Diagnostic dilemma between angular and interstitial ectopic pregnancy: 3D ultrasound features.

Angular pregnancy is a rare entity which is commonly confused with interstitial or cornual pregnancies. A lack of consensus about the specific ultrasound features of these 3 entities leads to inappropriate interchange between them among the literature. An angular pregnancy should be considered as a potentially viable intra-uterine eccentric pregnancy as it might be carried to term and result in a live-born baby whereas interstitial or cornual pregnancies should be considered as ectopic pregnancies which should be interrupted. We report here two cases of women at 8 weeks of pregnancy with an angular pregnancy diagnosed by vaginal 2D and 3D ultrasound and discuss about specific ultrasound features and alternative imaging modalities to distinguish it from interstitial and cornual pregnancies.

Relationships between the assessment of "grain of meat" and meat tenderness of Charolais cattle.

Beef industry operators often use a "grain of meat" assessment to aid in selecting carcasses according to their tenderness potential. The first aim of this study was to formalise this empirical notion by building a scoring scale for grain of meat. Two experts, regular users of this notion, were called upon to build the assessment grade. A group of 16 criteria was identified on the carcass as being effective in predicting an overall "grain of meat" score. The second aim of this study was to establish the relationship between the meat grain score estimated on the carcass and the tenderness of the longissimus thoracis muscle estimated by sensory evaluations. Some individual criteria such as "nerve presence", "marbling", and "touch of muscles" appeared to be linked to muscular characteristics such as collagen content, lipid content and shear force. No significant relationship was identified between grain of meat and either tenderness (initial: p=0.58; overall: p=0.50), shear force (p=0.33), or collagen content and collagen solubility (p=0.23; p=0.33).

Optical far-field microscopy of single molecules with 3.4 nm lateral resolution.

Optical far-field imaging of single molecules in a frozen solution at 1.2 K with a lateral resolution of 3.4 nm is reported. The mechanical stability of the fluorescence microscope, especially of the low-temperature insert, allows for the localization of fluorescing molecules with a reproducibility of better than 5 nm within observation times up to 10 min. For observation times of 9 h the reproducibility of the lateral position is limited to about 20 nm due to mechanical drift. Lateral position and orientation of 314 single molecules, present within the confocal detection volume of approximately 10 microm(3), are obtained. The possibility to correct for mechanical drift by monitoring the position of a spatial reference in the sample is demonstrated.

Effect of a dietary vitamin E supplementation on colour stability and lipid oxidation of air- and modified atmosphere-packaged beef.

The effects of dietary vitamin E supplementation on tissue α-tocopherol level and on the susceptibility of fresh and modified atmosphere-packaged beef on myoglobin and lipid oxidation were investigated. Charolais cattle, aged 32-44 months, were fed diets containing 75 (control, n=8) or 1000 mg (supplemented, n=8) α-tocopheryl acetate/kg feed/day for 111 days prior to slaughter. Following vacuum packaging, M. Longissimus lumborum and M. triceps brachii were aerobically packaged and held under refrigerated display (3°C) for 9 days or packaged under modified atmosphere (MAP; 20% CO(2): 80%O(2)) and held under refrigerated display (8°C) for 13 days under fluorescent light. α-tocopherol concentrations were significantly higher (P<0.05) in meat from the supplemented group than from the basal one. Whatever the measured colour characteristics (a*, R(630)-R(580),% MetMb), the vitamin E supplementation had a positive but non-significant effect on the rate of discoloration. But by visual assessment, essentially with MAP, a significant and positive effect of vitamin E supplementation was noted to lower discoloration (P<0.05). TBARS values were significantly lowered (essentially at the end of storage time for the two packaged modes) after an α-tocopheryl acetate-supplementation.

[Scoliosis and congenital heart diseases in children. Apropos of 44 cases]. / Scolioses et cardiopathies congénitales chez l'enfant. A propos de 44 cas.

In order to evaluate the difficulties of treatment of associated scoliosis and congenital heart disease (C.H.D.), 44 patients who have been treated between 1970 and 1988 were reviewed. The scoliosis was idiopathic in 30 cases, congenital in 11, neurologic in 3. There were 27 females and 17 males. Twenty one patients had a cyanotic C.H.D. (twelve tetralogies of Fallot). No relation was found between the side of the cardiac approach and the side of the thoracic curves. Three cases of right aortic arch with two left thoracic scolioses were noted. Associated anomalies were encountered in 60 p. 100 of cases. The analysis of old chest X-rays, revealed that the scoliosis was already present an average of 5 years before the first orthopaedic consultation. Eight patients had an orthopaedic treatment; in ten cases surgery was decided but not performed. Twenty six patients were operated. (22 posterior and six anterior procedures). The average angulation was 55 degrees pre-operatively, 30 degrees post-operatively and 40 degrees at a 40 months follow-up. In five cases a pseudarthrosis led to re-intervention. One patient died during a posterior procedure, an other post-operatively. Two patients had a severe complication (one heart arrest; one gaz-embolism) but recovered. The surgical prognosis can be evaluated on an original scale including different cardiac parameters, and the importance of the planned surgical procedure. Under a limited mark, no serious complications occurred. In conclusion, a closed collaboration between pediatricians and the orthopaedic team, should lead to more precocious screening of scoliosis in cardiologic children and before the orthopaedic procedure, to a more precise risk factors evaluation.

[The fate of children undergoing bone lengthening in congenital hypoplasia of the legs]. / Le devenir des enfants opérés d'allongement pour hypoplasie congénitale des membres inférieurs.

This retrospective study was conducted on 26 patients, 14 women and 12 men whose average inequality prognosis was 8.5 cm. They have been reviewed after they were more than 20 years old (mean 23.8 y). Between 1962 and 1979 these 26 patients have had 38 lengthening procedures with various methods. The results were evaluated after clinical examination and X-rays. The average radiological discrepancy was 1.5 cm at the follow-up. On the X-rays, the deterioration was rare for the hip point, more frequent for the knee and very frequent for the ankle and the foot. If the socio-professional integration was satisfactory, many problems remained unsolved at the review. The matter was the aspect of the lengthened limb considered as unesthetic and ugly by 22 patients. 20 of the 26 patients had problems to put on shoes. On the other hand two patients out of three had a relative intolerance to effort, cutaneous troubles probably in conjunction with vascular and trophic insufficiency with many concern for the future.

[Multiple pterygium syndrome in children. 7 cases]. / Le syndrome des pterygia multiples chez l'enfant. Etude de 7 cas.

Seven children have been observed and treated for a multiple pterygia syndrome. The characteristics of this affection which is rare and mostly transmitted as an autosomal recessive, are: a growth retardation, a facial dysmorphia, pterygia resulting in flexion deformities, and anomalies of hands, feet and external genitale. But the severity of the syndrome is linked with the spine malformation, whose fusions produce severe and precocious deformities. This syndrome must be differentiated from the popliteal pterygium syndrome, whose repercussions are only functional; from the arthrogryposis multiplex congenita, whose syndrome is already complete at birth; and from the false secondary pterygia (caudal spinal agenesis, campomelic syndrome, quadriceps hypoplasia). The multiple pterygia syndrome imposes a genetic investigation and a serious observation of the spine and of the evolutive flexion deformities.

[Thromboembolic complications in pediatric orthopedics. Multicentric collection of 33 case reports]. / Complications thromboemboliques en orthopédie pédiatrique. Recueil "multi-centrique" de 33 observations.

We report 33 cases of venous thrombosis of the limb, in children aged 15 years or less (average age is 10 years old): 22 acute thrombophlebitis have been treated, 11 children shown post-phlebitic disease. The thrombus was found, most of the time, in the iliac and/or femoral vein. Acute complications were seen in 30% of our cases, and 25% treated children reviewed, had post-phlebitic sequelae. Congenital disease of hemostasis (deficiency of antithrombin III, protein C or S) must be detect before anticoagulant start, because such deficiency influence the treatment and the prognosis. There is non indication for preventive treatment, because of the rarity of spontaneous thrombophlebitis by children. Nevertheless, we can draw an "high risk" population: antecedent of phlebitis, antecedent of congenital disease of hemostasis, antecedent of thrombophlebitis by parents below 40 years old, thrombogenic disease (homocystinuria), vertebral arthrodesis.

[The young homeless of Montreal: a longitudinal study]. / Les jeunes itinérants de Montréal: une enquête transversale.

A transverse survey conducted in 142 young homeless (age: 18-30) shows that they mainly come from broken families where alcoholism, violence and mental illness hold an important place. Regarding work, the majority of the surveyed homeless have not worked more than 24 months in all their life and have nearly continuously been on welfare; those who had jobs lost them much more because of their alcohol or drug use and their problems of interpersonal relationships than because of unemployment. On a personal level, these young adults are particularly battling against two major problems: alcoholism and drug addiction, and mental illness. Although 23% of the surveyed subjects have already been hospitalized in psychiatry, the majority of these young homeless have never received any psychiatric care. Nevertheless, they show mental health problems which are often mistakenly dismissed as the effects of alcoholism or chronic drug abuse. The authors believe that means of detection and adequate treatment must be developed for this growing population instead of thinking of social measures which would only give the young homeless a meal and protection from the elements.

[Spastic knee flexion deformity. Results of surgical treatment]. / Le genu flexum spastique. Résultat du traitement chirurgical.

The records of 36 children who had been treated surgically for spastic knee flexion deformity were studied. The procedures were either a modified Eggers' operation, a lowering of the patella or a combination of both. Thirty-three children were reviewed at a distance and a comparison made between their initial and final function. The results were also assessed in relation to the state of the muscles and the length of follow-up. Many patients were improved but this improvement could not reasonably be expected except in those who could walk or in whom walking had been abandoned for a short time. The indications for the type of procedure should follow systematic examination by a medical and surgical team, taking account of the strength of the gluteus maximus and the quadriceps and the response to novocaine infiltration of the sciatic nerve.

[Pre-operative correction of severe scoliosis by halo and walking-frame system (author's transl)]. / Détraction pré-opératoire des scolioses graves par halo céphalique en cadre de marche.

Ten cases of very severe scoliotic curves have been corrected pre-operatively by permanent traction with a halo suspended at a walking-frame device. The mean initial angulation was 110 degrees and the mean pre-operative correction was 48% for a mean use of two months. This procedure permits the patients a sub-normal activity, gives a good correction as "halo-cast" or "halo-pelvic" and avoids all cutaneous, neurological or psychological complications.

[Scoliosis and congenital cardiopathies]. / Scolioses et cardiopathies congénitales

The authors have followed up 26 children suffering from severe scoliosis associated with congenital heart disease up to the end of puberty. The curve was usually a very severe idiopathic scoliosis developing early and requring surgical treatment. Two types may be distinguished: I. Scoliosis without excessive surgical risk, in patients in whom the heart disease is not associated with cyanosis or where the heart condition has already been treated surgically and in which there are no clinical, radiological or electrical signs of cardiac failure. 2. Scoliosis with considerable surgical risk because of heart disease with cyanosis not treated surgically, or with signs of heart failure or pulmonary hypertension. In such cases, the surgical treatment of the scoliosis is likely to endanger life.

Astragalectomy in children. Results, technics, and indications based on personal experience in 33 cases. / L'Astragalectomie chez l'enfant. Résultats, technique, indications d'aprés notre expérience de 33 cas

The authors have operated on 33 equinovarus feet, (14 patients) with various condition--myelomeningocele, arthrogryposis, club foot or dwarfism. The results were poor, only 11 being satisfactory. Some failures were due to incorrect tecunique. The authors describe the technique which they consider to be the best. This procedure appears to have its main indication in myelomeningocele and arthrogryposis when the feet are severely deformed and rigid.