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The authors present the summary of a workshop of a group of radiation oncologists and radiation physicists on three dimensional treatment planning and conformal radiation therapy with multileaf collimator. It appears that this technic must be considered as experimental and that it cannot be promoted in all radiotherapy departments without scientific and clinical evaluation.

Left ureteral stenosis induced by pancreatitis was observed in one case. Five similar cases have been reported in the literature. Ureteral obstructions may be found in two clinical contexts--patent pancreatitis or retroperitoneal fibrosis. The ureter may be simply compressed mechanically, or there may also be enzymatic or ischemic necrosis. The clinical approach should be directed towards treating primarily the pancreatitis and secondarily the urological pathology. As regards the urological treatment, ureterolysis or ilio-ureteroplasty are indicated in cases of organized irreversible ureteral stenosis.

On the basis of a case of thoracic ectopic kidney, discovered following trauma and diagnosed at laparotomy (since it was confused with rupture of the left diaphragm) the authors review certain data concerning this rare malformation (150 published cases). --The site of origin of the renal artery may be used to distinguish on the one hand between true intra renal ectopic kidney with the renal artery arising from the aorta and secondly trans-diaphragmatic herniation of a kidney with a kidney with a normal vascular pedicle through a hernia, most often congenital, and equally often right as left. --Clinically, at the time of a routine examination or following trauma, chest X-ray reveals an opacity at the base of the thorax, the low and posterior topography of which is suggestive of the diagnosis and and IVP is then indicated. In the absence of violent trauma, the diagnosis of traumatic hernia is eliminated. The distinction between true ectopic kidney and congenital trans-diaphragmatic hernia becomes a false problem since there is no need for treatment in either case.

While Horner's syndrome resulted from a paralysis of the cervical sympathetic outflow, its opposite, Pourfour Du Petit's syndrome, was caused by the irritation of these nerves. The case described occurred after brachial plexus block.

The discovery of a parathyroid adenoma in the middle mediastinum is exceptional and fewer than 10 cases have been reported. On the basis of a new case, the authors propose several pathogenic hypotheses: this adenoma develops and/or migrates from the fourth branchial pouch. Preoperative imaging is very useful for guiding the operation via sternotomy. The absence of any CT signs in the present case caused us to explore the retro-aortico-caval region. Sternotomies performed for the treatment of primary hyperparathyroidism are unsuccessful in one third of patients. In more than 30% of cases, the cause for this failure is related to the persistence of a cervical adenoma: when the pathological gland is actually located in the mediastinum, the possibility of middle mediastinal ectopia should be considered when investigation of the classical sites in the neck and mediastinum remains negative.

The authors analyze sixty-two cases of acute generalized peritonitis with a non-traumatic colonic etiology. They point out that the prognosis depends on three main factors: the age of the patient, the time spent in diagnosis and the therapeutic difficulties. They recommend a gastrographin colonic enema to obtain earlier diagnosis, in the absence of radiological evidence of pneumoperitoneum, in elderly patients presenting with abdominal signs. They also recommend multistage surgical management combining effective drainage of the abdominal cavity with resection of the perforated segment of the colon, whenever there is extensive damage to the colon, or in the presence of a tumor. In their view, conservative surgery should be confined to strictly selected cases not involving tissue resection. These indications are essential if a satisfactory result is to be achieved.