) was superior to that of radionuclide bone scan (67%) in the detection of vertebral involvement, the specificity was the same (94%). MRI of the spine was not useful as a screening procedure before treatment, but offered advantages over radionuclide bone scan in patients with symptoms and when bone scintigraphy detected abnormal foci, including identification of additional vertebral metastatic foci and better analysis of the extent of metastatic involvement within vertebrae.

PET and plasma pharmacokinetic studies after bolus intravenous administration of [11C]melatonin in humans.

A human PET study was performed with carbon-11 labelled melatonin in a healthy volunteer. Plasma pharmacokinetics of melatonin and 6-sulfatoxymelatonin were simultaneously determined using radioimmunoassay. Analysis of tracer kinetics showed maximum activity in the brain 8.5 min following injection, which was different from the curve observed for the plasma radioactivity (maximum at 3.5 min). The results confirmed that melatonin readily crosses the blood-brain barrier and that 6-sulfatoxymelatonin is the main plasma metabolite. The distribution of tracer as a function of time in this study failed to reveal any specific binding.

Perfusion lung scan in patients operated for transposition of the great arteries.

Fifty perfusion lung scans were performed with Tc-99m albumin microspheres in 42 patients, 15 days to 12 years after corrective surgery for transposition of the great arteries. The scan was entirely normal in nine of 42 patients. Absence of left lung perfusion was observed in three patients and hypoperfusion of the left lung in 19 patients. Segmentary zones of hypoperfusion was visualized in 13 patients either in the right or left lung. A moderate right to left shunt was observed in eight cases. The absence or decrease in left lung perfusion was due to pulmonary vein occlusion in four patients, left pulmonary artery stenosis in two patients, and preferential right blood flow in one patient. Right to left shunt was due to dehiscence of the atrial patch in four patients.

Significance of solitary spine abnormalities on technetium-99m bone imaging.

Solitary abnormalities located within the spine from 75 bone images with Tc-99m MDP were reviewed. For the sake of convenience, patients were grouped in three classes of age: 15-50, 51-65, and 66-90 years. In 67 cases, the diagnosis was apparent from clinical studies, x-ray examinations, or biopsies. In eight cases, no diagnosis could be made. The maximum percentage of lesion sites were within the lumbar spine (45 cases). Metastatic lesions were the most common solitary abnormalities within the spine (29.3%). Osteoporosis was second (24%) with the maximum percentage in age group 66-99 years (83%) with a greater female predominance (67%).

Bone imaging in a case of chronic fluorine intoxication with mineral water.

A patient with chronic fluorine intoxication from mineral water demonstrated an abnormal intense uptake of Tc-99m MDP in the whole spine, the bone metaphyseal regions, and the sternum ("tie sternum"). Results of a bone biopsy revealed an intense osteomalacia and a high fluorine concentration. Bone imaging performed one year after the patient stopped drinking mineral water was normal.

Gallium-67 citrate whole body scanning for the localization of infected vascular synthetic grafts.

Ga-67 (3 mCi) was used in 11 patients to diagnose and locate an eventual infection of their synthetic vascular prostheses. In seven cases, an area of gallium uptake was found and the infection confirmed by surgery and bacteriology. In the remaining four cases, no uptake of gallium was found and the absence of infection was confirmed.

[Nicergoline and steal effect in favor of zones of hypoperfusion in cerebral ischemic accidents]. / Nicergoline et hémodétournement en faveur des zones d'hypodébit dans les accidents ischémiques cérébraux.

Hemispheric and regional variations of cerebral blood flow (CBF) were studied with the Xenon inhalation technique on 19 patients suffering from cerebral infarcts before and at the end of a 10 mg 'alpha-blocking' Nicergoline perfusion. CBF dynamic images and calculations were performed with a gamma computerized camera. No significant hemispheric CBF modification has been noted after Nicergoline perfusion (30.2 +/- 4.5 ml/min/100 g before perfusion and 31 +/- 5.6 ml/min/100 g at the end of perfusion) but, at the end of perfusion, we noticed a CBF increase on the more ischemic areas (25.7 +/- 5.6 ml/min/100 g before and 29.9 +/- 6.8 ml/min/100 g after). This variation depends on the patients (from +67% to -22%). The more ischemic areas are those with the more important CBF increase. This 'inverse steel effect' is comparable to the effect described by other authors for Vincamine or Piracetam.

[Broncho-pulmonary manifestations and gastroesophageal reflux]. / Manifestations broncho-pulmonaires et reflux gastro-oesophagien.

In 196 cases of gastro-oesophageal reflux, simple or connected to a hiatal hernia or to a cardio-tuberous misplacement, the respiratory signs that are found in 1 patient out of 4, are analyzed. The nocturnal fits of coughing (39 cases, 20% of the reflux) is the most frequent sign of laryngo-tracheal aspiration of stomach content. This symptom of great diagnostic value, though neglected, should be looked for systematically. Other troubles are less frequent: bouts of recurring broncho-pulmonary infections, asthma attack, Mendelson's syndrome, pulmonary fibrosis. In absence of a patent cause, the symptoms should lead to suspect a reflux of stomach content in the airways. Similarly to oesophagitis, respiratory signs represent a complication sometimes serious, of gastro-oesophageal reflux, needing more frequently a surgical treatment of hiatal herniae or of the cardiac inefficiency.