Biomedical subjects
Publications and source records attributed to J M Clavert.
Palmar and finger prints are recovered in children with congenital malformed hands. The skin ridges of various hand abnormalities are compared with normal dermatoglyphics. We have found a relationship between the embryogenesis of the hand and the epidermal ridge arrangement. Dermatoglyphics are a clinically useful information for the diagnosis of amniotic disease or agenesis and for the chronology of the congenital malformation of limbs.
This is a case report of a peritoneo-pericardial diaphragmatic hernia revealed by a respiratory distress in a newborn infant. Radiography and angiocardiography allowed preoperative diagnostic and the patient was operated upon successfully on two days of age. Anatomic finding was a defect of the central tendon of the diaphragm with a hernial sac. This anomaly is rare and probably results from a misdevelopment of the septum transversum.
By intra-adnexal injection of glucose in the rabbit embryo, we were able to stimulate all the anomalies associated with "Amniotic Disease". Since we were even able to obtain amniotic bands, this study provides an excellent experimental model of this disease. Resulting lesions occur early in development, corresponding to the first trimester of human gestation. All of the anomalies can ultimately be explained by the destruction of the most superficial cells: epiblastic cells of the embryo and the amnion, subjacent mesenchyme, and endothelial cells. The subsequent lack of interaction between these cells and the importance of the anatomical localizations of resulting hematomas can lead to the pathogenetic approach to this disease. In light of the present study, the disease appears to be caused by an external factor within the amniotic fluid. The exact nature of the destructive agent(s) remains a mystery in man.
The authors have reviewed two of Kuntscher's principles relating to intramedullary nailing: the moment of elasticity of the nail should be close to the moment of elasticity of the bone and the suppression of rotation movements at the fracture site is due to locking of the nail by virtue of its elasticity. They have conducted an experimental study which does not confirm these views. They considered that rotary stability is due to muscle tone, the line of the fracture and the anchorage of the ends of the nail at the upper and lower end of the bone.
Intra-adnexal injections of glucose into the rabbit embryo have induced amputations of digits or segments of limbs, congenital grooves, amniotic bands, club feet, syndactyly, hare lip, anencephaly, and ulcerations of the scalp. We have thus reproduced all the anomalies which are encountered in the clinical syndrome of "amniotic disease." These anomalies result from destruction of the cutaneous epithelium and the subjacent mesenchymatous cells, and extravasation of blood with hematoma formation around the superficial vessels. This general mechanism explains most of these anomalies. Intra-adnexal injections of glucose thus constitute an external trauma for the embryo and is good experimental model of amniotic disease.
By injections of cyclophosphamid to pregnant rabbits, we obtained different sorts of agenesis. These anomalies are the consequence of a lack of the quantity of mesenchyme necessary to the formation of the limbs. The final malformation depends on the date, the dose and the period of action of the cyclophosphamid.
The injection of 10 mg glucose and 0.4 U.I. of insulin in the ovulary fluid of 14th day rabbit embryo, produces less anomalies than the injection of the same concentration of glucose alone. This result shows that the insulin receptor is probably present in the 14th day rabbit embryo, before the differentiation of B cells in the pancreas.
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We studied the effect of injection of D-glucose in rabbit foetus ovulary liquid at the 14th, 16th and 18th day of pregnancy. Injection of 14th and 16th day determined a high percentage of foetal death and limb necrosis. On and after the 18th day of pregnancy, the foetus is insensible to the treatment. The 18th day is, in the rabbit, the period of a new hormonal equilibre establishment.
The cases of 2 children (9 and 11 years old) with hereditary multiple exostoses disease are presented. The lesions were located primarily in the acetabular fossa of the left hip and caused pain and limitation of range of motion. Hip arthroscopy was performed to remove the exostoses without damaging the articular surfaces and the Y cartilage. After the procedure, the pain disappeared and normal range of motion was recovered for both children. Conventional surgery would have required hip dislocation to access these lesions with an increased risk of femoral head necrosis. These cases constitute a new and interesting application of hip arthroscopy.
The authors report clinical and radiologic results of a series of 26 children who sustained an olecranon fracture, reviewed with a mean follow-up of 59 months. Mean age at time of trauma was 9 years. Direct trauma was the most common mechanism, and a radial head fracture was associated in one third of the cases. The fracture type usually consisted of a single fracture line, with a displacement >2 mm in one third of the cases. Treatment was usually conservative for nondisplaced or minimally displaced fractures, whereas open reduction with tension-wire pinning was proposed for displaced fractures. Clinical results were good, but radiologic results were less satisfying because of residual displacement on postoperative reviews. There was no functional impairment at final follow-up. Three patients from the surgically treated group with associated radial head fractures demonstrated a growth disturbance, possibly related to an ischemic cause.
Seven septic cases have been treated by bacteriophage; two infections after insertion of a hip prosthesis, two septic arthritis of the knee, one osteomyelitis of the tibia, one septic non-union of the femur and one septic complication following Harrington rodding. Only specific phages were used in association with several types of surgical procedure. The technique of treatment is described. All cases were long-term infections with resistant organisms. Results were good in five, fair in one and one case was a failure. It is concluded that phage therapy may be helpful in the treatment of long-term infections.
A 18-months-old boy, without antecedent nor abdominal trauma, revealed a congenital choledochal cyst by massive hemobilia. This way of revelation is extremely rare and to our knowledge has not been previously reported. The difficulties of diagnostic and surgical management are discussed.