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Metaphyseal anadysplasia is a rare form of metaphyseal chondrodysplasia with well-defined radiological abnormalities. The prognosis is good as the natural course results in regression of the lesions with normal stature in adulthood. The few reported cases, exclusively in male children, indicated possible X-linked recessive transmission. The documentation of two affected sisters suggests genetic heterogeneity or another mode of inheritance.

In cases of subclinical mammographic abnormalities, being able to determine after screening, the indications regarding the type of imaging guidance and the type of biopsy equipment. In presence of microcalcifications, stereotactic mammography, either screen-film or digital, is the modality of choice. As fine needle aspiration cytology is insufficient, it is necessary to obtain tissue specimens with at least 14 Gauge Tru-cut needle, triggered by automatic guns, or coaxial needles of 11 G or 8 G, adaptable on a vacuum aspiration system. In case of mammographic opacities or masses, the same type of sampling can be used under US guidance as long as there is a good sonographic contrast of the lesion. Fine needle puncture, well accepted, keeps all its interest for cystic lesions and for solid ones, because of the value of its multidirectionnal sampling that well trained cytopathologists can make very informative. However, in case of insufficient or discordant results, US guided microbiopsies or macrobiopsies, using newer guns, allow to obtain a histologic diagnosis equivalent to surgical biopsy. If fine needle US guided puncture can be performed in first intention, straight after ultrasonographic examination, percutaneous micro- or macrobiopsies (using US or stereotactic guidance) must be undertaken in second intention after having explained to the patient this ambulatory procedure, the eventual risks, and by insisting on the results that can be expected for a precise diagnosis.

Comparing Power Doppler imaging versus technetium-dimercapto-succinic-acid (Tc-DMSA) scintigraphy in acute pyelonephritis of childhood.First episode of urinary tract infection, clinical and biological findings suggesting an upper lesion, absence of urological malformation or obstruction, absence of reflux (or vesico-ureteral reflux inferior to grade 3). Number of patients: 49, length of the study: 26 months (from November 95 to January 98).Tc99m-DMSA scintigraphy (after five days), B mode and Power Doppler imaging (on the day of admission or the following day). Systematic cystography (day 5 to day 30).In terms of positive diagnosis, scintigraphy was superior to Power Doppler, and the latter was superior to B mode ultrasonography. Sensitivity (scintigraphy being the gold standard) was equal for both B mode and Power DopplerUS imaging, but combined Power Doppler and B mode US provided improved results.Currently, the results with Power Doppler imaging are insufficient to replace DMSA scintigraphy. However, Power Doppler is a good complement to B mode US.

CKS proteins, for which the original member, p13suc1, was identified as a suppressor of cdc2 alleles in S. Pombe, have long served as a reagent for the purification of p34cdc2, whereas their biological function has remained elusive. Apparently conflicting data derived from different model systems may indicate a diversity of function for these proteins. Several new observations in yeast and Xenopus egg extracts together with new structural information tends to enhance the hypothesis that CKS proteins function to alter the activity of cdc2 at several important points in the cell cycle. Here we review previous observations and recent data that suggest CKS proteins serve as adaptor proteins that modify the functions of cdc2 throughout the cell cycle.

The authors wanted to study diagnosis contribution and therapeutic importance of tenography in posterior tibial tendon tenosynoviopathies.The series included 42 patients (26 females and 16 males) from 23 to 69 years old. The affection had a course for about two years. A trigger or promoter factor was founded in 32 cases. Clinical examination found only 12 standard feet. Biological exams were normal.All patients had a tenography. When tenosynoviopathy was diagnosed, the surgeon injected cortivazol in the sheath by the catheter, within the extra-tendinous space. In case of treatment failure, a synovectomy was realized with possible tendinous suture, under the protection of a weight bearing plaster cast for 21 days.Pathological features: we have founded 26 major irregularities of the sheath, extensive with scalloped outlines of which 8 were supra-malleolar and 18 sub-malleolar, 15 irregularities located at the level of the sheath outline of which 4 were supra-malleolar and 11 sub-malleolar and with a tear of 1 cm length. Long term results: among 36 reviewed patients, pain disappeared in 29 cases, after only one injection (21 cases), or after a surgical treatment (8 cases).Tenography has for us great interest for the diagnosis of a tenosynoviopathy, allowing in the same time an extra-tendinous injection of corticoid in the sheath itself. But it doesn't always allow to make a diagnosis of a tendinous tear. A part of our failures can be secondary to these tears. According to our results it could be recommended to practice in a first time a tenotomodensitometry (teno TDM). In case of a tear, a surgical treatment by synovectomy with suture may be proposed first, for a tenosynoviopathy an injection must be realizes.Tenography allows a precise diagnosis and in the same time, a treatment by injection. The tendinous tears require a surgical suture but are better diagnosed on a teno TDM.

The authors report a case of a neonate presenting with thrombosis of the abdominal aorta following catheterisation of the umbilical artery. The diagnosis was established by ultrasonography in a context of isolated anuria. Immediate disobstruction by Fogarty's method results in cure.

Results are reported of therapy of 18 neonates in whom obstetrical ultrasound imaging had demonstrated uni- or bilateral pyelo-caliceal dilatation due to stenosis of pyelo-ureteral junction (18 children--2 hydronephroses). Neonatal biologic, ultrasound and urographic examinations confirmed presence and assessed importance of the hydronephrosis. As a function of findings therapy consisted of immediate operation (10 neonates), delayed surgery (5 cases) or surveillance (3 cases). Severe uni- or bilateral forms, classified stage III or IV were operated upon immediately, sometimes as emergencies. Less severe cases (stage III) were operated upon after 1 to 3 months, and the minor forms (stage II) were the object of simple surveillance. The operative technique used for treatment of the hydronephros was the Andersson-Hynes operation, anastomosis in 9 cases involving microsurgical procedures. Emphasis is placed on the serious nature of these neonatal forms, often bilateral or associated with contralateral uropathy. In utero shunts during the antenatal period are excluded, therapy being decided after birth. Based on their experience, the authors underline the reliability of early microsurgical pyeloplasty which appears to be the operation of choice in neonates at the present time.

Ultrasonography is the only morphological exploratory breast examination which is truly valid and inexpensive and may usefully complement clinical examination and mammography which remain the basic and absolutely necessary investigative tools in this pathology. Constant improvement of the spatial resolution of the "barrettes" permits us to characterize anomalies of 3 millimeters. These linear probes are easily manageable, permitting a better ultrasound guiding of breast punctures. The main indications for ultrasonography remain, in addition to the evaluation of any "nodule", the evaluation of disseminated or localized densities, where mammography is less beneficial. If exploratory ultrasonography proves very useful in malignant pathology, it has certainly been most useful in benign diseases, permitting us to determine a precise etiology and a better adjustment of the treatment.

Mammography and breast ultrasonography are complementary examinations. The combination of the two examinations can provide an accurate diagnosis, which mammography alone is unable to do. Ultrasonography is particularly important in the examination of dense breasts, especially for the visualization of sonolucent or hypoechogenic formations. However, ultrasonography should not be performed alone, as it is unable to visualize microcalcifications. It can not be used as a screening test and it would be a professional error to perform only a clinical examination and ultrasonography, as a large number of diagnoses would be missed. Two essential points should be stressed: 30% of carcinomas have microcalcifications; amongst these 30%, many lesions are small and impalpable and they may not be seen on ultrasonography in a fatty breast. 40% of occult cancers are detected by the microcalcifications identified on mammography, which remains the key to breast investigations. Ultrasonography compensates for some of the deficiencies of radiography and can be very useful in dense breasts, in cystic or hypoechogenic structures. It can also be used to guide aspiration biopsy of non palpable lesions and for the pre-operative localization of impalpable lesions with abnormal echostructure, which are not visible on mammography.