Anatomoclinical Study Research Articles

Cancers canalaires in situ du sein avec micro-invasion : Quelle exploration ganglionnaire axillaire ?

Specify the role of axillary lymph node removal in micro-invasive in situ duct carcinomas (DCIS-MI) of the breast with a series of 107 consecutive cases.Single-centre, retrospective, anatomoclinical study with application of the European guidelines adopting as pathological definition the presence of areas of micro-invasion not exceeding 1mm. Axillary lymph node dissection was systematically complete and was preceded by the search for the sentinel node in 10 patients using the isotope method.Lymph node invasion was revealed in 8 cases in the global population (7.5%). All the cases except one exhibited typical deleterious histological features: comedo architectural sub-type, high nuclear grade, and size of the lesion>3 cm. The lymph node invasion was of 18.5% in the sub-group of high-grade micro-invasive comedo-carcinomas measuring more than 3 cm.Contrary to those exhibiting pure DCIS, DCIS-MI patients require surgical exploration of the armpit, the most appropriate modalities of which are currently debated: classical axillary lymph node dissection or search for the sentinel lymph node; the selective lymphadenectomy procedure is not yet a consensually validated technique.

The gastrocolic trunk of Henle in pancreatic surgery: an anatomo-clinical study.

From 37 peroperative and cadaver anatomical investigations, it was concluded that, in contrast to the information in common texts on anatomy and surgery, a venous gastrocolic trunk was observed in only 46% of subjects; a true bipod gastrocolic trunk of Henle was a rare (8%) phenomenon. In this respect, a variate venous anatomy at the inferior border of the neck of the pancreas, as observed in this study, must be taken into account during pancreatic surgery and radiological procedures in the pancreas.

Anatomo-clinical correlation study in Alzheimer's disease

BACKGROUND: There is a major debate in Alzheimer’s disease (AD) research about the role of neurofibrillary tangles (NFT) and senile plaques (SP), as well as their main molecular counterparts – tau and beta amyloid proteins – in the pathogenesis of the disease. In this sense, anatomo-clinical studies are of special interest, since they can ultimately determine which neuropathological lesion is more closely related to the cognitive deficits found in the disease […] Anatomo-clinical correlation study in Alzheimer’s disease (abstract)

Long‐term thalamic stimulation in Parkinson's disease

Parkinsonian tremor may be suppressed by thalamic stimulation. For an equivalent clinical efficacy, its obvious advantage over micro-thalamotomy is its reversibility. This patient experienced postural tremor at the age of 44 years and akineto-rigid syndrome 8 years later. At the age of 60 years, intrathalamic stimulation was applied over a long-term period of 43 months until death and was efficient on tremor with low stimulation. This case is the first with anatomic verification. The extent of the lesion provoked by the electrode is very small. The location of the stimulation site was in the medio-inferior part of the intermedius complex at the entrance of cerebello-thalamic fibers. The stimulation of the cerebellar afferent axons could be the cause of the clinical effect. The stimulation site corresponds to the thalamic source of the precentral and accessory motor cortex, which correlates with changes observed in our PET study showing a regional cerebral blood flow decrease in cerebellar nuclei and also in precentral and accessory motor cortex. The places and mechanisms of the effects of stimulations and lesions could be different.

An anatomo-clinical study of delayed skin allergic reactions to nickel following intradermal injections of lidocaïne with a Dermo-jet.

10 women allergic to nickel developed skin reactions at injection sites with a Dermo-Jet (Krantz model) of (a) 2% lidocaine solution and (b) 0.9% saline solution. 10 women (age-matched) not allergic to nickel were selected as controls and submitted to the same injections; they had no positive reactions. Various controls (including injections with a needle and patch tests) were made in both groups. Nickel was leached into fluids from the metallic internal parts of the Dermo-Jet. The positive reactions were allergic and due to nickel. Histology showed changes of an allergic contact dermatitis with particular features, probably due to the intradermal injection of nickel. Some practical implications regarding the quality of medical instruments are discussed.

Les luxations des articulations interphalangiennes proximales des doigts longs: Étude anatomo-clinique et déduction thérapeutique

The authors report an anatomo-clinic study on dislocations of the PIP joint in order to point out the lesions and the adequate treatment. This study is composed of two parts: first an anatomoclinical study of 29 dislocations all of which were operated on principle after a clinical and radiographic examination. The second part is a complementary anatomical study of 20 cadaveric joints based on an analysis of the different stabilizing structures of the joint. The study showed that, in order to get a dislocation of the PIP joint, it is necessary that two stabilizing formations be damaged. There is a major lesion and a minor one. The major lesion is characteristic of the type of the dislocation. Anterior dislocations were very rare in this study. The major lesion is a rupture or desinsertion of the central slip of the extensor tendon and the minor lesion is a tear in the collateral ligament. The treatment must be surgical because of the major lesion of the extensor apparatus. Quite different from the anterior lesions are the posterior and the lateral dislocations. They are more frequent. Although they have some similarities, they are, in fact, very different from an anatomoclinical and a therapeutic point of view. In posterior dislocations the major lesion is a rupture of the volar plate. The minor lesion is a partial desinsertion of the collateral ligament. These dislocations are stable after reduction. According to the authors, the best treatment is orthopedic, with a partial immobilization preventing the last degrees of extension. The major lesion in lateral dislocations is a rupture or avulsion of the collateral ligament and the minor lesion is a partial tear of the volar plate. After reduction they are unstable, and thus justify, according to the authors, an operative treatment, especially as they are often associated with cartilaginous lesions.

Neuroaxonal dystrophy, a juvenile-adult form

This paper is an anatomoclinical study of a neuroaxonal dystrophy case, starting in childhood and evolving up to maturity, which may be considered as a juvenile-adult form of this syndrome. Several of the morphologic emphasized aspects suggest that this juvenile-adult form is a primary affection of the axon and therefore, may be considered as a separate entity, differing from the Hallervorden-Spatz disease.

Ergotism Anatomo-clinical study of a case

Ergotism Anatomo-clinical study of a case

Cerebral vascular accidents in the course of tumors of the cerebellopontine angle. Pathogenic considerations.

This paper reports on 2 cases of acoustic neurinoma, bilateral in one of the cases; the first patient exhibited an intraparenchymatous hemorrhage and the second a cerebellar hemorrhage. A description is given of the lesions at the level of the bulbopontine reticular formation, which are considered to be due to compression. Cerebral atherosclerosis lesions were also present in the first case and compression caused by central neurinomas in the second. The authors discuss a possible relationship between lesions of the reticular formation and the occurrence of cerebral vascular accidents, the evidence being based on neurophysiologic data, certain findings in the course of interventions on the brain stem, and ana-tomoclinical studies.

The thalamic hemorrhage. An anatomo-clinical study.

An anatomoclinical study has been performed on 5 cases with thalamic hemorrhages. The clinical picture occurring in elderly hypertensive subjects was constituted by a sudden hemiparesis or hemiplegia

Evolution clinique de la dystrophie neuro-axonale infantile à la lumière de la chronologie des atrophies systématisées sous-jacentes

The anatomo-clinical study of 4 cases of infantile neuroaxonal dystrophy enables us: 1. (1) to describe its clinical features: the disease starts usually at the end of the first year of life after a normal early psychomotor development; severe hypotonia, arrest of mental development followed by a rapidly progressive dementia, optic atrophy, progressive appearance of hypertonia with a pyramidal syndrome, bulbar signs, sphincter disturbances, death between the ages of 4 and 10 years; 2. (2) to stress the main histological features of the disorder: presence of spheroid bodies in the grey matter with a clear-cut predominance in the sensory bulbo-spinal relay nuclei, multiple system atrophies (optic and pyramidal pathways, cerebellar cortex, posterior columns), diffuse sclerosis of the white matter, accumulation of neutral fats in the striatum and the pallidum, histiocytic proliferation in the splenic Malpighian follicles; 3. (3) to confirm, through electron microscopy, the localization of the spheroids in the axon terminals and the presynaptic endings; 4. (4) to attempt a correlation between the clinical features and the evolution of the lesions in the central nervous system.

Anatomo-clinical study of the adrenals in nephrosclerosis.

The inter-relation of the adrenal gland and the kidney can be really demonstrated when these two glands, or one of them, show pathological alterations. In cases of nephrosclerosis, the adrenal gland shows notorious modifications in its structure, even if clinical studies through biological analysis of the secretions (blood and urine) would not show great alterations. We can find very important morphological alterations of the glomerular layer in the cortical zone and of all the medullar zone structure. The unilateral adrenalectomy improves the clinical state of the patient in many of these cases of nephrosclerosis.

On autonomic nervous lesions in viral hepatitis and liver cirrhosis

The anatomo-clinical study of the right coeliac ganglion in lethal viral hepatitis and liver cirrhosis was done in 12 cases by means of the confrontation of the clinical data and the histopathology of the liver with the histopathology of the coeliac ganglion. The autonomic nerve lesions were studied especially by means of Troitsky's silver block impregnation, in some cases of Bielschowsky's impregnation also and accessorily with Nissl's method and other current staining technics.

La cécité psychique.

This monograph on psychic blindness is based on a study of the literature and on experience of 415 personal observations of posterior hemispheric lesions. It is divided into three parts: (1) evaluation of conceptions of optic agnosia; (2) anatomoclinical study of methods of examination and semiology of visual agnosias, description and analyses of personal material, relations between the symptoms and statistical correlations, and anatomical conditions; (3) present conceptions concerning optic agnosia and the agnostic phenomenon. There is a brief bibliography. As a result of their study the authors isolate two groups, one of which is characterized by unilateral spatial agnosia and other correlated forms of spatial agnosia, the other by agnosia for objects and figured images and the statistically correlated agnosia for symbolic images. The first group can perhaps be extended also to agnosia for physiognomies and the second group also perhaps to agnosia for colors, but the number of

ON THE TOPOGRAPHICAL DISTRIBUTION OF CORTEX LESIONS AND ANOMALIES IN DEMENTIA PRÆCOX, WITH SOME ACCOUNT OF THEIR FUNCTIONAL SIGNIFICANCE

1. The writer has followed up his earlier work on the dementia praecox group (1910) with a more systematic anatomoclinical study of 25 cases, having a view to (a) definite conclusions as to the structurality (organic nature) of the disease, and (b) correlation of certain major symptom groups (delusions, catatonic symptom groups, auditory hallucinosis) with disease of particular brain regions. 2. As to (a), the structuratity of dementia prœcox, the writer feels that the disease must be conceded to be in some sense structural, since at least 90 per cent of all cases examined (50 cases, data of 1910 and 1914) give evidence of general or focal brain atrophy or aplasia when examined post mortem, even without the use of the microscope. 3. Moreover, with the use of the microscope, the problem of the normal-looking remainder can perhaps be solved, since the only two normal-looking brains7 in the 1914 series of 25 yielded abundant appearances of cell-destruction and satellitosis in the cerebral cortex, which had ...