Cutaneous mammary loxoscelism: An unknown cause of breast inflammation: A case report and review of the literature.

Envenomation due to a Loxosceles spider bite is a rare event in France and no case concerning the breast has yet been reported. We report the case of a 48-year-old woman who presented at Saint-Etienne University Hospital with a pulsatile pain in her left breast two days after feeling a fleeting bite. An abscess was diagnosed and antibiotics were prescribed. A few days later, a necrotic zone appeared around the areola and 75 percent of the surrounding skin was inflamed. The patient reported a persistent fever and a burning pain in her breast. Loxoscelism was finally concluded and surgical debridement was undertaken, followed by supervised wound therapy and local skin care. Complete healing was achieved after 4 weeks of treatment. The diagnosis of loxoscelism is generally presumptive, as the bite is usually painless and the spider rarely captured. Its diagnosis should be considered when an abscess responds poorly to antibiotics.

[Aberrant birth of a radial artery in the upper third of the forearm: A case report]. / Naissance aberrante d'une artère radiale au tiers supérieur de l'avant-bras : à propos d'un cas.

We report the case of a 68-year-old patient, operated on in our department of a quadruple coronary bypass grafting. The grafting strategy consisted initially on harvesting the left internal thoracic artery and the left radial artery. The harvest of this latter failed because of a rare anatomical variation of the radial artery, which rose from the confluence of two branches: a superficial and a deep radial artery at the proximal third of the forearm approximately 10cm below the elbow.

[Endoscopic anatomy of the terminal portion of the basilar artery and its distal perforating branches]. / Anatomie endoscopique de la terminaison de l'artère basilaire et de ses perforantes distales.

The aim of this study was to describe and highlight the endoscopic anatomy of the tip of the basilar artery and its perforating branches. Knowledges of the anatomy are crucial for neurosurgeons to avoid pitfalls during endoscopic third ventriculostomy.

[Biometric and histological study of human, porcine and sheep internal thoracic arteries (reflections on their use in revascularization of arteries of less than four millimetres diameter)]. / Etude biométrique et histologique comparative des artères thoraciques internes de l'homme, du porc et du mouton (application en chirurgie de revascularisation des artères de moins de quatre millimètres de diamètre).

In order to enhance the knowledge of the internal thoracic arteries of pig, sheep, and man, allowing to constitute a fundamental basis as for the current and later applications in the interventions in surgery of revascularization of the arteries of less than four millimetre of diameter, a biometric and histological comparative study of these arteries was carried out. Forty human corpses, 27 men and 13 women (mean age 75+/-6 years) were dissected, alike with three pigs respectively weighing 80 kg, 80 kg and 84 kg and four sheep weighing 70 kg each. The left and right internal thoracic arteries were harvested: exposure over the entire length and remote dissection before excision. At the same time their internal lengths and gauges were measured. The internal thoracic artery (ITA) of human has an average useful length of 18 cm and an average internal gauge close to 1.5 mm. ITA of the pig has an average length of 27 cm and an average internal gauge close to 2.8 mm. The ITA of the sheep has an average length of 18 cm with an average internal gauge close to 1 mm. The porcine Internal Thoracic Artery is an elastic artery like its human counterpart. Many elastic fibres and few smooth muscle cells are present in the media. On the other hand, the internal thoracic artery of the sheep has a mixed structure. Its media contains more smooth muscle cells than elastic fibres.

Advantages of adoptive chemoimmunotherapy with polyethylene glycol-cultured, antigen-activated, tumor-infiltrated spleen cells for the complete eradication of lethal MOPC-315 plasmacytomas.

The incorporation of polyethylene glycol-6000 (PEG) into the culture media of tumor-infiltrated spleen cells (TISpC) and MOPC-315 stimulator tumor cells at a responder to stimulator cell ratio of 30/1 had been shown to lead to the appearance of CD8+ T-cells that were effective in adoptive chemoimmunotherapy (ACIT) of mice bearing a barely palpable MOPC-315 tumor (J. A. Wise, M. B. Mokyr, and S. Dray, Cancer Res., 49:3613-3619, 1989). Here we show that in the presence of substantially fewer added stimulator tumor cells (responder to stimulator cell ratio, 100/1), the inclusion of PEG in the cultures of TISpC also enhanced the appearance of cells that were highly effective in curing such mice by ACIT. Moreover, these PEG-cultured TISpC were more effective in ACIT than TISpC cultured in the presence of an optimal concentration of recombinant interleukin-2 (60 IU/ml). The potency of the tumor-eradicating activity of the PEG-cultured TISpC in ACIT was further illustrated by their ability to cause the complete regression of a large (20-22 mm) s.c. MOPC-315 tumor in conjunction with a dose of drug that by itself did not cause tumor regression. PEG-cultured TISpC that were effective against MOPC-315 tumor cells in an antigen-specific manner. In fact, PEG-cultured TISpC were more effective than recombinant interleukin-2-cultured TISpC, not only in ACIT, but also in their ability to lyse MOPC-315 tumor cells in vitro. Thus, a direct specific lytic activity against the tumor by cytotoxic T-lymphocytes is the apparent mechanism through which the complete regression of the large tumor burden is brought about by the PEG-cultured TISpC. Finally, we suggest that the incorporation of PEG to render ineffective lymphoid cells effective in ACIT may offer some advantages compared with the incorporation of recombinant interleukin-2 and may be suitable for protocols to generate human cytotoxic cells for cancer therapy when there are relatively low numbers of available tumor cells.

[Anatomical basis of the extraspinal cord compression]. / Bases anatomiques des compressions tumorales extramedullaires.

Knowledge of anatomical landmarks of the spinal cord within the vertebral foramen is essential to understand the pathogenesis of spinal cord compression by tumor growth. The spinal cord can spread in the intervertebral foramen, the epidural space, the vertebral body, and the posterior neural arch. The morphology of the spinal cord, the relations of the spinal roots with the vertebrae, the principal fiber tracts, the spinal membranes, and the arterial and venous distribution are described in order to explain and analyze signs and disorders caused by the most frequent tumors involved in spinal cord compression.

HIV infection is associated with the spontaneous production of interleukin-1 (IL-1) in vivo and with an abnormal release of IL-1 alpha in vitro.

Interleukin-1 (IL-1) is not constitutively produced by normal human monocytes. We have investigated the production of cell-associated IL-1 in uncultured unstimulated adherent monocytes from HIV-infected patients, which reflects ongoing generation of IL-1 by the cells in vivo. High levels of cell-associated IL-1 activity and of cell-associated IL-1 alpha and IL-1 beta antigens were found in monocytes from HIV-infected patients as compared with those found in monocytes from normal individuals. Amounts of cell-associated IL-1 were high in patients with AIDS and in patients from Centers for Disease Control groups II and III. Serum-free culture for 24 h of monocytes from HIV-infected individuals in the absence of lipopolysaccharides (LPS) resulted in spontaneous release of IL-1 activity from the cells whereas no release occurred upon culture of normal cells. Stimulation of monocytes with LPS induced the release of IL-1 alpha and IL-1 beta from cells of infected patients. Only IL-1 beta was released from cells of normal individuals. Thus, circulating monocytes from HIV-infected patients are triggered to produce IL-1 in vivo. The present study also indicates that HIV infection is associated with an acquired defect in the intracellular processes regulating IL-1 secretion.

Induction of interleukin-1 production in patients undergoing cardiopulmonary bypass.

Systemic reactions resembling inflammation occur in patients undergoing cardiopulmonary bypass. We now report that interleukin-1, an endogenous pyrogen and a key mediator of inflammation, is transiently and consistently generated in vivo by circulating monocytes within hours after cardiopulmonary bypass. Interleukin-1 production was assessed by measuring interleukin-1 functional activity and interleukin-1 beta antigen concentration in cell lysates from monocytes of patients during and after bypass. There was no increase in intracellular interleukin-1 activity during bypass and within the first hours after bypass, possibly because of a suppressive effect of hypothermia on interleukin-1 production, as documented in vitro. Maximal generation of interleukin-1 was observed 24 hours after extracorporeal circulation, concomitantly with the occurrence of a peak in body temperature. The amount of interleukin-1 generated at that time was linearly correlated with the increase in patients' body temperature. The peak in interleukin-1 production followed by 20 hours the peak in complement activation as assessed by determining C3a desArg and C5a desArg concentrations in patients' plasma. These results indicate that interleukin-1 may be involved in the pathogenesis of adverse systemic reactions associated with cardiopulmonary bypass.

[A prospective study of alveolar bone resorption after radiotherapy and chemotherapy]. / Etude prospective de la résorption osseuse alvéolaire après radiothérapie et chimiothérapie.

A prospective comparative study of the alveolar bone resorption after teeth extraction was achieved in a series of 79 patients in order to analyze macroscopically the possible consequences of radiotherapy and chemotherapy on the toothless edges. After quarterly coronal and sagittal X-rays for two years, this study enhances quite a similar vertical resorption for the radiation and chemotherapy-treated patients as well as for the witness patients. The alveolar bone resorption progression also appears unaltered by anti cancerous treatments. In both cases, a resorption stabilisation can be clearly seen after 6 months according to dental extractions. The vertical alveolar bone resorption is more important in incisor and canine regions. The anti cancerous treatments may not have significant disastrous consequences as far as available bone amount is concerned, on a post prosthetic restoration.

Abuse during and before pregnancy: prevalence and cultural correlates.

This study examined the prevalence of abuse during pregnancy and the influence of cultural norms and acculturation on abuse in 1,004 Mexican American, Puerto Rican, Cuban American, Central American, African American and Anglo American women. Women were recruited from consecutive delivery logs in general community hospitals in Florida and Massachusetts. The Index of Spouse Abuse and the Abuse Assessment Screen ascertained history of adult physical, sexual, and emotional abuse, abuse during pregnancy, and childhood sexual abuse. An Interview Protocol assessed cultural attitudes, acculturation, and demographic information. Hispanic American women, as a whole, did not differ significantly from Anglo American women in their prevalence of abuse during pregnancy, after controlling for sociodemographic variables. However, Cuban American and Central American partners were significantly less likely to abuse their pregnant partners than were other groups even after adjustment. Women who spoke only Spanish (less acculturated) were less likely to report physical abuse from their partners both before and during pregnancy. Cultural norms, such as a partner's belief in wife/mother role supremacy and cultural group acceptability of men hitting women, were significantly positively related to both physical and emotional abuse. Other risk factors for abuse were the abuser not being the biological father of the baby, low income and little education, and being unmarried.

[Anatomy of the external laryngeal nerve: surgical implications. Report of 30 dissections]. / Anatomie du nerf laryngé externe: implications chirurgicales. A propos de 30 dissections.

OBJECTIVES: This anatomic study aimed to detail the anatomy of the external laryngeal nerve and to determine the possible variations of nerves at risk. MATERIAL AND METHOD: Fifteen cadavers (30 nerves) were dissected. The peri pharyngo laryngeal route, the anatomic rapports, the branches of division and the distal penetration point of the external laryngeal nerve were noted. RESULTS: The external laryngeal nerve gave branches to the inferior pharyngeal constrictor muscle in 90% of cases and to the thyroid gland in 70% of cases. There was an adherence between the nerve and the trunk of the superior thyroid artery in 13.33% of cases. The nerve had a distal superficial route even on the cricothyroid muscle in 6.67% of cases. In one case the nerve was situated close to the medial face of the superior thyroid lobe. DISCUSSION/CONCLUSION: The external laryngeal nerve has numerous anatomic variations. The anatomic variations at risk during thyroid surgery are: an adherence between the nerve and the thyroid artery (or a course of the nerve between the branches of the superior thyroid artery); a superficial distal route; a distal situation close to the medial face of the thyroid lobe. In this study, 7 nerves were considered at risk (23.33% of cases).

[A novel approach to the biomechanical study of the talocrural joint in man using MRI. Contribution of dynamic images]. / Nouvelle approche de l'étude biomécanique de l'articulation talocrurale chez l'homme par I.R.M. Apport des images dynamiques.

A cineradiographic study of the talocrural joint allows a new biomechanical approach of the ankle: MRI with axial and coronal slides were realized: for volume reconstruction in passive movement; scanner was used for axial slides in active movement. There is evidently neither distosis of the bimalleolar grip in dorso- and plantar flexion, nor movement of the lateral malleolus of the fibula, in opposition to the classical description. An anatomical rotation is discussed.

[Biometry and structure of the left internal thoracic and radial coronary arteries]. / Biométrie et structure des artères coronaires, thoracique internes gauche et radiales.

In an attempt to elucidate the causes of occlusion of radial arteries for coronary artery bypass grafts, we studied the biometry and histology of the coronary, radial and left internal thoracic arteries of 20 anatomical subjects (13 males and 7 females). These specimens were calibrated to the various bypass graft sites using coronary calibrators, and were then submitted to histological examination to determine the structure of the vessel wall. Our preliminary results show no correlation between the internal calibres of these various arteries. Like the coronary arteries and their branches, the radial artery is a muscular artery. In contrast, the left internal thoracic artery like the aorta, is an elastic artery.

[Subparietal cleavable spaces in the abdomen (author's transl)]. / Les espaces clivables sous-pariétaux de l'abdomen. Leur intérêt dans la chirurgie des hernies et éventrations de la paroi abdominale antérolatérale.

The subparietal cleavable spaces in the abdomen were studied with the view to their practical application in general surgical practice. These studies formed part of an applid anatomy research project on the repair of anterolateral gaps in the abdominal wall, using large prostheses, inserted without direct fixation, as a means of reinforcement of the visceral sac. The spaces were meeasured at different levels in 20 adult cadavers, and the values obtained were used to prepare representations on a plane surface. These morphological and metric data should enable the surgeon to make his incisions more easily, and to obtain a more effective insertion and use of prostheses for reinforcement of the peritoneal sac, thus avoiding the waste of time and material, and the various difficulties usually encountered.