[Techniques and applications of noninvasive high-resolution ultrasound imaging]. / Techniques et applications de l'échographie haute résolution non invasive.

Today manufacturers propose echographic systems with a resolution ranging from 100 microm down to 30 microm. This requires ultrasonic frequencies ranging from 20 to 60 MHz. However, when associated with an increase in the attenuation of the wave in the media this limits the applications to superficial exploration. High frequencies also bring special technological limitations mainly in the fields of transducers, electronics, and acoustic coupling. Although high-resolution echography has long remained marginal and been used for the exploration of the skin or the anterior chamber of the eye, new powerful and easy-to-use devices have recently appeared on the market. With these new products, new applications have also appeared such as the exploration of the oral cavity or small laboratory animals (mice).

[Importance of defecography in the evaluation of genital prolapses]. / Intérêt de la défécographie dans le bilan des prolapsus génitaux.

OBJECTIVE: To determine the interest of defecography for the initial evaluation of genital prolapses. PATIENTS AND METHODS: A retrospective study of 125 patients who had undergone systematically a defecography for the initial evaluation of a genital prolapse. RESULTS: 10% of defecogaphies were normal. On clinical examination a rectocele was found in 94% of patients and an enterocele in 33%. At defecography, these abnormalities were seen only in 39% and 15% respectively. 39% of patients with radiological rectocele had an intussusception at defecography. CONCLUSION: Defecography is appropriate to diagnose and to assess constitutional abnormalities associated with genital prolapse (rectocele, enterocele) and other anomalies which interact with it (intussusception, sphincter and pubo-rectal dyskinesia). Most of women with genital prolapse showed abnormal defecograms. We observed a marked discordance between clinical and radiological evaluation, specially for rectocele. Defecography is of great interest in the evaluation of posterior genital prolapses, specially in women complaining of dyschesia. Defecography may be proposed in case of: posterior vaginal wall prolapse (rectocele, enterocele), dyschesia, post-operative prolapse and before a cervicopexy.

[Congenital adenomatoid cystic malformation of the lung and renal polycystosis. A fetal case report and review of the literature]. / Malformation congénitale adénomatoïde kystique du poumon et polykystose rénale. A propos d'une observation chez un foetus et revue de la littérature.

We observed a plurifocal cystic adenomatoid malformation of the lung, Stocker class II, in a 21-week gestation fetus in association with polycystosis of a solitary medial kidney. There was no other notable abnormally. The caryotype could not be obtained. The association of these two congenital malformations is exceptional, only three similar cases have been reported in the literature. Two other cases of pulmonary adenomatoid malformations associated with nephromegaly with renal hyperlobulation have also been described. Whether this is a fortuitous association or not remains to be determined.

[Motivations, acceptance and refusal of contraceptive methods]. / Contribution à l'étude des motivations, de l'acceptation et du refus des méthodes anticonceptionneles.

PIP: To approach the question of motivation toward contraception, the new French law on contraception passed in 1967, and the mode of action and risks of pills, IUDs, and diaphragms are reviewed. The new law governs import sale, prescription, placement of IUDs, consent for minors, and facilities of the clinics that issue contraceptives. Physicians dislike the prescription registration system, the written consent, lack of reimbursement by social security, and neglect of abortion. Oral contraceptives act on gonadotropin release, cervical mucus, and endometrial development. The can cause nausea, weight gain, bleeding, and thromboembolism. The relationship of medicine phobia, forgetting pills, and religion to success with pills remains to be studied. IUDs act on tubal and uterine motility and the endometrium. They frequently cause bleeding, pain, and expulsion, and rarely infection or perforation. Their failure rate is .5-2%. They are indicated when contraception must be separated from sexuality. Diaphragms and caps require technical fastidiousness and usually are preferred by older women. Their failure rate is 10-12% Now that contraceptive research can be done openly in France, more information about contraceptive motivation will become available.^ieng

[Perinatal and infant mortality in French Guyana. Evaluation of a regional maternal and child health care policy]. / Mortalite perinatale et infantile en Guyane. Evaluation d'une politique regionale de sante maternelle et infantile.

PIP: High rates of infant and perinatal mortality in Guyana compared to France led to implementation of a regional maternal and child health policy in Guyana beginning in 1981. Additional personnel, improved equipment, administrative changes, and training activities were designed to reduce the perinatal mortality rate from 36 to 26/1000 and the infant mortality rate from 35 to 25/1000 over 2 years. Each death certificate was analyzed according to a systematic protocol to determine whether the mortality objective was being met and to identify epidemiological factors involved in each death. Rates of perinatal and infant mortality respectively declined from 37.6 and 36.3 in 1978 and 36.3 and 38.0 in 1982 to 27.3 and 25.3 in 1983. Half of the deaths occurred in 2 regions which accounted for only 1/4 of all births. The socioeconomic environment was considered good in 30% of cases, bad in 30%, and not known in 40%. Age did not play an important role in the deaths. 59% of the mothers had had at least 4 prenatal consultations. During pregnancy, 62% of cases had hypertension and toxemia, threatened premature labor, urinary infection, or anemia. Fetomaternal infections or syphilis were found in 16 of 62 deaths, maternal hypertensive disease in 15, acute fetal distress in 14, congenital malformations and placental pathology in 6, other causes in 8, and unknown causes in 3. 39 of the 62 infants were premature. Most of the term babies died from acute fetal distress or fetomaternal infection, causes directly related to labor, while the premature babies succumbed to uteroplacental pathology, syphilis, or indeterminate causes. Among 32 neonatal deaths and 26 postneonatal deaths respectively, 11 and 1 were caused by maternofetal infection, 8 and 0 by pathologies of pregnancy, 8 and 4 by pathologies of labor and delivery, 4 and 4 by congenital malformations, 1 and 11 by infections, 0 and 5 by nutritional problems, and 0 and 1 by accidents. The results appear to indicate that the maternal and child health policy initiated in 1981 has succeeded in improving perinatal surveillance and health care. Efforts should be continued to improve management of labor and delivery to avoid acute fetal distress and to improve health care in the regions with disproportionately high rates of perinatal and infant mortality.^ieng

[Deimons-Meigs syndrome and elevated CA-125: diagnosis of ovarian cancer and therapeutic implications]. / Syndrome de Deimons-Meigs (SDM) et élévation du marqueur (CA-125: diagnostic du cancer de l'ovaire et implications thérapeutiques.

Regarding a original observation of the Deimons-Meigs syndrome, the authors have derived, from a review of the literature, the main clinicals and etiopathogenics characteristics, and tried to discuss the terms and conditions of a therapeutic treatment appropriate to such a situation.

High frequency (20 MHz) ultrasonic devices: advantages and applications.

OBJECTIVE: This paper investigates the problems, advantages and potential applications of 20 MHz ultrasonic devices. METHOD: Aqueous gel and a thin appropriate membrane to enclose the front tip were used with 20 MHz probes without obvious decrease in resolution and sensitivity compared to the results obtained without a membrane and this considerably facilitates their routine use. RESULTS: Many applications with linear scanning were evaluated in dermatology, ophthalmology (investigations of the anterior chamber of the eye, checking of corneal grafts), stomatology (detection and evaluation of periodontal disease) and in the field of measurement of very low velocities in small vessels by means of a duplex probe comprising two 20 MHz transducers: an imaging transducer and an inclined blood flow measurement transducer. Velocity profiles (velocities less than 0.50 mm/s) were measured in 100-300 microm diameter vessels using a cross-correlation method. CONCLUSION: The use of 20 MHz frequency limits resolution but we have shown that this frequency allows the development of easy to handle probes.