Biomedical subjects
Publications and source records attributed to P Laffargue.
A case of alveolar rhabdomyosarcoma of the hand in a 21-year-old patient is reported. In the light of this case, the authors review the literature and analyse the therapeutic implications.
Giant cell tumors of bone are uncommon in the vertebrae above the sacrum. We report the case of a giant cell tumor of the third lumbar vertebra, revealed by lumbar and radicular pain. X ray, computed tomography and magnetic resonance imaging showed osteolysis of the body and vertebral arch of L3. Histologic evaluation gave a conclusion of a giant cell tumor, grade 2. Spondylectomy of L3 was performed using a combined approach (anterior and posterior) in two stages. The patient had a good functional result without recurrence at three years and six months. A review of the literature indicates that the radiological appearance is nonspecific but shows the extent of the tumor. Diagnosis can be based only on histological features. Radiotherapy could induce malignant transformation. Radical resection limits the risk of recurrence. Total spondylectomy is recommended for giant cell tumors when both the body and arch are involved.
The in vitro tests on cell viability reveal a favorable position for steel and hydroxyapatite (HA)? However, the roughness induces a negative effect on cell proliferation. Sandblasting of the stainless steel considerably decreased cell number compared with the polished substrate. HA showed a better percentage of proliferation in spite of the surface effect compared with controls. For in vivo biocompatibility, intramuscular implants revealed localized inflammatory reactions for the HA treated stainless steel but nor for the untreated alloy.
PURPOSE OF THE STUDY: The purpose of this study was to evaluate the results of the anterior cruciate ligament (A.C.L.) reconstruction according to two scoring systems (Arpege and IKDC), to analyse the influence of different factors on the results, to study the effect of a lateral extra-articular tenodesis, the morbidity of patellar tendon graft harvesting, and the advantage of arthroscopically assisted reconstruction. MATERIAL: Seventy nine patients, 17 to 39 years old (average 27 years), underwent an anterior cruciate ligament reconstruction for chronic instability, using a free bone-patellar tendon-bone graft. In 43 cases, a lateral extra-articular plasty was added (Lemaire's procedure). The reconstruction was arthroscopically assisted in 17 cases. Interval between initial injury and surgery was 24 months (2 months to 9 years and 7 months). The average follow-up was 2.5 years (range 1 to 18). METHOD: All patients were reviewed for evaluation with two scoring systems (Arpege and IKDC). Roentgenograms of both knees, including antero-posterior weight-bearing and lateral view, patellar view, dynamic radiographs, allowed evaluation of post-operative arthrosis and residual anterior laxity in extension. Fischer's test and chi square test were used for statistical evaluation. RESULTS: Using the Arpege CLAS system, functional results were excellent or good in 75.9 per cent of cases (excellent in 44.3 per cent, good in 31.6 per cent), fair in 15.2 per cent, poor in 8.9 per cent; according to the IKDC system, 65.8 per cent were excellent or good. 84.8 per cent of the patients were satisfied in Arpege system and 91.2 per cent in IKDC system. The pivot-shift test was negative in 86 per cent, equivocal in 7.6 per cent and positive in 6.4 per cent. The radiological Lachman's test (difference between control and affected knee) was 0-2 mm in 53.2 per cent, 3-5 mm in 39.2 per cent, 6-10 mm in 7.6 per cent, never greater than 10 mm. Antero-posterior weight-bearing radiographs were normal in 83.5 per cent, showed joint remodeling in 10.1 per cent pre-arthrosis in 6.3 per cent but no arthrosis. Functional results were not correlated with age at time of surgery, interval between initial injury and surgery, nor clinical Lachman's test. Competitive sportsmen had a better result (p = 0.001). Residual laxity in extension was correlated with lesions of medial meniscus (p = 0.035). Degenerative changes in femoro-tibial joint were correlated with residual laxity in extension (p = 0.019). There was no significative difference between A.C.L. reconstruction isolated or associated with lateral extra-articular tenodesis. Time to return to work was shorter for patients with arthroscopically assisted procedure (p = 0.067). DISCUSSION AND CONCLUSION: Functional results after A.C.L. reconstruction using a free bone-patellar tendon-bone graft are satisfactory and confirm the reliability of this procedure. Arpege CLAS and IKDC systems give comparable functional results, but IKDC evaluate anatomical results, residual laxity and degenerative changes of the joint, that constitute essential long-term pronostic factors. Morbidity of patellar tendon harvesting appears to be of short duration and largely reversible. Added lateral extra-articular tenodesis doesn't improve the results. Arthroscopically assisted procedure seems to allow a faster rehabilitation.
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The authors present 6 cases of müllerian papillary adeno-fibromata (or mixed mesodermal müllerian benign tumours) of which 4 are anatomo-clinical presentations and 2 are histological presentations, as well as 3 cases of müllerian adenosarcoma (mixed müllerian mesodermal tumour with stroma only sarcomatous). The study of these cases added on to those found in the literature leads to the following conclusions: The first group can be accepted. The second group will be of mild malignancy. All the same, 4 of which the sarcomatous nature is not in doubt at all (malignant from the start) recurred rapidly. Those in which the sarcomatous nature was attenuated or doubtful (15 cases) seemed to have a much longer evolution with some local recurrences. Only 3 patients have been followed up for more than 5 years. It is absolutely essential to carry out further observations before confirming for certain the prognosis of this new type of tumour.
The ultrastructure of normal ovarian hilar cells, both during the reproductive era and after the menopause, shows evidence of steroid hormone synthesis. In this respect these cells are very similar to Leydig cells in that they contain mitochondria with a dense matrix, a highly developed smooth endoplasmic reticulum, Reinke crystals, and microcystalline inclusions. The latter are much more numerous than in the normal testis. Their enzymatic activities are quite similar to those of Leydig cells. Ovarian hilar cells seem to originate from progressive metamorphosis of fibroblastic cells under the induction of sympathetic nervous structures. Their relations with hilar nerves are of three types: simple direct membrane contact without a Schwann cell sheath, intimate intracytoplasmic relationships, and specialized contacts, which are comparable to a synapse.
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The ultrastructural localization of 3 beta hydroxysteroid ferricyanide reductase, glucose-6-phosphate ferricyanide reductase and nicotinamide adenine dinucleotide and reduced form-ferricyanide reductase was investigated in some human steroidogenic tissues (corpus luteum of pregnancy, fetal adrenal gland and testis, adult testis and placenta) using ferricyanide as an electron acceptor. Copper ferrocyanide deposits were readily observed in the mitochondria, in the smooth endoplasmic reticulum profiles and in the cytoplasm. The sites of the various dehydrogenase activities could be visualized by using appropriate incubating media. The precise localization of various reactions in different electron transfer chains was determined by using different ferricyanide concentrations and intermediate electron-carriers such as menadione or exogenous nicotinamide adenine dinucleotide and reduced form-diaphorase. The use of respiratory chain inhibitors such as rotenone or antimycine A confirmed these data.
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