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In a human case of Creutzfeldt-Jakob disease, fragments of membranes were seen within some vacuoles. They form accumulations of vesicular or curled structures and have to be differentiated from other membranous profiles that one can observe within the large spongy cavities.

The electron microscopic study of a cortical biopsy from a child presenting a Tuberous Sclerosis shows the importance of the astrocytic gliosis, the existence of abnormal cells of which two types can be recognized, and the presence of giant cells. All these cells are remarkable by the abundance of the ergastoplasm, the development of the Golgi apparatus, and the presence of membrane bound dense bodies. These cells are undoubtedly of astrocytic origin and appear very similar to the cells observed in a tumour of the caudate nucleus of another child affected by the same disease.

In this case, showing the classical features of the Eaton-Lambert myasthenic syndrome, the neuromuscular symptoms appeared 21 months before the bronchial carcinoma was diagnosed. The electrophysiological study demonstrated, beside the marked potentiation under repetitive nerve stimulation at 30 c/sec., some modifications of distal latency, specially after administration of Edrophonium chloride. The muscle biopsy showed changes secondary to a peripheral motor nerve involvement; electronmicroscopic study of the motor end-plates revealed a highly developped subneural apparatus. Long-run treatment by guanidine hydrochloride determined haematologic and renal toxic manifestations. Prednisolone was for a time active on the myasthenic syndrome.

Simultaneously to the development of new techniques such as the computerized axial tomography, the gamma-angioencephalography is progressing in the field of cerebral investigation in its original way, keeping on non invasing character. In view to analyze this evolution we shall examine first its technical possibilities, then the extractible data of the various techniques. Finally we will consider in which way we must bring most of our effort for the best utilization of the gamma-angioencephalography in the routine work, on one hand, and for progressing in the knowledge of the physiopathology of some lesions, specially vascular accidents, on the other hand. Technical modalities are multiple. Besides the standard technique (pertechnetate angiography with rapid sequential views, regional transit curves, early and late static views) it is possible to replace or to repete the injection: --changing the patient's position, --using another radiopharmaceutical labelled with technetium -or another isotope, or two tracers for two compartments; --carrying out a pharmacodynamic or CO2 test, --using radioxenon, and secondly a pure vascular tracer, to measure relative regional blood pool and relative regional blood flow. a) morphological ones (vascular tracks, regional blood pool, radioactive areas: number, form, homogeneity, outline), b) dynamic and quantitative ones (transit times, blood flow, extravascular diffusion, changes of these parameters when changing the radiopharmaceutic, or when using a test). Progresses can take place in three ways, very closely related to each other: a) In the methodology, to precise --relative merit of the different radiocompounds according to the various cerebral lesions, --methods for examination according to the clinical problems, --computing and date processing techniques. b) In the indications, to choose the best, the simplest, though the surest method for the daily clinical problems, and the best one to assemble special information escaping to the morphological radiological techniques. This choice needs frequent and close discussions between clinicians and nuclear specialists. c) In the signification of the data, to interprate correctly: --preferential uptakes in lesions or in compartments, --changes in the relative volumes of vascular bed and extravascular space in lesions, --vascular reactivity to an hemodynamic test, --accumulation or clearance of a diffusible tracer such as xenon. It is not always easy to reach a non equivocal interpretation of a whole group of data. It can be better to give a descriptive analysis which brings together elements for the diagnosis and physiopathological observations helpful for a therapeutic action and to follow up the disease at short and long term.

Neuropathological study of 3 patients dying from bismuth encephalopathy showed the absence of specific lesions and the probably secondary nature of the abnormalities found. Multiple samples taken from various areas of the brain were used for the purpose of the analysis of the topographical distribution of bismuth. Levels were invariably very high and to toxic agent diffusely distributed. The concentration was nevertheless higher in the grey matter than in the white matter. They hypothesis of a liposoluble compound which would explain the affinity of bismuth for cerebral tissue is probable.

It is impossible to tell the exact prognosis of the patients affected with neuroglial cerebral tumors which are being treated with cytostatic chemotherapy. This impossibility has made it necessary to repeat the different examinations given before and during the treatment of 45 patients. We contemplate a series of clinical, immunological, biological, hematological tests; then electro-encephalogram, brain scan and a echography reveal the variations in volume of the tumor. If some of the examinations are not conclusive, the others, specifically the electro-encephalogram, the mental state evaluation are accurate in determining the final evolution. Immunological shows modification of cellular immunity with a decrease of T cells (57% +/- 5,9) which are hyporeactive (PHA 1/10: 42% +/- 7,5). EEG pertubations and clinical evolution are in agreement in 80% of cases. The median survival of patients as far as EEG signs are concerned in the third month is 375 days if there is an electival improvement and 188 days in the opposite difference which is significant. Scan ications are not conclusive because of peri tumoral edema evolution and hift of medical structures can be shown by echography.