Search

The results of 265 trochanteric fractures in the elderly treated between 1980 and 1983 have been analysed. Among them, 136 were treated by Ender's nailing, 110 by prostheses and 19 by internal fixation. In an earlier study, Ender's nailing had been used in 75 p. 100 of cases. The conclusions were that the increasing use of a prosthesis has brought about an improvement in the results-80 p. 100 satisfactory in the present series compared with 54 p. 100 in the preceding one. The mortality rate was comparable after Ender's nailing and prostheses. Ender's nailing is indicated in stable fractures and, in unstable fractures, internal fixation is indicated in very active persons, Ender's nailing in non-ambulatory patients and prostheses in elderly patients with sufficient walking ability.

The neuroendocrine factors synthetized by various regions of the nervous system and which have inhibiting or stimulating effects can control the male and female physiology of malacostraca via sexual hormones and moulting hormone. There are between decapods and peracarids functional homologies but some differences can be noticed as to the localization of these antagonistic neurosecretory systems. The functioning of these systems is regulated by external factors such as the photoperiod and the temperature. The interactions between these different neurohormones, the sexual hormones and the moulting hormone are discussed.

The authors studied 65 men who had a varicocele by semen analysis, estimating the levels of FSH, LH, testosterone and prolactin and in some cases the rise in FSH using GnRH. 59 cases were treated by operation and in each of these testicular biopsy was carried out on both sides. Indications are given as to the duration in years of the infertility, the localisation of the varicoceles and the preoperative semen analysis. It would appear that the FSH reading is most important. When it is more than 3.5 ng/ml no pregnancy occurred but when the level was within the mean range of 2.8 ng/ml the chances of pregnancy were higher. It came out at 43% of spouses becoming pregnant within 32 months. The authors make a plea for infertility in both partners to be treated by the same specialist.

Butel's hip plate was used for osteosynthesis of 241 fractures of upper end of femur (100 true cervical - 141 trochanteric and subtrochanteric fractures). Results for true cervical fractures were assessed as satisfactory in 89.5% of cases, with only 3 pseudarthroses and 4 cases of femoral head necrosis (2 septic, 2 aseptic), a total complication rate of 7.5%. These clinical results confirm the value of screw fixation at several cephalic anchorage sites (demonstrated biomechanically) in true cervical fractures. Results in trochanteric and subtrochanteric fractures were rated as satisfactory in 86.9% of cases, complications including 2 ruptures of plate, 1 sepsis and 4 early loosening of plate. The latter sequela was avoided by an improved choice of indication for the procedure and by substitution of this compound material (screw-plate) for a monobloc piece ("anti-loosening cervicocephalic screw apparatus"), in compound fractures of trochanter.

A reversal of sexual phenotype resulting in the appearance of neo-males and neo-females occurs in the populations of two marine subspecies of Idotea balthica. Sex inversions are rare in I. b. basteri but more frequent in I. b. tricuspidata. By crossing these two subspecies, the rate of neo-males (ti) was considerably increased, allowing us to study the determination of sex inversion. The I. b. tricuspidata used in this study came from the offspring (27 p. 100 neo-males) of one gravid albafusca female (A1) collected in La Rochelle (LR); these offspring had been studied for five generations. The I. b. basteri came from offspring of females collected in Marseille (M), Racou (eastern Pyrenees) and Tunis. The chi 2 or Mann-Whitney test was used to compare the results of the different crosses. The female Idotea balthica is heterogametic (WZ); the male is homogametic (ZZ). The loci of the genes which determine the colored phenotypes, albafusca (A) and bilineata (B), are situated on the W heterochromosome. The fundamental phenotype, uniformis (U), is the wild type, according to classical genetics. The males used were either ZZ and uniformis or WZ (neo-males) and albafusca. 1) Ten crosses: female A basteri (M) X male U tricuspidata (LR) gave a variety of offsprings (chi 2 = 56 - d.f. = 9), two having an A1-like ti and the other eight no or very few neo-males. 2) Backcrosses (from CRF2 to CRF5) between hybrid females and U La Rochelle males: in CRF2, the ti increased significantly and in CRF3, CRF4 and CRF5 it reached the ti of the A1 lineage. 3) In the female F1 X male UM backcrosses, the ti was nearly zero, thus being comparable with the basteri lineage of Marseille. 4) When female ALR X male UM of some lineages was crossed, the expressivity of the phenotype A was reduced (from A to U) only in neo-males. The penetrance of gene A did not vary significantly in seven crosses from F1 to CRF2. 5) The crossing of male male ULR with female female basteri B or U from various populations showed that only some B and U females were likely to favor sex inversion in their daughters; the resulting ti was ten times higher with A females. These results led to the following conclusions: --crosses 1, 2 and 3 showed that reinforcement of the tricuspidata genotype of La Rochelle, by means of a regular addition of mainly autosomal genes, induced an increase in the ti, whereas reinforcement of the basteri genotype induced a decrease in that rate. The results supported the hypothesis of a polyfactorial determination of sex involving autosomal, or partly sex-linked, factors acting as inhibitors of the major female gene(s); --crosses 4 showed that the reduction of gene A expressivity was always associated with the sex inversion of genetic hybrid females; that process also seemed to be controlled by some autosomal or partly sex-linked recessive genes, different from those of the preceding complex and acting as inhibitors of the major female-determining factor(s) situated on the W heterochromosome...

One hundred and seventeen shoulders in 113 patients were treated surgically for recurrent anterior dislocation of the shoulder by the Latarjet procedure - transplantation of the coracoid process to the anterior border of the glenoid fossa. 67 p. 100 of the patients engaged in sport and 33 p. 100 did not. The usual lesions found at operation were separation of the capsule from the anterior rim of the glenoid in 59 p. 100, a lesion of the glenoid labrum in 65 p. 100 and damage to the glenoid fossa short of a fracture in 18 p. 100. Postoperative complications were rare and usually mild, except in two cases of osteoporosis of the coracoid transplant and two fractures of the bone block. There was slight limitation of lateral rotation in 48 p. 100, of abduction in 14 p. 100 and of medial rotation in 4 p. 100. The results at follow-up were rated as excellent in 68 p. 100 (72 cases), good in 21.7 p. 100 (23 cases), with slight pain and limitation of lateral rotation of less than 20 p. 100 and fair in 6.6 p. 100 (7 cases). In these cases, the Latarjet procedure had been performed for postoperative recurrence after a previous surgical procedure. There were 4 poor results.

A symbiotic bacteroid matroclinously transmitted is present in the ovocytes and the follicular cells of the sub-species Porcellio dilatatus petiti of the Saint-Honorat island, as well as in all hybrid females born from a petiti mother. It is absent in the Porfellio dilatatus dilatatus females (population of Poitiers) and this seems to cause the lithality in the periblastula stage -- as a result of abnormal anaphases--of practically all the embryos of the crossing : male petiti x female dilatatus.

The males with female genital apertures of the Niort population of A. vulgare are genetic males that have been made intersexual by two factors which are probably epigenetic : one is feminizing, the other masculinizing. The transmission of the masculinizing factor seems to be controlled by a genetic mechanism which, in the crossing of an intersexe with a genetic female, makes half the female issue turn into neo-males and intersexes.

In thelygenous lines of Armadillidium vulgare, neo-females and intersex males (iM) with feminizing symbiotic bacteria are not masculinized by an extract from iM androgenic gland, which, however, masculinizes bacterialess genetic females. Injection of iM hemolymph extract masculinizes these genetic females. This indicates that androgenic hormone is present in iM hemolymph. Lack of androgenic hormone activity in thelygenous lines is supposed to result from the action of bacteria on the androgenic hormone receptors. Since a temporary recovery of the male differentiation of iM can be induced by implantation of different parts of central nervous system, bacteria effect is probably indirect, through an action on a neurosecretory system, perhaps one of those controlling the functioning of the androgenic gland.

A review of complications of 374 fractures of the proximal femoral end, treated by Ender's nailing was conducted: 255 cases only were available because of 46 early deaths and 73 patients without enough follow up. Complications were: 31 superior nails' perforations, 15 downward migrations, 17 dislocations of osteosynthesis and 19 rare complications. The authors believe that Ender's nailing is a great improvement, when compared with classical methods of osteosynthesis or prosthetic replacements. However, a perfect technical execution is necessary to avoid mechanical complications.