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A highly stereoselective asymmetric total synthesis of (-)-jimenezin (

Production of value-added chemicals from lignocellulose is one of the key strands of the emerging bio-economy. A synthetic approach has been developed to produce p-methoxy coumarate esters from waste corn stover and corn bran, and further transform these compounds into consumer products. In the first step, p-coumaric acid (pCA) and ferulic acid (FA) are released through mild alkaline hydrolysis of corn waste, in more than 20 mg g-1 yield (10 wt % based on lignin content). Subsequently, heterogeneous solid acids catalyze the esterification of pCA with various alcohols. Amberlite IR-15 shows the best catalytic performance, owing to its optimal acid density, large surface area, and suitable pore diameter. The solid acid catalyst can be recycled with slight activity loss and regenerated by acid washing and vacuum drying. Finally, methylation of p-coumarate ester to give target product p-methoxy coumarate esters is carried out by using commercially available and low-cost inorganic bases (e. g., K2 CO3 ). Base-catalyzed transesterification of methyl p-methoxy coumarate to p-methoxy coumarate esters is also investigated.

During drug discovery programmes, medicinal chemists rely on compounds derived from Haber ammonia as the source of this clinically important nitrogen heteroatom and as a result, the development of new pharmaceuticals is very energy intensive. Herein we report that biologically fixed nitrogen sourced from the biopolymer chitin can be readily incorporated into the diversity-oriented synthesis (DOS) of N-compounds relevant to drug discovery and development. The furfuryl alcohol derived from the chitin-sourced platform 3-acetamido-5-acetylfuran (3A5AF) undergoes a Piancatelli rearrangement to give a 3-aminocyclopentenone that is readily converted into a variety 4-aminocyclopentanones and 4-aminocyclopentene-1,3-diones. From two of these functionally rich bio-based platforms, structurally diverse, medicinally relevant N-scaffolds are attainable, including aminated Hajos–Parrish ketone (HPK) derivatives, aminated bicyclic ethers, bicyclic pyrrolidines, pyridines, isoquinolines and indoles. Thus, the DOS of compound libraries relevant to modern drug discovery programmes can be assembled independent of Haber ammonia.

Nanoparticle-loaded hydrogels are attractive pharmaceutical drug delivery systems that combine the advantages of both hydrogel (local administration and/or sustained drug release) and nanoparticle (stealthiness, targeting and decreased toxicity). The design of nanoparticle-loaded hydrogels is largely conventional, consisting of the dispersion of nanoparticles in a natural or synthetic polymer matrix to form a gel network. Novel nanoparticle-loaded hydrogels architecture could provide advantages in terms of innovation and application. We focused on the development of lipid nanocapsule (LNC)-based hydrogels without the use of a polymer matrix as a platform for drug delivery. Cytidine was modified by grafting palmitoyl chains (CytC16) and the new entity was added during the LNC phase-inversion formulation process allowing spontaneous gelation. Positioned at the oil/water interface, CytC16 acts as a crosslinking agent between LNCs. Association of the LNCs in a three-dimensional network led to the formation of polymer-free hydrogels. The viscoelastic properties of the LNC-based hydrogels depended on the LNC concentration and CytC16 loading but were not affected by the LNC size distribution. The LNC and drug-release profiles were controlled by the mechanical properties of the LNC-based hydrogels (slower release profiles correlated with higher viscoelasticity). Finally, the subcutaneous administration of LNC-based hydrogels led to classic inflammatory reactions of the foreign body-reaction type due to the endogenous character of CytC16, shown by cellular viability assays. New-generation nanoparticle-loaded hydrogels (LNC-based polymer-free hydrogels) show promise as implants for pharmaceutical applications. Once LNC release is completed, no gel matrix remains at the injection site, minimizing the additional toxicity due to the persistence of polymeric implants. Sustained drug-release profiles can be controlled by the mechanical properties of the hydrogels and could be tailor-made, depending on the therapeutic strategy chosen.

Human rhinoviruses (HRV) are one of the major causes of common cold in humans and are also associated with acute asthma and bronchial illness. Heat-shock protein 90 (Hsp90), a molecular chaperone, is an important host factor for the replication of single-strand RNA viruses. In the current study, we examined the effect of the Hsp90 inhibitor pochonin D, in vitro and in vivo, using a murine model of human rhinovirus type 1B (HRV1B) infection. Our data suggested that Hsp90 inhibition significantly reduced the inflammatory cytokine production and lung damage caused by HRV1B infection. The viral titer was significantly lowered in HRV1B-infected lungs and in Hela cells upon treatment with pochonin D. Infiltration of innate immune cells including granulocytes and monocytes was also reduced in the bronchoalveolar lavage (BAL) by pochonin D treatment after HRV1B infection. Histological analysis of the lung and respiratory tract showed that pochonin D protected the mice from HRV1B infection. Collectively, our results suggest that the Hsp90 inhibitor, pochonin D, could be an attractive antiviral therapeutic for treating HRV infection.

Resume Contexte Les complications des fractures de l’extremite distale du radius sont rares, en postoperatoire immediat. La paralysie medio-ulnaire est une complication meconnue par le chirurgien. Materiels et methodes Trois patients ont presente une paralysie medio-ulnaire distale, constatee en postoperatoire precoce. L’âge moyen de ces patients etait de 20 ans (15 ans, 16 ans et 30 ans). Dans chaque cas, aucun deficit preoperatoire n’etait retrouve. Pour le plus jeune, il s’agissait d’un accident sportif, dans les deux autres cas d’un accident de la voie publique. Les 3 patients presentaient une fracture du radius distal deplacee associee a une fracture du quart distal de l’ulna ou a une fracture de la styloide ulnaire. Dans tous les cas, il a ete realise une osteosynthese par plaque anterieure avec une duree moyenne d’intervention de 76 minutes. Le diagnostic de syndrome des loges n’a pas ete retenu, car les patients etaient peu algiques et les loges de l’avant-bras souples a la palpation. Resultats A un mois du traumatisme, les patients ont realise une electromyographie constatant une atteinte severe du nerf median et du nerf ulnaire. Le patient de 15 ans a beneficie a 6 semaines d’une neurolyse du nerf median et du nerf ulnaire. Au cours de cette intervention, aucune lesion ou fibrose n’a ete constatee. A 3 mois du traumatisme, la recuperation clinique a ete totale pour tous avec normalisation du trace electromyographique a 6 mois. Discussion La paralysie medio-ulnaire est tres peu decrite dans la litterature. Elle represente une complication rare des fractures de l’extremite distale du radius. Elle survient dans un contexte de traumatisme a haute cinetique et/ou de deplacement fracturaire important. Tout geste de neurolyse au vu de la litterature et de notre experience, est inutile. La recuperation clinique est la regle, a 3 mois du traumatisme. Niveau de preuve IV, fait clinique.

The reaction between the chitin-derived heterocycle 3-acetamido-5-acetylfuran and aliphatic ketones results in the formation of a novel dihydrodifuropyridine scaffold.

Resume Introduction Le cal vicieux du radius represente une complication majeure des fractures de l’extremite distale du radius (EDR). Selon les differentes series de la litterature, son taux varie de 0 a 33 %. La restauration anatomique de l’extremite distale du radius par une osteotomie de correction entraine generalement une amelioration fonctionnelle et une diminution significative de la douleur. Nous rapportons ici les resultats d’une serie de nos patients en critiquant la prise en charge initiale. Materiel et methode Il s’agit d’une etude retrospective monocentrique, multi-operateurs. La serie comportait 12 patients, d’âge moyen 35 ans (14 a 60 ans) au moment du traumatisme. Il y avait 8 fractures extra-articulaires dont 3 a bascule anterieure, 2 fractures marginales anterieures et 2 fractures intra-articulaires en T. Le traitement initial a ete realise par plaque anterieure 2 fois, par kapandji 5 fois, plaque et broches 2 fois. Il y a eu 3 traitements orthopediques et le cote dominant etait atteint 7 fois. Dix patients avaient un cal vicieux vers l’avant et 2 vers l’arriere. Deux patients presentaient un cal vicieux anterieur et articulaire. Tous ces patients ont beneficie d’une osteotomie de correction du radius entre 2005 et 2012. Le delai moyen entre l’osteotomie correctrice et la fracture initiale fut de 168 jours (45–180) pour 11 des 12 patients. Un greffon iliaque fut utilise chez 7 patients alors que 4 ont recu un greffon artificiel. Il n’y a eu aucun geste associe sur l’articulation RUD. Resultats Tous les patients ont ete revus au recul de 24 mois apres l’osteotomie. Les mobilites postoperatoires ont progresse en flexion/extension mais aussi en prono/supination. Tous les patients ont note une amelioration fonctionnelle de leur poignet. L’arc de flexion/extension etait augmente de 40° (+21° sur la flexion, +19° sur l’extension). La pronation et la supination ont egalement augmente de 46° (+13° sur la pronation, +15° sur la supination). L’EVA moyen etait de 1,7 (0–3). Dans les 2 ans qui ont suivi la chirurgie d’osteotomie, des complications ont ete notees : une algodystrophie, 3 arthroses radiocarpiennes, 3 patients presentaient une raideur en supination. Trois patients ont presente une raideur persistante en supination secondaire a une incongruence articulaire de la RUD. Cet aspect ne doit donc pas etre neglige dans la prise en charge d’un cal vicieux de l’extremite distale du radius. Discussion et conclusion Dans notre serie, nous avons eu 25 % de reprise chirurgicale avec 3 patients presentant une raideur persistante en supination. Concernant ces patients, l’erreur principale a ete l’absence de geste complementaire sur l’articulation RUD malgre une incongruence articulaire postoperatoire. Cette constatation et la revue de la litterature nous amenent aujourd’hui a plus de vigilance et a ne pas oublier que la congruence de l’articulation RUD est l’enjeu pronostic de ces osteotomies.

The first total synthesis and structure revision of (-)-11β-hydroxycurvularin (1b), a macrolide possessing a β-hydroxyketone moiety, were accomplished. The β-hydroxyketone moiety in this natural product was introduced by cleavage of the N-O bond in an isoxazoline ring that was formed diastereoselectively in a 1,5-remote stereocontrolled fashion by employing intramolecular nitrile oxide cycloaddition.

Resume Introduction Si la technique arthroscopique tend a s’imposer comme la technique de reference pour la reparation des tendons de la coiffe des rotateurs, aucune etude n’a apporte la preuve qu’elle occasionnait moins de douleurs postoperatoires que la chirurgie conventionnelle. L’objectif de ce travail etait de comparer de maniere prospective la douleur percue a court terme apres reparation « tout arthroscopique » et « tout ciel ouvert » de la coiffe des rotateurs, et de determiner les facteurs pouvant influencer son evolution. Materiel et methode De janvier 2012 a janvier 2013, 95 patients ont beneficie d’une reparation de la coiffe des rotateurs : 45 par arthroscopie (groupe @) et 50 a ciel ouvert (groupe O). La consommation d’antalgiques et l’auto-evaluation de la douleur sur echelle visuelle analogique (EVA) ont ete relevees en preoperatoire puis, de maniere biquotidienne du 2 e au 45 e jour postoperatoire. Ces donnees etaient comparees entre les 2 groupes puis analysees en fonction des facteurs demographiques et du bilan lesionnel peroperatoire. Resultats La douleur postoperatoire moyenne etait equivalente dans les 2 groupes ( p = 0,22). La consommation d’antalgiques de palier 2 etait plus elevee dans le groupe @ au-dela de la 4 e semaine ( p = 0,01). L’absence totale de douleur etait atteinte avant la 6 e semaine chez respectivement 75 % et 66 % des patients du groupe @ et O ( p = 0,34). Il existait une correlation positive entre la douleur preoperatoire et postoperatoire ( r = 0,25 ; p = 0,02). Les patients presentant un contexte d’accident de travail tendaient a etre plus algiques en postoperatoire ( p = 0,08). La consommation d’antalgiques de palier 3 etait plus importante chez les patients presentant une rupture massive de la coiffe des rotateurs ( p = 0,001). Conclusion Il n’a pas ete mis en evidence de superiorite de l’arthroscopie sur la chirurgie conventionnelle en termes d’analgesie apres reparation de la coiffe des rotateurs. Le choix de la technique de reparation ne saurait s’appuyer sur cet argument. Niveau de preuve II.

BACKGROUND: Fractures of the distal radius only rarely give rise to complications in the immediate postoperative period. Combined median and ulnar nerve palsy is a complication that can be missed by the surgeon. MATERIALS AND METHODS: Three cases diagnosed early after surgery are reported here. The patients were 15, 16, and 30 years of age, respectively. None had preoperative neurological deficits. The youngest patient was injured during sports and the other 2 patients during traffic accidents. All 3 patients had a displaced fracture of the distal radius combined with a fracture of the distal fourth of the ulna or ulnar styloid process and were treated by anterior plate fixation. Operative times were 47, 62, and 120minutes, respectively. Compartment syndrome was ruled out based on low pain intensity and absence of forearm tightness to palpation. RESULTS: The electrophysiological study performed 1 month post-injury in all 3 patients showed severe impairments of both median and ulnar nerve function. Median and ulnar nerve release surgery was performed in the 15-year-old 6 weeks post-injury. No nerve damage or fibrosis was seen during the procedure. All patients recovered fully within 3 months and had normal findings from follow-up electrophysiology testing after 6 months. DISCUSSION: Combined median and ulnar nerve palsy has rarely been reported and is among the rare complications of distal radial fractures that can develop in the event of a high-energy trauma and/or major displacement. Both previously published data and our experience indicate that surgical nerve release is unnecessary. Clinical recovery within 3 months is the rule. LEVEL OF EVIDENCE: IV, case-reports.

International audience; There has been lively debate regarding the rationale behind the use of radial head arthroplasty (RHA) for more than 80 years. Currently, its primary indication is for treatment of non-reconstructible RH fractures. The first RH implant, released in 1941, was a ferrul cap used to prevent heterotopic ossification. Biomechanical studies in the 1980s stimulated a revolution in RHA design by promoting modular implants that replicated the native bony anatomy of the elbow. Subsequent data-driven evolution in design led to the creation of a variety of devices that also accommodated for common ligamentous injuries occurring at the time of RH fracture. Despite significant advances in our understanding of complex elbow instability, improvements in implant design have to make RHA the gold standard for treatment of non-reconstructible RH fractures. The challenge in the coming years will be to perform high-level clinical studies in order to obtain consensus regarding the most appropriate treatment for comminuted RH fractures.

BACKGROUND: Total elbow arthroplasty is a therapeutic option for severe rheumatoid arthritis. We hypothesized that the semiconstrained characteristics of the Coonrad-Morrey prosthesis do not compromise the survival rate of the implant in a rheumatoid elbow. METHODS: Between 1997 and 2012, there were 54 Coonrad-Morrey total elbow prostheses performed for rheumatoid arthritis in 46 patients. Minimum follow-up was 2 years. There were 35 women and 11 men with a mean age of 60 years (29-83 years). According to the Mayo classification for rheumatoid elbow, there were 30 type IIIA, 21 type IIIB, and 3 type IV. The surgical procedure was the same for all patients. Survivorship was assessed with use of the Kaplan-Meier method, with revision surgery as the end point. RESULTS: The survival rate was 97% (95% confidence interval, 83.6-99.6) at 5 years and 85% (95% confidence interval, 68.3-93.7) at 10 years. At an average of 7 years of follow-up (2-16 years), the mean Mayo Elbow Performance Score was 91 points (55-100 points), and the shortened version of the Disabilities of the Arm, Shoulder, and Hand score was 34 points (0-75 points). There was a significant improvement in Mayo Elbow Performance Score and in all range of motion at latest follow-up in comparison to preoperative values (P

Resume Introduction En raison de la frequente degradation avancee de la premiere rangee des os du carpe dans la polyarthrite rhumatoide, la resection de la premiere rangee des os du carpe (RPRC) associee a l’arthrodese totale de poignet simplifie l’acte chirurgical et evite le recours a une greffe iliaque complementaire. Elle augmente egalement theoriquement les chances de consolidation puisqu’un seul interligne doit fusionner pour assurer son succes. Les effets de la perte de hauteur du carpe lies a ce geste ne sont pas connus a ce jour. Materiel et methodes L’evaluation clinique de 38 arthrodeses totales de poignets rhumatoides prenait en compte la douleur sur l’Echelle visuelle analogique (EVA), le score Patient Rated Wrist Evaluation (PRWE), la force de prehension, la presence de deformations digitales et la satisfaction. Un bilan radiographique standard evaluait la consolidation et les indices de hauteur du carpe. Resultats Au recul moyen de 50 mois, la douleur moyenne etait de 0,4 (0–7) sur l’EVA. Le score PRWE moyen etait de 21 (0–80,5). La force de prehension du membre opere rapportee au controlateral etait de 76 %. Trente-quatre patients (90 %) etaient satisfaits ou tres satisfaits. Le taux de consolidation etait de 92 % (35 poignets). Il n’a pas ete mis en evidence d’influence de la perte de hauteur du carpe sur les parametres cliniques et radiographiques. Discussion Les resultats de l’arthrodese totale de poignet couplee a la RPRC apportent des resultats fiables et reproductibles. Les effets deleteres potentiels lies a la perte de hauteur du carpe n’ont pas ete retrouves. Niveau de preuve Niveau IV : serie retrospective.

Background Advanced proximal carpal row damage is common in rheumatoid arthritis (RA). Proximal row carpectomy (PRC) simplifies total wrist arthrodesis, obviating the need for an iliac bone graft. In theory, PRC also improves the chances of healing, as fusion of a single joint space is needed for the procedure to be successful. Potential effects of the loss of carpal height related to PRC are unknown. Hypothesis We hypothesised that PRC performed concomitantly with total wrist arthrodesis in patients with RA produces good clinical and radiological outcomes, without inducing loss of strength or digital deformities. Material and methods In 38 total arthrodeses of rheumatoid wrists, a clinical evaluation was performed, including a visual analogue scale (VAS) pain score, the Patient-Rated Wrist Evaluation (PRWE), grip strength, digital deformities, and patient satisfaction. A standard radiographic workup was obtained to assess healing and carpal height indices. Results After a mean follow-up of 50 months, the mean VAS pain score was 0.4 (range: 0–7), the mean PRWE score was 21 (range: 0–80.5), and grip strength as a percentage of the contralateral limb was 76%. The healing rate was 92% (35/38 wrists), and 34 (90%) patients reported being satisfied or very satisfied. No effects of carpal height loss on clinical or radiographic parameters was detected. Discussion Total wrist arthrodesis combined with PRC provides reliable and reproducible benefits. This study found no evidence of adverse effects related to the loss of carpal height. Level of evidence IV, retrospective study.

BACKGROUND: Blount's method is controversial for the treatment of Gartland types IIB and III supracondylar fracture of the humerus (SCFH) in children. The purpose of this study was to evaluate the clinical and radiologic outcomes and the failure and complication rates. METHODS: All types IIB and III SCFH treated with Blount's method from 2003-2013 were included in this retrospective single-center study. Clinical assessment was performed according to Flynn criteria. Baumann angle, anteversion angle, anterior humeral line, and humeroulnar angle were measured for radiographic assessment. RESULTS: Among 447 children with types IIB and III SCHF, 339 were treated according to Blount's method. There were 173 boys (51%), and the mean age was 6.3 years (1-14 years); 71% were type III. Mean time to surgery was 5.7 hours. According to Flynn criteria, results were satisfactory in 91% of cases. No compartment syndrome was encountered. There were 16 (4.7%) secondary displacements requiring surgical revision. Five (1.9%) children developed a cubitus varus deformity. At latest follow-up, the mean Baumann angle was 74.7° (95% confidence interval, 74.1-75.3), the mean anteversion angle was 39.9° (95% confidence interval, 39.5-40.3), the anterior humeral line was normal in 87.6% of cases, and the mean humeroulnar angle was 8.7°. CONCLUSION: Blount's method is appropriate to manage types IIB and III SCFH, provided anatomic and stable reduction is obtained.

PURPOSE: Arthroscopic techniques tend to become the gold standard in rotator cuff repair. However, little data are reported in the literature regarding the improvement of postoperative outcomes and re-tear rate relative to conventional open surgery. The aim of this study was to compare clinical outcomes and cuff integrity after arthroscopic versus open cuff repair. METHODS: We prospectively assessed clinical outcomes and cuff integrity after an arthroscopic or open rotator cuff repair with a minimum follow-up of 12 months. Clinical evaluation was based on Constant score, Simple Shoulder Value (SSV) and American Shoulder and Elbow Score (ASES). Rotator cuff healing was explored with ultrasound. RESULTS: 44 patients in arthroscopic group A (mean age 56-year-old) and 43 in open group O (mean age 61-year-old) fulfilled the inclusion criteria. Tendons were repaired with a single row technique associated with biceps tenodesis and subacromial decompression. All objective clinical scores significantly improved postoperatively in both groups. No statistical difference was identified between group A and O regarding, respectively, Constant score (72 vs 75 points; p = 0.3), ASES score (88 vs 91 points; p = 0.3), and SSV (81 vs 85%). The overall rate of re-tear (Sugaya type IV or V) reached 7 and 9%, respectively, in group A and O (p = 0.8). CONCLUSION: This study did not prove any difference of arthroscopic over open surgery in case of rotator cuff repair regarding clinical outcome and cuff integrity at 1-year follow-up.

Lung cancer accounts for the highest death rate among cancers worldwide, with most patients being diagnosed with non-small cell lung cancer (NSCLC), urging more effective therapies. We report that JK273, a pyrrolo[2,3-d]pyrimidine analog, which inhibits α4 integrin signaling, showed a selective cytotoxic effect against HCI-H460 NSCLC cells, with an IC50 of 0.98 ± 0.15 μM, but showed less sensitivity to fibroblasts with a selectivity index (SI) greater than 30. This effect was attributed to cell cycle arrest at S phase by JK273 treatment, resulting in the apoptosis of NCI-H460 cells, further confirmed by exposing phosphatidylserine and morphological changes. Taken together with the previous study of JK273 inhibiting cell migration, we propose that JK273 could serve as an antitumor compound to specifically target cancer cells but not non-cancerous cells by triggering programmed cell death, in addition to anti-metastatic effects in cancer therapy.

International audience; BACKGROUND:Neurologic lesions are relatively common after total shoulder arthroplasty. These injuries are mostly due to traction. We aimed to identify the arm manipulations and steps during reverse total shoulder arthroplasty (RTSA) that affect nerve stress.METHODS:Stress was measured in 10 shoulders of 5 cadavers by use of a tensiometer on each nerve from the brachial plexus, with shoulders in different arm positions and during different surgical steps of RTSA.RESULTS:When we studied shoulder position without prostheses, relative to the neutral position, internal rotation increased stress on the radial and axillary nerves and external rotation increased stress on the musculocutaneous, median, and ulnar nerves. Extension was correlated with increase in stress on all nerves. Abduction was correlated with increase in stress for the radial nerve. We identified 2 high-risk steps during RTSA: humeral exposition, particularly when the shoulder was in a position of more extension, and glenoid exposition. The thickness of polyethylene humeral cups used was associated with increased nerve stress in all but the ulnar nerve.CONCLUSION:During humeral preparation, the surgeon must be careful to limit shoulder extension. Care must be taken during exposure of the glenoid. Extreme rotation and oversized implants should be avoided to minimize stretch-induced neuropathies.

Climate change adaptation is a response to global warming and climate change, that seeks to reduce the vulnerability of social and biological systems to relatively sudden change and thus offset the effects of global warming. For adaptation strategy, openness and cooperation is one major principle; the development and implementation of adaptation policies is hence accompanied by broad and diversified stakeholder participation processes. However, the engagement of stakeholder in decision-making processes for climate change adaptation has not been highlighted in many developing countries. Specifically, there is a significant lack of specific plans to integrate stakeholders into the adaptation of policy making and implementation in these parts of the world. In this paper, Vietnam is used as a case study to assess the extent of stakeholder participation into climate change adaptation policies. The results show that Vietnamese government has used the ‘top-down’ approach in their decision making process in which government bodies play the key role; communities and NGOs are only marginally involved in policy formulation and implementation; and private sectors are merely included in the implementation process. Generally, in Vietnam, although stakeholder participation have been recognized, the implementation is inadequately in the context of national climate change policies. As a consequence, the adaptation policies are unlikely to be effective in the specific contexts of different localities and may not be accepted by all stakeholders, which ultimately may limit adaptation action. It is suggested that Vietnam should promote the engagement of different stakeholders in the policy process. The lessons from Vietnam can be used by other nations when developing adaptation policies.

Resume Les protheses totales de coude a charniere permettent de repondre a un large spectre d’indications. La survie de ces protheses est favorable au long terme et plus importante que les protheses sans charniere. Cependant, la faillite de la charniere represente une des complications de ces protheses avec le recul. Nous rapportons un cas de rupture de l’axe prothetique 8 ans apres la mise en place d’une prothese totale de coude a charniere de Coonrad–Morrey pour le traitement d’une pseudarthrose supra-condylienne de l’humerus distal. Une premiere reprise chirurgicale a ete effectuee avec changement de l’axe prothetique et des paliers en polyethylene. Une deuxieme reprise chirurgicale a ete necessaire un an plus tard pour une nouvelle rupture de l’axe. Un axe sur mesure verrouille a du etre utilise pour stabiliser la charniere. A 3 ans de recul, la charniere etait intacte, les implants non deceles, et le coude restait fonctionnel.

Semiconstrained (linked design) total elbow arthroplasty is indicated in a wide variety of cases. Long-term survival is better than with non-linked prostheses. However, mechanical failure of the hinge mechanism is a complication that may occur during follow-up. We report a case of failure of the axle assembly of a Coonrad-Morrey elbow prosthesis 8years after implantation for nonunion of a supracondylar distal humerus fracture. Initial revision surgery included changing the axle and the polyethylene bushings. Revision surgery was necessary 1year later when the axle failed again. A custom-designed locking axle had to be used to stabilize the hinge mechanism. After 3years follow-up, the hinge was intact, there was no loosening of the components and function of the elbow was good.

The nitrogen (N) heteroatom is widespread throughout society enhancing chemicals. The source of this heteroatom is typically the base chemical ammonia (NH3) produced by the energy intensive Haber process. Thus, at present the production of N-compounds can be classified as Haber-reliant. A more sustainable strategy for N-compound production would involve sourcing the heteroatom from a biorenewable source, in processes that can be classified as Haber-independent. Herein, we show that the biorenewable nitrogen present in the biopolymer chitin can be embedded into several Haber-independent N-functional groups of relevance to a wide variety of areas within the chemical industry. The incorporation of Haber-independent nitrogen into chemical production processes is an important factor to consider when producing bio-based chemicals that contain this heteroatom.

International audience; IntroductionSi la technique arthroscopique tend à s’imposer comme la technique de référence pour la réparation des tendons de la coiffe des rotateurs, aucune étude n’a apporté la preuve qu’elle occasionnait moins de douleurs postopératoires que la chirurgie conventionnelle. L’objectif de ce travail était de comparer de manière prospective la douleur perçue à court terme après réparation « tout arthroscopique » et « tout ciel ouvert » de la coiffe des rotateurs, et de déterminer les facteurs pouvant influencer son évolution.Matériel et méthodeDe janvier 2012 à janvier 2013, 95 patients ont bénéficié d’une réparation de la coiffe des rotateurs : 45 par arthroscopie (groupe @) et 50 à ciel ouvert (groupe O). La consommation d’antalgiques et l’auto-évaluation de la douleur sur échelle visuelle analogique (EVA) ont été relevées en préopératoire puis, de manière biquotidienne du 2e au 45e jour postopératoire. Ces données étaient comparées entre les 2 groupes puis analysées en fonction des facteurs démographiques et du bilan lésionnel peropératoire.RésultatsLa douleur postopératoire moyenne était équivalente dans les 2 groupes (p =0,22). La consommation d’antalgiques de palier 2 était plus élevée dans le groupe @ au-delà de la 4e semaine (p =0,01). L’absence totale de douleur était atteinte avant la 6e semaine chez respectivement 75 % et 66 % des patients du groupe @ et O (p =0,34). Il existait une corrélation positive entre la douleur préopératoire et postopératoire (r =0,25 ; p =0,02). Les patients présentant un contexte d’accident de travail tendaient à être plus algiques en postopératoire (p =0,08). La consommation d’antalgiques de palier 3 était plus importante chez les patients présentant une rupture massive de la coiffe des rotateurs (p =0,001).ConclusionIl n’a pas été mis en évidence de supériorité de l’arthroscopie sur la chirurgie conventionnelle en termes d’analgésie après réparation de la coiffe des rotateurs. Le choix de la technique de réparation ne saurait s’appuyer sur cet argument.

Introduction Volar plates have emerged as a popular method of treatment for internal fixation of displaced distal radius fractures. The radiolucency of the PEEK volar locking plate allows for the observation of bone details and facilitates peroperative reduction and radiographic follow-ups. The purpose of this study was to evaluate the clinical and radiological outcomes of this plate for displaced distal radius fractures. Methods Thirty-three consecutive distal radius fractures treated with PEEK volar locking plate were prospectively reviewed. The patients comprised 23 women and 10 men with an average age of 53 years (17 to 81 years). According to the AO fracture classification, 21 patients were type A, one patient was type B and 11 patients were type C. The dominant hand was involved in 39% of cases. The surgical procedure and postoperative rehabilitation were uniformly performed in all patients. The functional assessment was evaluated using the patient rated wrist evaluation (PRWE). The range of motion and grip strength of the operated wrist were measured and compared to the contralateral wrist. Volar tilt, radial inclination and ulnar variance were measured using standard radiographs. Results At the minimum follow-up time of 6 months, the mean PRWE was 10.7 points. Comparing the operated and contralateral wrist, the mean range of motion in flexion-extension was 144.7° and 150.5° ( P = 0.34), in prono-supination was 161.3° and 163° ( P = 0.54), and in radial and ulnar inclination was 49° and 52° ( P = 0.44), respectively. The grip strength was 98.8% for the contralateral side if the operated side was dominant and 82.4% if it was non-dominant. Comparing the operated wrist to the contralateral wrist, the mean volar tilt was 7.7° and 9° ( P = 0.09), the mean radial inclination was 21° and 21° ( P = 0.99) and the mean ulnar variance was −1.35 mm and −1.56 mm ( P = 0.6), respectively. There were four complications (12%) comprising two complex regional pain syndrome, one frozen shoulder and one De Quervain's tenosynovitis + however, each complication had a favorable evolution with conservative treatment. There was no material-related complication. Conclusion The PEEK volar locking plate was shown to be a safe and effective treatment for distal radius fractures. It restored and maintained acceptable reduction, and had a complication rate comparable to standard volar locking plates after a minimum of 6 months of follow-up.

Background In low-copy-number plasmids, the partitioning loci (par) act to ensure proper plasmid segregation and copy number maintenance in the daughter cells. In many bacterial species, par gene homologues are encoded on the chromosome, but their function is much less understood. In the two-replicon, polyploid genome of the hyperthermophilic bacterium Thermus thermophilus, both the chromosome and the megaplasmid encode par gene homologues (parABc and parABm, respectively). The mode of partitioning of the two replicons and the role of the two Par systems in the replication, segregation and maintenance of the genome copies are completely unknown in this organism. Results We generated a series of chromosomal and megaplasmid par mutants and sGFP reporter strains and analyzed them with respect to DNA segregation defects, genome copy number and replication origin localization. We show that the two ParB proteins specifically bind their cognate centromere-like sequences parS, and that both ParB-parS complexes localize at the cell poles. Deletion of the chromosomal parAB genes did not apparently affect the cell growth, the frequency of cells with aberrant nucleoids, or the chromosome and megaplasmid replication. In contrast, deletion of the megaplasmid parAB operon or of the parB gene was not possible, indicating essentiality of the megaplasmid-encoded Par system. A mutant expressing lower amounts of ParABm showed growth defects, a high frequency of cells with irregular nucleoids and a loss of a large portion of the megaplasmid. The truncated megaplasmid could not be partitioned appropriately, as interlinked megaplasmid molecules (catenenes) could be detected, and the ParBm-parSm complexes in this mutant lost their polar localization. Conclusions We show that in T. thermophilus the chromosomal par locus is not required for either the chromosomal or megaplasmid bulk DNA replication and segregation. In contrast, the megaplasmid Par system of T. thermophilus is needed for the proper replication and segregation of the megaplasmid, and is essential for its maintenance. The two Par sets in T. thermophilus appear to function in a replicon-specific manner. To our knowledge, this is the first analysis of Par systems in a polyploid bacterium. Electronic supplementary material The online version of this article (doi:10.1186/s12864-015-1523-3) contains supplementary material, which is available to authorized users.

Background Distal radius malunion is a major complication of distal radius fractures, reported in 0 to 33% of cases. Corrective osteotomy to restore normal anatomy usually provides improved function and significant pain relief. We report the outcomes in a case-series with special attention to the potential influence of the initial management. Material and methods This single-centre retrospective study included 12 patients with a mean age of 35 years (range, 14–60 years) who were managed by different surgeons. There were 8 extra-articular fractures, including 3 with volar angulation, 2 anterior marginal fractures, and 2 intra-articular T-shaped fractures; the dominant side was involved in 7/12 patients. Initial fracture management was with an anterior plate in 2 patients, Kapandji intra-focal pinning in 5 patients, plate and pin fixation in 2 patients, and non-operative reduction in 3 patients. The malunion was anterior in 10 patients, including 2 with intra-articular malunion, and posterior in 2 patients. Corrective osteotomy of the radius was performed in all 12 patients between 2005 and 2012. In 11/12 patients, mean time from fracture to osteotomy was 168 days (range, 45–180 days). The defect was filled using an iliac bone graft in 7 patients and a bone substitute in 4 patients. No procedures on the distal radio-ulnar joint were performed. Results All 12 patients were evaluated 24 months after the corrective osteotomy. They showed gains in ranges not only of flexion/extension, but also of pronation/supination. All patients reported improved wrist function. The flexion/extension arc increased by 40° (+21° of flexion and +19° of extension) and the pronation/supination arc by 46° (+13° of pronation and +15° of supination). Mean visual analogue scale score for pain was 1.7 (range, 0–3). Complications recorded within 2 years after corrective osteotomy were complex regional pain syndrome type I ( n = 1), radio-carpal osteoarthritis ( n = 3), and restricted supination due to incongruity of the distal radio-ulnar joint surfaces ( n = 3). This last abnormality should therefore receive careful attention during the management of distal radius malunion. Discussion In our case-series study, 3 (25%) patients required revision surgery for persistent loss of supination. The main error in these patients was failure to perform a complementary procedure on the distal radio-ulnar joint despite postoperative joint incongruity. This finding and data from a literature review warrant a high level of awareness that distal radio-ulnar joint congruity governs the outcome of corrective osteotomy for distal radius malunion.

The alarming pollution in rivers of basin, particularly in Dong Nai River Basin (DNRB), has become the major concerns for Vietnamese government for many past decades. However, the involvement of many localities and various sectors make it challenge for managing the water quality in DNRB. The role of national government proves to be more effectively in terms of improvement of water quality protection activities as well as other socio-economic development targets in the basin. Despite of some significant improvements, the inadequate resources and legal framework to address the issues makes their role become challenge. Several priority actions have been recommended as solutions to deal with the situation.

Introduction La reparation primaire par reinsertion transosseuse est la technique de reference pour le traitement des lesions aigues des ligaments collateraux de l’articulation metacarpophalangienne (MCP) du pouce. La reconstruction par differents types de ligamentoplasties ont ete decrits pour le traitement des lesions chroniques de plus de 3 semaines. L’hypothese de notre etude etait que la reinsertion transosseuse des lesions chroniques des ligaments collateraux de la MCP du pouce apportait des resultats fonctionnels comparables a ceux des lesions aigues. Materiel et methodes De 2010 a 2014, 34 patients ont eu une reinsertion transosseuse (31 par ancres et 3 par points transosseux) de ligaments collateraux de la MCP du pouce (30 ulnaires et 4 radiaux). Vingt presentaient une lesion aigue (groupe A) et 14 une lesion chronique (groupe C) avec respectivement un delai de prise en charge moyen de 10 jours (3–19) et de 202,5 jours (23–1477). Il s’agissait de 22 femmes et de 12 hommes, d’âge moyen de 42 ans (13–68). Au dernier recul, les amplitudes articulaires de la MCP, le score de Glickel et le Quick-DASH etaient evalues. Des radiographies standards etaient realisees afin d’evaluer les signes d’arthrose et les eventuelles complications liees a l’implant. Resultats Au recul moyen de 22 mois (6–61), tous les patients presentaient une MCP stable. La perte de mobilite moyenne en flexion–extension par rapport au cote controlateral etait de 4,5° et de 10° respectivement dans les groupes A et C ( p = 0,16). Le score de Glickel moyen etait de 18,7 points (16–20) dans le groupe A et de 18,1 points (9–20) dans le groupe C ( p = 0,41). Les resultats selon la classification de Glickel etaient dans le groupe A, excellents dans 17 cas et bons dans 3 cas ; dans le groupe C, ils etaient excellents dans 11 cas, bons dans 2 cas et mediocres dans 1 cas. Le Quick-DASH moyen etait de 3,7 points (0–27,2) et de 7,46 points (0–50) respectivement dans les groupes A et C ( p = 0,3). Au dernier recul, aucune complication liee a l’implant (migration, osteolyse) n’etait deploree. Il existait un cas d’arthrose MCP avec un score de Glickel mediocre a 9 points. Conclusion La plupart des auteurs recommandent une reconstruction ligamentaire pour le traitement des instabilites chroniques. Nous pensons que la reparation primaire est possible dans ces indications s’il persiste un moignon ligamentaire. En effet, notre etude retrouvait des resultats fonctionnels equivalents aux lesions aigues.

The demand for fresh water has increased over the years, it has also become the key source of many long-standing conflicts between regions in the same nation as well as between trans-boundary nations, leading to severe adverse consequences. In fact, different kind of water conflict has different causes and consequences shaped by political, social, cultural and economic context. Therefore, it is necessary to understand carefully the nature of these conflicts before looking for the appropriate solution to them. To understand more clearly about the conflict over sharing water in many parts of the world, this paper will look at a representative example of classic case of an upper riparian/lower riparian argument. This long-standing conflict has occurred between India and Bangladesh over the sharing trans-boundary Ganga River that is the most basic resource of economic development in both countries. After more than 50 years, this severe conflict is still on the way of threatening to the relationship regarding political and economic between two nations despite many efforts of resolving. Through this essay, the underlying causes and nature of water sharing conflict between India and Bangladesh will be explored, and then the essay will also analyze how this conflict has evolved over many decades in order to outline a comprehensive solution aim to reduce the water-sharing conflict between these two countries.

Introduction Pres de 400 fractures de l’extremite distale du radius sont operees tous les ans dans notre service de chirurgie orthopedique. Les complications en postoperatoire immediat sont rares. La paralysie medio-cubitale est une complication meconnue par le chirurgien. Materiel et methode Trois patients ont presente une paralysie medio-cubitale basse, constatee a la visite postoperatoire a j1. L’âge moyen de ces patients etait de 20 ans (15 ans, 16 ans et 30 ans). Dans chaque cas, aucun deficit preoperatoire n’etait retrouve. Pour le plus jeune, il s’agissait d’un accident sportif ayant cause une fracture Salter 2 du radius distal tres deplacee associee a une fracture distale du cubitus. Le patient de 16 ans a ete victime d’un accident de la voie publique. Il presentait une fracture Salter 2 isolee du radius distal, tres deplacee. Concernant le patient de 30 ans, un accident de la voie publique a provoque une fracture de l’extremite distale du radius Melone 4. Apres reduction aux urgences dans les 2 premiers cas, le delai de prise en charge etait respectivement de 3 h, 8 h, et 12 h. Dans tous les cas, il a ete realise une osteosynthese par plaque anterieure avec une duree moyenne d’intervention de 130 minutes. En cours de chirurgie, aucune lesion n’a ete retrouvee sur le nerf median. Le diagnostic de syndrome des loges n’a pas ete retenu car les patients etaient peu algiques et les loges de l’avant-bras souples a la palpation. Resultats A j15, cette paralysie medio-cubitale etait toujours presente. Les patients ont realise une electromyographie a 1 mois du traumatisme constatant une atteinte severe du nerf median et du nerf ulnaire. Le patient de 15 ans a beneficie a 6 semaines d’une neurolyse du nerf median et du nerf ulnaire. Au cours de cette intervention, aucune lesion ou fibrose n’a ete constatee. A 3 mois du traumatisme, la recuperation clinique a ete totale pour tous avec normalisation du trace electromyographique a 6 mois. Discussion La paralysie medio-cubitale est tres peu decrite dans la litterature. Elle represente une complication rare des fractures de l’extremite distale du radius. Elle survient dans un contexte de traumatisme a haute cinetique et ou de deplacement fracturaire important. Tout geste de neurolyse au vu de la litterature et de notre experience est inutile. La recuperation clinique est la regle, a 3 mois du traumatisme.

Introduction L’indication d’arthrodese totale de poignet est frequente dans les atteintes severes symptomatiques du poignet rhumatoide. L’atteinte destructrice de la premiere rangee des os du carpe rend difficile son avivement et son positionnement avec risque de retard de consolidation ou de pseudarthrodese. La resection de cette premiere rangee (RPRC) en cas d’atteinte severe a ete peu decrite dans le cadre de la polyarthrite rhumatoide. Les consequences de la perte de hauteur du carpe restent inconnues dans ce contexte. Le but de cette etude etait d’evaluer les resultats de l’arthrodese totale du poignet associee a la RPRC dans la polyarthrite rhumatoide et de determiner les effets de la perte de hauteur du carpe. Materiel et methode De 2005 a 2012, 36 patients (38 poignets) aux stades 4 ou 5 de Larsen ont eu une arthrodese totale de poignet avec RPRC et resection de tete ulnaire. La technique utilisee comportait la mise en place d’un clou centro-medullaire a partir du 2 e espace intermetacarpien, traversant le capitatum et le radius. Une fixation radio-carpienne par agrafes y etait associee. Au dernier recul, la douleur (EVA), le score Patient Rated Wrist Evaluation (PRWE), la force de prehension et la satisfaction etaient evalues. Les deformations digitales etaient analysees. La position et la consolidation de l’arthrodese etaient appreciees par un bilan radiographique standard. L’evaluation radiographique pre- et post-operatoire comprenait egalement la mesure de la hauteur du carpe par les indices de McMurtry et Youm et de Bouman et Senwald, le glissement ulnaire du carpe par l’index de Di Benedetto et l’inclinaison du poignet selon Shapiro. Resultats Au recul moyen de 50 mois, la douleur moyenne etait de 0,4 (0–7) sur l’EVA. Le score PRWE moyen etait de 21 (0–80,5). La force de prehension du membre opere rapportee au controlateral etait de 90 % en cas de cote opere dominant (50 % si non dominant). Trente-quatre patients (90 %) etaient satisfaits ou tres satisfaits. La position moyenne de l’arthrodese etait de 3,6 ± 6,1° d’extension et de 9,3 ± 7,5° d’inclinaison ulnaire. Le taux de consolidation etait de 92 %. Deux des 3 pseudarthrodeses ont necessite une reprise chirurgicale. Il n’a pas ete mis en evidence d’influence de la perte de hauteur du carpe sur les parametres cliniques et radiologiques evalues. Discussion Tout en apportant des resultats superposables aux donnees de la litterature, la realisation d’une RPRC associee a l’arthrodese presente de nombreux avantages : simplification de l’intervention ; un seul interligne articulaire a faire fusionner ; utilisation des os reseques comme greffon osseux. Les effets deleteres attendus tels que la perte de force ou l’apparition de deformations digitales n’ont pas ete rencontres. Conclusion L’arthrodese totale de poignet associee a la RPRC apporte des resultats equivalents aux techniques conventionnelles tout en simplifiant l’intervention.

Introduction La prothese de Coonrad–Morrey est utilisee en premiere intention dans la polyarthrite rhumatoide malgre son caractere contraint. Hypothese Le caractere contraint de la prothese ne compromet pas la survie au recul de l’implant dans cette indication. Materiel et methode De 1997 a 2012, 46 patients (54 coudes) ont beneficie d’une prothese totale de coude de Coonrad–Morrey et ont ete revus au recul minimum de 2 ans. Il s’agissait de 35 femmes pour 11 hommes de 60 ans (29–83) d’âge moyen au moment de l’intervention. Selon la classification de la Mayo Clinic, il existait 30 stade 3A, 21 stade 3B, et 3 stade 4. La technique chirurgicale etait identique dans tous les cas. Le coude etait maintenu en extension pendant 2 jours, puis les patients etaient autorises a mobiliser leur articulation. Aucune reeducation n’a ete prescrite. Resultats Au recul moyen de 7 ans (2–16), le MEPS atteignait 91 points (55–100) avec un score quick-DASH de 34 points (0–75). Quarante coudes etaient indolores et 10 ne presentaient qu’une douleur moderee. L’arc de mobilite en flexion etait de 110°A25 (23° de perte d’extension 135° de flexion). Quarante-cinq coudes presentaient une fonction normale. L’analyse radiographique retrouvait des liseres autour de l’implant humeral dans 6 cas, dont 3 complets, et autour de l’implant ulnaire dans 6 cas, dont 4 complets. L’usure des paliers en polyethylene au niveau de la charniere etait moderee dans 11 cas, et severe dans 5. Il existait une complications dans 14 cas (4 insuffisances du triceps, 3 atteintes du nerf ulnaire, 3 sepsis profonds, 1 fracture de l’ulna, 1 fracture d’un implant ulnaire descelle, et 2 descellements aseptiques - 1 bipolaire et 1 ulnaire), necessitant une revision dans 6 cas (ablation de la prothese dans 2 cas, changement total de la prothese dans 2 cas et uniquement au niveau de l’ulna dans 2 cas). Au recul maximal, 48 des 54 protheses initiales etaient en place, soit un taux de survie de 97 % a 5 ans, et 85 % a 10 ans et 15 ans. Discussion La prothese de Coonrad–Morrey donne des resultats satisfaisants dans la polyarthrite rhumatoide qui perdurent avec le recul malgre son caractere contraint. Les complications principales sont infectieuses lies au terrain et traitements particuliers de ces patients. L’apparition de liseres notamment autour de l’implant ulnaire et l’usure des paliers en polyethylene au niveau de la charniere semblent representees les elements vulnerables de cette prothese.

Introduction La crainte des complications ischemiques rend le traitement orthopedique par methode de Blount controverse dans les fractures supracondyliennes de l’humerus de l’enfant (FSH) de stades III et IV de Lagrange et Rigault. L’objectif de cette etude etait d’evaluer les resultats cliniques et radiographiques de la methode de Blount dans ces indications. Patients et methode Il s’agit d’une etude retrospective, monocentrique, de 2003 a 2013. L’evaluation clinique etait faite selon les criteres de Flynn. L’analyse radiographique comprenait la mesure de l’angle de Baumann, de l’angle d’anteversion epiphysaire, la ligne humerale anterieure et l’angle humero-ulnaire. Resultats Parmi les 447 enfants pris en charge pour une FSH types III ou IV, 339 enfants ont ete traites par la methode de Blount. Deux cent cinquante-quatre ont ete inclus dans l’analyse clinique et radiographique avec un suivi moyen de 36,8 mois. Quatre-vingt-cinq qui n’ont pas ete revus apres la consolidation ont ete inclus uniquement dans l’analyse radiographique. Il s’agissait de 173 garcons et 166 filles. L’âge moyen etait de 6 ans (1–14). Soixante et onze pour cent des FSH etaient de type IV. Le delai moyen de prise en charge etait de 5,7 heures. Les resultats cliniques selon les criteres de Flynn etaient satisfaisants dans 97 % des cas. Aucun syndrome des loges n’etait deplore. 16 deplacements secondaires avaient necessite une reprise chirurgicale a un delai moyen de 9 jours (1–15). Cinq patients avaient developpe une deformation en cubitus varus et n’avaient aucune consequence fonctionnelle ou esthetique. Il existait une tendance a la correction du cubitus varus avec le recul (p = 0,00025). Aucune modification de l’angle d’anteversion epiphysaire n’etait retrouve avec le recul. Au dernier recul, la ligne humerale anterieure croisait le tiers moyen ou la jonction tiers moyen-tiers posterieur du capitellum dans 96,7 % des cas et l’angle humero-ulnaire moyen etait de 8,7° IC95 % [7,84 + 9,62]. Conclusion Les indications du traitement par la methode de Blount peuvent etre etendues aux stades III et IV, a condition d’obtenir une reduction anatomique et stable. Les echecs sont le plus souvent dus a des erreurs d’indication. La surveillance clinique et radiologique doit etre rigoureuse afin d’eliminer le syndrome des loges et les deplacements secondaires.

Introduction La prevalence des lesions neurologiques apres mise en place d’une prothese totale d’epaule est estimee a 4 %. Cette valeur semble majoree pour les protheses inversees en raison de l’allongement secondaire de l’humerus. Nous proposons ici un travail original utilisant un appareil de mesure des tensions qui nous a permis de quantifier les phenomenes de traction induits au plexus brachial en fonction du positionnement de l’epaule et permettant de determiner les temps operatoires a risque lors de la mise en place d’une prothese inversee. Materiel d’etude Six epaules cadaveriques ont servi de base a ce travail. Methodes Les specimens etaient installes en position demi-assise. Apres realisation d’une voie d’abord delto-pectorale et liberation du grand pectoral, le plexus brachial etait expose en dedans du tendon conjoint. Un appareil de mesure de tension (tensiometres FK 50Ty, Sauter, Allemagne) etait positionne sur chacun des nerfs issu du plexus avant d’imprimer differentes combinaisons d’abduction (0°, 30°, 60°, 90°), de rotation externe (0°, 30°, 60°, 90°) de rotation interne (0°, 30°, 60°, 90°) et de retropulsion (30°, 45°). Finalement, une prothese totale d’epaule inversee etait mise en place et les variations de tensions en fonction des temps operatoire etaient consignees. Resultats La mise en rotation interne ou en retropulsion augmente la tension du nerf axillaire. La mise en place d’une prothese inversee sollicite le nerf radial et le nerf axillaire lors de : la mise en place d’un ecarteur autostatique entre le deltoide et le tendon conjoint ; la luxation de la tete humerale – la tension etant dependante de l’importance de la retropulsion ; l’exposition de la glene avec mise en rotation externe et en abduction de l’epaule ; la mise en place des implants – l’epaisseur du polyethylene conditionnant l’importance de la tension. Discussion Certaines precautions permettent de limiter le risque de lesions neurologiques lors de la mise en place d’une prothese totale d’epaule inversee. Ainsi, lors de l’exposition, les positions extremes et les ecarteurs peuvent etre a l’origine de lesions par traction. Une installation en position suffisamment demi-assise permet de limiter la retropulsion et les tractions qui en decoulent lors du temps de preparation humeral. Il faut enfin eviter de surdimensionner les implants. Conclusion La connaissance de ces temps operatoires a risque devrait permettre de diminuer l’incidence des complications neurologiques lors de la mise en place d’une prothese totale d’epaule.

Europium ion doped BaMgAl 10 O 17 blue phosphor nanopowder has been fabricated by urea–nitrate solution combustion synthesis at 590 °C for 5 min. These phosphors were codoped with different europium ion concentrations (1–8 mol%). The experimental results of x-ray diffraction (XRD), scanning electron microscopy (SEM) and photoluminescence showed that the phosphors have a hexagonal single phase structure, the average particle size of the powders was about 50 nm and the emission spectra have a broad band with maximum intensity at wavelength λ max =455 nm due to transitions from the 4f 65d 1 to the 4f 7 electronic configuration of Eu 2+ ion. The maximum emission of phosphor corresponds to the europium concentration 7 mol%.