[Kirner's deformity. 4 case reports and review of the literature]

Kirner's disease is a rare deformity of the distal phalanx of the little finger, with a combination of camptodactyly and clinodactyly and clinodactyly. A review of the literature and analysis of our cases show that this anomaly appears to result from a unusual insertion of the deep flexor over the growth cartilage. No treatment is required in view of the absence of any clinical and functional symptoms.

Assignment of the protonated 13C resonances of apo-neocarzinostatin by 2D heteronuclear NMR spectroscopy at natural abundance

Nearly complete assignment of the protonated carbon resonances of apo-neocarzinostatin, a 113-amino acid antitumor antibiotic carrier protein, has been achieved at natural 13C abundance using heteronuclear 2D experiments. Most of the cross peaks in the proton-carbon correlation map were identified by the combined use of HMQC, HMQC-RELAY and HMQC-NOESY spectra, using already published proton chemical shifts. However, double-DEPT and triple-quantum experiments had to be performed for the edition of CH and CH2 side-chain groups, respectively, which were hardly visible on HMQC-type maps. The triple-quantum pulse sequence was adapted from its original scheme to be applicable to a natural abundance sample. The correlation between carbon chemical shifts and the apo-neocarzinostatin structure is discussed. In particular, 13C alpha secondary shifts correlate well with the backbone conformation. These shifts also yield information about the main-chain flexibility of the protein. Assignments reported herein will be used further for interpretation of carbon relaxation times in a study of the internal dynamics of apo-neocarzinostatin.

[Flaps for covering extensive losses of cutaneous substance on the upper limb. Apropos of 15 cases]

The authors report on their recent experience concerning flap treatment of upper limb complex trauma, based on 15 cases. Proper wound care, and the use of healthy, well vascularised tissues for coverage is of paramount importance for good results, whose quality mostly depends on the severity of initial lesions. The results of this series are encouraging and appear to be a consequence of the great possibilities offered by the cutaneous or muscular flaps used.

Anatomical basis of a fascio-cutaneous pedicle flap based on the infero-lateral collateral artery of the leg

An anatomical study of 30 cases has been performed on the vascularisation of the distal third of the antero-lateral compartment of the leg, with particular reference to the relations of the infero-lateral collateral artery of the anterior tibial artery, the perforating branch of the peroneal artery, and the antero-lateral malleolar artery. A fascio-cutaneous pedicle flap based on the infero-lateral collateral artery is described noting that the superior, anterior, and posterior limits are similar to those of the lateral supramalleolar flap of Masquelet. The inferior limit of this new flap is 15 mm distal to the site of emergence of the perforating branch of the peroneal artery. The advantages of this flap are; a large surface area for cover, antegrade vascularisation, and no significant vascular sacrifice. The distal half of the calf can be covered both medially and posteriorly as well as the proximal half of the dorsum of the foot, the medial and lateral arch areas, the perimalleolar region, and the region behind the Achilles tendon. The flap requires the presence of the infero-lateral collateral artery of the tibialis anterior which can be confirmed either peroperatively or preoperatively by angiography.

[Preservation of a foot by shortening tibial osteotomy after a circumferential electric burn to the leg]

A patient presented with circumferential loss of skin substance of lower quarter of leg. The patient's advanced age and the poor local conditions could have produced an aleatory result for a flap graft. It was therefore decided to perform a shortening tibial osteotomy as a conservative surgical procedure.

Processing of vasoactive intestinal peptide and transferrin in human cancerous colonic cells

Endocytosis of vasoactive intestinal peptide (VIP) and of transferrin (Tf) was comparatively studied in human cancerous colonic HT-29 cells. Cellular depletion in potassium inhibits the internalization of VIP (23%) and to a greater extent (42%) that of Tf. This indicates that clathrin-coated pits are also involved, at least in part, in VIP uptake. The distribution of 125I-Tf- or 125I-VIP-containing vesicles in sucrose gradients revealed low and high density vesicle subpopulations. The low density vesicle subpopulation represented a transient compartment from which incoming vesicles containing N-leucyl-beta naphthylamidase were recycled back to the membrane while those containing beta-hexosaminidase (HA) and ligand were mostly transferred into the high density compartment. Subsequent fusion of the latter with heavy vesicles was demonstrated by the shift of HA and ligand with vesicles that had been prelabeled with horseradish peroxidase (HRP). Simultaneous internalization of Tf-HRP and 125I-VIP showed that both the low and high density vesicle subpopulations comprised of two types of VIP-containing vesicle, as confirmed by the density shift reaction: two-thirds of VIP shifted with the Tf-HRP-containing vesicles to denser fractions and the remaining was found with unshifted vesicles. These findings indicate that the VIP-receptor complex processing in HT-29 cells follows two routes, the major route being common with Tf endocytosis.

Anatomical basis of neurotisation of the median nerve in the hand by the radial nerve

The sensory sequelae after lesions of the median nerve cause difficulties in treatment since few sensory transfers are available. Neurotisation of the median by sensory branches of the radial nerve have aroused little interest although they have already been used by some authors after anastomosis at the wrist or through the first or second interosseous spaces. Based on what was originally a purely anatomic study, our interest was directed to the possibilities of performing more distal neurotisation for the treatment of sensory disorders of limited extent. The chief object was to obtain faster sensory reinnervation. 30 hands were dissected and a radial branch was defined as suitable for neurotisation whose diameter approximated that of its palmar digital homolog. Only those findings constantly observed in analysis of the hands studied were taken into account. It is therefore possible to reliably define the type and site of the routes of approach as well as the sensory branches suitable for neurotisation.

[Synovial cyst of the hip with revealing neurologic symptoms]

The authors report an exceptional case of a ganglion cyst of the hip revelated by sciatica. They recall the usual clinical expression of this pathology, her diagnostic tests and her treatment. They open the discussion about ganglion cyst and mucoid pseudocyts.

The Lefevre ulnar nail

The Lefevre nail applies the principles of locked intramedullary nailing in the treatment of fractures of the ulna. It is made up of two segments which slide telescopically, so that assembly may be in compression, distraction or neutral. Fixation at the two ends of the ulna is guaranteed by two transverse screws. It may be used in pseudarthrosis and osteotomies for lengthening and shortening, as well as in simple or complex fractures. The cases presented provide an overview of the use of the nail at the Brest Center, where the nail was invented and developed, and at the Rizzoli Institute. The study includes 22 fractures, 1 pseudarthrosis and 1 osteotomy. Consolidation was obtained in all of the cases after an average of 2.5 months. Immobilization in plaster was required only in cases with associated lesion of radius. The functional results obtained were satisfactory.

Centric relation and programming semiadjustable articulators with the universal jig. Part II: Experiments

The "universal jig" described in a previous article was tested on 10 patients to check for reliability. The recording of centric relation by this method was compared with Lucia's method of recording centric relation. The results of three series of three recordings were analyzed. The influence of the universal jig on rear-determinant movement was measured by two pantographic recordings, one enabling occlusion to take place, the other using the universal jig. The results were analyzed and demonstrated that the universal jig is a reliable means of simplifying the setting up of models and the programming of semiadjustable articulators.

[Ledderhose's disease. Report of 7 cases]

Ledderhose's syndrome, or plantar fibromatosis, is a rare fibrous dystrophy and the plantar equivalent of Dupuytren's disease. It occurs mainly in adult subjects, as a plantar fibrous nodule. The authors report 7 operated cases of Ledderhose's syndrome, including one in a 14-year-old adolescent. When the plantar nodule becomes symptomatic, surgery is the only means of treatment. Plantar aponeurotomy must then be as extensive as possible to prevent recurrent.

Computer analysis of double labeling: ultrastructural distribution of vasoactive intestinal peptide and transferrin in human colon cancer cells

Transferrin (Tf) and vasoactive intestinal peptide (VIP) were labeled with horseradish peroxidase (HRP) and 125I, respectively. To determine whether two simultaneously incubated ligands are conveyed by the same population of endosomal vesicles in human colon carcinoma cells (HT-29), we used an analysis system derived from the cross-fire method for quantitation of autoradiographic data. This system permitted the collection of data and the statistical calculations required by the double labeling of the cells. HRP-labeled Tf organelles were chosen as reference structures of the endosomal apparatus and taken as the conventional source of the radiolabeling. Our data established from the co-localization hypothesis strongly suggest that after a 30-sec (T 1/2) and a 10-min (T10) internalization at 37 degrees C, VIP and Tf share in major part the same endocytic pathway and even the recycling route to the cell surface. At T10, most of the radiolabeling was located inside the tubulovesicular network, and we also detected slight radiolabeling inside the vesicles recycling Tf. The number of double-labeled endosomes involved in ligand traffic were advantageously observed with our computer-assisted analysis system.

Centric relation and programming semiadjustable articulators with the universal jig. Part I: Technique

To obtain centric relation and program recordings, a universal jig was made to be molded after adjustment to the upper incisors by means of dental plaster. The jig can be produced by means of an autopolymerizing resin mold based on the wax model. Once the jig is in position, the patient is asked to produce left and right lateral movements until muscular relaxation is obtained. This allows centric relation to be recorded by whatever method use. After plaster has been injected on the occlusal surfaces of the teeth, the patient is asked to close his jaws on the jig and to perform either a propulsion movement or left- or right-lateral movement so as to obtain two plaster "bites" ready for the programming of semiajustable articulators.

[Description of an acquisition, management and archiving system for digital images]

The authors present a digitalizing and archiving system, for radiologic pictures. This system is composed by a camera, a microcomputer (MacIntosh II) with a digitalizing card and a great capacity optical disk (WORM) for storage. Acquiring and archiving are automatically driven by a special soft. The principal qualities of this system are simplicity for the user, speed and low cost.

On the formulation of discrete-time epidemic models

Jacquez constructed a properly posed, more general model for the Reed-Frost epidemic process by assuming independent behaviors for the susceptibles and introducing the generating function for the number of contacts per person. An alternative approach is proposed here that relies on similar hypotheses for the infectives and allows the usual chain-binomial structure of the infection process to be extended. For this new model, the derivation of the final size and the threshold phenomenon becomes much simpler. A detailed analysis and its generalization to heterogeneous populations and continuous-time models will be the subject of a forthcoming paper.

[A simple method for measuring anteversion of the acetabulum from a frontal radiograph of the hip]

A simple, reproducible and reliable method is proposed for measurement of cotyloid version. Using a standing frontal image of hip, the cotyloid borders are identified and a single-plane geometric projection determines the precise degree of version. This study can also be made from a conventional frontal pelvic image with bipodalic weight bearing. Knowledge of spatial orientation allows a better approach to head-cotyle biomechanical phenomena and thus improved understanding of the genesis of certain hip diseases.

Radiologic anatomy of duplication of the inferior vena cava: a trap in abdominal imaging. A report of 8 cases

Eight cases of duplication of the inferior vena cava are reported. Three of these bear witness to the errors of interpretation that may be committed when the anomaly is not initially detected in the ultrasonographic transverse sections and when no preliminary phlebography is available. Two other cases illustrate the influence of this duplication on the choice of the prophylactic surgical treatment of pulmonary embolism. The last clinical observation indicates the need to puncture both the femoral veins when performing iliocaval phlebography. Finally, two observations on the cadaver help to clarify the imaging appearances of this anomaly. The report concludes with a review of the classical anatomic and pathogenic concepts and a short discussion of the practical problems posed by duplication of the inferior vena cava.