Charles-Pierre Denonvilliers (1808-1872): renowned anatomist, plastic surgeon, and influential member of French society.

Charles-Pierre Denonvilliers was one of the most influential and prolific French anatomists and surgeons of the 19th century. Born in Paris and educated at the Paris Faculty of Medicine in 1826, he steadily created a reputation for himself in the field of medicine. Starting in 1833, Denonvilliers lectured with exquisite clarity and scientific accuracy in surgery and anatomy. Not only did he make a name for himself in this arena but also as an anatomist of high caliber based on his anatomical dissections and presentations. These talents and skills afforded Denonvilliers the opportunity to acquire different other titles and positions throughout his career. His reputation as a plastic surgeon, anatomist, and lecturer coupled with his status and influence made his sudden death in 1872, an occasion of bereavement for the French medical profession.

The proatlas: a comprehensive review with clinical implications.

BACKGROUND: The proatlas is derived from the fourth occipital sclerotome in human embryos. It usually fuses with the three upper occipital sclerotomes to form the occipital bone. However, this does not always occur. Manifestations of a partial proatlas structure may persist due to failure of fusion. CLINICAL CONSIDERATIONS: These embryological remnants can induce several symptoms in humans, ranging from mild to severe. On occasion, this structure can go unnoticed until a precipitating traumatic event results in symptoms. Proatlas segmentation abnormalities form bony masses at C1 and the foramen magnum. A number of surgical procedures have been devised to rectify the resulting neural compression and vascular compromise. DISCUSSION: This paper will discuss the development of the proatlas and the resultant anomalies associated with its failure to merge with the occipital sclerotomes to form the occipital bone. In addition, some consideration of comparative anatomy and surgical techniques will be presented.

A Comparison of Inhaled Epoprostenol in Patients With Acute Respiratory Distress Syndrome and COVID-19-Associated Acute Respiratory Distress Syndrome.

Introduction Acute respiratory distress syndrome (ARDS) and coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome (CARDS) are both characterized by non-cardiogenic pulmonary edema and severe hypoxemia that leads to a high percentage of patients suffering in-hospital mortality. Mechanistically, inhaled epoprostenol (iEPO) has shown a role in the treatment of ARDS and CARDS but little data are available directly comparing the two disease processes. Due to the lack of evidence of iEPO in ARDS and CARDS, the authors sought to compare the pulmonary effects of iEPO for mechanically ventilated patients with CARDS against a case match control of those with ARDS. Methods A retrospective cohort of all patients receiving iEPO between January 1, 2020, and February 22, 2022, was reviewed. Patients with ARDS were case-matched in a 2:1 allocation ratio of CARDS to ARDS by the number of medical comorbidities and age +/- 5 years. Clinical data collected included patient demographics, laboratory values, ventilator settings, length of hospitalization, and 28-day mortality. Comparisons of the effectiveness of iEPO between ARDS and CARDS were conducted using the chi-squared statistic for categorical variables and the Mann-Whitney statistic for continuous variables. Results A total of 72 patients were included in the final analysis, with 24 having ARDS and 48 CARDS. The number of medical comorbidities was no different for patients with ARDS or CARDs (p = 0.18), though the frequency of patients diagnosed with coronary artery disease (p=0.007), congestive heart failure (p=0.003), chronic obstructive pulmonary disease (p=0.004), and pulmonary hypertension (p=0.004) did vary between the two groups. A moderate but non-significant difference in pre-iEPO partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio was noted between the groups (0.74 vs 0.65; p=0.33). Following iEPO treatment, patients with ARDS showed a greater PaO2/FiO2 ratio than those with CARDS (0.87 vs 0.70; p=0.02). CARDS patients who received iEPO had a longer length of stay as compared to those with ARDS (17.5 vs 12.5 days; p=0.01). However, no difference was noted in 28-day mortality between the two groups (14 vs 34; p=0.29). Conclusion In this small sample from a single community hospital, a statistically significant improvement in the PaO2/FiO2 ratio was noted for both those with ARDS and CARDS. However, those with CARDS who were given iEPO had a longer length of stay without a significant difference in mortality as compared to those with traditional ARDS.

Winged Scapula: A Comprehensive Review of Surgical Treatment.

Winged scapula is caused by paralysis of the serratus anterior or trapezius muscles due to damage to the long thoracic or accessory nerves, resulting in loss of strength and range of motion of the shoulder. Because this nerve damage can happen in a variety of ways, initial diagnosis may be overlooked. This paper discusses the anatomical structures involved in several variations of winged scapula, the pathogenesis of winged scapula, and several historical and contemporary surgical procedures used to treat this condition. Additionally, this review builds upon the conclusions of several studies in order to suggest areas for continued research regarding the treatment of winged scapula.

Ligaments of the rectum: anatomical and surgical considerations.

The ligaments of the rectum have been the subject of controversy for decades. Not only have their contents and components been a source of contention, but also the very existence of these ligaments has been called into question. This article explores the anatomical features of these ligaments with implications for surgical treatment of rectal prolapse, rectal cancer, and resection of the rectum and mesorectum. A theory about the evolution of the lateral rectal ligaments and the mesorectum in humans and higher mammals is also presented.