[Peripheral neuropathy with cryoglobulinemia (author's transl)]. / Neuropathies périphériques associées à une cryoglobulinémie.

The author describe 2 personal observations of peripheral neuropathy with cryoglobulinemia and the 28 cases previously recorded are reviewed. The characteristics of the usually sensorimotor neuropathy are not specific. Nevertheless, the association with purpura, Raynaud's syndrome and leg ulcers and the inconstant aggravation of the symptoms with cold allow the diagnosis to be suspected on clinical grounds. Cryoglobulin can be recognised by immunoelectrophoresis and classified as type I monoclonal, types II and III mixed and polyclonal. Associated disease should be looked for; lymphocytic proliferation or auto-immune disease. If none is found a diagnosis of essential cryoglobulinemia can be made but with caution as cryoglobulinemia can precede by several years the appearance of associated disease.

[Pseudo-tumoral softening of the cerebellum]. / Les ramollissements pseudo-tumoraux du cervelet.

The author establish an onerall picture of cerebellar infarction with brain stem compression after reviewing 63 cases published in the literature and 4 personal observations. The frequency of this affection can be compared with that of cerebellar hematomas. Diagnosis is based on its predominance in males, the early age at which it appears, its rapid and typical onset, and the delayed signs of brain stem compression. Conventional neuroradiological procedures show an expanded cerebellar volume, and the scanner can specify the ischaemic nature of the lesion. As soon as changes in consciousness occur surgical decompression is necessary, first by external drainage of C.S.F. and later, if necessary, by direct access to the postdrior fossa.

[Urethral fistula following reconstructive surgery of hypospadias. Apropos of 34 cases]. / Fistules urétrales après chirurgie réparatrice pour hypospadias. A propos de trente-quatre cas.

Thirty-four children, ten of them coming from another Surgical Center, underwent repair for urethral fistula after hypospadias reconstructive surgery, over a period of three years (1985-1987). After the first operation, there was no recurrence in 59% (20 cases). Currently, all fistulas have been closed, except in 3 cases. Closure by direct suture was used in 30 cases (88%). The best results were observed with suture in three planes and without diversion, on an outpatient basis (91% of success for 12 cases). The Leveuf method is a safe operation for complex penile fistulas after repeated surgery.