[Nerve repair or muscle-tendon transfers in posttraumatic paralysis of the upper limb].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to C Bonnard.
Explore the source record for details and available documents.
The effects of the non-12-O-tetradecanoylphorbol-13-acetate type tumor promoter palytoxin on human bronchial epithelial cells was studied in an in vitro serum-free culture system. Unlike the results of previous studies with another tumor promoter, 12-O-tetradecanoylphorbol-13-acetate, palytoxin did not induce squamous differentiation of normal bronchial epithelial cells and was equally cytotoxic for normal human bronchial epithelial cells, a human lung tumor cell line, and human bronchial epithelial cells immortalized by infection with adenovirus 12-SV40 hybrid virus (BEAS-2B cells). Palytoxin did not induce a change in free cytosolic Ca2+ concentration of BEAS-2B cells. The effect of palytoxin on the c-myc mRNA steady state level in BEAS-2B cells was studied: 1 pM palytoxin increased the steady-state level at 12 and 18 h. Furthermore, the induction was accompanied by an increase in [3H]thymidine uptake. Because palytoxin binds to (Na+ + K+)ATPase, the effects of ouabain were compared to the effects of palytoxin. A ouabain-resistant cell line was as sensitive to the growth inhibitory effect of palytoxin as the parent ouabain-sensitive cell line, suggesting different binding sites to the (Na+ + K+)-ATPase for palytoxin and ouabain. Ouabain also increased the steady-state level of c-myc gene expression, but earlier than palytoxin, and the increase in the level of c-myc mRNA was accompanied by a drop in DNA synthesis. These results suggest that palytoxin does not act by growth stimulation, differential cytotoxicity or terminal differentiation of normal versus neoplastic cells which are proposed mechanisms of tumor promotion.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Surgical treatment of the thoracic outlet compression syndrome is being presently reconsidered. Until these last few years, there was the choice between two interventions only: scalenotomy, a simple operation entailing no complication, but with a 60% recurrence rate--or the resection of the first rib through an axillary approach, an efficacious intervention which caused, however, serious nervous complications in 14% of treated cases. The follow-up of 75 cases operated for a TOCS reveals to the authors that--all techniques taken into account--results are unsatisfactory in 33% of cases. These failures are due either to technical deficiencies, or to a complication arising in the course of the operation, or to an erroneous diagnosis. The authors resort to surgery only to treat serious vascular syndromes (absolute indication) or invalidating neurological compression syndromes, after failure of physical therapy (relative indication). They propose a cervical approach--the only one enabling a safe dissection of the brachial plexus--a partial scalenectomy, resection of all fibrous bands pressing on nervous trunks, or the resection of a cervical rib. Should the costo-clavicular space appear anatomically too narrow, the first rib, already partially freed by the cervical approach, will be resected through the axillary route.
240 patients out of 752 seen over a period of 21 years with traction lesions of the brachial plexus including a palsy of the intrinsic muscles of the hand have been studied by the authors. This study is biased by a high number of imprecisions. Nevertheless it shows that the fate of the intrinsic muscles depends essentially on the initial severity of injury whatever the type of conservative or operative treatment. There is no useful recovery when the lesions of these pathways are more severe than the 2nd degree of Sunderland. Palliative surgery is indicated in cases when all muscles of the forearm have reached a good function after conservative or operative treatment. Reconstructive surgery is however limited or prone to fail in 2/3 of cases because in the vast majority of patients with traction lesions of the brachial plexus there is no recovery of wrist and long finger extensors.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
After surgical correction, hiatus hernia recurs in 5--15%. Papers dealing with these recurrences are rare. Among 140 hiatus hernias operated in our service, quite a few had some residual symptoms such as intermittent dysphagia, epigastric pain and flatulence. Three of them had to be reoperated on for a recurrence. In this paper 20 patients operated for recurrent hiatus hernia are reviewed. Some factors predispose to recurrence: inadequate initial operation, stage 3--4 oesophagitis, kyphosis, very broad hiatal orifice at initial operation. When the cases reoperated upon are reviewed some of them are not improved. Most of these patients have psychosomatic problems or are under psychiatric treatment. This is why a patient coming for a recurrent hiatus hernia should be investigated thoroughly. Psychosomatic cases are as bad an indication for a second operation as they probably were for the first one. When reoperation has been decided, several procedures can be used. The choice depends on what was done at the first operation, on the radiological, endoscopic and peroperative findings. In the majority of the cases, an abdominal approach can be used, but occasionally a thoracic or thoraco-abdominal route is preferable. Associated vagotomy does not improve the results and adds its own morbidity.
We describe a technique of reconstruction for complete midsubstance ruptures of the anterior cruciate ligament in patients with wide open physis, using the central third of the patellar tendon. This specific procedure is named the Clocheville technique. Results were very good in five cases and good in three cases at 2 years minimal follow-up. We neither noticed angular deformity, nor significant change in lower leg length. The Clocheville technique is an excellent alternative for young patients, with residual growth of the knee greater than 15 mm, if presenting an objective instability in activities of daily living or a proven meniscal tear that should be repaired.
Explore the source record for details and available documents.