Biomedical subjects
Publications and source records attributed to M Triffaux.
The present report describes a young child who developed generalized epileptic seizures in the course of severe head injury. The start of epileptic seizures was associated with the occurrence of acute hyponatremia and hypoosmolality due to excessive Desmopressine administration. The seizures resistant to conventional therapy resolved completely with intravenous nimodipine infusion.
The influence of intravenous propacetamol hydrochlorid administration on postoperative analgesia and intramuscular opioid consumption was assessed in a randomized placebo-controlled study. Fourty patients scheduled for lumbar disc surgery were randomly allocated to two groups. They were given either propacetamol 2 g or saline every 6 hours, starting at the end of procedure for a 24 hours period. The pain intensity (VAS) was not significantly different between the two groups except 3 and 4 hours after surgery, where it was higher in the paracetamol group. The cumulative narcotic consumption (piritramide on request) was higher in the placebo group from 6 hours till 9 hours after surgery but not significantly different after 24 hours. Piritramide administration decreased VAS score significantly in both groups while propacetamol reduced it in a significant way only when given from 12 hours after surgery.
The cardiomyoplasty procedure involves the use of a transformed skeletal muscle to augment cardiac pump function or to substitute for the heart after parietal resection. This study of the intramuscular vascularization of latissimus dorsi was carried out in order to establish the relationship between the dominant thoracodorsal blood supply and the distal supply issued from the intercostal and lumbar arteries. This data is mandatory for the safe manipulation of the muscle flap during cardiomyoplasty. Thirty human latissimus dorsi flaps were carefully studied. We confirmed anatomically as well as angiographically previous macroscopic anatomical reports, as well as the constancy of the neurovascular pedicle. Three principal branching patterns were observed for the thoracodorsal artery. The thoracodorsal artery divides into three main tributaries in 20/30 (67%), and into two tributaries in 10/30 (33%) of the flaps observed. When three tributaries were observed, one of them was a small recurrent artery for the proximal third of the latissimus dorsi (14/20, 70%). Thus the distal vascularization is actually dependent on three principals in 6/30 (20%) and two principals in 24/30 (80%). From these two or three principals emerge several subsequent longitudinal branches (5 to 9) that have a straight course until their distal anastomoses with segmental arterial pedicles issued from intercostal and lumbar arteries. The latter ligation can thus occur without ischemic damage to the medial and distal aspect of the flap. This study emphasizes that, due to macroscopic anatomic features and systematic intramuscular vascular distribution, the latissimus dorsi is probably the most suitable muscle for the purpose of cardiomyoplasty.
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The anatomical data concerning to the latissimus dorsi and its neurovascular pedicle are revised with its applications in reconstructive surgery. The use of this muscle in cardiomyoplasty depends upon a good understanding of its vascularisation and the intramuscular innervation. Our angiological study of the human latissimus dorsi demonstrates clearly the topographic distribution of the branches of the thoraco dorsal artery ant the peripheral blood supply after interrupting the intercostal and lumbar perforating vessels. These findings demonstrate the vascular reliability of the muscle for cardiomyoplasty.