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Biomedical subjects

J G Pous

Publications and source records attributed to J G Pous.

At least 19 recordsLinked to original sources
PubMed1996

Chronic recurrent multifocal osteomyelitis (C.R.M.O.). A case report and review of literature.

The case of an 8-year-old boy presenting two episodes of osteomyelitis of the left and right tibial diaphysis is reported. The recurrent course, the negative cultures and the symmetrical aspect of the lesions suggest the diagnosis of recurrent multifocal osteomyelitis. The location of the lesions at the middle of the diaphysis and the histological finding of predominant bone necrosis are unusual.

Child↗
PubMed1992

Cause and prevention of osteochondritis in congenital dislocation of the hip.

All treatment modalities of congenital displacement of the hip (CDH) bear the risk of ischemic necrosis at the proximal femoral epiphysis. The causes of ischemic necrosis were investigated in a review of the literature and personal experience with CDH patients during the past 30 years. Compression of articular cartilage, caused by an increase in intraarticular pressure, has been implicated as the mechanism of osteochondritis. Muscle spasm, pressure on posterior circumflex vessels, and compromised pericephalic microcirculation in the newborn have been demonstrated to increase intraarticular pressure. The most dangerous causative factors include forced reduction under general anesthesia, spica cast immobilization of the hips in the Lorenz or Lange position, insufficient continuous prereduction traction, and splints or braces that are either too rigid or that force the hip into an extreme position. An intertrochanteric varus osteotomy can also lead to ischemic necrosis when performed at the time of reduction. Preventive measures include sufficient continuous traction, casting in a moderate position, and bracing that allows active movement. None of these measures constitute a guarantee against necrosis, but they will lessen the incidence and severity of involvement.

Child, Preschool↗
PubMed1986

Pedicled scapular apophysis transplantation. Growing grafts studied in dogs.

Twenty-eight immature dogs, divided into three groups, have been studied to determine the possibilities of pedicled epiphyseal transplantation from a rarely used donor site area, the scapula. One group of 8 immature dogs were studied anatomically using India ink and Batson's compound injection methods. We identified the vascular pattern of the diaphyseal portion of the graft, consisting of the lateral crest or border of the scapula. In two groups of 10 immature dogs, this area was used as a pedicled island graft to rebuild the semiresected or totally resected proximal humerus. There were marked differences between these two groups on the basis of morphologic, histologic, histochemical and electron microscopic aspects of the samples. Preservation of normal growth appeared to be directly related to the compressive forces applied to the graft. Preservation of the cartilage was also related to the biomechanical situation; fibrocartilage and signs of arthrosis were noted 1 year after the operation in several animals whose humeri had been fully subjected to normal stresses. Both the diaphyseal and epiphyseal areas had increased one- to fivefold in volume, but longitudinal growth was markedly deficient.

Animals↗
PubMed1985

Ultrastructural aspects of nerves, bones, and vessels in hereditary sensory neuropathy.

This study concerns two children, from the same otherwise normal family, presenting progressive spontaneous amputations of the limbs, suggesting peripheral hereditary sensory neuropathy. Samples from the distal nerves and vessels and the distal tibial epiphyses were examined ultrastructurally. The nerves showed signs of degeneration, and a typical bone necrosis, without osteoclasts, was observed in the 2 cm margin of the samples. Simultaneous modifications of the vessels suggest a neurally initiated vascular reflex resulting in bone destruction. Theories that might explain the observations are discussed.

Arterioles↗
PubMed1985

[Biology of micro-vascularized cartilaginous transplantation in the growing dog].

Epiphyseal bone transplantations including growth area have been extensively studied experimentally in different animals and applied in children for several decades. Results were unpredictable and the amount of growth obtained with the graft could get 50 per cent of the normal. Development of microsurgical techniques has determined new possibilities of epiphyseal transfer with the respect of the epiphyseal vascularization. Growth plate germinal cell division is directly related to the epiphyseal vascular respect. In a large multifacetted program we could successively determine the vascular patterns of the donor site areas and then utilized different grafts in some experimental situations reproducing the clinical pathology in children, like hip dysplasia or epiphyseal defects after resection for tumor or infection. Results demonstrate that the main problem, in epiphyseal transplantation, is not vascular but mechanical. Further studies have to be done in this direction.

Aging↗
PubMed1985

[Arrangement of collagen fibers in the epiphyses and metaphyses of long bones in vertebrates].

The arrangement of collagene fibers in bone epiphyses and mataphyses form various species of reptiles and mammals was studied with a polarized light microscope and with a scanning electron microscope. In spite of the variety of shape observed in the long bone extremities of different species, the collagenic fibers arrangement in the bone epiphyses and metaphyses appeared constant. Even in reptiles known to lack a growth plate, the metaphyseal and epiphyseal fiber patterns evoked those observed in mammals. A common fiber pattern may therefore be proposed which allows the coexistence of two apparently incompatible functions: growth, that induces an increased fragility at the epiphyseo-metaphyseal junction as opposed to mechanical support, which has to cope with load and traction forces at the same junctional site.

Alligators and Crocodiles↗
PubMed1984

Epiphyseal vascularization during growth: the upper limb.

Sixty fetal, newborn and child cadavers were injected with India ink and plastic material (Batson's technique) via the subclavian artery. The arterial and capillary intracartilaginous and intraosseous networks of the physes of the long bones of the upper limb were then studied by microdissection of the vascular sources and serial epiphyseal sections in different planes. Already present in the third week of fetal life and present all during the rest of life, this circulation plays a fundamental role not only in the ossification of the epiphyseal cartilage but also in the trophicity of the bone that supports the cartilaginous articular surfaces. Like those of the lower limb, the epiphyses of the upper limb present a typical vascular pattern consisting of three entries, with the exception however of the inferior extremity of the ulna.

Arm↗
PubMed1983

[Acetabuloplasty using pedicle graft of the iliac crest epiphysis in puppies].

Pedicled iliac crest epiphysis transplantation was performed after resection of the outer portion of the acetabulum in 30 puppies 3 months old. The best joint congruency was obtained when using a vertical pedicled graft, the surface of which developed into normal articular cartilage through metaplasia, and presented normal cartilage growth by means of conservation of the epiphyseal vessels. The results of this experiment enable the authors to propose a new surgical technique in the treatment of certain difficult dysplastic conditions in the hip.

Acetabulum↗
PubMed1983

[Technics and strategy in the treatment of severe paralytic scoliosis].

Sixty-three paralytic scolioses with severe disability have been treated between 1973 and 1982. Fifty-two were due to poliomyelitis. The average angular deformity was 95.8 degrees and was related to delay in treatment and rapid progress of the curve. All cases were operated on. Spine fusion was performed either by the anterior approach (Dwyer or V.D.S.) or by a posterior approach (Harrington or Harrington - Luque). The pre-operative management was based on Cotrel or Halo traction. There were several complications - three non-unions, three neurological impairments, and nine cases of sepsis. It was concluded that the pre-operative management should be as short as possible, that the spine fusions should be done systematically and that any paralytic scoliosis increasing by more than 10 degrees a year between the ages of 8 and 10 years should be operated on early. This type of treatment should lower the incidence of severe disability and allow good functional and educational rehabilitation. The degree of diminished growth of the spine was moderate.

Adolescent↗
PubMed1983

[Surgical treatment of dislocated hips after 5 years of age].

Fifty dislocated hips after the age of 5 were treated between 1975 and 1980. The surgical procedures performed combined tenotomy of the iliopsoas and adductor muscles, shortening of the femur, capsulorraphy and a pelvic osteotomy usually for re-orientation (Salter procedure) and rarely for widening of the acetabulum (Chiari procedure). It is thought that tenotomies and femoral shortening were more efficient than pre-operative traction which produced osteoporosis. However post-operative traction was used. In some cases plaster cast immobilisation was not used. The advantages of this technique were an acceleration of the surgical programme, better articular stability and early mobilisation. Osteochondritis and post operative stiffness were rare. The average range of movement included 90 degrees of flexion and lumbar balance was the most significantly improved factor. This type of surgical procedure aims to slow the development of coxarthrosis but it cannot diminish the risk. The limit of age for such treatment appears to be 10 years. After that, the indications need to be assessed carefully.

Age Factors↗
PubMed1983

[Pneumoblastoma in children. Apropos of 2 cases].

Pulmonary blastoma is an exceedingly rare primary neoplasm in the paediatric age group. Pre-operative diagnosis is impossible because of its lack of specificity in clinical and radiological signs. The only diagnosis is the histopathological one. It is a malignant tumor capable of metastasis with a poor prognosis. The best method of treatment is still unknown but at the present time, the only survivals are the result of a complete and early surgical excision. The authors report 2 paediatric cases which have been observed at the hospital of Montpellier (France) for a 20 years period. They try to determine why children's pulmonary blastoma is slightly different from the adults one. They ask the question of histogenesis.

Adolescent↗