Feeding cows with hay, silage, or fresh herbage on pasture or indoors affects sensory properties and chemical composition of milk and cheese

In European countries, silage-free feeding is an ancient tradition and has a particularly positive reputation among consumers. In the present study, we compared grass-based forages from the same plot conserved as hay or silage or fed fresh either on pasture or indoors, and we evaluated the differences in sensory properties of milk and uncooked pressed cheese. All herbage from the first cut of a grassland dominated by perennial ryegrass was harvested on the same day and preserved either as hay or silage. The first regrowth of the same plot was used for strip grazing or green feeding indoors. Balanced by breed, 24 Montbéliarde and 24 Holstein cows were allocated to the 4 treatments. Apart from the forages, the late-lactation cows received 3 kg/d of dry matter from concentrate. After 2 wk of dietary adaptation, the bulk milk of 3 subgroups, each with 4 cows, was collected. Part of the milk was pasteurized, and part was left raw and partly transformed to small-sized Cantal-type cheese ripened for 9 wk. Milk and cheese underwent descriptive sensory analysis by a trained sensory panel, as well as analyses of physicochemical traits. Volatile organic compounds of the cheeses were also analyzed. Raw and pasteurized milk from hay-fed cows had less intense odors of cooked milk, cream, and barnyard than milk from grazing cows, whereby the effect of pasteurization did not differ between herbage utilization methods. Cheeses obtained from cows fed fresh herbage (grazing and indoors) were clearly yellower than cheeses from silage- and hay-fed cows, which coincided with the color intensity perceived by the panelists. Moreover, cheeses from cows fed fresh herbage had more intense barnyard and dry fruit flavors, were perceived as creamier and having less lactic odor, and exhibited more fat exudation than those from cows fed conserved herbage. Only a few differences were observed in milk and cheeses from hay-fed compared with silage-fed cows, and those differences were far less pronounced than those of milk and cheeses from cows fed fresh herbage. In conclusion, the present study did not substantiate assumptions of clear sensory differences of milk and uncooked pressed cheese from hay-fed compared with silage-fed cows. For the first time, this study reports that the global flavor intensity of cheeses from indoor green-fed cows is similar to that of cheeses derived from cows fed conserved forages, whereas cheeses from grazing cows have the greatest global flavor intensity.

Consequences of walking or transport by truck on milk yield and quality, as well as blood metabolites, in Holstein, Montbéliarde, and Valdostana dairy cows

In the mountains, the traditional practice of transhumance is common in dairy production systems to make use of the high-altitude summer pastures. Although the effects of highland grazing have been intensively studied with respect to cow performance and milk and cheese quality, the actual moving of the animals to the highlands and the consequences of this stressor for performance and milk quality in the days immediately following transhumance has not been investigated in detail. The aim of the present study was to compare the effects of a 6-km walk (lasting 1.5 h) to those of a truck transport of 10.5 km (lasting 1 h), simulating cow movement in transhumance systems, as well as a control treatment in which cows were not moved. The experiment included 12 late-lactating Valdostana Red Pied, 12 Montbéliarde, and 12 Holstein cows (i.e., breeds contrasting in genetic merit for milk production). Each cow was subjected to each treatment in a 3-wk Latin square design. Milk yield was measured, and milk and blood samples were taken around the transhumance simulation events. Cows of the 3 breeds responded similarly to both movement treatments. Walking decreased milk yield by 1 kg/milking, but truck transport did not affect milk yield. Both treatments led to an increase in plasma nonesterified fatty acids and milk somatic cell count compared with controls, and truck transport increased milk fat content. Milk coagulation properties were better for Valdostana Red Pied and Montbéliarde cows than for Holstein cows but were not affected by walking or truck transport. Further studies aiming to compare the 3 breeds should include a wider range of response variables over a longer term, including reproduction performance and repeated transhumance.

Grazing behaviour of dairy cows on biodiverse mountain pastures is more influenced by slope than cow breed

The aim of this study was to determine how cows with different genetic merit behave and perform when grazing biodiverse and heterogeneous mountain pastures with different slopes. Three groups of 12 cows in late lactation, each composed of four Holstein, four Montbéliarde and four Valdostana Red Pied cows, breeds of increasing presumed robustness and decreasing milk yield (MY) potential. Cows grazed without concentrate either on a low-diversity flat pasture or on two species-rich mountainous pastures having slopes of either 7° or 22°. Milk yield, BW and grazing behaviour were monitored two times in the first and once in the second grazing cycle. Cows of different breeds had similar behaviour on all pastures. The Montbéliarde cows performed close to their production potential; Holstein and Valdostana cows produced less milk than anticipated. No breed difference in terms of BW loss was found. The Valdostana cows exhibited the least selective behaviour with respect to plant species and plant growth stage. Still, all cows searched for the most palatable vegetation regardless of pasture diversity. On the steep pasture, cows optimised the trade-off between ingesting and saving energy to obtain feed. They remained longer at the lowest zone and selected forbs, whereas cows on the flatter pasture went to the upper zone to select grasses. The present study gave no evidence for a superior short-term adaptation to harsh grazing conditions through an optimised feeding behaviour of the Valdostana breed compared to Montbéliarde and Holstein cows.

Meat and carcass quality of Dexter cattle compared with that of suckler, Charolais-cross calves: a preliminary study

Tenderness, flavour and colour are the most important quality traits of beef that are influenced by breed and age. Suckler calves (SC) produce very tender, high-quality meat. Extensively growing, small-framed breeds are known for high-quality beef, but information about the particularly small Dexter cattle (D) is yet unavailable. Eight D and seven Charolais-crossbreed SC were kept for 11 weeks on alpine pastures to be able to compare their meat quality. The SC were kept with their dams. The animals of the two breeds were slaughtered at different ages (D: 15 months and SC: 7 months) consistent with their respective production system conventions. Although this meant that age and breed effects were confounded, slaughter took place at the same carcass fatness score, thereby avoiding a confounding effect on meat quality. Quality of the carcass and of two muscles (M. biceps femoris, M. longissimus thoracis) was analysed. Despite being older, D had lower body and carcass weights, dressing percentage and bodyweight gains than SC. Dexter meat was darker than SC meat. Shear force did not differ between D and SC in the M. longissimus thoracis but was higher in the M. biceps femoris from D than from SC. Sensory analysis by a trained panel demonstrated an overall preference for D meat, associated with more favourable flavour and juiciness. Tenderness was not rated differently. Despite the unfavourable darker colour of D compared with SC meat, its characteristic flavour might attract consumers in a high-price niche market. For a more comprehensive characterisation, sensory evaluation of additional muscles is required. Additional measurements on a larger number of animals and muscles are required.

Technical note: Development and validation of an HPLC method for the quantification of tocopherols in different types of commercial cow milk

In the present study, a methanol-fluorescence-based HPLC method was validated for its use to quantify α-tocopherol and γ-tocopherol in raw milk, whole UHT milk, partially skimmed UHT milk, whole pasteurized milk, and partially skimmed pasteurized milk. Repeatability and reproducibility, calculated as relative standard deviation of 10 measurements within the same day and 30 measurements across 3 d, respectively, were always below 5% for both tocopherols concentrations and retention times. Recovery was assessed through 3 spiking levels and it ranged from 89 to 107%. The method was able to detect the expected declines in tocopherols in milk exposed to UHT or skimming treatments. Vitamin E, calculated as the sum of α-tocopherol and γ-tocopherol, was similar in whole pasteurized and raw milk, averaging 1.57 and 1.56 mg/L, respectively, followed by whole UHT (1.33 mg/L), partially skimmed pasteurized (0.77 mg/L), and partially skimmed UHT milk (0.61 mg/L).

Osteoid osteoma transformation into osteoblastoma: fact or fiction?

BACKGROUND

Osteoid osteoma and osteoblastoma are rare, benign, bone-forming tumours. The clinical presentation, imaging study findings, and course indicate clearly that these two tumours are distinct entities.

CLINICAL REPORTS

We report two cases suggesting transformation of osteoid osteoma into osteoblastoma and therefore inviting a discussion of the links between these two tumours. An 11-year-old girl with a small metaphyseal lesion of the proximal tibia was given a diagnosis of osteoid osteoma. Over the next few weeks, worsening pain and marked tumour growth prompted a biopsy, which was consistent with an aggressive osteoblastoma. A review of the case suggested primary osteoblastoma at the earliest stage of development. In a 14-year-old boy, en-bloc excision was performed to remove a 1cm defect located within the femoral shaft cortex and typical for osteoid osteoma. An asymptomatic recurrence measuring 20mm along the long axis was removed 18 months later. Reassessment of the histological slides indicated recurrence of an incompletely excised osteoid osteoma.

DISCUSSION

The histological similarities between osteoid osteoma and osteoblastoma, together with the lesion size criterion, may result in confusion. Collaboration between the clinician and pathologist is crucial and should take the tempo of evolution into account.

CONCLUSION

The histopathological differences between these two tumour types deserve to be emphasized. The data reported here challenge the concept that osteoid osteoma can transform into osteoblastoma. These two tumours are distinct entities that should no longer be differentiated based on size, as was long done in the past.

Neutron field characterisation at mixed oxide fuel plant

A neutron field characterisation was conducted at the AREVA Melox Plant to determine the response of passive and active neutron dosemeters for several stages in the mixed oxide fuel manufacturing process. Landauer Europe provides radiation dosimetry to many contractors working at the Melox site. The studies were conducted to assist in determining the neutron radiation fields the workers are exposed to routinely, evaluate the need for specific neutron correction factors and to ensure that the most accurate neutron dose is reported for the Melox Plant workers.

Prenatal diagnosis of congenital genu recurvatum following amniocentesis complicated by leakage

Congenital genu recurvatum (CGR) is an extremely rare condition observed at birth. It is associated with, among other malformations, genetic entities such as the Larsen syndrome. When CGR is isolated, orthopedic treatment will usually lead to a good functional prognosis. We report the first case of isolated CGR diagnosed prenatally and suspected to be a consequence of reduced amniotic fluid volume due to leakage following amniocentesis. The etiology and management options for CGR are briefly discussed.

Outcome of 27 patients with Hurler's syndrome transplanted from either related or unrelated haematopoietic stem cell sources

Over the last 15 years, we have performed a total of 30 haematopoietic stem cell transplants on 27 children suffering from Hurler's syndrome. These children were of median age 11 months at the time of diagnosis and 25 months at the time of transplantation. The phenotype was severe in 21 cases (78%). The donor was familial in 13 cases: nine genotypically identical, one phenotypically identical father and three HLA-mismatched donors. Unrelated donors were selected in 17 cases: four phenotypically identical and 13 with 1-4 HLA mismatches. The conditioning regimen generally consisted of busulphan 600 mg/m(2) plus cyclophosphamide (Endoxan) 260 mg/kg and cyclosporin with methotrexate for GvHD prophylaxis. Rabbit anti-thymocyte globulin (Thymoglobuline) was given for all unrelated or familial mismatched transplantations. The median nucleated cell dose infused was 6.00 x 10(8) TNC/kg. No bone marrow (apart from one) was T cell depleted. For first transplants, engraftment was observed in 23/27 patients (pts) (85%). Primary graft failure was observed in 4/27 patients (16%), two were retransplanted from an unrelated donor, one with success. Four patients have died. The primary cause of death was infection in three cases (TRM : 11%) and disease progression in one case, after primary graft failure. Of the 23 living patients, two have disease progression after graft failure and 21 (78%) have functional grafts with a favourable long-term outcome after a median follow-up of 4.7 years, having either full or mixed chimaerism. Among surviving patients with functional grafts, 13 (62%) were transplanted from unrelated donors of whom 10 (77 %) had HLA disparities. There was a remarkably low incidence of GvHD. In our experience, haematopoietic stem cell transplantation using an HLA-matched familial donor or an HLA-matched or -mismatched unrelated donor without T cell depletion or irradiation can achieve a favourable outcome in Hurler's syndrome, with improved cognitive function, but with a limited effect on the corneas and skeleton.

Management of purpura fulminans at the upper extremity

A multidisciplinary approach often is needed, especially at the acute phase. Indeed, resuscitative treatment is first indicated. [figure: see text] Optimal time for surgery depends on the patient's status. Surgical management should be more aggressive than previously thought. Debridement of necrotic tissue must be performed when the eschar has demarcated to avoid infection. Escharectomy can improve the vitality of the distal segments by releasing the compressive mechanical effect. In the same vein, early amputations are likely to reduce the need for secondary revisional surgery. Necrotic tissue over a joint should be excised early and procedures to provide coverage by flaps should be undertaken to avoid osteoarthritis. Late sequelae are dominated by skeletal growth disturbances and require specific procedures.

Paternity assessment in rhesus macaques (Macaca mulatta): multilocus DNA fingerprinting and PCR marker typing

Establishing kinship relations in primates using modern molecular genetic techniques has enhanced the ability to scrutinize a number of fundamental biological issues. We screened 51 human short tandem repeats (STRs) for cross-species PCR amplification in rhesus macaques (Macaca mulatta) and identified 11 polymorphic loci with heterozygosity rates of at least 0.6. These markers were used for paternity testing in three social groups (M, R, and S) of rhesus macaques from Cayo Santiago, Puerto Rico. Several consecutive birth cohorts were analyzed in which approximately 200 males were tested for paternity against more than 100 mother/ infant pairs. Despite a combined exclusion rate of more than 99.9% in all three groups, some cases could not be solved unequivocally with the STR markers and additional testing of the MHC-associated DQB1 polymorphism. A final decision became possible through multilocus DNA fingerprinting with one or more of the oligonucleotide probes (GATA)4, (CA)8, and (CAC)5. Paternity assessment by multilocus DNA analysis with probe (CAC)5 alone was found to have limitations in rhesus macaques as regards the number of potential sires which might be involved in a given case. Multilocus DNA fingerprinting requires large amounts of DNA, and the ensuing autoradiographic patterns present difficulties in comparisons across gels and even within the same gel across remote lanes. Computer-assisted image analysis was incapable of eliminating this problem. Therefore, a dual approach to DNA typing has been adopted, using STR markers to reduce the number of potential sires to a level where all remaining candidates can be tested by multilocus DNA fingerprinting on a single gel, preferably in lanes adjacent to the mother/infant pair.

Natal dispersal in rhesus macaques is related to serotonin transporter gene promoter variation

A VNTR polymorphism previously characterized in the promoter region of the human serotonin transporter (SLC6A4) gene was also found to segregate two major alleles (l and s) among the free-ranging rhesus macaques of Cayo Santiago, Puerto Rico. When VNTR genotypes were related to age at male natal dispersal on Cayo Santiago, ss homozygotes (43 of 532 males tested) were found to have left their natal groups significantly earlier (age 57.1 +/- 2.6 months) than carriers of the l allele (ll age, 71.5 +/- 2.1 months; ls age, 63.5 +/- 1.5 months; P = 0.0001). Since migration implies reproductive costs and benefits that change with age at dispersal, migration at an intermediate age might have conferred a heterozygote advantage serving to maintain the VNTR polymorphism via overdominant selection.

[Prevalence and morbidity of hip excentration in cerebral palsy: review of the literature]

PURPOSE OF THE STUDY

Excentration of the hip is one of the main orthopedic complications of ante and perinatal cerebral palsy. Excentration can progress to dislocation even if tenotomy is performed. What is the prevalence and morbidity of hip excentration?

METHODS

We reviewed the pertinent literature on the prevalence and morbidity of hip excentration in patients with cerebral palsy based on the Medline and Reedoc databases.

RESULTS

Data presented in the literature vary greatly. Populations are representative of the referral network of the teams reporting the study rather than the cerebral palsy population in general. Signs reported were pain, difficult nursing procedures, difficult sitting position, pressure sores and fractures, but only one sign can be taken fully into account: 50 p. cent of the dislocated hip joints were painful.

DISCUSSION

No one study gives a precise assessment of the prevalence of hip excentration and displacement and its consequences in patients with cerebral palsy. In a population of quadriplegic patients who do not walk, the question is whether complementary tenotomy should be performed, knowking the difficult operative and postoperative situation of such procedures. In this population, walking is an exceptional goal of bone surgery, pain relief and patient comfort are more common goals. Data in this literature (50 p. 100 of the dislocated hips are painful) suggest a prudent approach. However, there is no known marker which can be used to distinguish hips which will become painful from those which will remain pain free. In addition, irreversible cartilage degeneration can cause pain contraindicating reconstructive surgery.

Morphological evidence for a subpopulation selection effect by estrogen and antiestrogen treatments in the heterogeneous MCF-7 cell line

Recently, we developed a method to quantitatively study tumour cell heterogeneity in terms of both nuclear size and estrogen receptor (ER) content by image cytometry. The method, previously used to analyse the proliferation of the breast cancer cell line MCF-7, was applied here to analyse the growth of this cell line under estradiol (E2), hydroxytamoxifen (OH-TAM), and both E2 and OH-TAM treatments. The method extracts characteristic parameters of single nuclei and features that measure the global and local organisation of the cells in their growing phase. Modifications of the heterogeneity of the cell line are emphasised through phenotypic changes and modifications of the spatial organisation of the cells. The hormone (E2) generates a very fast growth of cells with small nuclei that became ER negative in the long term. The antihormone (OH-TAM) produces a gradual selection of ER negative or poorly positive cells with large nuclei. These modifications are reversed when E2 and OH-TAM are simultaneously used. Moreover, estradiol induces a permissive context of proliferation, whereas hydroxytamoxifen acts only on some subpopulations. The combination of cell count, cytomorphology, and cell organisation revealed the magnitude of the potential of structuration of hormones or antihormones on in vitro growing cells.

DNA sequence polymorphisms in genes involved in the regulation of dopamine and serotonin metabolism in rhesus macaques

A systematic search was performed for DNA sequence variation in genes regulating neurotransmitter metabolism in rhesus macaque (Macaca mulatta). These genes included dopamine and serotonin receptors and transporters, and tyrosine hydroxylase. A total of 13 single nucleotide polymorphisms in five different genes were identified, namely: DRD1 (-244T->G), q = 0.45; DRD1 (-179C->T), q = 0.19; DRD1 (-127G->A), q = 0.25; DRD1(-11T->G), q = 0.08; DRD1(-81C->T), q = 0.19; DRD3 (248G->A), q= 0.08; DRD3(341G->C), q = 0.11; DRD3(377A->G), q = 0.19; DRD3 (403C->T; A59V), q= 0.11; DRD4(2608G->A), q= 0.48; HTR1D(-506G->T), q = 0.47; HTR1D(-173C->T), q = 0.47; and HTT(340G->A), q = 0.39. The nucleotide positions listed correspond to the human homologs.

[Prenatal diagnosis of partial trisomy 9p]

The prenatal diagnosis of trisomy for the distal half of the short arm of n(o) 9 chromosome (partial trisomy 9p) has been realized from a morphologic ultrasound. A genetic investigation has permitted to establish that this trisomy was due to a bad segregation of a stable translocation present in the patient's mother. To our knowledge, the ultrasound prenatal diagnosis of partial trisomy 9p has never been reported in the literature. The prognosis of this syndrome remains very pejorative and the termination of pregnancy is the most often proposed solution.

[Pregnancy in women with a mechanical heart valve. Review of the literature]

AIM

To define therapeutic ways to manage obstetrics at an optimal level for a patient carrying a mechanical prosthetic heart valve.

METHOD

From a review of literature and documented cases, we propose an obstetrical and cardiological management scheme for pregnant patients carrying a mechanical prosthetic heart valve. We deal successively with the preventive (anticoagulation) and curative treatment (surgery and thrombolytic therapy) of valvular thrombosis, in fact, a severe -but unfortunately frequent- complication of these pregnancies.

RESULTS

Pregnancy concerning patients with mechanical prosthetic heart valves is a high-risk pregnancy. In fact, the risk of thrombo-embolic accidents even with a closely followed anticoagulant treatment seems to come from the existence of the prothese, the state of physiological hypercoagulation and peri-partum hemorrhages. Naturally, multidisciplinary follow-up is indispensable. The prescription of anticoagulant treatments must respect the main principals and the normal counter-indications in order to minimise maternal and fetal complications.

CONCLUSION

Pregnancy amongst patients carrying mechanical prosthetic heart valves should be considered rare and highly exceptional cases, from a cardio-vascular surgeon's point of view. For obstetricians, it is sometimes difficult to forbid pregnancy to a nullipara. The discussion whether to authorize a pregnancy will be treated case-by-case, holding into account the socio-cultural environment of the patient, as the principles of an anticoagulant treatment and the underlying risks must be well understood.

Selective neurotomy of the tibial nerve in the spastic hemiplegic child: an explanation of the recurrence

A series including 13 unilateral selective tibial neurotomies for spastic foot in hemiplegic children is reported. The results were considered excellent in three cases. Two cases needed additional corrective casts postoperatively. Eight cases had poor result with recurrence of the same deformity. The authors conclude that the effect of tibial neurotomy for spastic foot in hemiplegic children is transient in 61% of cases with a recurrence of the same deformity. Four of the patients with failed treatment underwent orthopedic surgery with muscle biopsies. Histologic data clearly demonstrate that previously denervated muscle fibers were reinnervated carrying into extensive motor units. This finding can explain the recurrence of the foot spasticity and deformity in neurotomized children.

Myotonic dystrophy and pregnancy. A report of two cases and a review of the literature

Myotonic dystrophy is a rare disease (1/8000), that is rarely associated with pregnancy, due to the fact that parents carrying the disease often encounter hypogonadism. Myotonic dystrophy is a neuro-endocrinian 'heredo-degenerative' dystrophy, with dominant autosomic transmission. Its association with pregnancy can lead to several problems. The myotony is often aggravated which leads to obstetrical complications turning into fetal loss, premature term delivery, hydrops, in-utero death, difficulties in expulsion, haemorrhage during delivery and/or anaesthetic accidents. The following signs during the pregnancy can diagnose fetal damage: presence of a hydrops, rare active fetal movements, and low fetal cardiac rhythm. They signify serious fetal damage leading to a diagnosis of myotonic dystrophy. Personal and family antecedents as well as an important hypotony and respiratory distress discovered in the new born are equally evocative elements. In congenital cases (6-30% of the time) the prognosis of the child is pessimistic. For all of the above elements, transmission is of maternal origin. The diagnosis of the congenital form is difficult because the disease is often unknown by the mother. The appearance of molecular tools permits a diagnosis to be formed much more rapidly in a new-born suspected to carry the illness of neonatal Steinert. Two observations illustrate this pathology. The occurrence of congenital myotonic dystrophy in a new-born allows us to diagnose the disease within the mother.

Pregnancy after myocardial infarction and a coronary artery bypass graft

The authors report a pregnancy in a 34 year old patient who previously experienced a myocardial infarction. The pregnancy ended at 39 weeks in the birth of a healthy girl weighting 3040 g, by cesarean section under epidural anesthesia. A review of the literature revealed 33 similar cases, 16 of which were adequately documented.

Early and semi-early surgery for scoliosis caused by hemivertebrae--indications and results

We report a series of 50 congenital scolioses due to hemivertebrae. This malformation was responsible for progressive deformity, largely predominant on the frontal plane. The average follow-up was 5 years and 3 months. Seven patients had mature bones. The series comprised 31 girls and 19 boys. Three types of operations were performed: (a) hemivertebrae resection (5 cases); (b) early, most posterior convexity fusion carried out before the age of 6 years (26 cases), and (c) semi-early convexity fusion performed between the ages of 6 and 12 years (19 cases). The results obtained in children with a more than 2 years' follow-up were: (a) early convexity fusion (18 cases): 7 epiphyseodesis effects, 6 graft effects and 4 failures; (b) semi-early convexity fusion (16 cases): 6 epiphyseodesis effects, 8 graft effects and 2 failures; (c) hemivertebrae resection (5 cases): moderate gain that remained stable in 4/5 cases.

Generalized thyroid hormone resistance: identification of an arginine to cystine mutation in codon 315 of the c-erb A beta thyroid hormone receptor

The present report studies a large kindred (WR) with generalized thyroid hormone resistance that has varying degrees of neuropsychological dysfunction, hyperactivity, poor attention span, decreased IQ and/or abnormalities in spatial perception. In this kindred, there has been found tight linkage of the syndrome with the c-erb A beta gene. The present study was performed to identify the presence of a possible gene mutation as a cause for this syndrome. DNA from peripheral leukocytes was isolated from 15 unaffected and 8 affected individuals from the kindred. Primers encompassing exons 9 (nucleotides 1171-1429) and 10 (nucleotides 1430-1698) were synthesized and used in PCR reactions to amplify these exons. Direct sequencing revealed a consistent substitution in each affected subject, but in none of the unaffected individuals, of a C to T change in one allele from nucleotide 1243, resulting in an arg to cys change in codon 315. The mutant and wild-type human beta 1 receptors were prepared and their translated proteins were analyzed for T3 binding. The WR T3 receptor from affected patients had reduced T3 binding affinity, with values approximately 2.5 x 10(10) M-1 compared to about 5 x 10(10) M-1 in normals. In summary, we have: i) identified a consistent and reproducible mutation of a C to T change in nucleotide 1243 in each of the affected but in none of the unaffected individuals of a large well characterized kindred with generalized thyroid hormone resistance; and ii) noted that the WR allele causes an approximate 50% decrease in the T3 binding affinity.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pygomelus. A single monster or a double monster?]

With an anatomical case and a clinical case, the authors describe the pygomelus, a very rare monstruosity. Legend and reality are often mixed in the description of literature. It is difficult to classify this monstruosity either in the simple monster or in the twin monsters.

Kingella kingae osteoarthritis and osteomyelitis in children

Kingella kingae is still a poorly understood germ which is responsible for osteoarticular infections. We observed nine cases of osteoarthritis involving K. kingae in children. They included 4 cases of arthritis, 2 of osteomyelitis, and 3 of spondylodiscitis. The germ was cultured in all cases by direct surgical approach or by needle aspiration of the septic locus. Evolution was always good after immobilization and nonspecific antibiotherapy. Our nine clinical cases, along with the few cases already published, allow us to state that K. kingae shows a strong affinity for bones and joints in the young child. Clinical presentation is nonspecific. The bacterial sampling must be cultured in enriched atmospheres (CO2). The strains are sensitive to most common antibiotics.

[Plant prickle arthritis in children. Apropos of 6 personal cases]

Six children with arthritis after penetration of a vegetable prickle into the joint are reported. The affected joints were the knee (5 fold) and the elbow (1 fold). The prickles were of palm-tree (2 cases), sloe-tree (2 cases) or unknown (2 cases) origin. The culture of the synovial fluid was negative and the diagnosis was based on microscopic examination of the centrifugated fluid. Four patients needed synovectomy.

[Congenital superior radioulnar synostoses. A study of 43 cases]

Superior radioulnar synostosis is a rare abnormality which frequently gives rise to functional disability. Its pattern of inheritance is uncertain. We have studied 29 children, 18 boys and 11 girls, who had a total of 43 such synostoses. Twenty children had significant functional disability. Fourteen required operation, 10 undergoing a Judet's osteotomy and 4 osteotomy of the lower end of the radius. The dominant hand was placed in the position of function, and the other in 30-40 degrees of supination. The osteotomies were secured by pins and supported in a plaster splint. Use of the forearm and hand was improved in all cases. Operation is best carried out between the ages of 4 and 10, and a useful functional improvement can be expected.

[Spina ventosa, a historic disease]

We report a case of tuberculous dactylitis--spina ventosa--in a 5 year-old girl from a French upper class family. Being today an unusual affection, the diagnosis of spina ventosa can be missed. Symptoms and means of diagnosis are reviewed.

The distribution of haemoglobin concentration in a sample of native high-altitude women

Two hundred and twenty-two indigenous women living in La Paz, Bolivia at an altitude of 3700 m were screened for the haematological parameters of haemoglobin, transferrin saturation, haematocrit and total iron-binding capacity. The data from 152 nonpregnant healthy women under 45 years of age were utilized in both distributional and maximum likelihood analyses in order to evaluate the prevalence of abnormal haemoglobin levels. The prevalence of anaemia and polycythaemia in the population was low and not considered to be a public health problem. Eleven per cent of the population was found to be iron deficient (less than 15% transferrin saturation).

[Corynebacterium acnes osteitis. A case in a child]

The authors report a case of Corynebacterium acnes osteitis in an 11 year old girl, involving the upper of the right tibia. The lesion resembled a malignant tumour radiologically and tuberculosis histologically. Scintigraphy revealed involvement of the seventh right rib. 3 months treatment with Pristinamycin resulted in cure.

[Idiopathic ostonecrosis of the scaphoid tarsal bone (Köhler's second disease)]

The authors report 9 cases of major radiological abnormality of the navicular bone, of which only 5 were cases of Köhler's disease. The diagnosis of this disease requires a combination of clinical and radiological signs, the isolated presence of radiological signs only represents abnormalities of ossification which are very common in this bone. The treatment is generally accepted to be plaster immobilisation, but its duration is a topic of debate, varying between 4 and 8 weeks, according to different authors.

[Sigmoid volvulus in children. About 6 cases (author's transl)]

About six of sigmoid volvulus m children, the authors underline the rarity of this etiology in large bowel obstruction. Two cases happened during neonate and four cases are associated with other pathologic diseases (2 neurologic ans 2 Hirschsprung diseases). Diagnosis is based on baryum enema and the best surgical management in emergency is resection and derivation with secondary anastomosis.

[Mesoblastic nephroma. Apropos of 6 cases]

6 cases of congenital mesoblastic nephroma removed surgically between 5 days and 2 months 1/2 of age are reported. The authors point out the peculiar histological aspect of this tumor : myomatous or fibromyomatous proliferation which surround in some places normal or dysplastic glomerular or tubular structures and penetrates by digitations in parenchymatous elements without destroying them. At the periphery of the tumor there are some lymphatic capsular ectasia or lymphoid infiltration or cartilaginous islets. In case of a renal tumor of the newborn or infant they emphasize the necessity to search for a congenital mesoblastic nephroma in order to avoid all types of radio therapic or chimiotherapic treatment without histological diagnosis. These forms of therapy are responsible for severe complications heavily impairing a prognosis which in most cases is an excellent one when nephrectomy alone is carried out. In some exceptional cases it seems useful to add other forms of therapy when the tumor proves itself to be of a peculiar aggressivity macro or microscopically.