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F Canovas

Publications and source records attributed to F Canovas.

At least 19 recordsLinked to original sources

[Assessment of carpal bone maturation by imaging: an alternative to bone age determination or a complementary study?].

Radiographic evaluation of skeletal maturation with or without automated systems relies on the comparison between the radiographic appearance of portions of a child's skeleton and the standardized appearance in a comparable population of children. Assessment of skeletal maturation using image analysis of wrist computerized-assisted tomography is a quantitative method allowing for measurements of the volume of each carpal bone, the axis of inertia, and the mean bone density. Morphological modifications of carpal bones are characterized by quantitative data relating to the length of the axis of inertia and the volume. Imaging is a potentially useful method for carpal bone assessment during growth.

Age Determination by Skeleton↗

Systemic viral interleukin-10 gene delivery prevents cartilage invasion by human rheumatoid synovial tissue engrafted in SCID mice.

OBJECTIVE: To assess the effects of viral interleukin-10 (vIL-10) gene delivery on human rheumatoid synovial tissue. METHODS: SCID mice were engrafted subcutaneously with human rheumatoid synovial tissue and homologous cartilage before systemic injection of 10(9) plaque-forming units of type 5 E1a Elb-deficient non-replicative adenovirus vector containing the vIL-10 gene under control of the cytomegalovirus promoter (AdvIL-10; n = 10) or a control gene (AdvIL-10mut; n = 7). Three weeks later, the graft was removed for histologic analysis of cartilage invasion by synovial tissue. The number of CD3-positive mononuclear cells was assessed in the synovial tissue by immunohistology. Messenger RNA (mRNA) expression of matrix metalloproteinase 3 (MMP-3), tissue inhibitor of metalloproteinases 1 (TIMP-1), and proinflammatory cytokines was determined by polymerase chain reaction. RESULTS: Systemic vIL-10 gene transfer resulted in high sustained production of vIL-10 protein in SCID mouse sera (mean +/- SD 25 +/- 5 ng/ml on day 40 post vector injection). Moreover, vIL-10 mRNA expression was detected in the synovial tissue 3 weeks after intravenous injection of AdvIL-10, reflecting the gene transfer in the human graft. In animals treated with AdvIL-10, cartilage invasion by rheumatoid synovial tissue was significantly inhibited compared with the control vector (mean +/- SD histologic score 2.5 +/- 0.52 versus 0.75 +/-0.8; P < 0.0001). The number of T cells infiltrating the synovium and perichondral resorption in the animals treated with AdvIL-10 gene were not significantly modified relative to the control vector. In animals treated with AdvIL-10, the MMP-3-TIMP-1 balance was partially restored, independent of the effect on mRNA expression of tumor necrosis factor a, IL-1, IL-6, or IL-8. CONCLUSION: Systemic vIL-10 gene transfer prevented cartilage invasion by synovial tissue engrafted in SCID mice. This model offers the opportunity to study the biologic effects of gene transfer in vivo in rheumatoid synovium.

Adenoviridae↗

Total elbow arthroplasty in rheumatoid arthritis: 20 GSBIII prostheses followed 2-5 years.

From 1993 to 1996, we implanted 20 primary GSB IlI prostheses in 17 patients with rheumatoid arthritis. The Mayo Clinic performance index for the elbow was used for the evaluation. The average follow-up was 3 (2-5) years. At the follow-up examination, 12 elbows had an excellent result and 8 a good result. The median performance index increased from 30 (15-53) points to 95 (80-100) points. The subjective assessment was excellent for 11 elbows, good for 8 and poor for 1.2 elbows had radiographic loosening with a progressive radiolucent line and a change in the orientation of the prosthesis.

Aged↗

[Evaluation of the Scarf osteotomy in hallux valgus related to distal metatarsal articular angle: a prospective study of 79 operated cases].

PURPOSE OF THE STUDY: The hallux valgus surgery concerns many operative techniques. The purpose of this report was to evaluate the radiographic results of the Scarf osteotomy related to Distal Metatarsal Articular Angle (DMAA). MATERIAL AND METHODS: The Scarf osteotomy was performed on 79 feet with an hallux valgus deformity (75 females and 4 males from 16 to 82 years). Pre and postoperative weight-bearing X-rays were performed; We measured the Distal Metatarsal Articular Angle (DMAA), the intermetatarsal angle (M1-M2, M1-M5), the metatarsophalangeal angle, the obliquity of the metatarsocuneiform joint and the length of the first and second metatarsal. RESULTS: All parameters were statistically significantly improved by the surgery. However correction on the DMAA was not sufficient (from 14.6 degrees to 12.6 degrees although normal value is 6 degrees). We found a correlation between the metatarsophalangeal angle and the DMAA. DISCUSSION: The preoperative measures showed that the DMAA value increases with the value of the metatarsophalangeal angle; it is insufficiently decreased in comparison to the normal value. It has to be strongly taken in consideration in the preoperative evaluation. CONCLUSION: The preoperative DMAA value is the most important factor in the hallux valgus evaluation. It determines if Scarf or other operative technique are indicated. Its normalisation may provide less recurrences.

Adolescent↗

Treatment of a simple bone cyst of the calcaneus by endoscopic curettage with cancellous bone injection.

The authors report a case of simple bone cyst involving the calcaneus, treated by curettage under endoscopy with cancellous bone injection, and its course and follow-up at two years. This new technique has not yet been published for simple bone cysts of the calcaneus. Endoscopic curettage of the cavity of a simple bone cyst can be advocated for the calcaneus to minimize incisions and to avoid cutaneous complications.

Adolescent↗

Biometry of the muscular branches of the median nerve to the forearm.

The aim of this study was to determine the biometry of the muscular branches of the median nerve to the forearm in ten embalmed upper limbs. We measured the length of the forearm and the level of origin of each muscular branch of the median nerve to the forearm from the middle of a line between the medial and lateral epicondyles. The level of origin of each branch was then calculated as a percentage of the length of the forearm. Mean length of the forearm was 25 +/- 2.36 cm (range: 22-29 cm). Although the levels of origin of the proximal and distal nerves to pronator teres, and of the nerves to palmaris longus, flexor carpi radialis and flexor digitorum superficialis, were quite variable (coefficient of variation: CV > 48.61%), the level of origin of the anterior interosseous nerve (CV = 31.24%) and its branches (nerves to flexor pollicis longus and flexor digitorum profundus, CV = 20.06%) was less variable. These results suggest that the anterior interosseous nerve of the forearm is probably the nerve to connect in muscular free transfers in order to restore flexion of the fingers after damage to the flexor tendons to the forearm. We observed Martin-Gruber communications in six out of ten dissections.

Aged↗

Anatomic basis for the treatment of aneurysms of the upper cervical segment of the internal carotid artery by extra-intracranial cervico-petrous bypass with inverted "in situ" saphenous vein graft.

In the surgical treatment of aneurysms of the upper cervical portion of the internal carotid a., exclusion of the affected vascular segment combined with an extra-anatomic cervico-petrous bypass using a vein graft (great saphenous v.) may be considered. One of the problems specific to these extra-anatomic bypasses is associated with the sub-cutaneous positioning of the vein graft, exposing it to risks of angulation, torsion or extrinsic compression that may lead to early venous thrombosis. We suggest an alternative technique using the principle of telescoping and consisting of positioning the vein graft within the cervical portion of the artery ("in situ" bypass). The cervical portion of the ICA may be used as a tunnel for the vein graft since there are no collateral arterial branches at this level. The technical features of such a bypass are defined by means of an anatomo-surgical study in the cadaver: exposure of the petrous portion of the internal carotid a. in its horizontal segment by subtemporal access, exposure of the ICA in the neck, transverse arteriotomies of the ICA, angioplasty with a Fogarty balloon, intracarotid telescoping of a saphenous vein graft from the cervical to the petrous region, distal end-to-end anastomosis between the vein graft and the petrous portion of the ICA, and proximal end-to-end anastomosis between the vein graft and the cervical portion of the ICA.

Cadaver↗

Biometry of the capsular ligaments of the wrist.

The aim of our study was to measure the length, width and inclination in the coronal plane of the capsular ligaments, and to express these measurements as a ratio in order to determine the correlation between these parameters and the bone index. The capsular ligaments were studied from 15 cadaveric upper limbs. We identified 11 volar and 2 dorsal intracapsular ligaments. For each ligament, we measured the length to its middle and to its proximal and distal edge, the width at its average portion, and the inclination in the frontal plane. There was a difference between the proximal or distal length and the middle length for four ligaments. In these cases, however, there was a significant correlation between the proximal or distal length and the middle length. The length of capitate, the length of the third metacarpal bone, and the carpal height were significantly correlated with four ligaments. There were correlations between the length of one ligament and that of all others. There was no correlation between the inclination of the radius and the inclination of ligaments in the coronal plane. Nevertheless, there were six significant correlations between the inclination of one ligament and that of all others.

Aged↗

Interleukin-4 and interleukin-10 are chondroprotective and decrease mononuclear cell recruitment in human rheumatoid synovium in vivo.

We used the severe combined immunodeficient (SCID) mouse model to assess the effect of interleukin-4 (IL-4) or IL-10 injection on cartilage degradation and mononuclear cell (MNC) recruitment to human rheumatoid synovium in vivo. Human rheumatoid synovium and cartilage from five rheumatoid arthritis patients, obtained after joint replacement surgery, were engrafted subcutaneously to 6-8-week-old SCID CB17 mice. Synovial tissues were injected with recombinant human IL-4 (rhIL-4, 100 ng; rhIL-10, 100 ng), both cytokines, or tumour necrosis factor-alpha (TNF-alpha) (1000 U), or phosphate-buffered saline twice a week for 4 weeks. The graft was removed and immunochemical analysis was carried out to assess intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin expression. Moreover, cartilage degradation was assessed through the quantification of the erosion surface on a computerized image of the engrafted cartilage at high power view. MNC recruitment in the synovial tissue was determined by labelling blood MNC with indium-111 before their intraperitoneal injection. The activity obtained in the region of the graft were determined with a gamma camera 72 hr postinjection. The results are expressed as a percentage of initial injected activity. After 4 weeks we observed a decrease of cartilage area in controls (77 +/- 8%), inhibited after injection of IL-4, IL-10, or both cytokines (90 +/- 3%, 89.1 +/- 4%, 89.2 +/- 5% respectively), and 57 +/- 17% after TNF-alpha injection. The % MNC activity in the graft decreased to 77 +/- 81% (NS), 9 +/- 4% (P < 0.003) and 19 +/- 6% (P < 0.007) compared with untreated synovial tissue after treatment with IL-4, IL-10, or both cytokines, respectively. Moreover, IL-10 but not IL-4 decreased the expression of ICAM-1 but not VCAM-1 or E-selectin by synovial cells. These results suggest that IL-10 and IL-4 could have chondroprotective properties, and that IL-10 but not IL-4 inhibits MNC traffic towards the synovial tissue efficiently.

Animals↗

Tophaceous gout of the navicular bone as a cause of medial inflammatory tumor of the foot.

A case of tophaceous gout of the navicular bone in a 24-year-old woman is reported. Emphasis is placed on the conditions that might have been precipitating, i.e., anorexia nervosa and alcoholism, and the mechanisms by which increased uric acid level may be explained. The main radiographic patterns of tophaceous gout of the foot are recalled to avoid unnecessary surgery in future cases.

Adult↗

[Apropos of a case of epidermoid carcinoma of the nail bed with intraneural metastasis to the median nerve].

The authors report a case of squamous cell carcinoma of the nail bed with multiple metastases including a metastasis of the median nerve. This particular site raises the problem of the mechanism of dissemination and the aggressiveness of this squamous cell carcinoma of the nail bed contrasts with the data reported in the literature. The initial treatment of this tumour must consist of amputation of the distal phalanx.

Amputation, Surgical↗

[Radiographic analysis of the orientation of the distal articular surface of the first metatarsal in the horizontal plane].

PURPOSE OF THE STUDY: The lateral obliquity of the distal metatarsal articular surface is a predominant anatomical factor in hallux valgus pathology. It is important to know its normal angular value. MATERIAL-METHODS: The study included 105 feet without any pathology (48 females and 57 males; 53 left and 52 right between 15 and 72 year old). Weight-bearing, anteroposterior X-rays of the foot was made. We measured the distal metatarsal articular angulation (DMAA), the intermetatarsal angle, the metatarsophalangeal angle, the obliquity of the metatarsocuneiform joint and the length of the first and second metatarsal, and the length of the hallux. RESULTS: The main value of the DMAA was 5.78 degrees in our study, 6.79 degrees for women and 4.92 degrees for men. There was no difference between left and right side, no correlation between intermetatarsal angle and DMAA, neither between biometrics parameters and DMAA. DISCUSSION: Our results confirm the Richardson study on cadaver with a main value of 6 degrees for the DMAA. The DMAA value increases in women and it does not increase proportionaly to the intermetatarsal angle; it increases with the value of the metatarsophalangeal angle. All these points have to be taken in consideration in hallux valgus evaluation. CONCLUSION: The distal metatarsal articular surface has a lateral obliquity of 5.78 degrees. It must be evaluated before surgical correction of hallux valgus, in order to decrease recurrence rate of this pathology and iatrogenic deformity.

Adolescent↗

[Surgical treatment of rheumatoid polyarthritis].

Surgical treatment of rheumatoid arthritis aims to suppress pain, correct deformities, and restore function. This treatment should be adapted to each patient on the basis of clinical and radiographic criteria, with priority given to surgical treatment of the lower limbs. In the early stages, conservative surgery is called for (tenosynovectomy, joint synovectomy) and in later stages, palliative surgery (arthrodesis, prosthesis).

Adult↗

The relationships of the bile duct and the retroduodenal arteries and their importance in the surgical treatment of hemorrhagic duodenal ulcer.

The anatomic relationships of the gastroduodenal artery (GDA) and the posterior superior pancreaticoduodenal artery (PSPD) with the bile duct in their retroduodenal courses were studied in 35 bloc specimens from normal cadavers, injected after removal. The distances between the GDA, the pylorus, and the bile duct were measured in the sagittal plane. The origin and course of the PSPD in relation to the bile duct were studied. The relation of the GDA and the bile duct were divisable into four types: in Type 1 (n = 22) the two structures separated progressively, the artery being on the left of the bile ducts; in Type 2: (n = 7) the structures approached each other without crossing, Type 3: (n = 5) the GDA crossed in front of the bile duct at the level of the first part of the duodenum (D1), Type 4: (n = 1) the GDA crossed the bile duct below D1 and ran along its right border. The PSPD originated at the posterior face of D1 in 20% of cases (n = 7) and crossed the anterior surface of the bile duct at the posterior surface of D1. In four cases there was no pancreatic tissue between the PSPD and the bile ducs. It follows that the risk of injury to the bile duct when securing hemostasis by transfixing a bleeding duodenal ulcer in the D1 segment is great when the arterial structures (GDA and PSPD) cross the bile duct. This risk is increased when there is no pancreatic tissue between them.

Arteries↗

Carpal bone maturation during childhood and adolescence: assessment by quantitative computed tomography. Preliminary results.

The aim of our study was to measure the volume of each carpal bone during childhood and adolescence by image processing from computed tomography (CT) scans, and to analyze the relationship between the eight carpal bones. Thirteen CT scans were performed in nine normal prepubertal, peripubertal and post-pubertal children, six boys and three girls, aged 5-14 years. Each scan was processed in order to extract the carpal bones. The volume was computed for each bone. There was a significant correlation between carpal bone volume and age (0.55 < r < 0.79), and a very strong correlation between the volume of a given carpal bone and the volume of all the others, whatever the age (0.87 < r < 0.99, p < 0.01). Image processing is a potentially useful method for assessing bone maturation. The constant ratio between carpal bone volumes indicates that these bones interact with each other in wrist bone maturation.

Adolescent↗

Circular arterial supply of the pisiform bone.

The arterial vascularization of the pisiform bone was studied from 15 cadavers to assess the possibility of pedicled pisiform transfer in Kienböck's disease. The arterial vascularization of the pisiform bone comes from three pedicles: an upper pedicle arising from the dorsal carpal artery, a lateral pedicle arising from the ulnar artery, and a lower pedicle arising from the deep palmar branch of the ulnar artery. The pisiform bone is well vascularized and, whatever the distribution of the pedicles within the bone itself, we always found an arterial circle around it. The lengths of the upper and lower pedicles expressed as ratios of the length or width of the pisiform bone were variable, as indicated by the coefficient of variation that was greater than 36%. There was no significant correlation between the length of the upper or lower pedicle and the length or width of the pisiform bone. The length of the upper pedicle, which was greater than the distance between the origin of the dorsal carpal artery and the center of the lunate, allows a pedicled pisiform transfer in Kienböck's disease. Nevertheless, it is difficult to assert definitively that the upper pedicle is sufficient to avoid a partial necrosis of the pedicled pisiform bone.

Aged↗