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Body-powered upper-limb prostheses remain a popular option for those with limb absence due to their passive nature. These devices typically feature a constant transmission ratio between the forces input by the user and the grasp forces output by the prosthetic gripper. Work incorporating continuously variable transmissions into robotic hands has demonstrated a number of benefits in terms of their motion and forces. In this work, we use a custom prosthesis emulator to evaluate the viability of applying variable transmissions to a body-powered prosthetic context. With this haptics test bed, we measured user performance during a grasping and lift task under a variety of transmission ratio conditions and with three different test objects. Results indicate that use of a variable transmission leads to the successful manipulation of a wider variety of objects than the constant transmission ratio systems, while requiring less shoulder motion. Analysis also shows a potential tendency for users to apply higher grasp forces than necessary, when compared to constant transmission conditions. These findings suggest a multifaceted effect on grasp performance with both benefits and drawbacks when considering a variable approach that supports the continued study of variable transmissions in assisted grasping.

Purpose: To report the clinical results of lens capsular flap (LCF) transplantation in a patient with refractory medium macular hole (MH)., Methods: Case report., Results: A 66-year-old female myopic patient with a history of medium macular hole (MH) was previously unsuccessfully treated by vitrectomy surgery, internal limiting membrane (ILM) peeling and air-fluid exchange followed by 12% C2F6 tamponade into the vitreous cavity and face-down positioning. After the first surgery, the patient's visual acuity of the left eye remained only 20/400 on the Snellen scale, and a persistent medium MH (290 µm) was observed on optical coherence tomography. Cataract of the left eye was also noted. A second surgery, combined cataract-vitrectomy surgery, was carried out to seal the MH, performed under retrobulbar anesthesia. Because there was insufficient ILM tissue to perform the ILM flap procedure, we decided to use another technique involving an autologous LCF. The patient underwent LCF placement onto the MH along with gas tamponade. At 6 months, the MH was sealed, and the patient's vision had improved to 20/32 on the Snellen scale., Conclusion: This is the first case report to describe the use of LCF to treat persistent medium MH. LCF seems to be effective in sealing small macular holes and was well tolerated by the patient.

Objective: To compare the efficacy of double gloving with an inner coloured pair of gloves and double gloving with classic gloves, for prompt detection of perforation during a single standard operation., Design: Prospective, randomised study., Setting: Teaching hospital, France., Subjects: 100 Consecutive patients with haematological malignancy or AIDS, who were referred for implantation of a vascular access port., Interventions: Insertion of a central line with an implantable chamber under local anaesthesia. The use of double gloving with an inner coloured pair or with classic gloves was decided preoperatively by random allocation., Main Outcome Measures: Visual detection of one or more perforations on one or more gloves during operation, localisation of the perforation(s), and post-operative evaluation of the water tightness of the gloves., Results: There were a total of 14 perforations of the outer gloves, 9 were detected during operation in the coloured inner pair group compared with none in the standard gloves group. Postoperative testing showed that there were no undetected perforations in the coloured inner pair group compared with 5 in the standard gloves group., Conclusions: Double gloving with a coloured inner pair is effective in the peroperative detection of accidental perforations in surgical gloves.

This prospective study examined the presence of foreign bodies in postoperative adhesion specimens and parietal peritoneum removed in a given patient at the same operative site. Fifty-two consecutive patients were enrolled. A significantly larger number of foreign bodies were observed in adhesion specimens than in peritoneum specimens. Inflammatory processes were also found to develop preferentially on the perioneum. In man, foreign bodies participate in the mechanism of development of postoperative intraperitoneal adhesions.

Among hepatic hemangiomas (the most common solid hepatic tumor in adults), "giant hemangiomas" are those defined by a diameter greater than 4 cm. The natural history of such lesions is unclear, and many surgical procedures have been described. In five women and one man (mean age 49), we successfully used enucleation of the tumor under blood inflow control. This technique was made possible by a cleavage plane between the hepatic parenchyma and the hemangioma. This straightforward and safe procedure required a low rate of transfusion (mean 200 mL/patient) and spared a maximum amount of hepatic tissue.

Usually considered as totally unoffensive, antalgic suppositories can, under certain conditions, lead to extensive anorectal injury with anatomic, functional and legal implications which we evaluated on the basis of two cases and a review of the literature. Clinicians, surgeons, pathologists and pharmaceutical firms should be aware of these pathophysiological events. Consumer information is required to reduce the risk of self-medication. There are characteristic psychologic situations and "dose-dependent" toxic effects which, as the saying goes "errare humanum est, perseverare diabolicum". Careful use of scientific knowledge and wise decisions by both experts and judges are required to avoid misinterpreting the pathogenesis of this particular anatomoclinical entity.

From 1990 to 1993, programmed surgery was performed in four patients with histologically low grade malignant gastric lymphomas of mucosa-associated lymphoid tissue (MALT) (partial gastrectomy = 1, total gastrectomy = 3). These small cell lymphomas have the B phenotype and are uncommon. The clinical course is usually slow and classically limited to the stomach. As for other gastric lymphomas, there is still a certain amount of discussion as to the best therapeutic choice between surgery, chemotherapy and radiotherapy. Certain elements in the literature can help in managing these low grade gastric lymphomas. Recent publications report on a prospective study on primary lymphomas of the digestive tract, a clinical trial on single drug chemotherapy alone and the relationships between Helicobacter pylori and MALT lymphoma.

Our experience with 168 consecutive implantable chamber catheters over a one year period led us to establish the criteria for this implantation technique. Implantation should be carried out under local anaesthesia and be well tolerated and comfortable for the patient who is often weak. It should be a first indication technique in order to save the venous capital. Based on our experience, subclavian implantation corresponds best to these criteria.

Postoperative intraperitoneal adhesions are known to occur after conventional surgery. The prospective study that we have performed in 1992 shows that the frequency of postoperative intraperitoneal adhesions is very high (93% of patients). It is higher than was stated 20 years ago, while so-called "spontaneous" adhesions seem to be decreasing. The histological study of postoperative intraperitoneal adhesions shows a specific evolution in time and a very high frequency of foreign bodies (starch, variably decayed textile fibers) (92%). The very great frequency of such foreign bodies in postoperative intraperitoneal adhesions, logically involving them in the genesis of this condition, may be an argument in favor of the new surgical techniques, especially of celioscopy.

We report about one case of cystic lymphangioma of the jejunum in a 27-year-old woman admitted to hospital for abdominal pain. The study of this case and the review of the literature enabled us to bring out the main characteristics of the lesion: rarity in adults, benignancy, mode of occurrence--most often painful--, radiological--and particularly CT--features, diagnosis based on histological findings only, and lastly, treatment with surgical exeresis that must be complete to prevent recurrence.

An experimental study on 15 piglets allowed defining the technical procedure and controlling the anatomical and functional results of various modes of restoration of the ileocolic tract after resection with a terminolateral tubing including and intracolic ileal sleeve. Coloileal fixation was ensured only by a few seromuscular sutures and adhesion with "Tissucol". The clinical application of this procedure was very satisfactory for 9 recent right colectomies, thus confirming the results previously observed for 33 ileal perforations in Africa. The ileocolic tubing technique is easy, reliable, morbidity-free, and causes no leakage of intestinal fluid, no intestinal ischemia and no stenosis. As it prevents coloileal reflux, this assembly may prevent ileitis after right colectomy. Its valvular effect also contributes in the mechanical regulation of transit. The assembly produces a system that can be compared to the ileocecal valve.