Contact versus feeding intoxication by fipronil in Reticulitermes termites (Isoptera: Rhinotermitidae): laboratory evaluation of toxicity, uptake, clearance, and transfer among individuals.

The susceptibility to fipronil of U.S. and French populations of Reticulitermes flavipes (Kollar) (Isoptera: Rhinotermitidae) was evaluated in two types of laboratory bioassays: contact intoxication with 0.01-1 ppm treated sand and feeding intoxication with 0.1-10 ppm treated filter paper. Contact intoxication with 0.01 ppm fipronil caused 60% mortality after 55 and 64 h in the French and U.S. populations, respectively, whereas in the 5 ppm feeding assay 70 and 60% mortality was observed after 7 d in the French and U.S. populations, respectively. We evaluated the uptake, clearance, and transfer of fipronil among workers of French R. flavipes using [14C] fipronil in contact (0.01 ppm) and feeding (3 ppm) bioassays. Fipronil amounts were measured on their cuticle and in their bodies. Maximal uptake was observed in the contact assay. A significant uptake of fipronil occurred in the feeding assay. Transfer from exposed donors to unexposed recipients occurred within 24 h. Frequent horizontal transfer resulted in a significant uptake in recipients, particularly when donor fipronil acquisition was by feeding. Donors transferred approximately 46% of the toxicant to recipients. Social behaviors such as contact and grooming, together with internalization of the biocide, may be components of the horizontal transfer process and contribute to the efficacy of fipronil in the field.

Lateral hemiepiphysiodesis of the first metatarsal for juvenile hallux valgus.

BACKGROUND: Juvenile hallux valgus (JHV) frequently results in an impaired quality of life because of pain and deformity. We used a validated clinical score to investigate the efficacy of lateral hemiepiphysiodesis of the first metatarsal base as a treatment for JHV. METHODS: We conducted a prospective, nonrandomized, single center cohort study of children who underwent lateral hemiepiphysiodesis for 31-IV, with a clinical and radiologic follow-up of at least 2 years. The efficiency of the procedure was assessed with the Hallux Metatarsophalangeal Interphalangeal Scale (HMIS), the metatarsophalangeal angle (MPA), and intermetatarsal angle (IMA). RESULTS: Twelve patients (22 feet) with JHV were treated by lateral hemiepiphysiodesis between 2012 and 2015. Average age at surgery was 10 years, and average follow-up was 3.5 years. The average HMIS score increased from an average of 56 at baseline, to 92 at last follow-up ( p < 0.01). The average IMA decreased by 2°, from 13° preoperatively to 11° postoperatively. Average MPA decreased from 26° at baseline to 22° after surgery. No complications occurred in the immediate postoperative period, and no patient needed an additional procedure. CONCLUSION: The HMIS score was significantly improved after lateral hemiepiphyslodesis, with a clear improvement in pain and functional impairment at last follow-up. We noted a stabilization of the IMA and MPA, but the radiologic benefit did not reach statistical significance. Our data support the use of lateral hemiepiphysiodesis as an effective and safe treatment of JHV.

Outcomes of Gartland type III supracondylar fractures treated using Blount's method.

BACKGROUND: Supracondylar fractures of the elbow with major displacement are usually treated by surgical pinning and less often non-operatively as described by Blount. The objective of this study was to assess the clinical and radiological outcomes of Gartland type III supracondylar fractures treated at least 3 years earlier using Blount's method. HYPOTHESIS: Blount's method produces good outcomes after more than 3 years when used to treat Gartland type III supracondylar fractures of the humerus. METHODS: A single-centre retrospective study was done in paediatric patients who were seen within 24hours after sustaining a Gartland type III supracondylar fracture then re-evaluated at least 36 months after treatment. Closed reduction was performed either in the operating room under general anaesthesia or in the radiology suite under procedural sedation. The upper limb was then immobilised for 4 weeks using the cuff-and-collar method described by Blount (mean elbow flexion, 134°). The child was evaluated and radiographs obtained at the outpatient clinic on days 7 and 14. Functional outcomes were assessed using the 1962 SoFCOT criteria and Flynn's criteria and the radiological outcome using Baumann's angle, the humero-condylar angle, and distal fragment rotation. From 2009 to 2013, 22 patients met the inclusion criteria. Mean follow-up was 57 months. RESULTS: Clinical outcomes assessed using the 1962 SoFCOT criteria were very good in 15 patients and good in the remaining 7 patients. The rate of satisfactory outcomes according to Flynn's criteria was 100%. At last follow-up, mean Baumann's angle was 68°, mean humerocondylar angle was 42°, and 2 patients had residual rotation of the distal fragment. CONCLUSION: This work confirms the effectiveness of Blount's method for treating Gartland type III supracondylar fractures. We advocate routine first-line treatment of these fractures using Blount's method in the absence of vascular compromise and instability. LEVEL OF EVIDENCE: IV, retrospective study.

Five-year outcomes of the First Distal Uninstrumented Vertebra after posterior fusion for Adolescent Idiopathic Scoliosis Lenke 1 or 2.

BACKGROUND: Tilt of the First Distal Uninstrumented Vertebra (FDUV) reflects changes in the main curve and compensatory lumbar curve after posterior fusion to treat thoracic Adolescent Idiopathic Scoliosis (AIS). HYPOTHESIS: FDUV tilt 5 years or more post-fusion depends chiefly on reduction of the main curve and on other factors such as selection of the last instrumented vertebra. MATERIAL AND METHOD: A multicenter retrospective cohort of 182 patients with Lenke 1 or 2 AIS treated with posterior instrumentation and followed up for a mean of 8 years and a minimum of 5 years was studied. The patients were divided into two groups based on whether tilt of the upper endplate of the FDUV was ≤5° or >5°at last follow-up. Variables associated with tilt were identified by multiple logistic regression. RESULTS: Six variables were significantly associated with FDUVtilt: percentage of correction at last follow-up, correction loss, lumbar modifier B, number of instrumented vertebrae, inclusion within the instrumentation of the distal neutral vertebra, and inclusion within the instrumentation of the lowest vertebra intersected by the central sacral vertical line. DISCUSSION AND CONCLUSION: The main variables associated with FDUVtilt ≤5° were a final correction percentage ≥60% and absence of correction loss between the postoperative period and last follow-up. Given the stable reduction provided by contemporary instrumentations, we recommend selective thoracic fusion of Lenke 1 or 2 AIS with lumbar modifiers A, B, and C. The lowest instrumented vertebra should be either the neutral vertebra or the vertebra intersected by the central sacral vertical line if it is distal to the neutral vertebra. LEVEL OF EVIDENCE IV: Retrospective multicenter study.

[Percutaneous surgical treatment of two epiphyseal plate fractures of the proximal humerus]. / Réduction et embrochage percutanés de deux décollements épiphysaires de l'humérus proximal.

We report two cases of Salter 2 displaced epiphyseal detachment of the proximal humerus treated successfully by percutaneous reduction and centromedular nailing. This surgical treatment was required because of the irreducibility of the lesion in one patient and instability in the other. This percutaneous technique can be recommended after failure of orthopedic treatment and is an attractive alternative to open surgery.

Initial treatment of congenital idiopathic clubfoot: Prognostic factors.

BACKGROUND: The initial treatment of congenital idiopathic clubfoot (CIC) is nonoperative. Either the French physiotherapy method or the Ponseti casting method may be used. Whether either method is superior over the other remains unclear. However, the method used initially is not the only determinant of the final outcome. OBJECTIVE: The primary objective was to identify determinants of the final outcome as evaluated based on the need for surgical treatment and on the Ghanem-Seringe score. HYPOTHESIS: Factors associated with the final outcome can be identified. METHODS: Between 2004 and 2011, 100 CICs in 79 patients were treated in two centres, 47 using the French method and 53 the Ponseti method. The Dimeglio grade was determined at baseline and the Ghanem-Seringe score at last follow-up. Surgical procedures (if any), splinting duration, and rehabilitation therapy duration were recorded. The two groups showed no statistically significant differences for Dimeglio grade distribution, time from birth to treatment initiation, or mean follow-up. RESULTS: Factors significantly associated with a poor outcome by univariate analysis were use of the Ponseti method (P=0.0027), older age at last follow-up (P=3×10-4), initial Dimeglio grade (P=7×10-5), and need for surgery (P=10-5); no significant effect was found for splinting duration, rehabilitation duration, bilateral involvement, or antenatal diagnosis. By multivariate analysis, factors independently associated with a poor prognosis were older age at last follow-up, Dimeglio grade, and need for surgery. CONCLUSION: This study confirms the major prognostic significance of initial severity (Dimeglio grade) on the final outcome. The data do not firmly establish that one method is superior over the other. Nevertheless, the need for percutaneous Achilles tenotomy with the Ponseti method leads us to prefer the French physiotherapy method. LEVEL OF EVIDENCE: IV, retrospective study.

Too-long calcaneal process: Results of surgical treatment and prognostic factors.

INTRODUCTION: The too-long anterior process (TLAP) can be responsible for ankle pain or repeated sprains in children or adolescents. The objective of this study was to assess the results of TLAP surgical treatment and to analyze influencing factors in case of this surgery's failure. MATERIAL AND METHODS: Retrospective single-center study conducted from 2009 to 2012 including all patients under 18 years of age for a TLAP with follow-up equal to or longer than 1 year. The results of surgical treatment were assessed using the AOFAS score. Failure was defined as no significant improvement in the AOFAS score at the last follow-up. HYPOTHESIS: Predictive factors of the result of surgical treatment for TLAP can be identified. RESULTS: At the mean follow-up of 2.5 years, 35 patients (43 feet) fulfilled the inclusion criteria. Thirteen feet (30%) presented surgical failure. According to the AOFAS score, the results were excellent in 30 feet (70%), good in four (9%), fair in five (12%), and poor in four (9%). Surgical failure was influenced by the patient's age at the onset of symptoms and at the time of surgery, the degree of functional limitation, the duration of symptoms before surgery, the number of sprains, and gender (P<0.05). CONCLUSION: Firstly, in this pediatric population with its high functional demand, the overall rate of failure of TLAP surgery was 30%. Secondly, the factors associated with failure demonstrated made it possible to identify the ideal patient for this surgery: male, with symptom onset between 7 and 10 years of age, who had experienced fewer than 15 sprains, and undergone surgery in the 3 years following the beginning of symptoms. LEVEL OF EVIDENCE: IV.

Effect of age and sex on the production of internal and external hydrocarbons and pheromones in the housefly, Musca domestica.

The epicuticular and internal waxes of male and female houseflies were examined by capillary gas chromatography-mass spectrometry at closely timed intervals from emergence until day-6 of adulthood. New components identified included tricosan-10-one, 9,10-epoxyheptacosane, heptacosen-12-one, a series of odd-carbon numbered dienes from C31 to C39, several positional isomers of monoenes including (Z)-9- and 7-pentacosene and a number of methyl- and dimethylalkanes. (Z)-9-tricosene appears in internal lipids prior to appearing on the surface of the insect, suggesting that it is transported in the hemolymph to its site of deposition on the epicuticle. The large increases in the amount of (Z)-9-tricosene in females from day-2 until day-6 is compensated for by a concomitant decrease in (Z)-9-heptacosene. The C23 epoxide and ketone only appear in females after the production of (Z)-9-tricosene is induced, and are only abundant in epicuticular waxes, suggesting they are formed after (Z)-9-tricosene is transported to the cells which are involved in taking them to the surface of the insect. Mathematical analysis indicated that the time shift between internal production and external accumulation in females is more than 24 h. The divergence between male and female lipid production occurs at an early stage, when insects are less than one day old.

Chart review of alcohol problems in adolescent psychiatric patients in an emergency room.

Of 459 consecutive teenage patients seen for psychiatric evaluations in a general hospital emergency room during a 1-year period, 76 (17%) had blood alcohol levels over 100 mg/dl. Males and females were represented equally in this group. The most common DSM-III diagnoses in these patients were affective disorders and conduct disorders.

Isolation of putative olfactory receptor sequences from pig nasal epithelium.

Binding to olfactory receptors is the first step in odorant and pheromonal recognition and discrimination. These receptors constitute one of the most important, although poorly known, families of neuronal receptors. In this study we used degenerated oligonucleotides and a RT-PCR approach to selectively amplify olfactory receptors in the nasal epithelium of the domestic pig Sus scrofa. Several combinations of oligonucleotide were tested and allowed the isolation of eleven different partial sequences belonging to the seven transmembrane olfactory receptor family. These receptors formed a separate family within the seven transmembrane receptor superfamily in pigs. Using the criteria of Ben Arie et al. [Ben-Arie N., Lancet D., Taylor C., Khen M., Walker N., Ledbetter DH., Carrozzo R., Patel K., Sheer D., Lehrah H. and North M., Hum. Mol. Genet., 3 (1994) 229-235], the 11 receptors described here can be classified into three known families and seven subfamilies (one known and six new).

Changes in cuticular hydrocarbon composition in relation to age and sexual behavior in the female Calliphora Vomitoria (Diptera).

Qualitative and quantitative changes in epicuticular hydrocarbon synthesis/release were observed during the first gonadotrophic cycle of Calliphora vomitoria. Up to 12 hours after eclosion, hydrocarbon synthesis/release is low, with little change in the relative proportions of the compounds detected. At 24 hours there is a marked increase in hydrocarbon synthesis/release, especially in the monomethylalkanes (both absolute and relative amounts). Between 48 and 72 hours, hydrocarbon synthesis stabilizes. At 83 hours, two hydrocarbon patterns can be distinguished, depending on the state of receptiveness of the females. The results show for the first time that differences in age, sexual attractiveness and receptivity are accompanied by characteristic changes in cuticular n-alkanes and mono-methylalkanes.

[Long-term results of the Harrington operation. Apropos of a series of 200 cases (1964-1986)]. / Résultats à long terme de l'opération de Harrington. A propos d'une série de 200 cas (1964-1986).

The authors present a series of 200 patients who underwent vertebral arthrodesis with Harrington's distraction rods for idiopathic scoliosis reviewed after a mean follow-up of 7.5 years (maximum: 24 years). The surgical procedure consisted of either simple distraction or distraction associated with convex compression or a transverse traction device or insertion of double rods according to Armstrong's technique. The operative gain was 44%, the angular loss was 12% and the definitive gain was 32%. The results were better in girls and in juvenile scoliosis type III and adolescent scoliosis. The best long-term correction was obtained in cases of lumbar scoliosis. The best operative reduction was obtained in thoracic and thoracolumbar scoliosis and the greatest angular loss was observed with major double scolioses. The most favourable results were obtained in cases of scoliosis were severe angulation. The best system was Armstrong's followed by Dollar's and the least effective was simple distraction. Heavy pre- and intra-operative vertebral traction improved the angular score. Rupture of the rod, when it occurred late, was not equivalent to pseudarthrosis. Angular deterioration over time was essentially observed over the first 10 years but led to disappointing results.

[Enlargement plasty of the acetabulum by vascularized iliac crest cartilage transfer in children]. / Plastie d'agrandissement du cotyle par transfert vascularisé de cartilage de la crête iliaque chez l'enfant.

INTRODUCTION: Following an experimental study with rabbits published in 1983, the authors report the results of a surgical technique for the enlargement plasty of the acetabulum in children. This study was preceded by an anatomical study of the vascularization of foetal iliac crest epiphysis. MATERIAL: 10 children were operated on at an average of 8 years old. The indications were 5 dysplastic hips (short acetabulum), and 5 Perthes diseases. The results were evaluated by the acetabular index of the weight-bearing zone, Wilberg center-edge angle and joint congruence. The comparison with the non operated side estimated the growth due to the graft. METHODS: An iliac crest cartilaginous fragment 4 to 5 cm long is harvested from the endopelvic side. This graft is pediculized on the deep circonflex iliac vessels. The hip joint is opened and the labrum is partially resected. The graft is correctly oriented, placed at the periphery of the acetabulum in an intra-articular position and fastened with two trans osseous stitches. The length of the vascular pedicle allows to place the graft without any microanastomosis. RESULTS: At maximum follow-up (range 3.3 to 8 years), in average values, the coverage Wilberg angle increased of 4 degrees on the non operated side and of 23 degrees on the operated side (increase of 19 degrees due to the graf). The acetabular index decreased of 2 degrees on the non operated side and of 10 degrees on the operated side (decrease of 8 degrees due to the graft). The joint congruence showed that the graft molds itself on the femoral head and ensured harmonius coverage. It seemed that it favoured growth remolding of the femoral head. DISCUSSION: The results showed the growth pursuit of an iliac crest cartilage vascularized graft placed intra-articularly. This graft increases the acetabulum size by adjusting itself to the femoral head. The hyalin cartilage cells of the graft which are in contact with the femoral head, are likely to transform themselves into articular cartilage cells. This surgical technique seems to have its place with the enlargement techniques of the acetabulum as long as remolding of the head and acetabulum is required.

[Contribution to hair medulla study (author's transl)]. / Contribution à l'étude de la medulla des poils.

In this study, the authors aim to bring to light the anatomical characteristics of the medullary cells of hairs and to examine the evolution of these characteristics according to the mammals genuses. Previous studies of the morphogenesis of the medullary cells have shown that the cytoplasm of the medulla would turn amorphous while microfibrils are formed in the cytoplasm of the inner root sheath. The medulla and the inner root sheath are sulfur-poor but are rich in citrulline and the proteins are bound by epsilon(gammaglutamyl)lysine dipeptides. Our observations, both anatomical and ultrastructural, with the SEM and the TEM, have showed that the medullary cell is also evolved and complex that the others hairs cells. Furthermore, we have observed that the medullary cell content of some mammal's hairs is amorphous, as was shoôn in previous works; but it seems to evolve towards a biphasic phase (or granular) in superior mammals while the medullary cells of the hairs of human and closely related anthropoids contain macrofibrils and microfibrils. Medullary microfibrils are similar to those of the inner root sheath of the hair and therefore, we now understand why citrulline and epsilon(gammaglutamyl)lysine bonds are also found in the medullary cells.

[Experimental study of a growing acetabulum shelf (vascularized graft)]. / Etude expérimentale d'une butée cotyloïdienne en croissance (greffon vascularisé).

The author has operated on 50 immature rabbits to perform a vascularised transplantation of the growing iliac crest to replace the rim of the acetabulum. Vascularity was preserved through the vascular pedicle and there was no need for vascular anastomosis. The results were assessed radiologically and by histological studies. The subsequent growth of the transplanted epiphysis could be illustrated in 15 out of 16 cases. The growing shelf had the advantage of good adaptation to the shape of the femoral head and produced a satisfactory physiological result.

Children distal humerus supracondylar fractures: the Blount Method experience.

INTRODUCTION: Extension-type supracondylar fractures of the humerus in children are frequent lesions whose orthopaedic treatment remains under debate in Rigault and Lagrange type III fractures and highly controversial in type IV fractures. The objective of this study was to extend the Blount method to fractures with substantial displacement even in patients presenting significant swelling and to evaluate the results. PATIENTS AND METHODS: We conducted a prospective continuous study from December 2005 to August 2007 on 67 children: 49 boys and 18 girls with a mean age of 6 years (range, 3-14 years). The mean time lapsed from consultation to treatment was 30 h. The mean hospital stay was 72 h. In 50 children, the limb was elevated preoperatively for a mean 48 h. The fracture was reduced under fluoroscopy-guided general anesthesia with mask and immobilized with 5-cm cloth banding padded with foam. The follow-up was clinical and radiological. The mean follow-up was 16 months (range, 6-26 months). Assessment followed the 1969 SOFCOT guidelines. RESULTS: At union, mean flexion was 124 degrees , the mean extension lag was 26 degrees . At last follow-up, the mean flexion was 146 degrees , the extension lag was 0.5 degrees , and pronation and supination were free. Immediately after surgery, the mean Baumann and anteflexion angles were 75 degrees and 43 degrees , respectively; at union they were 76 degrees and 44 degrees and at follow-up 79 degrees and 42 degrees . We found no vascular or nerve lesions. According to the SOFCOT criteria, at follow-up we obtained 80.6% very good results and 19.4% good results. LEVEL OF EVIDENCE: Level IV. Therapeutic study.

Congenital scoliosis: a frontal plane evaluation of 251 operated patients 14 years old or older at follow-up.

INTRODUCTION: Congenital scoliosis, carrying an incidence between 0.5 and 1 per 1000 births, raise the problem of their evolutive potential. HYPOTHESIS: Some predictive factors for the evolution of scoliotic curvature due to congenital vertebral malformation (CVM) can be found. MATERIAL AND METHODS: This was a retrospective multicenter study of 251 patients, at least 14 years old when evaluated at end of follow-up, with CVM and spinal deformity predominating in the frontal plane. RESULTS: 38.8% of patients showed associated neurologic, visceral or orthopedic abnormalities. CVM was single in 60.6%, double in 20.3%, triple in 6.4% and multiple in 12.7% of cases. 34.1% of CVMs were thoracic. Congenital scoliosis curvature was single in 88.8% of patients, double in 10% and triple in 1.2%. Mean curvature angle was 31.7° at diagnosis (range, 0-105°) and 41.3° preoperatively (range, 10-105°). Sixty-one patients showed associated kyphosis. Mean change in postoperative curvature angle over follow-up was 1.6° (range, -20° to 38°) in the 73 patients managed by arthrodesis, -0.4° (-24° to 30°) in the 64 managed by epiphysiodesis, and 0.4° (-18° to 35°) in the 49 managed by hemivertebral (HV) resection. Results were found to correlate significantly with age at surgery for patients managed by epiphysiodesis, but not for those managed by HV resection or arthrodesis. DISCUSSION: More than 30% of congenital scolioses involve associated intraspinal abnormality. All CVM patients should therefore undergo medullary and spinal MRI to assess the CVM in all three planes, and the medullary canal and its content. The evolution of scoliotic curvature induced by CVM is hard to predict. Several factors are to be taken into account: CVM type, number and location, and patient age. Curvature progression may be slow or very fast. It accelerates during the peak of puberty, stabilizing with bone maturity. Surgery is mandatory in evolutive scoliosis. Four procedures may be recommended, according to type of CVM and especially to patient age: arthrodesis, convex epiphysiodesis, HV resection or rib distraction. Surgery seeks to correct the spinal deformity induced by the CVM and prevent compensatory curvature and neurologic complications, while conserving sagittal and frontal spinal balance and sparing as many levels as possible. In case of HV involvement, the procedure of choice is CVM resection, which provides 87.5% good results in this indication; the procedure is relatively safe, conservative of spinal levels, and without age limit. LEVEL OF EVIDENCE: Level IV. Retrospective study.