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Biomedical subjects

M Merle

Publications and source records attributed to M Merle.

At least 73 records · Page 4Linked to original sources
PubMed1988

Experimental and clinical study of fast absorption cutaneous suture material.

Fast Absorption Vicryl was irradiated with gamma rays. The experimental study on 14 mice grafted with human skin showed a constant rupture of the sutures on the 12th day, with the development of a moderate macrophage reaction. Injection of isotonic saline around the suture material did not accelerate the process of resorption. The clinical study with 27 children operated on the limbs showed rupture of the sutures between the 12th and 16th days, without inflammatory reaction, infection or wound dehiscence. Simply wiping the wound with a compress removes the stitches painlessly. This is appreciated by the young subject and his or her family. Since we began to use FAV systematically we have not needed to conduct dressing under anesthesia. The long term results of healing (follow-up: 11.3 months) are similar to those obtained with conventional non-absorbable suture material. The tolerance, the rapid resorption, the comfort of the patient and the cost advantage make FAV the suture material of choice.

Absorption↗
PubMed1988

Automated photography in microsurgery.

An automated method is proposed for photographing a microsurgical field that avoids missed photographs and time-consuming manipulations. The basic principles applied to microscopic photography are briefly reviewed and instructions are provided for standardized, reproducible, high quality photographs. A limitation at present is that auto-focusing cameras have not yet been adapted for use with surgical microscopes. One type of microscope is discussed and details about the only camera system currently suitable for such a microscope are described.

Humans↗
PubMed1988

[Cross replantation in a case of bilateral amputation of the legs].

A case is reported of a patient aged 32 years who suffered bilateral traumatic amputation of the legs by a wagon. Neither of his two feet could be re-implanted to its original site. In spite of the severity of the lesions, reconstructive surgery was attempted by crossed re-implantation of the right foot onto the stump of the left leg. After bony shortening by 20 cm and internal fixation of the tibia, revascularisation was achieved by suture of the posterior tibial vascular pedicle. Primary repair of the posterior tibial nerve allowed protective sensibility to recover in the sole of the foot. Secondarily, a free musculo-cutaneous graft from the latissimus dorsi improved skin cover. Bony union occurred after 10 months. Prolonged rehabilitation resulted in satisfactory walking and activities of daily living and a return to work 18 months after the accident.

Accidents, Occupational↗
PubMed1987

[Primary repair of the collateral cubital ligament of the metacarpophalangeal articulation of the thumb using Jenning's barb-wire].

The authors report their technique of primary repair of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. Under loco-regional anaesthesia with a pneumatic tourniquet, the principal band of the ulnar collateral ligament is reinserted by means of Jenning's barb-wire anchored on the proximal phalanx. After 4 weeks' immobilisation, a regime of splintage is used to regain range of movement.

Bone Wires↗
PubMed1987

Free compound transfer of the distal interphalangeal joint. A case report.

The first case of free vascularized transfer of a distal interphalangeal (DIP) joint, used to replace a severely damaged proximal one, is presented. The case is interesting not only for the procedure used, but it also illustrates the principle by which useful components of nonsalvageable digits are used to reconstruct other damaged, but still salvageable, parts of the hand.

Adult↗
PubMed1987

[Fibrolipomatous hamartoma of the peripheral nerves. Anatomico-clinical study of 5 cases, including 2 with ultrastructural study].

Five cases of fibrolipomatous hamartoma are described. The median nerve was involved in four cases, the medial plantar nerve in one case. In the two cases with involvement of the median nerve in the wrist, the diagnosis was macroscopically suspected on the typical fusiform, segmentary enlargement of the nerve by fibrolipomatous tissue. Histologically, the epineurium was expanded by fibrolipomatous tissue and the scattered nerve bundles were dissociated by perineurial and endoneurial fibrosis. At ultrastructural examination the nerve bundles were constituted of "onion bulblike formations" with one or two central nerve fibers and peripheral perineurial cells. Eighty-eight cases of fibrolipomatous hamartoma were published in the medical literature, thirty-six with macrodactyly. This rare and probably congenital affection frequently involve the median nerve (78%).

Adult↗
PubMed1986

Kinetic evidence for half-of-the-sites reactivity in tRNATrp aminoacylation by tryptophanyl-tRNA synthetase from beef pancreas.

The aminoacylation reaction catalyzed by the dimeric tryptophanyl-tRNA synthetase from beef pancreas was studied under pre-steady-state conditions by the quenched-flow method. The transfer of tryptophan to tRNATrp was monitored by using preformed enzyme-bis(tryptophanyl adenylate) complex. Combinations of either unlabeled or L-[14C]tryptophan-labeled tryptophanyl adenylate and of aminoacylation incubation mixtures containing either unlabeled tryptophan or L-[14C]tryptophan were used. We measured either the formation of a single labeled aminoacyl-tRNATrp per enzyme subunit or the turnover of labeled aminoacyl-tRNATrp synthesis. Four models were proposed to analyze the experimental data: (A) two independent and nonequivalent subunits; (B) a single active subunit (subunits presenting absolute "half-of-the-sites reactivity"); (C) alternate functioning of the subunits (flip-flop mechanism); (D) random functioning of the subunits with half-of-the-sites reactivity. The equations corresponding to the formation of labeled tryptophanyl-tRNATrp under each labeling condition were derived for each model. By use of least-squares criteria, the experimental curves were fitted with the four models, and it was possible to disregard models B and C as likely mechanisms. Complementary experiments, in which there was no significant excess of ATP-Mg over the enzyme-adenylate complex, emphasized an activator effect of free L-tryptophan on the rate of aminoacylation. This result disfavored model A. Model D was in agreement with all data. The analyses showed that the transfer step was not the major limiting reaction in the overall aminoacylation process.

Amino Acyl-tRNA Synthetases↗
PubMed1986

Tryptophanyl adenylate formation by tryptophanyl-tRNA synthetase from Escherichia coli.

By gel filtration and titration on DEAE-cellulose filters we show that Escherichia coli tryptophanyl-tRNA synthetase forms tryptophanyl adenylate as an initial reaction product when the enzyme is mixed with ATP-Mg and tryptophan. This reaction precedes the synthesis of the tryptophanyl-ATP ester known to be formed by this enzyme. The stoichiometry of tryptophanyl adenylate synthesis is 2 mol per mole of dimeric enzyme. When this reaction is studied either by the stopped-flow method, by the fluorescence changes of the enzyme, or by radioactive ATP depletion, three successive chemical processes are identified. The first two processes correspond to the synthesis of the two adenylates, at very different rates. The rate constants of tryptophanyl adenylate synthesis are respectively 146 +/- 17 s-1 and 3.3 +/- 0.9 s-1. The third process is the synthesis of tryptophanyl-ATP, the rate constant of which is 0.025 s-1. The Michaelis constants for ATP and for tryptophan in the activation reaction are respectively 179 +/- 35 microM and 23.9 +/- 7.9 microM, for the fast site, and 116 +/- 45 microM and 3.7 +/- 2.2 microM, for the slow site. No synergy between ATP and tryptophan can be evidenced. The data are interpreted as showing positive cooperativity between the subunits associated with conformational changes evidenced by fluorometric methods. The pyrophosphorolysis of tryptophanyl adenylate presents a Michaelian behavior for both sites, and the rate constant of the reverse reaction is 360 +/- 10 s-1 with a binding constant of 196 +/- 12 microM for inorganic pyrophosphate (PPi).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Monophosphate↗
PubMed1986

Joint reconstruction following trauma: comparison of microsurgical transfer and conventional methods: a report of 61 cases.

Joint reconstruction at the metacarpophalangeal or proximal interphalangeal levels remains a difficult problem in hand surgery. The authors reviewed sixty-one joints reconstructed acutely or electively allowing to compare Swanson spacer (30 joints), interpositional arthroplasty (4), non vascularized joint transfer (5) and vascularized joint transfer (21). Among these, two different techniques have been used: island compound transfer from a finger bank (10) and free vascularized transfer from the second toe (10) or from a non replantable finger (1). It is not worth while comparing different techniques applied to different indications. The only point which can be stressed is the better average range of movement of metacarpophalangeal reconstruction compared to that obtained at the proximal interphalangeal level.

Arthroplasty↗
PubMed1986

Sarcoid tenosynovitis in the hand. A case report and literature review.

We report a case of involvement of a finger flexor tendon by sarcoidosis. A review of twelve cases suggests that this is a rare manifestation of the illness that most often affects the finger extensors at the wrist. It tends to present in established sarcoidosis and is associated with a higher than usual incidence of polyarthritis. The main differential diagnosis would be tuberculous tenosynovitis. We suggest that a histological spectrum exists running from a predominantly cellular picture to one of fibrotic nodules, perhaps explaining previously described instances of pseudo-tumour. We would recommend tenosynovectomy in conjunction with corticosteroid therapy as the treatment of choice.

Female↗
PubMed1986

[Revascularization of digital avulsion injuries caused by rings].

The authors describe an original technique of ring fingers revascularization, avoiding two chief dangers met in the double vein grafts: the one of the joint and tendinous devascularization with its risks of stiffness, and the other one of the devascularization of the skin sheath with secondary necrosis or trophic trouble. The worse artery is resected and the defect is bridged by a long venous graft, the skin of the distal fingers being provided by the backflow.

Finger Injuries↗