[Effects of neurotensin on the development of suckling rats with intestinal resection]. / Efectos de la neurotensina en el desarrollo de la rata lactante con resección intestinal.

Massive intestinal resection produces malabsorption which, in the suckling rat, reduces growth. Our aim was to determine whether the proliferative action of neurotensin, can reduce the negative effects on growth induced by bowel resection. Fifteen days old suckling Wistar rats were used. Twenty rats underwent 90% midgut resection and twelve were used as controls. Half the animals were treated with neurotensin (600 micrograms/kg-day) until sacrifice 30 days later. Body and bone weight were measured and mucosal samples obtained. All resected animals lost body weight and bone weight. Neurotensin treatment reduced femur weight loss. After bowel resection, significant trophic effects were observed at mucosal level (crypt and villous size) but only in the jejunum of resected animals neurotensin treatment had a trophic effect. In conclusion, neurotensin favors intestinal adaptation after resection without improving mid-term growth in the suckling rat.

Arteriovenous fistula with venous aneurysm as a complication of the trapeziometacarpal arthrodesis.

An iatrogenic radial artery-cephalic vein fistula with venous aneurysm occurred in a 55-year-old woman as a complication of trapeziometacarpal arthrodesis. The clinical diagnosis was confirmed by humeral arteriography. The fistula was ligated, and the aneurysm was removed successfully.

Stress fracture of the femoral neck in a young adult with Maroteaux-Lamy syndrome.

A rare case of stress fracture of the femoral neck with Maroteaux-Lamy syndrome occurred in a 20-year-old woman. The healing was achieved by the use of an autogenous ipsilateral fibular graft.

Isolated fracture of the coracoid process of the scapula.

We present a case of an isolated fracture of the coracoid process in a 49-year-old woman. Healing after conservative treatment was entirely satisfactory, with radiographic union and painless normal range of movement.

Isolated fracture of the capitate with a volar dislocated fragment.

We describe a patient with a capitate fracture with a volar dislocation of the proximal fragment. After open reduction and pin fixation an excellent range of wrist motion was achieved.

Slipped capital femoral epiphysis in primary juvenile hypothyroidism.

We report a case of a patient with a unilateral slipped upper femoral epiphysis and primary juvenile hypothyroidism. A satisfactory outcome was observed two years after surgery.

[False aneurysm of the posterior tibial artery complicating fracture of the tibia and fibula]. / Faux anévrisme de l'artère tibiale postérieure compliquant une fracture des deux os de jambe.

PURPOSE OF THE STUDY: Although tibia and fibula fractures are common, associated injury of the posterior tibial artery is rare. We present an unusual case of pseudoaneurysm of posterior tibial artery complicating a closed tibial and fibular fracture. MATERIAL: A 21-year-old man injured his left leg while playing football. METHOD: The diagnosis was suspected by the presence of persisting painful swelling at the fracture site. Echography, and later angiography confirmed it. RESULT: The patient was successfully treated with a saphenous vein interposition graft. The tibial fracture was stabilized with a Küntscher nail, and five months after surgery the fractures healed. DISCUSSION: A review of the literature revealed only 11 civilian cases of pseudoaneurysm of the posterior tibial artery. The clinical signs, specific diagnosis and operative treatment are discussed. CONCLUSION: Our case emphasizes that attention must be paid to the vascular complications of fractures, that may not become evident until some time after the initial injury.

[Simultaneous dorsal luxation of metacarpophalangeal joints of the four long fingers. Apropos of a case]. / Luxation dorsale simultanée des articulations métacarpophalangiennes des quatre doigts longs.

PURPOSE OF THE STUDY: The authors describe an unusual case of simultaneous dorsal dislocation of the metacarpophalangeal joints of the index, long, ring, and little fingers. MATERIAL AND METHODS: A 67-year-old man fell on the pavement when walking, striking his outstretched left hand. A diagnosis of multiple fingers dislocation was easily clinically and radiologically established. The wound was cleaned and the dislocations reduced by closed manipulation at the operating room. RESULT: The patient had an uneventful recovery, after a three week period of immobilization with a dorsal extension block splint. DISCUSSION AND CONCLUSIONS: The use of art extension block splint allowed a minimal healing delay for disrupted volar metacarpophalangeal structures, allowing a good fingers range of motion.

[Acute compartment syndrome as a complication of a distal forearm fracture: apropos of a case of a child]. / Syndrome aigu de la loge antérieure de l'avant-bras après fracture distale des deux os: à propos d'un cas chez un enfant.

PURPOSE OF THE STUDY: We describe a case of acute volar compartment syndrome of the forearm occurred after fracture of the diaphyseal-metaphyseal junction of the distal radius and ulna. MATERIAL: A 7-year-old child fell down steps and injured his left forearm. METHODS: After reduction, the patient developed clinical signs of volar forearm compartment syndrome. Measurement of intramuscular pressure by the saline injection technique confirmed the diagnosis. RESULTS: Early decompressive fasciotomy led to uneventful healing with no residual symptoms. DISCUSSION: We discuss the mechanism, diagnosis and treatment of this injury. CONCLUSION: The development of suspicious clinical signs should be supplemented by compartment pressure measurements to determine the need of surgical decompression.

Sacral osteomyelitis due to Nocardia asteroides. A case report.

Nocardial osteomyelitis is increasing in both immunocompetent and immunosuppressed patients. We report a case of a Nocardia asteroides infection of the sacrum in a 37-year-old man who was successfully treated surgically.

Carbon and polyester fibers as a scaffold for bone repair. Studies of segmentary implants in the rabbit radius.

To determine the function in the repair of bone defects, implants of carbon and polyester fibers of comparable dimensions were used to replace a 2-cm long segment of the radius of 29 rabbits. The healing process was analyzed by scintigraphic, radiographic, and histologic methods after periods of 15-90 days, comparing the results with a control group without implants. In the rabbit, carbon and polyester fibers did not induce repair of bone defects, although they did permit invasion of the implant during the later stages.

Orthopaedic treatment in tibial diaphyseal fractures. Risk factors affecting union.

A retrospective of 216 tibial fractures treated orthopedically was carried out. The aim was to analyze a set of clinicobiological parameters that owing to their assumed action on the physiological model of consolidation can be considered as risk factors to be taken into account in all kinds of orthopedic treatment, because they may lead to a lengthening of the normal consolidation time of the fracture. The variables analyzed were the following: type of immobilization, causative agent of the fracture, location of the focus of the fibular fracture, initial displacement, degree of conminution, type of wound, type of fracture, appearance of radiologically observable callus, commencement of weight-bearing, post-fracture hematoma, secondary displacement, and infection of soft tissues. In the particular case of immobilization by an ischiopedic plaster cast, the following parameters showed a greater degree of prognostic significance: initial displacement, secondary displacement, and age.

[Comparative study between conservative orthopedic therapy and intramedullary osteosynthesis of diaphyseal tibial fractures]. / Vergleichende Studie zwischen konservativer orthopädischer Therapie und der intramedullären Osteosynthese diaphysärer Tibiafrakturen.

The authors present the results obtained in a series of 275 tibial shaft fractures, 216 of which were treated by a functional orthopaedic procedure and 59 with different kinds of nailing techniques. The results are evaluated according to the criteria established by Johner and Wruhs. "Good" results were obtained with both kinds of treatment; "excellent" results were slightly more frequent with nailing techniques, owing to better alignment and a lesser degree of shortening in the fractures, although the residual deformities after the functional orthopaedic treatment were tolerable.

Effects of exogenous neurotensin on intestinal postresectional growth in the suckling rat.

BACKGROUND: In the suckling rat, massive bowel resection provokes intestinal malabsorption that leads to diminished growth. The object of this report was to test whether neurotensin, intestinal trophic peptide, enhances postresection intestinal adaptation, improving absorption and reducing the adverse effects of resection on growth. METHODS: Fifty-seven 15-day-old suckling. Wistar rats were divided into four groups: 41 rats were subjected to resection of 90% of their small bowel, while the rest (n = 16) underwent laparotomy. Half of the animals, resected and laparotomized, were treated with neurotensin for 30 days. The body weight was monitored, and samples of bone and intestinal mucosa were obtained at the end of the study period for analysis. Blood was tested to determine iron, ferritin, folic acid, and vitamin B12 levels. RESULTS: The resected animals lost body weight regardless of neurotensin administration. In the resected animals, femur weight increased significantly when they received neurotensin. Bowel resection provokes significant increases in the intestinal mucosa (crypts and villi), but after neurotensin administration, significant increases were detected only in the jejunum of the resected animals but not in the ileum of laparotomized rats. In the resected animals, significant decreases in iron, ferritin, folic acid, and vitamin B12 levels were observed. The postresection administration of neurotensin only produced a significant rise in the ferritin concentration. CONCLUSIONS: In the suckling rat, neurotensin enhances the intestinal proliferative phenomenon but does not improve the course of medium-term postresection growth.

Low diversity in the major histocompatibility complex class II DRB1 gene of the Spanish ibex, Capra pyrenaica.

During the last two centuries, the Spanish ibex (Capra pyrenaica) has shown a significant demographic decline as a result of the progressive destruction of its natural habitat, disease epidemics, and uncontrolled hunting. Partial sequencing of the class II MHC DRB1 gene revealed that the Spanish ibex has remarkably low levels of genetic variation at this locus, with only six different DRB1 alleles and an observed heterozygosity of 0.429-0.579. The rates of nonsynonymous vs synonymous substitutions were significantly different in the peptide-binding region (dN/dS=5.347, P=0.002), a feature that indicates that the DRB1 gene is under positive selection. A phylogenetic analysis of the Spanish ibex and a set of domestic goat DRB1 alleles revealed that the reported sequences represent four major allelic lineages. The limited allelic repertoire of the DRB1 gene in the Spanish ibex is likely the direct result of the recent history of population bottlenecks and marked demographic decline of this species. A genetic survey of 13 microsatellite loci was consistent with this idea. The Spanish ibex subspecies C. p. hispanica and C. p. victoriae consistently showed considerably lower levels of microsatellite heterozygosity (Ho=0.184-0.231) and allelic diversity (mean number of alleles per locus=2-2.4) than those reported in other wild ruminants. This study demonstrates the significance of both natural selection and the demographic history of populations in determining patterns of genetic variation at MHC loci. In addition, our results emphasize the importance of locally adapted populations for the preservation of genetic diversity.