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Biomedical subjects

C Fontaine

Publications and source records attributed to C Fontaine.

At least 91 records · Page 5Linked to original sources
PubMed1994

Causes of dislocation of total hip arthroplasty. CT study of component alignment.

We reviewed radiographs and CT scans of 38 total hip arthroplasties which had dislocated (36 posteriorly; 2 anteriorly) and compared the alignment of the prosthetic components with those of 14 uncomplicated arthroplasties. No difference was found between the alignment of the prosthetic components in the two groups. In the seven patients who had reoperations, the cause of dislocation diagnosed by CT was confirmed in only two cases (one retroversion of the cup and one protruding osteophyte). Muscular imbalance rather than malposition of the components was the major factor determining dislocation. CT allows accurate measurement of cup and neck anteversion but contributes little to preoperative planning.

Adolescent↗
PubMed1993

[Radiologic evaluation of the rotation center of the hip].

We studied 98 normal hips in 54 patients in order to assess precise settlement of the theorical hip center using the U landmark as reference i.e. determine A distance (vertical settlement) and C distance (horizontal settlement)) A being the vertical distance between U landmark and the femoral head center, C the horizontal distance between U landmark and the femoral head center. We found two indexes (A/E = 0.2 and C/D = 0.3) which allowed us to fix that center in vertical (A/E) and in horizontal (C/D) direction even in case of bilateral hip dysplasia, and which can be used either in pre-operative planning or in post-operative evaluation. D being the horizontal distance between the U landmarks, and E the vertical one between the U landmark and the sacroiliac joint.

Adult↗
PubMed1992

Anatomic basis of pronator quadratus flap.

The pronator quadratus m. can be raised as a flap on its main anterior interosseous pedicle, whose characteristics are as follows: diameter of the artery 2.1 mm, diameter of the each of both veins 2.4 mm, length of useful pedicle 70-80 mm, after possible intraneural dissection of the nerves to the flexor pollicis longus m.

Forearm↗
PubMed1992

[Neuropathology of the brain in 174 patients who died of AIDS in a Paris hospital 1982-1988].

Between 1982 and 1988, 174 brains were systematically collected from consecutive, autopsied AIDS patients in a Parisian general hospital without neurology and psychiatry departments. The data obtained under these conditions provide reliable information on the frequency of central nervous system (CNS) involvement in a non-selected population of AIDS patients, most of whom were homosexuals (75.9%). One or several lesions were observed in 148 cases (85%). HIV encephalitis and/or leucoencephalopathy with multinucleated giant cells was found in 33 cases (18.9%). Opportunistic infections were identified in 91 patients (52.3%): toxoplasmosis (65 cases; 37.3%), cytomegalovirus encephalitis (25 cases; 14.3%), cryptococcosis (9 cases; 5.8%), progressive multifocal leukoencephalitis (5 cases; 2.8%), candidosis (1 case) and tuberculosis (1 case). Neoplasias were observed in 23 patients: primary (16 cases; 17.9%) or secondary malignant non Hodgkin's large B-cell lymphoma (3 cas; 1.1%), Kaposi's sarcoma (1 case) and glioma (3 cases; 1.1%). Non-specific lesions (vasculitic, hemorrhagic, metabolic and especially microglial nodules) were common. During the 6 years of study, the rate of CNS involvement was constant. The number of toxoplasmosis cases per year was stable, however, evolutive forms were more prevalent between 1982 and 1986, whereas treated inactive lesions were seen most frequently thereafter. The opportunistic complications were often associated and it should be noted that HIV encephalitis was associated with one of several such infections in 85% of the patients. This high rate of association suggests that these opportunistic infections may play a role in the pathogenesis of HIV encephalitis.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Chiari's osteotomy in adults--apropos of 70 cases].

Between 1975 and 1987, 83 Chiari osteotomies were performed on 49 women and 11 men. The osteotomy was bilateral in 5 cases. The average age was 34 years. The average follow-up was 4 years with a range of 1 to 12 years. In 65 patients there was acetabular dysplasia, associated in 26 cases with coxa valga and, in one patient, with coxa vara. In 12 cases there was a subluxation of the femoral head, greater than 15 mm and in 16 cases, the femoral head was deformed after a post-reductional osteochondritis. The technique and results are discussed.

Acetabulum↗
PubMed1989

Antigenic modulation induced by four monoclonal antibodies adsorbed on gold particles (specificity anti-CD4, anti-CD5, anti-CD7, and anti-150-kDa antigen): relationship between modulation and cytotoxic activity of immunotoxins.

The present study concerns the antibody-induced antigenic modulation of CD4, CD5, CD7, and 150-kDa antigens present on cells of the CCRF-CEM human T line. The immunogold electron microscopy method was used, and it was found that the entry routes associated with the various antigen-antibody complexes were different. Thus, the anti-CD7 monoclonal antibody (MoAb) was frequently internalized via the coated structures of the cell membrane, whereas anti-CD5 MoAb was rarely internalized via those structures and anti-CD4 and anti-150-kDa antigens never used this route. The delay required for 50% internalization of the labeled MoAb-receptor complexes was 30 min. 1 h, 2 h, and 9 h for anti-CD7, anti-CD5, anti-CD4, and anti-150-kDa antigen MoAbs, respectively. A shedding of complexes from the cell surface was never observed. The internalized labeled MoAbs were sequentially transferred into endocytic vacuoles, then into fine anastomosed tubulovesicular structures, and then into lysosomes. However, the anti-150-kDa antigen MoAb proceeded directly from endocytic vacuoles to lysosomes. Among the four MoAbs studied, anti-CD7 MoAb was the most abundant in the endosomal compartment (up to 34% of internalized particles) before it proceeded to the lysosomes. The overall valency of the anti-CD7 MoAb-labeled beads (from 3.8 to 14 MoAb molecules per bead) did not modify the intracellular routing. These results suggested that the subcellular fate of MoAbs was an intrinsic property of each MoAb-antigen complex. More importantly, the comparison between the MoAb-induced modulation and the cytotoxic level of the immunotoxin built with the same MoAb suggested that receptor-mediated endocytosis via coated pits, along with an abundant occurrence of the antigen-MoAb complex within the endosomal complex, could correspond to the best set of conditions for the transfer of the toxin moiety of the immunotoxin to the cytosol.

Antibodies, Monoclonal↗
PubMed1989

[Surgical reduction of the external ligament for chronic instability of the tibio-tarsal joint. Apropos of 58 reviewed cases].

Between 1975 and 1986, 75 cases of surgical tightening of the lateral ligament have been performed for chronic instability of the ankle. 58 of them have been reviewed with a mean delay of 36 months (extremes of 6 months to 6 years). Surgery corrected completely the instability four out of five times. In six patients there still remained more or less incapacitating pain. Talo-navicular movements were constantly preserved, as well as that of the sub-talar joint, except in six cases where it was slightly diminished. The results have been excellent in 18 cases; very good in 18 cases; good in 6 cases; mild in 8 cases and poor in 4 cases. Furthermore, four patients who originally had an excellent or very good results have subsequently presented with a recurrence of joint laxity and instability following a new severe ankle sprain. X-ray results were less satisfactory as the joint laxity was only partially controlled (average tilt of 7 degrees). But all joint laxities except one have been improved by this type of surgery. After failure of proprioceptive rehabilitation which must be performed systematically, surgical tightening of the lateral ligament can be proposed, and should be preferred to peroneus brevis ligamentoplasties, which are more traumatic and less physiological.

Adolescent↗
PubMed1987

[Contribution of x-ray computed tomography to the diagnosis and treatment of fractures of the acetabulum. Apropos of 88 cases].

Eighty-eight recent fractures of the acetabulum have been investigated by standard antero-posterior and oblique radiographs and by CT scanning. The results of the two examinations have been compared. Whilst the type of fracture is well defined by radiography, CT scanning frequently reveals associated lesions, not seen on standard radiographs, which may have an effect on the relationship between the femoral head and the acetabulum. Thus, out of 28 cases with intra-articular fragments, 18 were not visible on standard radiographs and were discovered by CT scan. Similarly, out of 25 peripheral impactions of the acetabulum, 16 were not visible on standard radiographs, of 12 notching lesions of the femoral head, nine were not visible and six out of 23 sacro-iliac displacements were not recognised. CT scanning improved the appreciation of congruence between the femoral head and the acetabular roof in 15 cases and between the femoral head and the acetabulum in 24 cases. Only in 17 patients was there complete agreement between standard radiographs and CT scans. In particular, there is no doubt about the value of CT scanning in comminuted fractures and in fractures of the posterior wall or posterior column. It is a useful adjunct in the choice between conservative and operative treatment.

Acetabulum↗
PubMed1987

[Chiari's osteotomy in the adult. Apropos of 70 cases].

Seventy Chiari osteotomies have been performed between 1975 and 1986. Fifty-three cases have been reviewed with a follow-up greater than a year and with a mean of four years and eight months. In half of the cases, the operation was done for very dysplastic hips, usually at an advanced stage of osteoarthritis (stage two in 37.5 per cent and stage three in 25 per cent). Post-operative complications were very rare except for two cases of non-union. The functional results were very satisfactory, with 83 per cent of very good and good results, especially in respect of relief of pain which was remarkable. These results were sustained in the long-term follow-up; 21 hips had a follow-up of 5 to 11 years, with a mean of 6.8 years. Only two hips needed a total hip arthroplasty. Radiologically, the osteotomy produced normal antero-posterior and lateral hip measurements in almost all the cases, largely due to a considerable medial displacement of more than 20 mm in 87 per cent of cases. There was improvement in the osteoarthritic changes in 74 per cent of cases. The factors which affected the outcome favourably were the degree of dysplasia, a round femoral head and a technically correct operation, with bone division close to the femoral head and a sufficiently upward slope to the osteotomy. An advanced osteoarthritis is not a contra-indication if it is due to a very marked acetabular dysplasia.

Acetabulum↗
PubMed1986

Long term therapy by captopril in children with renal hypertension.

We report on 29 treatment courses in 25 children aged 1.5-18 years who received captopril because of severe renal hypertension. The mean initial dosage was 1.3 (0.5 to 3) mg/kg/day and the mean sustaining dose 2.2 mg/kg/day. The treatment was followed for 2-40 (mean 15) months. We observed a lowering of both systolic and diastolic blood pressure (BP) from 26% at the 2nd day to 65% at the 6th month. The isolated use of captopril was ineffective in 13% of cases, but blood pressure dropped in all of them after addition of beta blocking agents. No clear-cut relation was found between response of blood pressure and etiology, degree of HT or plasma renin activity (PRA). No side effects occurred during treatment except for one case of reversible acute renal failure in a transplanted patient with renal artery stenosis.

Acute Kidney Injury↗
PubMed1986

[Comparison of the vasomotor effects of dopamine on the renal and iliac arterial beds of the anesthetized rat].

Dopamine remains the reference in the study of the mechanisms involved in the antihypertensive effects of dopaminomimetics. Its renal vasodilator effects are well characterized but relaxation of other vascular beds is less known. The iliac vascular response to dopamine was studied in the anesthetized rat (pentobarbital) and compared to the renal response. Simultaneous measurements of arterial pressure, iliac and renal blood flows (electromagnetic flowmeter probes, Skalar, Delft) allowed iliac and renal vascular resistance (IVR, RVR) to be calculated. Their variations were studied after intravenous injections of increasing doses of dopamine (1.5 to 200 micrograms/kg) in unpretreated animals and in animals receiving various pretreatments. Without pretreatment, dopamine induced a biphasic renal response, vasodilation partially masked by subsequent vasoconstriction for doses above 12.5 micrograms/kg of dopamine. Simultaneously, IVR was increased. After alpha-adrenolytic pretreatment (prazosin 2.5 mg/kg, i.v.), dopamine decreased the RVR while iliac vasoconstriction persisted. The association of yohimbine (5 mg/kg, i.v.) to prazosin completely abolished the vasoconstrictive effects: dopamine lowered then by about 30% both IVR and RVR. Dopamine-induced iliac and renal decrease in vascular resistance persisted in the presence of a beta-adrenoceptor antagonist [+/-)-sotalol 30 mg/kg, i.v.), after depletion of catecholamines from sympathetic terminals (reserpine 10 mg/kg, i.p. 20 h before the experiment) or inhibition of cyclo-oxygenase (indomethacin 2.5 mg/kg, i.p. 20 h and 1 h before dopamine). On the contrary, a specific antagonist of dopamine receptors, (+)-butaclamol (60 micrograms/kg/min, i.v.) stereoselectivity inhibited the dopamine-induced renal vasodilation but did not modify the iliac response.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗