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Resume L’etude a compare les proprietes mecaniques de l’os trabeculaire humain cryoconserve avec une nouvelle allogreffe issue de tissu humain traitee par Osteopure™. Nous avons utilise une procedure de test par compression, non destructive, sur trois faces orthogonales (70 echantillons 10x10x10 mm provenant de tetes femorales humaines). Les tests mecaniques ont ete appliques sur les echantillons frais et apres la procedure de nettoyage Osteopure™ et de sterilisation. Des tests destructifs ont finalement ete appliques suivant la direction axiale et les resultats compares a ceux d’un groupe controle (31 echantillons). Les courbes contrainte-deformation obtenues pour les echantillons traites ne differaient pas significativement de celles observees pour des echantillons cryoconserves humains. Les modules de Young obtenus, aussi bien pour les procedures non-destructives (os frais, degraisse et apres sterilisation) que destructives (os frais et apres sterilisation) n’ont pas ete significativement differents (respectivement 183 ± 71, 192 ± 96, 202 ± 92 et 325 ± 200, 311 ± 92 MPa). La force maximale de rupture etait de 6,62 ± 3,58 MPa pour les os traites par Osteopure™ et de 9,94 ± 2,74 MPa pour les os cryoconserves. Les proprietes mecaniques de l’os cryoconserve ne sont pas significativement modifiees par le traitement Osteopure™ en particulier en ce qui concerne le module de Young, autorisant un bon comportement mecanique et fonctionnel du greffon.

The purpose of this study was to find if the performance of the vertical jump is improved by the result of increasing the force, velocity, and muscle adaptation(s). For the experiment, there were four groups (Gr): three groups did the training programs and the fourth group was the control group (CG). In order to establish improvements in force and velocity, the groups performed three variations using eccentric (Ecc) and concentric (Con) movement. Finally, the leg presses, squat jumps (SJ) and countermovement jumps (CJ) were used to determine the changes in the muscle adaptations before and after the training program. For measuring the force, four force transducers were used. In determining the velocity, a displacement transducer was used. A surface EMG was used to measure the muscle activations during all of the tests that were performed. After eight weeks of training, Gr 1 and Gr 2 improved the isometric force and the power during the Con. movement for the leg press. For the SJ, Gr. 1 and 2 increased their height, muscle activity, force, and power, but only group one improved the velocity. However, group three improved the isometric force and power for the leg presses, the squat jump and the countermovement jump. For both of the jumps, they also increased velocity, muscle activity and height. There were no changes observed for group four. Although the three combinations of Ecc/Con movements existed during the training program, the force, velocity and muscle adaptations increased, but not all of the improvements were of the same degree.

The arteries and veins of the left vagus (VN) and left recurrent laryngeal (RLN) nerves from the thoracic inlet to the subaortic region are described following vascular casting with red colored latex in 6 adult fresh non-embalmed cadavers. In all specimens the anterior bronchoesophageal artery supplied at least one vessel to the VN and RLN in the subaortic region. For the RLN other arterial sources were arteries arising from the aortic arch in 1 specimen, the subclavian artery in 3 specimens, the first intercostal artery in 1 specimen, and the inferior thyroid artery in all specimens. For the VN other arterial sources were arteries arising from the aortic arch in 2 specimens and the inferior thyroid artery in 1 specimen. For both the VN and RLN the veins were located under the pleura and directed towards the internal thoracic vein anteriorly and the thoracic intercostal veins posteriorly. In conclusion, the inferior thyroid artery at the thoracic inlet for the RLN and the anterior bronchoesophageal artery are the more consistent vessels supplying the VN and RLN. Vascular damage occurring during mediastinal lymph node excision to the VN and RLN, especially in the subaortic region, may explain postoperative vocal fold paralysis.

The development of new leisure activities such as walking has spread the use of the backpack as a means of carrying loads. The aim of this work was to present a way of defining the movements imposed on the trunk by this type of load carrying. A 20 kg load situated at the thoracic level (T9) of the trunk, was placed in a backpack (2.5 kg). The 12 subjects were average mountain guides of Auvergne region, intermediate level and complete beginners. External markers were glued to the projecting contours of the spinous processes of the C7, T7, T12, L3 and S1 vertebrae, the shin and the external occipital tuberosity (EOT). Using a Vicon 140 3-D system we measured the effective mobility of the different spinal segments in the sagittal plane during one step. For every subject, we noticed a significant decrease of the effective inter-segmental mobility (EISM) between S1-L3-T12 (p < .01) while backpacking a 22.5 kg load. A decrease of EISM also appeared at the next level between L3-T12-T7 (p < .05). An increase of the EISM between T7-C7-EOT was noted (p < .05). We supposed that strength loss of the back muscles and/or angular oscillations of the trunk could be a common cause of symptoms during backpacking. The subjects using this type of load carrying have to adopt an adequate position of the lumbar, dorsal and cervical vertebrae.

La pathologie tumorale colorectale de l'enfant est dominee classiquement par les polypes juveniles hamartomateux qui constituent, selon Duhamel [5], l'affection proctologique la plus courante dans cette categorie d'âge. Toutefois, une telle pathologie reste exceptionnelle chez le nourrisson et avant l'âge de 2 ans. C'est pourquoi la decouverte d'une masse polypoide exteriorisee a la marge de l'anus, soit en permanence, soit au decours de la defecation, chez le tres jeune enfant, constitue le plus souvent une surprise d'examen. Dans notre pratique, nous avons ete confrontes 13 fois a une telle eventualite et, d'apes notre experience, ces tumeurs cliniquement monomorphes se sont revelees tres differentes a l'examen histopathologique. Cette heterogeneite des lesions et leur caractere inhabituel expliquent sans doute l'extreme pauvrete de la litterature medicale consacree a ce sujet, puisqu'il semble que l'article [13], ou nous avons tente une etude synthetique d'ensemble, soit completement original.

Finite element modelling of the human lumbar vertebral column employs data-processing procedures for study of the linear and nonlinear elasticity of materials such as are currently used in mechanics or in civil engineering. Thanks to developments in computer science, requiring a close collaboration between doctors and engineers, we put forward in this preliminary study a linear computerised model of the lumbar column comprising 4824 meshes and 6813 nodes. By reducing the simplificatory hypotheses and integrating new parameters, this model as developed is capable of important clinical applications in surgery and ergonomics.

Opto-electronic systems utilising measurement of displacement of skin markers allows study of movement in the living subject. The authors have used this method in a kinematic study of the thoracic and lumbar spine measuring the displacement of skin markers placed over the spinous processes. It was possible to approach the physiological state of these complex movements once the apparatus had been calibrated to the correct level, and the error margins minimised. Repeated measurements confirmed the reliability of this method even if movement of the skin with respect to the bony reference points introduced some margin of error. Three dimensional displacement of the vertebrae were measured during voluntary movements of the spine demonstrating the complex geometry. Since opto-electronics are non-invasive they constitute an important advance in the study of the kinematics of the spine.

The infratemporal fossa and its contents (particularly the pterygoid muscles) is a region difficult to explore, in spite of its importance in odontostomatological pathology. In order to reduce the indications that justify examination by computed tomography and magnetic resonance imaging, for reasons of economy of health, the authors describe by application of orientated anatomical slices the way in which ultrasonography can be performed. Only the posterior approach between the mandible laterally and the mastoid process medially provided consistently adequate exploration of the infratemporal fossa and the pterygoid muscles.

Depuis le debut des annees 1975, des travaux americains (2, 4, 5, 7, 9, 10) ont attire l'attention sur les dangers encourus par les enfants en raison du developpement intensif du machinisme dans ce pays a forte industrialisation agricole. Ce n'est que plus recemment que des equipes francaises se sont interessees a ces lesions graves, tant du point de vue vital que par leurs sequelles (6, 11). Notre experience a ete rapportee dans une publication recente (12). La frequence de ces lesions, a la lecture des faits divers des journaux, est probablement plus importante que ne le laisse supposer la litterature medicale. Un colloque organise le 11 octobre 1990 par le CIRPAE (Centre d'information et de rencontre pour la prevention des accidents d'enfants) a permis une confrontation entre les differentes categories de professionnels concernees. A la lumiere de notre experience, cet article a pour but d'attirer l'attention sur ce type d'accident responsable de nombreux deces par an et de sequelles tres invalidantes. Si la therapeutique des lesions constituees reste cas d'espece, nous souhaitons mettre en valeur l'importance d'un transport primaire medicalise par les SAMU et l'imperieuse necessite de mesures prophylactiques individuelles et collectives destinees a prevenir ces accidents.

This work studied the development of the ventral part of Meckel's cartilage and its relationship to the morphogenesis of the mandible in a series of human fetuses. The development of the cartilage was followed up to the end of the embryonic period (stage 23, 8th week) when the primary ossification centre, which was formed from a condensation of embryonic mesenchyme, had become two bony plates forming a trough in which lay the neurovascular bundle. From this trough invagination of the bony plate formed the dental crypt. The primary ossification centre disappeared around the sixth month of fetal life.

According to the ultrasound and MRI findings, supported by planned dissections, the female perineum is organised around the musculofascial system converging towards the fibrous structure of the central perineal tendon (CPT). Behind the CPT the fascial layers form part of a fibrous assembly extending from the ventral surface of the sacrum to the anal complex, prolonging the direction of the sacral concavity downwards and forwards. On the other hand, in front of the CPT the fasciae fuse to form two aponeurotic bands circumscribing the urogenital fossa. The fascial system is reinforced cranially by the structures of the hypogastric sheath and the uterosacral ligaments. The weak point of the urogenital fossa is partly filled by the urethral-clitoridal-vulvar complex. The perineum so formed plays a cardinal role in stabilising the pelvic viscera. Stress is placed on the firmness of the posterior perineum, a key element in pelvic stability. The posterior perineum is often involved in pathological conditions and a good acquaintance with these structures is essential in defining therapeutic indications.

The authors have studied the relationship between anatomic and CT sections of the lateral pterygoid muscle in 39 anatomic specimens. Good superimposition of the images was found, which seems important in neoplastic invasion of the infratemporal fossa and which may lead to a pathogenic interpretation of the algo-dysfunctional syndrome of the masticatory apparatus.

Cette etude confirme que les sujets utilisant ce moyen de transport de charge doivent adopter une position adequate des vertebres cervicales, thoraciques et lombaires. Pour chaque sujet, on note une diminution significative de leur EISM thoracique et lombaire, mais les oscillations de la colonne vertebrale sont differentes suivant le niveau d'expertise des sujets. Par rapport aux sujets novices qui sont sensibles a la charge transportee, les sujets experts maintiennent un meilleur controle de leur nouvelle posture en diminuant les oscillations du tronc. Ce comportement postural des sujets experts peut etre explique par une reponse volontaire, consequence d'un developpement et d'un entrainement musculaire. Cette adaptation de la posture peut s'averer necessaire afin d'ameliorer la performance et la protection des epaules ainsi que de la colonne vertebrale lors d'un port de charge par sac-a-dos.