[Methods of measuring the mechanical stresses on the human lumbar spine and their results]

The authors in a review of the literature and their personal studies, report the various measurements methods of the stresses exerted on the lumbar spine, with their results. This study comprises three chapters: study of an isolated spinal segment, static study of the lumbar spine and dynamic study of the lumbar spine.

[Hypersensitivity pneumopathies ("bird fancier's lung") in children. Diagnostic value of bronchoalveolar lavage]

A current view of "pigeon fancier's lung" in children is reported through a familial case presenting as a severe denutrition in a 9 year-old boy. Cellular and biochemical analysis of broncho-alveolar lavage fluid is essential to proper diagnosis. Treatment is based upon the eviction of inhaled antigenic organic materials issued from pigeon's droppings, corticosteroid treatment being only additional. Pulmonary fibrosis is a rare but possible complication in the outcome of the disease.

Orf and pregnancy

A 31-year-old woman presented with orf on the forefingers at 34 weeks of gestation. The disease, contracted after handling sheep a week before, was uncomplicated, and the patient gave birth at term to a normal baby. Although some cases with features suggestive of viremic spread had been described, the authors find an overall benign picture of orf in man and recommend symptomatic therapeutic measures.

[Dexamethasone suppression test in psychiatric pathology]

The dexamethasone suppression test (DST) has been used in psychiatric pathology for about 10 years. Carroll et al. consider this test to be specific of endogenous depression. According to these, and many other authors, approximately 55% of patients with endogenous depression show a positive response to the test, whereas a positive response is observed in only 4% of normal subjects or patients with psychiatric disorders other than major depressive disorders. The DST was performed in 162 psychiatric inpatients (5 with organic disease, 28 with schizophrenic disorders, 17 with major affective disorders, 5 with obsessive compulsive disorders, 103 with dysthymic disorders and 4 unclassified). Dexamethasone (1 mg) was administered orally at 11 p.m., and plasma cortisol concentration was measured the following day at 16 p.m. Response to the test was positive in 53% of patients with major affective disorders, 25% of those with schizophrenic disorders, 60% with obsessive compulsive disorders and 18% with dysthymic disorders. There was no statistical difference in the results according to age, sex ratio, family history of depression or duration of the disorders. Only two variables were close to the P less than 0.05 level of statistical significance: severity of the disorders and early morning awakening. DST sensitivity, therefore, would appear to be about 50% in major affective disorders, but this test is not specific as it may also be positive in other psychiatric disorders. A positive dexamethasone suppression test may be regarded as a sign of severity of psychiatric disorders.

[Comparative anatomy of the velopharyngeal complex in human and non-human primates (2)]

The authors describe the soft palatal-pharyngeal unity, composed of the levator palati and palatopharyngeus muscles in the adult man, the new-born and the Saimiri. They recall the importance of the soft palatal-pharyngeal sphincter in the man's phonation. After having described the general evolution of the aerodigestive tract in the no human mammals and the man, notions of evolutive morphology of the soft palatal-pharyngeal unity are established. They are characterized by the gradual divergence of the axis of the 2 muscles forming the soft palatal-pharyngeal unity ending in the appearance met in the adult man, indispensable in view of a soft palatal-pharyngeal ability allowing a articulated language.

[Comparative anatomy of the velopharyngeal complex in mammals--excluding primates (1)]

From the anatomic element known with the man by the name of soft palatal-pharyngeal sphincter and which takes a major part in the phonation, the swallowing, the breathing, we have studied the evolutive morphology of the soft palatal-pharyngeal unity in several mammals. This unity which includes the levator palati and palatopharyngeus muscles is confirmed by the phylogenic and embryologic investigations. The comparative anatomy of the rat, rabbit, sheep and lion, allows to make obvious a evolutive line characterized by the gradual divergence of the axis of the two muscles common to the soft palatal and pharyngeal musculature, which could correspond with a phylogenic evolution.

[Charcot-Marie-Tooth disease and glomerular nephropathy]

Anatomoclinical profile and follow-up of a glomerular nephropathy in a prepubertal girl with Charcot-Marie-Tooth disease is reported; striking common pattern features with the few cases previously published of such an association strongly suggest that renal involvement is possible in sensorineural neuropathies and may be one major factor in the overall prognosis of the disease.

[Optical methods in the study of superficial displacements of the lumbar vertebrae under a vertical load. Initial results and methodological aspects]

In order to assess superficial displacements under load in human lumbar vertebrae, the authors used three different optical methods: photogrammetry under non coherent light; double-exposure holographic interferometry; speckle granularity under laser exposure. Without any structural interposition, the displacements are measured within 10 mu for linear variations and 0.1 degrees for angular variations. Photogrammetry seems to be more adequate for the study of large range of displacements while holographic and speckle techniques are useful to assess, in the displacements, the part of the disc and the osseous structure deformation respectively.

[Anatomic study of a omphalosite monster]

The authors report the main anatomical features of a twin holoacardius amorphus monster. Diagnosis of the abnormality was assured by echography at the end of a "normal" gemellary pregnancy. Echograms were consistent with the diagnosis of "amorphus monster" and this was supported by dissection. The caudal extremity of the fetus was clearly identified by the presence of recognizable lower limbs in spite of the several abnormalities of the pelvic area. The cephalic extremity was characteristic of the malformation. Examinations of visceres allowed to precisely identify digestive structures such as intestinal loops (with disseminated atresias). It could not be find any kidney structure. Medially, a small rounded mass was observed and could be identified as hypoplasic cardiac structure. Other main anatomic features consisted of an enormous liquid-filled cavity largely communicating with both the lower part of the neural tube and the basis of the cranium. The placenta was unique and two umbilical with several and large anastomotic by-passes were increased from it.

Elevated plasma 1,25-dihydroxyvitamin D concentrations in infants with hypercalcemia and an elfin facies

We measured plasma concentrations of 1,25-dihydroxyvitamin D (1,25-(OH)2D) in the course of a 6-to-37-month survey of four children with hypercalcemia and an elfin facies (Williams syndrome). Levels of 1,25-(OH)2D were elevated (160 to 470 pg per milliliter) during the hypercalcemic phase of the disease, when the children were five to nine months old, and they decreased thereafter. Plasma 1,25 (OH)2D levels were higher than those found in three children (16 to 60 months old) with the elfin facies syndrome and no hypercalcemia (42 to 71 pg per milliliter) and eight children (1 to 36 months old) with hypercalcemia and no dysmorphy (12 to 140 pg per milliliter), including two children with vitamin D intoxication. Hypercalcemia in the three children with elfin facies was controlled by a low-calcium diet. Serum calcium levels fell to the normal range, and plasma 1,25-(OH)2D levels were normal for age (18 to 105 pg per milliliter) at 14 to 47 months of age, even after appropriate therapy had been discontinued. These observations suggest that hypercalcemia may be the consequence of abnormal synthesis or degradation of 1,25-(OH)2D in children with the elfin facies syndrome.

Biomechanical properties of spinal ligaments and a histological study of the supraspinal ligament in traction

This paper reports the results of a biomechanical study of 43 human spinal ligaments from fresh cadavers and living subjects. Tensile tests were performed with an original testing machine. The tension load and relaxation were applied at the same constant slow rate (1 mm min-1) on entire ligaments. In order to avoid ligament injuries, fixation in the apparatus was on the bone held in clamps specifically designed for each bone, never the ligament itself or its bony attachments. All the load-deformation curves had a sigmoid shape and during load-unload cycles ligaments exhibited elastic properties. This was particularly evident for the ligamentum flavum. The intertransverse posterior longitudinal ligament and the ligamentum flavum were the most resistant. The elongation-tension curve pattern may be explained by the microscopic architectural change that was studied in supraspinous ligament.

Prognostic factors and indications for surgical treatment of acute aortic dissections: a report based on 191 observations

A total of 191 acute aortic dissections were examined to define prognostic factors for surgical intervention. Overall survival rate reached 40% in the 94 patients operated upon and 8% in the 97 patients not operated upon. Among the 122 patients with involved ascending aorta, survival rate was 2% in the 42 nonoperated patients versus 42% in 80 patients undergoing surgery. Since 1977, overall survival rate has reached 60% in the surgical group (21 of 35 patients) and 20% in the nonsurgical group (5 of 25 patients). Factors that showed a significant correlation with postoperative death include: persistent shock; persistent anuria; persistent neurologic deficit; diffuse intravascular coagulation; and involvement of either the celiac trunk, superior mesenteric artery, or both renal arteries at angiography. With the exception of those patients exhibiting any of these high-risk factors, emergency surgical treatment is recommended for all dissections that involve the ascending aorta.

[The anconeus muscle. Anatomical and electromyographic study]

Since Duchenne de Boulogne's study, controversial statements are made about anconeus muscle. The authors presented an anatomical study from 10 cadavers and an electromyographic study from 10 examinations performed on 10 living subjects 18 to 47 years old. The authors found that anconeus muscle was an extensor of the elbow, a pronator of the forearm and that this muscle mobilized the ulna upward in adduction playing a role in the stabilisation of the elbow in various movements and in the ulnar deviation of the wrist. Finally the anconeus muscle might be considered an active lateral ligament of the elbow.

Characterization of the monoamine uptake system in catecholamine storage vesicles isolated from a pheochromocytoma taken from a child

The catecholamine storage vesicles of a pheochromocytoma taken from a child have been isolated and characterized. The tumor contained almost exclusively noradrenaline and a large proportion of this amine was vesicle-bound. The noradrenaline-containing vesicles showed great resemblance to bovine chromaffin granules. Their catecholamine and dopamine beta-hydroxylase contents were that of chromaffin granules; their morphology and density were similar to those of the subpopulation of these granules that contain noradrenaline. The pheochromocytoma vesicles contained in their membranes an abundant polypeptide of mol. wt 110,000, which was not apparent in bovine adrenal medulla vesicle membranes. Monoamine uptake by pheochromocytoma noradrenaline vesicles did not differ significantly from that observed in bovine chromaffin granules. The time-course, plateau level and KM for noradrenaline were similar for both types of organelles. Both had an oligomycin-resistant ATPase with similar properties. Investigations using the tetrabenazine derivative [2-3H]dihydrotetrabenazine (2-hydroxy-3-isobutyl-9,10-dimethoxy-1,2,3,4,6, 7-hexahydro-11b-H-benzo[a]quinolizine), which binds specially to the bovine chromaffin granule monoamine carrier indicated that granule membranes from the tumor have a 10-fold increased number of [2-3H]dihydrotetrabenazine binding sites, with no change in dissociation constant. As in the case of bovine chromaffin granules, [2-3H]dihydrotetrabenazine can be totally displaced by noradrenaline and serotonin. To account for the discrepancy observed between the uptake data (which indicated no difference with bovine chromaffin granules) and the [2-3H]dihydrotetrabenazine binding studies (which showed a large excess of binding sites in the tumor membranes), we propose that granules in the investigated tumor contained a large amount of inactive monoamine carrier.

[Talo-calcaneal continuity. Myth or reality?]

On the basis of two separate biomechanical studies of talus and calcaneus, the authors show: the absolute continuity of the trabecular structure of these bones, the mechanical behaviour characterised as "fragile" for the talus and "intermediate" for the calcaneus, superficial strains underload: by photoelastic studies, they are show to be in reversed phases both on their lateral and medial sides. Authors conclude that these two bones act together as sectional across which collect dispach and absorb transmitted forces during gate.

Comparison of three low-nitrogen diets containing essential amino acids and their alpha analogues for severely uremic children

Six infants, 4.5 to 19 months old, whose creatinine clearance was less than 6 ml/min/1.73 m2 received, successively, three low-nitrogen diets. Diet A contained 9.3 g of human milk protein; and diet B, 4.2 g of human milk protein plus synthetic essential amino acids. Diet C was the same as B except that five essential amino acids were replaced by alpha-keto and hydroxy analogs. Serum urea decreased as the infants were transferred from diet A to diets B and C, and the serum urea/creatinine ratio decreased from diet A to diet B and from diet B to diet C. Urea appearance was 14.8 +/- 4.5, 9.1 +/- 4.3, and 6.9 +/- 1.7 mmoles/day, with diets A, B, and C, respectively. Weight gain was also lowest with diet C, as was the difference between nitrogen intake and urea nitrogen appearance, an indicator of nitrogen balance. Plasma free amino acids were not modified by diets A and B, but valine, leucine, and the plasma free essential amino acid pool decreased significantly with diet C.