Utility of arteriography in penetrating extremity injuries.

The role of contrast arteriography in the management of patients with penetrating injuries of the extremities is a subject of active debate. To examine our experience, the charts of patients with penetrating injuries of the extremities were retrospectively reviewed. Data from 82 consecutive patients with 98 wounds over the 5-year period from January 1984 to December 1988 were reviewed. Sixty-five arteriograms were obtained to investigate 98 wounds: 8 to localize a clinically apparent wound and 57 because of proximity of the wound or the trajectory of the injuring agent to a major neurovascular bundle. Of the 57 arteriograms obtained because of proximity, 11 identified a vascular injury (19%). Six of these wounds required vascular repair; five patients were treated expectantly. Six of the eight arteriograms obtained for clinical indications were positive (75%), while two were negative (25%). There were no amputations in the study, and all vascular reconstructions were considered successful by clinical and vascular laboratory criteria. One patient died of thoracic injuries; otherwise, all patients were discharged in good condition. Long-term follow-up was not available. In summary, 19% of arteriograms done because of proximity criteria alone identified a clinically occult vascular injury. While only 11% of all proximity arteriograms revealed injuries requiring surgical repair, this rate of significant injury warrants aggressive use of proximity arteriography in a patient population that is prone to poor follow-up.

[Perceptual aspects in the Rorschach test in the schizophrenic and his siblings]. / Aspects perceptifs dans le test de Rorschach chez le schizophrène et les membres de sa fratrie.

The Rorschach records of 100 schizophrenics cases were compared to 100 non-schizophrenic psychiatric cases and to 100 normal subjects. The study has allowed to evidence 6 patterns of response and 12 diagnostic signs which are characteristic but variable in frequency for the schizophrenic cases. The same patterns and signs do not exceed 2% in the two control groups, but were also found in the same proportion as in the schizophrenics in a well-adjusted sample of 52 siblings of schizophrenic subjects.

[Psychometry of anxiety]. / Psychométrie de l'anxiété.

The methods of anxiety assessment include: on one hand the rating scales, based on either a global or analytical clinical evaluation, or on a self evaluation; on the other hand, the mental tests. Among the latter, the questionnaires, corresponding to a direct approach to the object of measure, are the most numerous and the most frequently used.

[Nondiscal sciatica without organic lesion]. / Les sciatiques non discales sans lésion organique.

Among 1 800 patients operated on for hernia of the disc, 2% were completely negative on surgical exploration. Since a psychiatric aetiology might be involved, these patients were again given physical examination, clinical psychiatric examination and a personality test (minimult). This psychometric examination yelded pathological results in 68% of these patients. A comparison with two control groups operated on for hernia of the disc permitted a distinction of statistically significant differences. The results are compared with similar studies by other authors on patients with lumbalgia and dorsalgia. A practical approach is defined.