Search

During therapeutic treatment with heavy ions like carbon, the beam undergoes nuclear fragmentation and secondary light charged particles, in particular protons and a particles, are produced. To estimate the dose deposited into the tumors and the surrounding healthy tissues, an accurate prediction on the fluences of these secondary fragments is necessary. Nowadays, a very limited set of double differential carbon fragmentation cross sections are being measured in the energy range used in hadron therapy (40 to 400 MeV/nucleon). Therefore, new measurements are performed to determine the double differential cross section of carbon on different thin targets. This work describes the experimental results of an experiment performed on May 2011 at GANIL. The double differential cross sections and the angular distributions of secondary fragments produced in the 12C fragmentation at 95 MeV/nucleon on thin targets (C, CH2, Al, Al2O3, Ti, and PMMA) have been measured. The experimental setup will be precisely described, the systematic error study will be explained and all the experimental data will be presented. [ABSTRACT FROM AUTHOR]

Nanoparticle's success as drug delivery systems for cancer treatment has been achieved through passive targeting mechanisms. However, tumor heterogeneity and rapid drug clearance limit the treatment efficacy. Improved outcomes and selective drug release can be achieved by grafting ligands at the surface of nanocarriers that bind molecules overexpressed in the tumor microenvironment (TME). In this work, we developed a docetaxel-loaded nanoemulsions (NEs) binding an anti-netrin-1 monoclonal antibody (NP137) to selectively target the netrin-1 protein overexpressed in many different tumors. The goal is to refine a combined approach utilizing NP137 and docetaxel as an improved tumor-targeting chemotherapeutic agent for addressing triple-negative breast cancer (TNBC). Several factors have been considered for the optimization of the active targeted drug delivery system via the click-chemistry conjugation, as the impact of PEGylated surfactant that stabilize the NEs shell on conjugation efficiency, cytocompatibility with EMT6 cell line and colloidal stability over time of NEs. Results showed that a 660 Da PEG chain length contributed to NEs colloidal stability and had no impact on cell viability or on the antibody binding ability for its ligand after surface conjugation. Moreover, docetaxel was encapsulated into the oily core of NEs, with an encapsulation efficiency of 70 %. To validate our treatment strategy in vivo, the 4T1 murine breast cancer model was used. As a result, the comparison of active-targeted and non-targeted NEs revealed that only active-targeted NE could decrease the tumor growth rate., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Giovanna Lollo reports financial support and equipment, drugs, or supplies were provided by University Claude Bernard Lyon 1 - Campus Rockefeller. Benjamin Gibert reports financial support and equipment, drugs, or supplies were provided by Cancer Research Centre Lyon. Ilaria Marigo reports financial support and equipment, drugs, or supplies were provided by Veneto Oncology Institute. Patrick Mehlen declares to have a coflict of interest as shareholder of Netris Pharma. The other authors declare that they have no financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

In Gram-positive bacteria, cell wall polysaccharides (CWPS) play critical roles in bacterial cell wall homeostasis and bacterial interactions with their immediate surroundings. In lactococci, CWPS consist of two components: a conserved rhamnan embedded in the peptidoglycan layer and a surface-exposed polysaccharide pellicle (PSP), which are linked together to form a large rhamnose-rich CWPS (Rha-CWPS). PSP, whose structure varies from strain to strain, is a receptor for many bacteriophages infecting lactococci. Here, we examined the first two steps of PSP biosynthesis, using in vitro enzymatic tests with lipid acceptor substrates combined with LC-MS analysis, AlfaFold2 modeling of protein 3D-structure, complementation experiments, and phage assays. We show that the PSP repeat unit is assembled on an undecaprenyl-monophosphate (C 55 P) lipid intermediate. Synthesis is initiated by the WpsA/WpsB complex with GlcNAc-P-C 55 synthase activity and the PSP precursor GlcNAc-P-C 55 is then elongated by specific glycosyltransferases that vary among lactococcal strains, resulting in PSPs with diverse structures. Also, we engineered the PSP biosynthesis pathway in lactococci to obtain a chimeric PSP structure, confirming the predicted glycosyltransferase specificities. This enabled us to highlight the importance of a single sugar residue of the PSP repeat unit in phage recognition. In conclusion, our results support a novel pathway for PSP biosynthesis on a lipid-monophosphate intermediate as an extracellular modification of rhamnan, unveiling an assembly machinery for complex Rha-CWPS with structural diversity in lactococci., Competing Interests: Conflicts of interest C. C. is an employee of Alphagraphix (cambillau.alphagraphix@gmail.com). Authors and Alphagraphix declare that they have no competing interests. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Lactococcus lactis and Lactococcus cremoris are Gram-positive lactic acid bacteria widely used as starter in milk fermentations. Lactococcal cells are covered with a polysaccharide pellicle (PSP) that was previously shown to act as the receptor for numerous bacteriophages of the Caudoviricetes class. Thus, mutant strains lacking PSP are phage resistant. However, because PSP is a key cell wall component, PSP-negative mutants exhibit dramatic alterations of cell shape and severe growth defects, which limit their technological value. In the present study, we isolated spontaneous mutants with improved growth, from L. cremoris PSP-negative mutants. These mutants grow at rates similar to the wild-type strain, and based on transmission electron microscopy analysis, they exhibit improved cell morphology compared to their parental PSP-negative mutants. In addition, the selected mutants maintain their phage resistance. Whole-genome sequencing of several such mutants showed that they carried a mutation in pbp2b , a gene encoding a penicillin-binding protein involved in peptidoglycan biosynthesis. Our results indicate that lowering or turning off PBP2b activity suppresses the requirement for PSP and ameliorates substantially bacterial fitness and morphology. IMPORTANCE Lactococcus lactis and Lactococcus cremoris are widely used in the dairy industry as a starter culture. As such, they are consistently challenged by bacteriophage infections which may result in reduced or failed milk acidification with associated economic losses. Bacteriophage infection starts with the recognition of a receptor at the cell surface, which was shown to be a cell wall polysaccharide (the polysaccharide pellicle [PSP]) for the majority of lactococcal phages. Lactococcal mutants devoid of PSP exhibit phage resistance but also reduced fitness, since their morphology and division are severely impaired. Here, we isolated spontaneous, food-grade non-PSP-producing L. cremoris mutants resistant to bacteriophage infection with a restored fitness. This study provides an approach to isolate non-GMO phage-resistant L. cremoris and L. lactis strains, which can be applied to strains with technological functionalities. Also, our results highlight for the first time the link between peptidoglycan and cell wall polysaccharide biosynthesis., Competing Interests: The authors declare no conflict of interest.

Oral administration of nanoparticles (NPs) is a promising strategy to overcome solubility and stability issues of many active compounds. However, this route faces major obstacles related to the hostile gastrointestinal (GI) environment, which impairs the efficacy of orally administered nanomedicines. Here, we propose nanocomposites as a promising approach to increase the retention time of NPs in the intestinal tract by using bio- and mucoadhesive matrixes able to protect the cargo until it reaches the targeted area. A microfluidic-based approach has been applied for the production of tailored nanoemulsions (NEs) of about 110 nm, used for the encapsulation of small hydrophobic drugs such as the anti-inflammatory JAK-inhibitor tofacitinib. These NEs proved to be efficiently internalized into a mucus-secreting human intestinal monolayer of Caco-2/HT29-MTX cells and to deliver tofacitinib to subepithelial human THP-1 macrophage-like cells, reducing their inflammatory response. NEs were then successfully encapsulated into alginate hydrogel microbeads of around 300 μm, which were characterized by rheological experiments and dried to create a long-term stable system for pharmaceutical applications. Finally, ex vivo experiments on excised segments of rats' intestine proved the bioadhesive ability of NEs embedded in alginate hydrogels compared to free NEs, showing the advantage that this hybrid system can offer for the treatment of intestinal pathologies.

Rhamnose-rich cell wall polysaccharides (Rha-CWPSs) have emerged as crucial cell wall components of numerous Gram-positive, ovoid-shaped bacteria-including streptococci, enterococci, and lactococci-of which many are of clinical or biotechnological importance. Rha-CWPS are composed of a conserved polyrhamnose backbone with side-chain substituents of variable size and structure. Because these substituents contain phosphate groups, Rha-CWPS can also be classified as polyanionic glycopolymers, similar to wall teichoic acids, of which they appear to be functional homologs. Recent advances have highlighted the critical role of these side-chain substituents in bacterial cell growth and division, as well as in specific interactions between bacteria and infecting bacteriophages or eukaryotic hosts. Here, we review the current state of knowledge on the structure and biosynthesis of Rha-CWPS in several ovoid-shaped bacterial species. We emphasize the role played by multicomponent transmembrane glycosylation systems in the addition of side-chain substituents of various sizes as extracytoplasmic modifications of the polyrhamnose backbone. We provide an overview of the contribution of Rha-CWPS to cell wall architecture and biogenesis and discuss current hypotheses regarding their importance in the cell division process. Finally, we sum up the critical roles that Rha-CWPS can play as bacteriophage receptors or in escaping host defenses, roles that are mediated mainly through their side-chain substituents. From an applied perspective, increased knowledge of Rha-CWPS can lead to advancements in strategies for preventing phage infection of lactococci and streptococci in food fermentation and for combating pathogenic streptococci and enterococci., Competing Interests: Conflict of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Ion sensitive field effect transistors (ISFETs) form a very attractive solution for wearable sensors due to their capacity for ultra-miniaturization, low power operation, and very high sensitivity, supported by complementary metal oxide semiconductor (CMOS) integration. This paper reports for the first time, a multianalyte sensing platform that incorporates high performance, high yield, high robustness, three-dimensional-extended-metal-gate ISFETs (3D-EMG-ISFETs) realized by the postprocessing of a conventional 0.18 μm CMOS technology node. The detection of four analytes (pH, Na + , K + , and Ca 2+ ) is reported with excellent sensitivities (58 mV/pH, -57 mV/dec(Na + ), -48 mV/dec(K + ), and -26 mV/dec(Ca 2+ )) close to the Nernstian limit, and high selectivity, achieved by the use of highly selective ion selective membranes based on postprocessing integration steps aimed at eliminating any significant sensor hysteresis and parasitics. We are reporting simultaneous time-dependent recording of multiple analytes, with high selectivities. In vitro real sweat tests are carried out to prove the validity of our sensors. The reported sensors have the lowest reported power consumption, being capable of operation down to 2 pW/sensor. Due to the ultralow power consumption of our ISFETs, we achieve and report a final four-analyte passive system demonstrator including the readout interface and the remote powering of the ISFET sensors, all powered by an radio frequency (RF) signal.

Wearable systems could offer noninvasive and real-time solutions for monitoring of biomarkers in human sweat as an alternative to blood testing. Recent studies have demonstrated that the concentration of certain biomarkers in sweat can be directly correlated to their concentrations in blood, making sweat a trusted biofluid candidate for noninvasive diagnostics. We introduce a fully on-chip integrated wearable sweat sensing system to track biochemical information at the surface of the skin in real time. This system heterogeneously integrates, on a single silicon chip, state-of-the-art ultrathin body (UTB) fully depleted silicon-on-insulator (FD-SOI) ISFET sensors with a biocompatible microfluidic interface, to deliver a "lab-on-skin" sensing platform. A full process for the fabrication of this system is proposed in this work and is demonstrated by standard semiconductor fabrication procedures. The system is capable of collecting small volumes of sweat from the skin of a human and posteriorly passively driving the biofluid, by capillary action, to a set of functionalized ISFETs for analysis of pH level and Na + and K + concentrations. Drop-casted ion-sensing membranes on different sets of sensors on the same substrate enable multiparameter analysis on the same chip, with small and controlled cross-sensitivities, whereas a miniaturized quasireference electrodes set a stable analyte potential, avoiding the use of a cumbersome external reference electrode. The progress of lab-on-skin technology reported here can lead to autonomous wearable systems enabling real-time continuous monitoring of sweat composition, with applications ranging from medicine to lifestyle behavioral engineering and sports.

Anterior lumbar spine approaches may be indicated for fusion in degenerative lumbar spine disorders or to fill discal and bone gaps after fracture reduction. We present an anterior extraperitoneal approach applicable to any discal and vertebral levels from T12 to S1. The anatomic study, based on 25 cadavers, highlights retroperitoneal dissection principles for easy kidney and duodenopancreatic mobilisation and direct left anterior access to the entire lumbar spine. We established a precise description of the lumbar veins and the anastomoses between the left renal vein and hemiazygos system, in order to define different topographic and anatomic factors related to safe and easily reproducible approaches for cage or graft implementation. Independent of the level and previous intraperitoneal surgery, lumbar spine access with this approach safeguards the kidney, ureter, spleen, hypogastric plexus and duodenopancreatic system. Regarding operating time, blood-loss and possibilities for freshening and grafting, this technique seems an effective counterbalance to the difficulties and complex technology of endoscopic approaches. The clinical study includes our first 42 cases in traumatic and degenerative lesions. Avoiding the neurologic or hemorrhagic risk inherent in classical posterior lumbar interbody fusion (PLIF) techniques, it can be considered as a reasonable and valid alternative. This technique could be used in the near future for mini invasive discal prosthesis insertion.

The deformations and stresses acting on the acetabular rim have not been very precisely documented. The authors present a study based on an experimental simulation of hip loading with anatomic correlations. 122 dissections were performed in order to define the anatomic aspect of the roof (and especially of Byers's "area 17") and the intermediate area between the anterior and posterior acetabular cornua. Ten fresh cadavers were tested on the lines of previous studies on monopodal or bipodal loading. An extensometric study was performed with special attention to the transverse acetabular ligament, supra-acetabular area and obturator foramen. The area 17 of Byers is a transitional zone and the mobility of the posterior cornu is 3 times that of the anterior cornu. Resection of the acetabular ligament modifies the displacement of the posterior cornu under loading but has no influence on deformation of the oburator foramen. The biomechanical behavior of the acetabular roof in the standing position is influenced by the conditions of monopodal or bipodal loading and by femoral rotation, but a tendency to extrusion was constantly noted.

Background: High-resolution magnetic resonance imaging (MRI) of subungual glomus tumors has been recently reported., Objective: Our purpose was to compare high-resolution MRI and standard MRI for the diagnosis of 44 glomus tumors of the toes and fingertips., Methods: Glomus tumors (11 cases) were first examined by MRI with a commercial surface coil (set 1). Thirty-three other glomus tumors and one tumor from set 1 were then examined with a high-resolution module designed for skin imaging (set 2)., Results: All 44 glomus tumors were identified with MRI. The limits of the tumors were detected in 54% of set 1 and 100% of set 2. A capsule was present in most cases, but was incomplete or absent in eight cases. Subtypes of glomus tumors were more easily differentiated in set 2., Conclusion: Standard MRI was adequate to detect glomus tumors, but high-resolution MRI assessed tumor characteristics more accurately.

Purpose: To assess the usefulness of magnetic resonance (MR) imaging in the diagnosis and clarification of the physiopathology of digital mucoid cysts., Materials and Methods: Twenty-three patients (14 women, nine men; aged 52-75 years) with mucoid cysts underwent MR imaging at 1.5 T with a local surface gradient coil. The pixel size was 117 microns in one direction. T2 relaxation times were measured. Contrast material was intravenously administered in 15 patients., Results: All mucoid cysts had high signal intensity and sharp borders on T2-weighted images. Intracystic septa were present in nine patients (39%). Most cysts were solitary (n = 13) and/or in the proximal nail fold (n = 16). Satellite cysts were present in five patients. Nineteen patients (83%) had cysts with pedicles that extended to the joint. Osteoarthritis of the distal interphalangeal joint was present in 16 patients (70%). Five patients (22%) had multiple flattened cysts that were usually independent of the joint. In seven patients (30%), MR images showed cysts beneath the nail plate., Conclusion: Digital mucoid cysts may be polymorphic. MR imaging is helpful when cysts are in the nail bed.

High-resolution sagittal magnetic resonance images depict an oval area in the dermis beneath the nail matrix that gives a particular signal. This study defines the magnetic resonance imaging characteristics of this area and examines its correlation with the lunula. A high-resolution surface gradient coil specially designed for skin imagining was used on a 1.5 T magnetic resonance unit. The subnail matrix (SNM) areas of 12 subjects had a significantly longer T2 relaxation time and a higher enhancement ratio after injection of gadolinium than did the nail bed dermis. The length of the SNM area distal to the free edge of the proximal nail fold was highly correlated with the length of the lunula (R = 0.98) in 30 fingers and 10 toes. The total length of the SNM area was somewhat correlated with the nail thickness (R = 0.86) in 30 fingers. The histology and microvascularization of the subungual tissue in 21 fingers showed that this SNM area had specific features: The area was composed of loose connective tissue without bundles, and the reticular and subdermal vascular networks had large regular meshes in this oval area. The lunula is shown to be linked to a well-defined area in the underlying dermis with a specific histology and microvascularization.

Purpose: To determine the magnetic resonance (MR) imaging features of subungual glomus tumors., Materials and Methods: Thirty-one patients with a clinical suspicion of glomus tumor and 10 control subjects underwent MR imaging at 1.5 T. MR images of normal glomus bodies of a cadaver finger were correlated with histologic slices. With a local surface gradient coil, the pixel size reached 117 microns in one direction. Relaxation times were measured. Gadoterate meglumine was injected in 19 patients., Results: Normal glomus bodies were visualized in the reticular dermis of the nail bed. Twenty-seven of 28 pathologically confirmed glomus tumors were detected with MR imaging. A peripheral capsule was present in most tumors. The nail matrix was compressed in 13 cases. The authors were able to differentiate three subtypes of glomus tumors (vascular, solid, and myxoid) on the basis of relaxation times and enhancement characteristics. Four patients had mucoid cysts or angioma in the nail bed., Conclusion: MR imaging can help accurately define the location and limits of glomus tumors before excision.

The ligaments of the ankle are superficial and easily accessible at ultrasonography. Surprisingly, the reliability of this technique has never been proven. With this goal in mind, ten ankles were subjected to a ultrasono-anatomic comparison. The five principle ligamentous fascicles (three on the lateral side and two on the medial side) measured at ultrasonography and the values verified after dissection. This study shows that the ligaments of the ankle are analyzed with ultrasonography and that the measures done are valid and have a precision of 2 mm for the anterior fascicle and the lateral fascicle of the lateral ligamentous plane Due to its simplicity and its low price, ultrasonography appears to be an important method in evaluating the ligaments and the degree of seriousness of ankle sprains.

This anatomic study, based on six subjects, is aimed at a better description of the anterolateral thoracic fascia, not previously studied in its entirety. The literature describes a fascia of the pectoralis major m. continuous with that of the serratus anterior m., starting at the lateral border of the pectoralis major or pre-pectoral. The upper limits have never been studied and the lower limits are ill-defined, the aponeurosis of the pectoralis major or the pre-pectoral fascia being continuous with that of the rectus abdominis m. It is shown that this fascia, from a retropectoral origin, extends to the base of the axilla above and is stretched as bridge between the pectoralis major and latissimus dorsi mm. and the muscles of the anterolateral wall of the abdomen. This fascia has some surgical importance as a plane of coverage in the protection of mammary implants. The lack of concordance with classical anatomic accounts, the histology and the vascularisation of this fascia call for complementary studies.

The authors report a series of 41 dissections of the forearm intended to study the orientation of the fibers of the flexor carpi radialis (FCR). This shows that there is a constant torsion of the fibers of the FCR by an average of 180 degrees. Half of this torsion occurs in the forearm and half in the sheath of the FCR at wrist level. Awareness of this torsion is particularly useful surgically when the tendon is employed in ligamentoplasty, particularly after trapeziectomy. Our study of the orientation of the fibers was aimed at the ability to perform subcutaneous splitting of the fibers for use of part of the tendon.

Ossifications in the caudal attachments of the ligamentum flavum were studied on 121 dried thoracic spines. Most of them were aged. Frequency increased in a caudal direction. At T12, frequency depended on the orientation of the zygapophyseal joints of T11-12 which determined the range of rotation. When they were of thoracic orientation, allowing large range of rotation, ossifications were present in 83% of cases. If orientation was lumbar, allowing poor range of rotation, ossifications became much less frequent:33%. The size of ossifications was also studied. The smaller were in T1 and T2. In T11 and T12, size also depended on the orientation of the zygapophyseal joints of T11-12. If it allowed important range of rotation, ossifications were large sized. In the opposite case, they were small sized. Ossifications of caudal attachments of ligamentum flavum appear to be a normal feature of the aged lower thoracic spine. Their frequency in a given motion segment seems to be influenced by rotational strains.

The need to perform triple osteotomies of the pelvis passing very close to the articular surface leads to the isolation of bony fragments whose vascularisation may be precarious. To assess the risks of such surgery, we undertook an anatomic study of the vascularisation of the acetabulum in the fetus. 53 specimens were injected to study the vessels to the acetabulum and their distribution within the osteocartilaginous specimen. The acetabular a., a branch of the obturator a., gives a central pedicle distributed to the acetabular fossa, the triradiate cartilage and ending in the three primary bony components. The superior gluteal, inferior gluteal, internal pudendal and obturator aa. form a periacetabular vascular circle. The abundant vascularity of the acetabulum makes massive necrosis improbable in the child. However, there is a zone of precarious anastomosis at the anterior portion of the acetabulum.

Lesions of the thoracic aorta create problems related to their site and relations with the main aortic branches. The aim of surgery must be to treat the lesion while ensuring perfusion of the tissues excluded by clamping during the operation. Anatomic study of the aortic lesions is based on imaging. Angiography is still often the basic examination though it shows only the lumen and course of the aorta. However, CT and MRI visualise the aortic wall and especially the relations of the aorta to the mediastinal structures. A comparison of anatomic and imaging studies was made on 10 fresh subjects coming from the anatomy department of the Saints-Pères and from the school of surgery of Fer à Moulin. Sections were made every 3 to 5 mm in 3 planes (sagittal, coronal and axial) after CT localisation of the plane of section. This anatomic study was correlated with CT and MR images made on healthy volunteers. The choice of surgical management of a lesion of the thoracic aorta is based on preoperative anatomic assessment by imaging applied not only to the aorta but also to its branches and the territory supplied.

This anatomic study is based on 50 adult cadaver upper extremities. The general disposition of the forearm arteries and muscles and the main anatomic variations encountered are specified. Constant existence of an "anterior oblique artery" satellite of the pronator teres was established. The median nerve artery was principally dedicated to the flexor digitorum superficialis and participated appreciably in the constitution of palmar arches in only one case. A supernumerary intermedial radial muscle was found only in two cases. The abductor pollicis longus and extensor pollicis brevis appeared as a single muscular and vascular unit in 84 percent of cases. All the arteries destined for muscles were reckoned whatever their caliber might be. Despite its limitations, this study confirms the very great number of the forearm muscular pedicles. Each forearm contained an average of 264 muscular vascular pedicles. The systematization of the origins and destinations of the 13,158 muscular pedicles is described in a numbered manner for each of the 20 normal forearm muscles and for each of the 12 studied arterial segments. The pronator teres was likely to be supplied by all the anterior arteries of the upper limb. The flexor carpi radialis had one or two dominant pedicles originated from the recurrens ulnaris anterior, recurrens ulnaris, or ulnaris-interossea communis arteries, and many transversal branches originated from the radial artery. The flexor carpi ulnaris was supplied in its proximal third by the recurrens ulnaris posterior artery and in its distal two-thirds by many branches of ulnar artery.(ABSTRACT TRUNCATED AT 250 WORDS)

The authors describe the distribution of the medial branches of the upper thoracic dorsal rami (T1 to T5 levels). At each level, after travelling through the erector spinae, they become superficial, and reach the apex of the spinous process of the corresponding vertebra. They then spread out laterally, innervating the skin. They can occasionally be compressed by paravertebral tendons, and this possibly contributes to certain forms of dorsal pain. Anastomosis of the dorsal cutaneous branch of the second thoracic nerve (T2) with the descending lateral branch of the accessory nerve has been observed. Its presence could explain the occasional clinical situations where there is no resultant paralysis from accidental surgical section of the latter nerve.

On the supposition that some "pseudocoxalgias" might be due to a neuralgia of the lateral rami leaving the subcostal and iliohypogastric nerves above the lateral edge of the iliac crest, the authors undertook an anatomic study of their pathways and pattern of distribution. These rami supplying the skin below the iliac crest, which they cross close together, the ramus arising from the subcostal nerve by perforating the internal and external oblique abdominal muscles, that arising from the iliohypogastric nerve a little lower, creating a bony groove palpable in thin subjects and transformed into an osseomembranous tunnel by the aponeurosis of these muscles. This arrangement may give rise to an entrapment syndrome. At this intersection, the course is either vertical or "bayonet-shaped", directly subcutaneous, and hence exposed to possible friction and microtraumata (tight clothes). The two rami are of unequal length. Frequently, the ramus arising from the subcostal nerve is short, not exceeding 10 cm, below the iliac crest, thus corresponding to the usual description. That arising from the iliohypogastric nerve descends further, passing 3 to 5 cm anterior to the great trochanter. It ends either at this level or 8 to 10 cm below. This accounts for the distribution of the pain felt when there is irritation of this ramus.

The metacarporetinacular fascicle, the fourth fascicle of the medial collateral metacarpotrapezial ligament, was examined in 25 anatomic specimens. It contributes to stability of the ligament and plays an important role in the pronosupination of the thumb. This role becomes determinate when the geometry of the articular surfaces is disturbed.

The authors have injected the arteries and dissected 79 wrists. They propose a systematization of the vascular supply of the carpus, based on the major longitudinal and transverses axes; on the areas of arterial convergence and divergence, at the origin of 2 systems: the deep system (SAPRUC) is a vestige of the foetal morphology; it is periostal and sub-capsular. The superficial system (SASRUC) is predominant; it is constituted by the proximal and distal extracapsular pedicles.

Manual compression of the vertebral artery is used in routine clinical practice for diagnosis of positional hemodynamic vertebro-basilar insufficiency (VBI). The supraclavicular and suboccipital areas were carefully dissected in 20 cadavers. Anatomical variations observed on dissection were compared to angiographic data from 150 patients and data from the literature. Objective results of manual compression of the vertebral artery can be obtained by sonography. In patients with VBI, such compression induces signs of reversible cerebellar or brain stem ischemia, whereas no signs are observed in patients without VBI.