Subchondral bone alterations in a novel model of intermediate post traumatic osteoarthritis in mice.

In Post Traumatic Osteoarthritis (PTOA), hypomineralization and increased remodeling of the Subchondral bone (SB) are the first stages of tissue alterations. Although these alterations are well depicted and one of the main targets in OA intervention, the link between SB compositional and mechanical properties alterations during OA progression remains scarce in the literature. Here, we hypothesized that SB shows - right after the first sign of gait pattern changes - a decrease in SB tissue formation depicted by (i) a decrease in thickness, (ii) a lower nanoscopic stiffness, and (iii) a decrease in mineral and collagen maturity. To test our hypothesis, we investigated PTOA in female C57Bl6 mice's right knee (n = 13 control group [CL] and n = 27 PTOA group) by using Gait Analysis, Histomorphometry, Nanoindentation, and Raman Spectroscopy (RS). We showed (i) an increased OA histological grade, (ii) a decrease in Cartilage and SB thickness, and (ii) an increase of stance time and stride length on both limbs. The lateral condyle - where the main forces were applied - of mice with PTOA decreased in the degree of mineralization and crystal size and presented a lower Modulus of Elasticity (E). However, while no difference was observed regarding collagen or mineral-related compositional RS properties, we depicted higher crystallinity in the medial condyle than the lateral condyle in the PTOA group, which we did not observe in the control group. Our study depicts an early onset of intermediate PTOA where SB nanoscopic stiffness decreases while the degree of mineralization is not severely altered yet.

[Management of swallowing disorders after brain injuries in adults]. / Prise en charge des troubles de déglutition après lésions cérébrales dans un centre de réveil pour adultes.

The management of swallowing disorders after brain injury must be soon as well. The physiopathological analysis and the organization of the therapeutic project of these patients require the intervention of an interdisciplinary team. Dysphagia falls under a complex clinical context associating impairments of cognition, communication and behavioural control. The management associates speech therapist, caregivers, otolaryngolologist, phoniatrician, physiotherapist and nutritional therapist without forgetting the family circle. The fluctuations of consciousness and concentration of our patients brings us to constantly readjusting and rehabilitating the strategies of feeding. Obstacles with their evolution towards a normal feeding are akinesia, limits of motor functions, impairements of cognition and behavioural control. In the located lesions swallow recovers can be fast, instead of in severe brain-injury the challenge is to ensure safe and adequate nutrition, using a variety of strategies depending on the presenting symptoms. The purpose of this article is to relate our experience beside patients with an acute or recent cerbrovascular event.

Magnetic excitations in a weak-stripe-domain structure: A 2D dynamic micromagnetic approach

The high-frequency susceptibility spectra of ferromagnetic films supporting a weak-stripe-domain structure are computed using a 2D dynamic micromagnetic model that we have developed. The existence of multiple resonances resulting from the excitation of surface and volume modes is predicted. The main features of spectra (number of resonances, resonance frequencies, intensities, and linewidths) strongly depend on the equilibrium spin configuration and on the rf exciting field orientation. These theoretical results are successfully compared with zero-field microwave permeability measurements.

Hepatic and cerebral infarction in the survivor after the in utero death of a co-twin: sonographic pattern.

We report a case of diffuse hepatic and cerebral infarction in a surviving preterm co-twin and twin-twin transfusion syndrome studied by ultrasound and confirmed by post-mortem examination.

Magnetic resonance imaging of the fetus: a study of 20 cases performed without curarization.

Twenty patients underwent magnetic resonance imaging (MRI) at a mean gestational age of 32 weeks. There were 12 patients with suspected fetal brain abnormality and four with intrauterine growth retardation (IUGR), while the remaining four cases were studied for other reasons. The MRI examinations were performed on a 0.5 Tesla machine, with surface coils. One minute acquisition time T1 sequences were used. All the studies were performed without fetal curarization, and only under maternal sedation using flunitrazepam given per os 1 h before MRI examination. Three examinations were incomplete because of fetal movement artefacts. In the remaining cases, MRI allowed the examination of fetal brain anatomy. In five cases, it helped to differentiate isolated hydrocephalus and corpus callosum agenesis. Sub-ependymal nodules were depicted in a case of fetal tuberous sclerosis. One suspected arachnoid cyst was proved to be an ultrasound artefact. Decreased fetal fat on MR images was correlated with low birth weight in cases of IUGR. Due to its better spatial resolution, ultrasonography was more accurate for the diagnosis of facial and lumbar anomalies. Fetal MRI may be performed without curarization. Surface coils allow the detailed analysis of brain parenchyma, and thus MRI is especially useful in the difficult prenatal diagnosis of fetal brain abnormalities.

Role of CT in chronic pulmonary embolism: comparison with pulmonary angiography.

To assess the value of CT in chronic pulmonary embolism (CPE), CT scans and pulmonary angiograms of 21 consecutive patients were reviewed. Computed tomography was better than angiography in assessing proximal clots (three thrombi not seen by angiography, three angiographic false-positives confirmed by surgery). Furthermore, CT was able to analyze pulmonary arteries distal to angiographic amputations. Computed tomography was less sensitive than angiography for vascular distortions (38 vs. 50%) and stenosis (35 vs. 71.8%). Pulmonary infarctions were better detected and characterized by CT than by angiography. Isolated parenchymal ground-glass opacities were seen by CT in 18 patients, especially in those with right cardiomegaly. High resolution CT delineated them better than did standard CT. Computed tomography may be a useful adjunct to angiography in the assessment of CPE.

Acute pulmonary embolism: diagnostic value of digital subtraction angiography.

Digital subtraction angiography (DSA) performed via a peripheral vein was compared prospectively with selective conventional pulmonary angiography (CPA) in 54 patients suspected of having pulmonary embolism (PE). All patients also underwent ascending venography. In contrast to the conventional pulmonary angiograms, all of which were considered satisfactory, 13 of 54 digital subtraction angiograms (24%) were technically unsatisfactory. The interpretable digital subtraction angiograms had 81% sensitivity and 64% specificity. With DSA, one cannot exclude the diagnosis of PE on the basis of normal angiograms (27% false-positive results) as one can with perfusion scanning. On the other hand, DSA showed good sensitivity (94%) in medium to major PE. Therefore it may be the technique of choice in the screening of life-threatening PE for which curative emergency treatment with thrombolytic agents or embolectomy is often necessary.

[Multicystic renal dysplasia, peculiar developmental aspects: spontaneous remission followed-up by ultrasonography. Apropos of 2 cases]. / La dysplasie rénale multikystique, aspects évolutifs particuliers: régression spontanée suivie par échographie. A propos de deux observations.

Two cases of unilateral multicystic kidney followed an atypical course, the non-communicating anechogenic images on ultrasound examination that projected into the renal region disappearing within several months and the infants' condition appearing satisfactory at 2-year follow up review. Analysis of the literature showed the increasing frequency of this outcome, but persistence of a multicystic kidney after the first year of life requires its surgical removal because of risk of degenerative changes.

[Transfontanelle echography: correlation with anatomopathological data. Apropos of 39 cases in newborn infants]. / Echographie transfontanellaire: corrélations aux données anatomopathologiques. A propos de 39 observations de nouveau-nés.

Thirty-nine neonates including 29 prematures had correlation studies of trans-fontanelle ultrasounds with post-mortem anatomic findings. Occipital hyper-echogenicity can be physiological when it is symmetric in the premature infant, and may indicate ischemia and/or anoxia when it is asymmetrical. No abnormal pathology went undetected by echo. Cortical gyri were never seen prior to 32 weeks gestational age.

Early echographic findings in non-hemorrhagic periventricular leukomalacia of the premature infant.

The ultrasonic detection of periventricular leukomalacia is described in two neonatal patients. Confirmation of this condition by CT and post mortem was obtained in one case. CT scan and further echography was positive in the other. Neither patient had evidence of an intracranial hemorrhage. It is suggested that echography is of value in the early diagnosis of this lesion which may be similar to intraparenchymal hemorrhage in its mechanism and prognosis.

[Shwachman's syndrome with neonatal thoracic manifestations]. / Syndrome de Shwachman à manifestations thoraciques néonatales.

The authors report a case of Shwachman's syndrome in whom neonatal respiratory distress was the initial manifestation. Metaphyseal dysplasia, which was severe at birth, progressively disappeared. By the age of 10 years, radiologic anomalies persist only in the pelvis.

Sonography in the diagnosis and follow-up of pancreatic pseudocysts in childhood. A report of 4 cases.

Pancreatic cyst disease is rare in children and pseudocysts are in general post traumatic. The authors present four cases of pancreatic pseudocysts in children aged from 2 to 12 years, seen in Institut National de Santé de l'Enfance (Tunis) and in Hôpital Antoine Beclère in Clamart (France). All were verified by surgery. The diagnosis was not established before echography. The authors present the echographic patterns of this rare condition and review the literature. The contribution of the sonographic examination in the diagnosis of the pancreatic cyst in children and in the follow-up of the patients is emphasised.