PubMed Health⌕ Search

Biomedical subjects

D Rivet

Publications and source records attributed to D Rivet.

11 recordsLinked to original sources

Comparison of comparative genomic hybridization with conventional karyotype and classical fluorescence in situ hybridization for prenatal and postnatal diagnosis of unbalanced chromosome abnormalities.

The comparative genomic hybridization (CGH) technique was initially used for detection of chromosomal imbalances in tumor cells. CGH can also be used as a supplementary method to karyotypic analysis in clinical cytogenetic cases. In order to evaluate CGH usefulness in prenatal and postnatal analysis of whole chromosome and segmental aneusomies, we investigated 13 clinical samples from blood, cultured chorionic villi, cultured amniotic fluids and uncultured amniotic fluids. These specimens, initially analyzed by conventional cytogenetics, included 5p monosomy, 9p duplication, add 6p, unbalanced translocation between chromosomes 5 and 10, mosaic tetrasomy 12p (50%), unbalanced (X;X) translocation and Prader-Willi deletion (15q11-13). In addition, six numerical chromosome aberrations (tetrasomy X, trisomies 13, 18, 21 and monosomy X) were analysed. All the chromosomal abnormalities, except the Prader-Willi deletion, were correctly detected by CGH. Here, we have demonstrated that the CGH technique is an alternative to classical fluorescence in situ hybridization using specific probes for detection of the unbalanced chromosomal aberrations in prenatal and postnatal diagnosis and could be used for rapid prenatal screening for unbalanced aberrations.

Amniotic Fluid↗

[The "extreme" brachial flap: a distal pedicled use of an external brachial flap. Preliminary report].

The authors present a new application of the procedure they called the "reverse flow YV pedicle extension" which allows a very distal pedicled mobilisation of the lateral arm flap. Until now, only the distally based lateral arm flap and the ulnar recurrent fascicutaneous island flap could to be transferred distally but reached only the proximal third of the forearm. In our experience these flaps did not seem to be very reliable. Lengthening of the lateral arm flap pedicle using the lateral triceps artery (branch arising from the profunda brachii artery) allows the lateral arm flap to be transferred beyond the distal third of the forearm. This so-called "extreme" lateral arm flap has advantages and disadvantages which are discussed in this paper. We consider cutaneous or osteocutaneous reconstructions of the forearm to be the best indication for this flap. Our first clinical case is reported.

Accidents, Traffic↗

The posterior radial epiphysis free flap: a new donor site.

The authors present the anatomy and clinical applications of a new donor site for free or pedicled transfers. It is localised on the posterior aspect of the forearm, over the distal radius, and based on a posterior branch of the anterior interosseous artery. It can be used as a free skin flap, osteoperiosteal or osteocutaneous transfer. Reinnervation is possible. Indications in hand surgery are numerous. Five consecutive cases have been operated upon successfully.

Adult↗

Restoration of elbow flexion using the latissimus dorsi musculo-cutaneous flap.

The latissimus dorsi myo-cutaneous flap has been used for restoration of elbow flexion in 8 cases. The indication for this transposition were brachial plexus injuries, significant trauma to the upper limb and restoration of arm contour. The surgical technique involved unipolar muscular transposition (4 cases) with tendon plication (one case) and bipolar transposition (three cases). The evaluation of results is based on the force and degree of elbow flexion, active pronation and supination, as cortical integration. We consider that we have obtained good results in 5 cases and moderate results in three. We think that the latissimus dorsi pedicle transfer for restoring elbow flexion, is an excellent procedure which can give a good functional result with minimal donor site sequelae.

Adolescent↗

[Nerves of the external brachial flap. An anatomical study].

The lateral arm flap is located on the lower lateral portion of the arm. The blood supply is via the profunda brachii artery. The flap is based on the lateral intermuscular septum of the arm, the septum being always taken with the flap; the flap can be composite and include the anterior skin of the arm or a segment of humerus, or the nerve of passage, which can be used as a vascularized nerve graft. The lateral arm flap has an important relation with three nerves: the radial nerve, which should always be preserved, the posterior cutaneous nerve of the arm, which can give a sensory innervation for the flap, and the posterior cutaneous nerve of the forearm, which can be used as a vascularized nerve graft. The authors recount the anatomic variations of the artery of the flap and describe the variations of the posterior cutaneous nerve of the arm and the forearm. The knowledge of the relation between these nerves is very important, when one wants to use one of the nerves for sensory innervation of the flap and the other as a vascularized nerve graft. The practical application of this principle is illustrated by the example of one clinical case.

Brachial Artery↗

Delayed excision of a defect after free omental transfer with uncertain viability; a case report.

We present the case of a 45-year-old man with an extensive radionecrotic ulcer of the anterior aspect of the thigh and exposure of the femur. Difficulty in the revascularisation of a free omental transfer due to radiation damage to the recipient vessels led us to delay excision of the defect and to store the flap temporarily in a plastic bag close to the recipient site; 48 hours later its satisfactory appearance allowed excision of the defect and successful final inset of the omentum. Advantages of this procedure are discussed.

Graft Survival↗

The lateral arm flap: an anatomic study.

The anatomy of the lateral arm flap is further elucidated, and the surgical techniques involved in raising the flap are described in detail. The data are derived from studies in 25 cadavers and five clinical cases. The relative merits of this versatile free flap are discussed. Three clinical cases are cited for illustration.

Amputation, Traumatic↗

[Use of the Pavlik harness before the age of 3 months in congenital hip dislocation].

The authors report 128 cases of reduction of congenital dislocation of the hip by the Pavlik harness with more than one year of follow-up. They studied 60 patients who had less than 3 months of age at the beginning of the treatment. They obtain 59 reductions (98%) without necrosis of femoral heads. The only case of unsuccess, treated after by continuous extension, has doubtful femoral heads at 15 months of age. The femoral heads appear in normal delay and walk was normal between 10 and 18 months. Only a strict watchfulness, as strict as a continuous extension, can obtain good results with progressive flexion. Bath is not authorized and harness is not removed before stable reduction. Parents are taught how to hold their infant without bringing his knees together. The most important thing is the X-ray control on D8, D21, and D60, the prevent the trap of too much flexion, too nice penetration or persistent eccentration. Under these conditions, the authors think that the treatment of congenital dislocation of the hip by the Pavlik harness is the safest method especially before 3 months of age.

Braces↗

[Adenocarcinoma of the kidney with invasion of the inferior vena cava. Apropos of 32 cases].

The authors present 32 cases of renal cell carcinoma with inferior vena cava involvement. Three sub-groups of patients can be distinguished on the basis of the level of this involvement: A (24 patients) with infra-hepatic involvement, B (6 patients) with retro-hepatic involvement and C (2 patients) with supra-hepatic involvement. The surgical tactics and results are analysed for each of these 3 sub-groups. The prognosis is relatively good in sub-group A, but is increasingly less favourable in groups B and C.

Aged↗