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Biomedical subjects

F Bonnel

Publications and source records attributed to F Bonnel.

At least 19 recordsLinked to original sources
PubMed2005

[The human body and the computer as pedagogic tools for anatomy: review of the literature].

Since the first dissections, the human body has been the main tool for the teaching of anatomy in medical courses. For the last 30 years, university anatomy laboratory dissection has been brought into question and the total hours of anatomy teaching have decreased. In parallel, new technologies have progressed and become more competitive and more attractive than dissection. The aim of this review of the literature was to evaluate the use of the human body as a pedagogic tool compared to today's computer tools. Twenty comparative studies were reviewed. Their analysis showed that the human body remains the main tool in anatomy teaching even if anatomic demonstration (prosection) can replace dissection, and that the computer tools were complementary but not a substitute to dissection.

Anatomy↗
PubMed2004

Study of carpal bone morphology and position in three dimensions by image analysis from computed tomography scans of the wrist.

The morphology and positioning of the carpal bones were studied in three dimensions in 18 normal adults on computed tomography (CT) scans of the wrist. The digital data from each CT scan were processed to extract the carpal bones and to automatically characterize their geometry (geometric centroid, principal axes of inertia) using specific software tools. Biometric and angular parameters were defined for this purpose, and most of these parameters showed a normal distribution. The mean distance between the geometric centroid of the capitate and that of the triquetrum, expressed as a relationship to the length of the first principal axis of inertia of the capitate, was found to be the greatest (157.6%+/-8.4%), whereas the smallest mean distance was between the hamate and triquetrum (91.4%+/-7.3%). In the sagittal plane, the first principal axis of inertia of the bones of the first carpal row projected in front of the vertical axis of the orthogonal reference system, whereas the first principal axis of the capitate projected behind it. Measurements using this methodology are far more numerous than those from standard plain radiographs and have the additional advantage of being independent of the examiner. Future investigations on normal wrists should provide a normal range for each quantitative parameter, and comparative study of normal and pathologic wrist measurements should help to define the most relevant parameters for specific traumatic pathologies of the wrist.

Adult↗
PubMed2003

Plagiocephaly: morphometry of skull base asymmetry.

The aim of this study was to perform a morphometric analysis of the skull base to understand the mechanism of asymmetry between malformational and deformational plagiocephaly. Since 1988, we have carried out 102 CT scans with three-dimensional reconstruction of the endocranial side of the skull base. There were 20 cases of malformational plagiocephaly, consisting of 18 unicoronal synostoses (UCS) and two unilambdoid synostoses (ULS), and 82 cases of plagiocephaly without synostosis, made up of 60 cases of frontal plagiocephaly (FP) and 22 of occipital plagiocephaly (OP). The skull base asymmetry was analyzed in three ways: (1) the hemibases and the cranial fossa angles were compared with each other; (2) the structural asymmetry of the chondrocranium was calculated; and (3) the architectural asymmetry was measured in relation to the medio-labyrinthine plane. The skull base asymmetry of malformational plagiocephaly was located in the anterior and middle cranial fossae for UCS and in the posterior and middle cranial fossae for ULS. The asymmetry was the result of a localized structural anomaly of the chondrocranium. The asymmetry of deformational plagiocephaly corresponded to a distortion in relation to the medio-labyrinthine plane while the chondrocranium remained symmetric. The skull base asymmetry of malformational plagiocephaly is secondary to a localized malformation of the chondrocranium, and that of the deformational plagiocephaly is secondary to an architectural deformation.

Analysis of Variance↗
PubMed2003

[Clinico-radiological study of the skull deformation in the plagiocephaly without synostosis].

UNLABELLED: The aim of this study was to analyze the mechanism of the skull deformation observed in frontal and occipital plagiocephaly without synostosis. POPULATION AND METHODS: From 1987 to 2001, 96 plagiocephalies without synostosis, 72 males and 24 females, were examined. There were 72 Frontal Plagiocephalies (FP) and 24 Occipital Plagiocephalies (OP). The clinical examination of the neck muscles was performed to find out a torticolis with or without retraction. All patients underwent a 3D CT scan of the skull to exclude a craniostenosis. Cephalic Index (CI) was also calculated. RESULTS: The FP had a torticollis in 89.3% of cases associated with a muscle retraction (54.8%), a tonus asymmetry (16.6%), or in association (28.6%). The skull had a parallelepiped shape and the greater axis was oblique. The CI was 0.85. The OP had a torticollis in 50% of case associated with a retraction (28.6%), a tonus asymmetry (57.1%), or the association (14.3%). The skull had a square shape with an occipital flat and the CI was 0.95. DISCUSSION: The FP and OP are two deformations whose mechanism is different. The FP corresponds to a three plans skull asymmetry secondary to muscle traction on the base of the skull, and the OP corresponds to a posterior localized asymmetry of the skull secondary to compression. CONCLUSION: The traction and/or compression deformation start in utero or in the newborn period and the supine position is an aggravating positional factor.

Anthropometry↗
PubMed2002

Biometry of the radial head: biomechanical implications in pronation and supination.

The aim of this study was to perform biometry of the proximal extremity of the radius and to characterize the shape of the radial head. Knowledge of the size and shape of the radial head is necessary for the creation of a radial head prosthesis that is anatomically and biomechanically correct. Twenty-seven measurements, focused on the proximal extremity, were done on 96 radii. The shape of the radial head was determined by the difference between the maximum diameter and the minimum diameter. We considered the shape to be circular when the difference was less than 1 mm, and elliptical when the difference was greater than 1 mm. The shape of the radial head was compared with the neck/diaphysis angle. Fifty-seven percent of radial heads were elliptical and 43% were circular. When the head was elliptical the maximum diameter was 22 mm +/-2.9 and the minimum diameter was 20 mm +/-2.8 ( P<0.001). When the head was circular the maximum diameter was 21.2 mm +/-2.4 and the minimum diameter was 20.4 mm +/-2.4 ( P<0.14). The angle between the neck and the diaphysis varied with regard to the shape of the radial head. It was 166.75 degrees +/-3 for the circular heads and 168.62 degrees +/-3.2 for the elliptical heads ( P<0.01). The biomechanics of the circular shape and the elliptical shape are different, involving an adaptation of the angle between the neck and the radial diaphysis. This difference must be taken in consideration in the design of a radial head prosthesis.

Anthropometry↗
PubMed2001

Free osteocutaneous scapular apophysis flap for reconstruction of the lateral malleolus.

Lateral malleolus avulsion is uncommon, and fusion of the syndesmosis of the ankle joint is usually performed in such cases. Others have reported successful reconstruction of the lateral malleolus with a vascularized fibular head. A case of reconstruction in a 17-year-old girl, with a free scapular apophysis flap, is presented and compared with alternative flaps available. The anatomy and development of the scapular crest with its cartilaginous apophysis are discussed.

Adolescent↗
PubMed2001

Exposure to anaesthetic agents, cognitive functioning and depressive symptomatology in the elderly.

BACKGROUND: Anaesthesia could provoke persistent alterations in specific cognitive domains in the elderly where ageing-related neuronal changes may exacerbate pharmacotoxic effects. AIMS: To evaluate anaesthesia effects on the incidence of cognitive dysfunction after orthopaedic surgery in elderly patients. METHOD: A total of 140 patients over the age of 64 years completed a full range of computerised cognitive tests. The study takes into account effects of pre-operative cognitive dysfunction, depressive symptomatology and ability to perform activities of daily living. RESULTS: Postoperative cognitive decline persisted for up to 3 months in 56% of subjects. Dysfunction was limited to verbal, visuo-spatial and semantic abilities and secondary and implicit memory. Age, low educational level, pre-operative cognitive impairment or depression are risk factors. CONCLUSIONS: Cognitive functions are not equally affected, type of impairment being determined by the risk factors described above and anaesthesia type.

Activities of Daily Living↗
PubMed2001

[Interpretation of thoracic radiographs re-examined and corrected with tomodensitometry].

To our knowledge, conventional chest radiography is not likely to become obsolete or disappear from the daily practice of medical imaging. As such, it is important to insure that chest radiographs are acquired using optimal technique. Evaluation of chest radiograph findings must be comprehensive and the art of reading chest radiographs must be well thought to physicians in training. Chest radiography is characterized by the projection of tridimensional anatomical structures and disease processes onto a two-plane radiographic film. Correlation with cross-sectional data obtained from CT may greatly enhance the understanding and interpretation of conventional chest radiographs. Indeed, review of CT images facilitates anatomical understanding of the segmental and subsegmental anatomy, of the superior segments of the lower lobes and of the three dimensional orientation of the fissures. CT also has improved the understanding of some chest radiography findings. Careful review of findings at chest radiography is helpful to optimize CT acquisition protocols in order to reduce some of the pitfalls of CT and improve detection of specific processes that could otherwise be poorly demonstrated or overlooked. Chest radiographs can sometimes detect diseases or abnormalities that are difficult to demonstrate at CT.

Humans↗
PubMed2001

[Optimal screening tool for thoracic diseases: chest X ray or CT?].

There are good reasons to believe that screening of lung parenchymal diseases by CT is superior to chest radiographs. Nevertheless, conventional chest radiography often remains the first examination performed for evaluation of thoracic diseases and, irrespective of clinical indication, it plays an important role in screening procedures. The interpretation methodology of a chest radiograph in a screening condition is reviewed. Specific attention to poor detectability zones is emphasized and a check-list is proposed, mainly to reduce the risk of overlooking lesions. Techniques, indications and respective diagnostic values for both chest radiography and CT scan are analyzed and applied to the screening of lung cancer, asbestos exposure and tuberculosis.

Humans↗
PubMed2000

Thoracic helical CT: influence of subsecond scan time and thin collimation on evaluation of peripheral pulmonary arteries.

The objective of this study was to analyze the influence of collimation on the identification of peripheral pulmonary arteries on helical CT scans. Three hundred sixty of 370 consecutive helical CT angiograms of the pulmonary circulation obtained during an 18-month investigation period were considered as technically acceptable for the detection of acute pulmonary embolism and were retrospectively analyzed. Patients in group A (n = 274) underwent CT with 2-mm collimation and pitch of 2; those in group B (n = 86) underwent CT with 3-mm collimation and pitch 1.7; a 0.75-s rotation time was systematically used. A total of 2160 segmental (six arterial zones per patient) and 2160 subsegmental (six arterial zones per patient) arterial zones were assessed. Whereas the percentage of segmental arteries was not significantly different between group A (86%) and group B (89%), the percentage of analyzable subsegmental arteries was greater in group A (65%) than in group B (43 %) (P<0.001). The causes of inadequately depicted subsegmental arterial zones were partial-volume effects (group A, n = 302; 52%; group B, n = 197; 67%; P<0.001), suboptimal enhancement (group A, n = 145; 25%; group B, n = 43; 15%; P<0.05), motion artifacts (group A, n = 113; 20%; group B, n = 30; 10%), and unincluded arteries (group A, n = 20; 3%; group B, n = 25; 8%). Helical CT with 2-mm collimation at 0.75 s per revolution enables marked improvement in the analysis of subsegmental arteries in routine clinical practice.

Adolescent↗
PubMed2000

[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↗
PubMed2000

Carpal bone maturation assessment by image analysis from computed tomography scans.

Bone maturation is the only reliable indicator of growth and its radiologic assessment with or without automated systems is a qualitative method. Image processing allows the study of bone maturation with quantitative data. Carpal bone maturation was studied in 20 children (13 boys and 7 girls, ages ranging from 4 to 15 years) without any clinical evidence of endocrine disease by image analysis from computed tomography (CT) scans. Each wrist CT scan was processed in order to extract the carpal bones and to measure quantitative data regarding volume, axes of inertia and density for each bone. The volumes and the length of the inertia axes were significantly correlated with age. Whatever the age, there were strong correlations between the volume or the length of the main inertia axis of one carpal bone and that of all others. The decrease in the carpal bone volume measured from the processing procedure compared with the theoretical volume of bone defined from the length of the three inertia axes indicated a change in bone shape during growth. Although the mean density was constant, there was an increase in the standard deviation of density with age. Skeletal maturity assessment with image analysis from CT scans seems to be a good complementary investigation to determine bone age in children.

Adolescent↗
PubMed2000

Helical CT angiography of thoracic outlet syndrome: functional anatomy.

OBJECTIVE: The objective of this study is to determine the anatomic characteristics of the thoracic outlet in symptomatic patients before and after postural maneuver. SUBJECTS AND METHODS: Seventy-nine symptomatic patients (61 female patients [group 1]; 18 male patients [group 2]; mean age, 38 years) underwent helical CT angiography of the thoracic apices in the neutral position and after a postural maneuver, enabling the evaluation of the functional anatomy of the musculoskeletal and arterial structures of the ipsilateral thoracic outlet. RESULTS: A statistically significant difference was found between the distribution of the distances (maximum and costosubclavian) measured in the neutral position and after postural maneuver in groups 1 and 2. The median value of these distances was smaller after postural maneuver in groups 1 and 2. A statistically significant difference was found between the distribution of the distances (maximum and costosubclavian) measured in patients of group 1 with arterial stenosis and in patients of group 1 without arterial stenosis. A slight indentation of the anterior wall of the subclavian artery when it arches around the anterior scalene muscle was observed in 39 patients (64%) in group 1 and in 11 patients (61%) in group 2 in the neutral position, in 19 patients (31%) in group 1 and in six patients (33%) in group 2 after the postural maneuver. The predominant positional changes of the vascular structures were the posteroanterior displacement of the subclavian vessels observed in groups 1 and 2, the arch made by the subclavian artery above the first rib in 40 patients (66%) in group 1 and nine patients (50%) in group 2, and the posterior displacement of the axillary artery observed in 36 patients (59%) in group 1 and in 12 patients (67%) in group 2. CONCLUSION: Helical CT shows significant narrowing of the costoclavicular space after postural maneuver in symptomatic patients.

Adolescent↗
PubMed2000

[Spiral (helical) CT of tracheobronchial diseases].

The acquisition techniques, including some important dosimetric considerations, and the reconstruction methods reviewing the tomographic, bronchographic and endoscopic rendering techniques are first taken into consideration. They are applied to the most usual problems and diseases encountered in the daily activityThe main purpose of this review, which merges the modern technology of spiral (helical) CT with the multislice acquisition in the very near future, consists in delivering, whenever possible, an integrated diagnostic and therapeutic approach of imaging, endoscopy and surgery.

Bronchial Diseases↗
PubMed1999

[Anatomy, physiology and clinical examination of the shoulder].

Shoulder pain is usually caused by periarthritis. Impingement syndrome and frozen shoulder (adhesive capsulitis) are the more frequently clinical aspect observed. A shoulder standardised clinical examination often give a precise lesional diagnostic. Complementary examinations are useful to distinguish other cause of shoulder pain.

Diagnosis, Differential↗