[An anatomical wax of the deep structures of the pelvic limb (by Tramond, 19th century): observation of the tridimensional photographic rotation]. / Une cire anatomique du membre pelvien profond (par Tramond, XIX(e) siècle): observation et rotation photographique tridimensionnelle.

UNLABELLED: Anatomical wax modelling was widely used during the 19(th) century, especially in France and Italy. In Paris, The Tramond house was specialized in the realization of this kind of samples. MATERIAL AND METHODS: The sample was placed on two large horizontal marble disks, rotating every 5°. We could then describe the sample, verify its anatomical accuracy and also perform a virtual reconstruction with Quick Time Reality QTVR(®) software. RESULTS: The muscular, nervous and arterial elements were represented. We divided the description in three parts: (1) lumbar, pelvic and femoral; (2) femoro-tibial; and (3) tibio-tarsian. We focused the anatomical description on the sciatic nerve; on the organization of the muscles of the gluteal region and the neurovascular organization; and on arterial segmentation. This sample was getting damaged with time, noticeably the representation of the nerves, which are very thin and so, very fragile. Nowadays, 3D representation of the dissected human body is more common, with new techniques such as plastination (Von Hagen's type), which allows one to preserve all the anatomical elements of the subject. This paper and the realization of the virtual museum also aim to participate in a work memory, which recognize the knowledge of the anatomist of wax makers, their teaching quality remained unequalled as their obvious artistical value.

["Left hemicranium, the cranial nerves" by Tramond: An anatomical model in wax from the Delmas, Orfila and Rouvière's Museum in Paris: description and tri-dimensional photographic reconstruction (TDPR)]. / « Hémicrâne gauche, les nerfs crâniens ¼ par Tramond: pièce anatomique en cire des musées Delmas, Orfila et Rouvière à Paris: description et reconstruction photographique tridimensionnelle (RPTD).

An anatomical model in wax made by Tramond (middle of the 19th century) represented the cranial nerves of a left hemicranium. The aim of the study was to verify its anatomical veracity, to realize a tri-dimensional visualization by computer, and finally to numerize and to diffuse it to the general public in the purpose of culture on the internet. The model belonged to the Delmas, Orfila and Rouvière Museum (Paris Descartes university). It represented the cranial nerves especially the facial and the trigeminal nerves and their branches. To perform the photographic rotation every 5° along 360°, we used a special device made of two identical superimposed marble disks linked by a ball bearing. A digital camera and the Quick Time Virtual Reality software were used. Seventy-two pictures were shot. This wax was realized with a great morphological accuracy from a true cranium as a support for the cranial nerves. The work of numerization and its free diffusion on the Internet permitted to deliver to everybody the images of this sample of the collection of the Orfila Museum, the pieces of which were evacuated on December 2009 after its closure.

[Dissection of the neck: a wax anatomical sample of the Spitzner Collection (no 23) in the Delmas, Orfila and Rouvière Museum of Anatomy: an observation and photographical tri-dimensional reconstruction]. / Dissection du cou: une pièce anatomique en cire de la collection Spitzner (no 23) des musées d'anatomie Delmas, Orfila et Rouvière: observation et reconstruction photographique tridimensionnelle.

An anatomical model of the dissection of the human neck, supraclavicular and submandibular regions, was studied in order to determine its anatomical accuracy. The sample was made of brightly coloured wax and was of female appearance. Formally, it belonged to the collection (n(o) 23) of a medical doctor: Spitzner (1813-1894). It was donated late in the 20th century to the Delmas, Orfila and Rouvière museums, 45, rue des Saints-Pères, Paris 6(e), université Paris-Descartes (catalog n(o): 1222, SRA-1995). It measured 36cm in width and 27cm in height. With the camera, it was pictured on its main views and every 5-degree on 270° along its vertical axis in order to obtain a tri-dimensional, photographic reconstruction. The arterial and venous vessels were enhanced and the thyroid and submandibular glands as well. The musculo-osseous frames limited five main regions of dissection. Neither nerves nor lymphatics were represented. The author of this wax sample remains unknown (no signature). The aspect does not look like the samples of the Tramond or Auzoux's factories. The Spitzner collection was primarily an itinerant exhibition; however, it is of a highly anatomical quality. It is well known by the anatomical art world, especially abroad: its aesthetical features and facial characters make it very recognizable.

[The nerves of the face: anatomical sample in wax in the Delmas-Orfila-Rouvière Museum in Paris]. / << Les nerfs de la face >> par Tramond : pièce anatomique en cire des musées Delmas, Orfila et Rouvière à Paris.

The aim of the study was to check the anatomical veracity of the model of wax no. 262, from the Delmas, Orfila and Rouvière museums, 45, rue des Saints Pères, Paris 6th, made by Tramond M.D., entitled "nerves of the face". We successively took several numerical photographs with several view angles; anatomically described the nerves of the face as they were represented on this model; correlated the anatomical veracity of this representation with the classical, textbooks' data; approached the technical bases of fabrication; and collected successive photographs of the model every 5 degrees , all along 180 degrees , thus allowing an animated rotation on computer, using the QuickTime Virtual Reality program. The oversize of the model excluded a set on a real human skeleton. The building technique of the model was deduced from known data but could not be completely reported. The anatomical veracity of the sample was excellent. The difficulties of realization in wax of an oversized model of the nerves of the human face were solved in the late 19th century, in Paris by Tramond's factory. They remained unequalled.

[An enlarged dismantable anatomical model of the ear by Auzoux: observation and photographical tridimensional reconstruction]. / Un modèle d'oreille agrandie, démontable par Auzoux : observation et reconstruction photographique tridimensionnelle.

The aim of the study was to determine the accuracy of a 19th century anatomical model of an ear by Auzoux (a French manufacturer). It measured 63 cm in length; 43 cm in width; 37 cm in height. The disassembled parts were studied on the morphological aspect in its whole and after removing of its components: external ear (43 cm x 23 cm x 15 cm), tympanic drum and middle ear ossicles; cochleo-vestibular apparatus. The main dimensions of each part were recorded. The arterial vascularisation of the three components of the ear and its sensitive and sensorial nervous system were established on the model which represented the external carotid artery with its terminal bifurcation, several collateral branches specially the posterior auricular artery and the middle meningeal artery; the internal carotid artery at the two extremities of the carotid canal. The cochleo-vestibular and facial nerve as well as other elements of small calibre were exactly figured and labelled by a number. The middle ear components were disassembled. The ossicles of the middle ear and a dried peritoneal tympanic membrane were dismountable as a whole. Only a few minor modification from the admitted data of anatomy as well as the cutaneous muscles of the external ear were observed on this sample, the anatomical aspects of which were very precisely represented. The material was typical of the Auzoux manner: a special papier-mâché whose conception and realization remains unequalled. This kind of very rare model can be dated at the earliest 1835 (Lemire, 1990).

[Constant Duméril (1774-1860) anatomist doctor and naturalist, about a portrait by G. Devers]. / Constant Duméril (1774-1860) médecin anatomiste et naturaliste, à propos d'un portrait par G. Devers.

André, Marie, Constant Duméril (1774-1860) served as a professor in the << faculté de médecine de Paris >> from 1801 to 1855. He was also chairman of herpetology and ichthyology of the << Muséum national d'histoire naturelle >> in Paris. The Paris-Descartes University (department of anatomy) owns a great, framed portrait which is an oil painting by Giuseppe Devers, 1855, representing C. Duméril sat on a chair. The study of his portrait, biography and bibliography brings precisions on a noticeable scholar of the anatomical and naturalistic field in Paris in the first half of the 19th century.

[The Vitruvian Man: an anatomical drawing for proportions by Leonardo Da Vinci]. / L'Homme de Vitruve: un dessin de proportion anatomique par Léonard de Vinci.

The aim of the study was to find out and to analyse the text by Vitruvius which inspired the famous drawing by Leonardo da Vinci (circa 1490) kept in the Galleria dell'Accademia, in Venezia, Italy: the man inscribed in one circle and in one square. The book "de Architectura" by Vitruvius Marcus Pollio was printed several times since the Renaissance when both the roman architecture of antiquity and this text became very popular. From a French translation by Claude Perrault in 1864, it became easy to find a French translation with the original text in Latin (Paris, 2003, Les Belles Lettres, French text by Pierre Gros). The drawing by Leonardo da Vinci illustrates with great accuracy and fidelity the quotation of Vitruvius (with the exception of two of the 12 main relationships). The genius of Leonardo da Vinci was to keep only one trunk, head and neck for two pairs of limbs: scapular and pelvic; to make the circle tangent to the lower edge of the square; to adjust a few features of the quotation for the equilibrium of the whole figure; and of course to bring his incredible skill as a drawer (one of the best of his century). The drawing was made on a sheet of paper 344x245mm, in black ink which became dark brown with time; several lines complete the figure above and below; a short caption and a horizontal scale appear just under the drawing. The celebrity of the drawing, a symbol of the Renaissance, of the equilibrium of man and mankind, of the universality of the artists and intellectuals of the time (Humanism) made it iconic and it has been constantly reproduced and adapted especially for advertisement and logos, not only in the medical field.

Mercuric chloride, a chemical responsible for T helper cell (Th)2-mediated autoimmunity in brown Norway rats, directly triggers T cells to produce interleukin-4.

Mercurials may induce immune manifestations in susceptible individuals. Mercuric chloride (HgCl2) induced autoimmunity in the Brown Norway (BN) strain but an immuno-suppression in the Lewis strain with, however, autoreactive anti-class II T cells present in both strains. In the present study we looked at modifications of cytokine production by PCR and cytofluorometric analyses in normal BN and Lewis rat splenocytes, cultured with or without HgCl2. Unfractionated BN rat splenocytes and purified T cells exposed to HgCl2 expressed high levels of IL-4 mRNA. Increase in class II and CD23 molecule expression on B cells was partly inhibited by anti-IL-4 mAb showing that IL-4 was produced. By contrast, no overexpression of IL-4 mRNA could be seen in Lewis rats. Although an increase in class II molecule expression was observed suggesting that other T helper cell 2 cytokines were produced, there was also a concomitant decrease in CD23 molecule expression that was abrogated after addition of an anti-IFN-gamma mAb to the culture. IFN-gamma mRNA production was induced in unfractionated spleen cells and T cells from both strains after HgCl2 exposure. Altogether these findings demonstrate that HgCl2 has very early direct effects on cytokine production and that these effects differ depending on the strain. The early effect on IL-4 production observed on BN rat spleen cells and T cells may explain that the autoreactive anti-class II T cells that are found in HgCl2-injected BN rats have a Th2 phenotype.

Preclinical profile of the monodisperse iodinated macromolecular blood pool agent P743.

RATIONALE AND OBJECTIVES: To summarize the chemical synthesis, physicochemical characterization, pharmacokinetic behavior, and biological evaluation of P743, a new macromolecular iodinated contrast medium. METHODS: The synthesis and molecular modeling of the iodinated macromolecule P743 are described. The pharmacokinetic profile was established in rabbits and rats. Acute toxicity in mice, renal tolerance in normal rabbits, and renal tolerance in uninephrectomized, dehydrated rats undergoing selective intrarenal injection was evaluated. In vitro permeability effects on isolated mastocytes and on the coagulation pathways were carried out. Computed tomography vascular imaging was performed after intravenous injection of P743 (300 mg I/kg) in rabbits and compared with the nonspecific nonionic agent iobitridol. RESULTS: P743 is a monodisperse, macromolecular iodinated contrast medium. In both rabbits and rats, P743 showed a pharmacokinetic profile consistent with that of a rapid-clearance blood-pool agent. Its diffusion through the endothelium was found to be low in vitro, thus confirming early confinement of this macromolecule, unlike nonspecific contrast media. In both species, P743 was excreted by glomerular filtration. Acute toxicity disclosed no mortality at the highest volume that could be injected into mice, leading to a median lethal dose greater than 8.9 g I/kg. Renal tolerance was found to be good in both euvolemic rabbits and uninephrectomized, dehydrated rats. No histamine or leukotriene B4 release was found on RBL-2H3 isolated mastocytes. P743 did not interfere with the coagulation pathways. Imaging experiments confirmed that P743 remains in the vascular compartment for a longer time than does iobitridol, thus allowing vascular enhancement that is twice as high as that of iobitridol in the recirculation phase. CONCLUSIONS: The pharmacokinetic and imaging profiles of P743, a new, monodisperse, macromolecular blood-pool iodinated contrast medium, were consistent with those of a rapid-clearance blood-pool agent. Its initial safety profile is satisfactory. Further experimental imaging studies are required to define the clinical interest in such molecules.

Stereology of the myocardium in human foetuses.

The rate of cellular proliferation and hypertrophy of the cardiac myocytes in the human perinatal period is still controversial. This work uses stereology to evaluate the prenatal quantitative changes of the myocardium. The hearts of 36 human foetuses, ranging from the 2nd trimester to the 3rd trimester, were studied. Fifteen random microscopic fields were analyzed in each heart. The following stereological parameters were determined: Vv[myocyte] and Vv[interstitium] (the volume densities of the cardiac myocyte and interstitium, respectively) and the Nv[myocyte] (the numerical density of the cardiac myocytes). The total number of myocytes (N[myocyte]) and the mean myocyte volume (V[myocyte]) were also determined. All differences between the second and the third trimester of gestation, tested with the Mann-Whitney test, were statistically significant (P < 0.05). The Vv[myocyte] decreased 8.69% and the Vv[interstitium] increased 49.83% in this period. Simultaneously, the Nv[myocyte] decreased 16.64%, the V[myocyte] increased 16.39%, the cardiac weight increased 366.67% and the N[myocyte] increased 272.06%. In conclusion, during the last two gestational trimesters the human heart increases in weight more than 4.5 times, the volume density of myocytes decreases while the volume density of the cardiac interstitium increases. The numerical density of myocytes per myocardium volume decreases but the myocytes became greater in mean volume (more than 16%).

[Study of atrial conduction tissue in the 17 mm V-C human embryo. Morphological contribution to the pathogenesis of sinoauricular node dysfunction]. / Etude du tissu de conduction atrial chez l'embryon humain de 17 mm V-C. Contribution morphologique à la pathogénie du dysfonctionnement du noeud sinu-auriculaire.

Is there a specialised conduction pathway connecting the sinoatrial and atrioventricular nodes within the crista terminalis? As lesions of this zone can cause sinus node dysfunction and the sick-sinus syndrome, we decided to study this structure at the beginning of its embryonic development. Serial 10 micronthichness transverse sections of a 17 mm vertex-coccyx (Stage 19) human embryo were studied by light microscopy, anatomical reconstruction (Born) and morphometry. The region of the sinus venosus and venous valves, of the superior vena cava and the atrioventricular region were drawn and reconstructed with 150 X magnification by Born's method using wax plates of the following dimensions: 175 X 95X 1.5 mm. The volume of the region of the sino-atrial node was determined by multiplying the thickness of the sections by the surface of the region (measured by planimetry using the point counting method); its value was 15.4 X 10(6) microns3 with an antero-posterior diameter of 490,0 micron. These results show that this region is already proportionally larger in Stage 19 embryos. Reconstruction showed the sinoatrial node region to be a round bulge with a groove on either side: that of the sulcus terminalis and the superior vena cava on the left and the same vein with the mesocardium on the right. The right venous valve connects this zone with the interatrial septum and comprises two distinct cellular components, on derived from the atrial wall and the other from the muscle of the sinus venous. The artery fo the sinoatrial node was identified.(ABSTRACT TRUNCATED AT 250 WORDS)

[Double mitral orifice. An anatomical case]. / Orifice mitral double. Une observation anatomique.

A double mitral orifice was discovered at autopsy in a 74 year old woman. Death resulted after several episodes of cardiac failure complicating mixed mitral and aortic valve disease. A vertical limbus bridged the mitral annulus separating it into two distinct right and left orifices, with oblique long axes aligned towards the lower part of the limbus perpendicular to each other from the left atrial view. After opening the left ventricle, both orifices were observed to have their own sets of chordae tendinae attached to normal papillary muscles: the right orifice to the posterior and the left to the anterior papillary muscle. The inferior end of the limbus was attached to a supplementary papillary muscle. Echocardiography and CT scanning were performed before dissection. This malformation results from symphysis of the mid parts of the two mitral leaflets during embryonic stages 15 and 16 (8-10 mm vertex-coccyx, 31st-33rd days).

[Dural fistulae of the cavernous sinus and interventional neuroradiology. Apropos of 4 cases]. / Fistules durales du sinus caverneux et neuroradiologie interventionnelle. A propos de 4 cas.

PURPOSE: Our purpose was to show how difficult it is to diagnose a dural fistula of the cavernous sinus, which is an anomalous arteriovenous shunt within the dura mater extending from meningeal arteries to the cavernous sinus. CASE REPORT: A dural fistula was suspected in four female patients aged between 61 and 80, presenting with a red eye, dilated episcleral veins, exophthalmos and elevated intraocular pressure. A cerebral hyperselective angiography was performed in all cases. RESULTS: The cerebral angiography confirmed the diagnosis of a dural fistula in all cases, showing the early filling of the cavernous sinus followed by the draining vessel (posterior in case n. 4, anterior in cases n degrees 1, 2, 3). Case n degrees 2 was unilateral and cases n. 1, 3, 3 were bilateral. The blood flow was low in all cases. A successful embolization was performed in all patients with resolution of all symptoms. CONCLUSION: The diagnosis of dural fistulas is often difficult because of misleading clinical signs. It is documented by a cerebral angiography showing the feeding vessels and helping to choose either venous or arterial embolization which is the most suitable treatment.

[THe Laumonier wax model of the ear (Collections of the Museums of the Anatomy Laboratory of Saints Pères, Paris)]. / Un modèle d'oreille en cire de Laumonier (Collections des Musées du Laboratoire d'Anatomie des Saints Pères, Paris).

Authentified by the name of Laumonier (fecit), written on the zygomatic process of the temporal bone, a model in wax of the medial, middle and lateral ears, belongs to the collection of the "Musées Delmas, Orfila et Rouvière" in Paris. This model presents large dimensions with a great anatomical rightness. The entire temporal bone is represented with the upper part of the endocranial petrous bone removed in order to demonstrate the main elements of the internal ear (cochlea and semi-circular canals) and of the middle ear (malleus and incus). Also were represented the temporal muscle and temporal vessels, the emergency of right cranial nerves, the superior orbital fissura and its elements; the internal carotid artery and the internal jugular vein, the upper part of the sterno-cleido-mastoidal muscle and of the styloïd muscles; the middle internal part of the basis of the cranium with the trunk of the trigeminal nerve, the Gasser's ganglion with its trifurcation, the sigmoïd sinus. The dimensions are greater than the real size: total highness: 22 cm; total length: 46.5 cm; maximal highness of the ear cartilage: 16.5 cm; hemicranium width: about 22 cm. Thus the magnification of size is 2 or 3 if calculated on the basis of the external ear and 3 or 4 with reference to the half width of the cranium. The sample is fixed by two screws on a single wood board measuring 46.5 cm on 29.2 cm with two supplementary boards of 2.4 cm width under the two extreme of width, with a thickness of 1 cm.

Lymphocyte activation gene-3 induces tumor regression and antitumor immune responses.

The lymphocyte activation gene-3 (LAG-3) product is an MHC class II ligand related to CD4. We investigated whether LAG-3 could be used in vivo to stimulate MHC class II(+) antigen-presenting cells (APC), such as resident macrophages or dendritic cells known to play a crucial role in processing and presenting of antigens to the immune system. We first introduced human (h) LAG-3 or mouse LAG-3 into three types of tumor cells (MCA 205, TS / A and RENCA) to evaluate its capacity to stimulate a tumor-specific immune response in vivo. In contrast to the progressive growth of wild-type cells in syngeneic mice, LAG-3-transfected tumors completely regressed or their growth was markedly reduced. Mice were significantly to completely protected against a rechallenge with parental tumor cells. Protection induced by hLAG-3(+) tumor cells involved recruitment of a CD8(+) T cell response since nu / nu mice and CD8-depleted mice did not reject tumors, and a systemic tumor-specific CTL activity was induced. Co-administration of soluble LAG-3 with wild-type tumor cells also markedly reduced primary tumor growth. Interestingly, immunization with LAG-3(+) tumor cells or co-administration of soluble LAG-3 with irradiated wild-type tumor cells reduced the growth of pre-established tumors. We therefore suggest that LAG-3 could be used as a vaccine adjuvant for its ability to trigger APC via MHC class II molecules.

[Measurement of the renal veins: dissection of 200 fresh corpses]. / Biométrie des veines rénales: dissection de 200 sujets frais.

The total length of the vena renalis sinistra is 100.5 mm in mean, the v. renalis dextra one is 47.4 mm. The end diameter in the v. cava inferior is 16.1 mm in mean for the v. renalis sinistra, and 12.8 mm for the v. renalis dextra. The end of the v. testicularis (ovarica) sinistra in the v. renalis sinistra is more distant from the v. cava inferior in 71% of the cases than the end of the v. surrenalis principalis sinistra.

[An ivory visceral anatomic mannequin]. / Un mannequin anatomique, viscéral, en ivoire.

The pregnant woman statue (h: 170 mm) from the Académie Nationale de Médecine in Paris, is a visceral manikin carved in ivory, probably in southern Germany, by Stefan Zick (1639-1715) from Nuremberg. It lies flat on its back and stuck in a box; its head and neck are slightly flexed and the two upper limbs are sagittally movable at the shoulder. The left elbow is flexed and the forearm blocks a removable thoraco-abdominal plate under which a cavity showing the main viscera is carved: a pregnant uterus contains an orientable fetus and a removable intestinal shield covers it. The anatomical precision is limited by the size of the manikin, but several visceral or vascular details are carved or drawn. Reported in 1912 by Wickersheimer, as an 'anatomical Venus', this object could be used for basic teaching to midwives and parturients.