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Open Journal of Orthopedics 2022年第3期12卷 79-84页

作者： Ngo Yamben Marie-Ange Nana Chunteng Theophile Nseme Etouckey Eric Muluem Kennedy Olivier Tsiagadigui Tsiagadigui Jean Gustave Ndongo Mvela Laurent Stephane Manga Alexandre guifo marc leroy Faculty of Medecine and Biomedical Sciences Department of Surgery and Specialities University of Yaounde 1 Yaounde Cameroon National Center of Rehabilitation of Disabilities Persons Yaounde Cameroon Faculty of Health Sciences Department of Surgery University of Buea Buea Cameroon Teaching Hospital of Yaounde Yaounde Cameroun

Multiple segmental fractures of the lower limbs, common in developing countries, are the prerogative of Road Traffic Accidents (RTA) involving two-wheeled vehicles. Their management is difficult, associated with complications, and is most often based on a two-stage strategy: Damage Control Orthopaedics, followed by delayed internal osteosynthesis. The aim is to allow early functional rehabilitation and rapid recovery of patients. We report the case of a 39-year-old man, bike rider, after his RTA, presented with segmental homolateral fractures of the femur and two bones of the left leg. Short-term evolution was marked by the appearance of significant lymphedema and bone infarctions of the lower left limb necessitating a transfemoral amputation. Through this observation, the authors highlight the problems related to the complexity of the management of multiple segmental fractures of the lower limb by emphasizing two post-traumatic complications rarely described but to be feared: chronic lymphedema and bone infarction.

关键词： Lymphœdema Multiple Fractures Bone Infarction Amputation Damage Control Orthopaedic

Consolidation of a Femoral Neck Fracture in Sickle Cell Disease Patient after Surgical Abstention: A Beneficial and Favorable Outcome

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Surgical Science 2024年第7期15卷 438-443页

作者： marc leroy guifo Albert Desiré Atangana Fouda Faustin Atemkeng Tsatedem Emini Ngono Mengale Ntang Ulrich Bisay Souhe Ginette Kalla Faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Ebolowa Ebolowa Cameroon

Femoral neck fracture is classically a traumatic pathology in the elderly but it can also occur in young people during a road traffic accident or occasionally when the femoral neck has been weakened by a pathological process. In sickle cell patients, the hip is often subjected to aseptic necrosis. The authors report the case of the child NL, aged 5 years and 4 months in whom a fracture of the femoral neck classified Delbet 3 was found as well as his sickle cell status discovered and in whom treatment by surgical abstention was carried out with a favorable evolution. This association of factors of the femoral head necrosis or nonunion is unusual and confirms the osteogenetic potential of a child. However, monitoring is necessary because other anomalies may reveal themselves.

关键词： Sickle Cell Disease Fracture Femoral Neck Osteomyelitis

Clinical Epidemiology and Surgical Treatment of Spontaneous Perforations of the Terminal Ileum: A Multicentre Study in Cameroon

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Surgical Science 2024年第5期15卷 311-320页

作者： Eric Patrick Savom Richard II Mbele Mahamat Yannick Ekani Boukar Abdal Deudeu Cédric Paterson Atangana Fred Dikongue Dikongue Guy Aristide Bang marc leroy guifo Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Yaoundé Teaching Hospital Yaoundé Cameroon

Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbidity and mortality remain high. The aim of this study was to review our experience in the surgical management of perforations of the terminal ileum. Patients and methods: This is a descriptive cross-sectional study with retrospective data collection from January 1, 2017 to December 31, 2021, in five hospitals in Cameroon. Patients’ demographic, clinical presentation, surgical findings and 30-days postoperative outcomes data were collected. Results: We collected 34 files. The sex ratio was 1.4 and the average age was 20.28 years. The average consultation time was 9.1 days. Abdominal pain was present in all our patients. Peritoneal irritation was present in 46 cases (88.5%). The mean time to treatment after admission was 17.5 hours. The perforation was unique in 40 cases (76.9%) and located between 6 and 10 cm from the ileocecal valve in 29 cases (55.8%). Typhoid was the most suspected etiology intraoperatively in 38 cases (73.1%). A simple suture was performed in 18 patients (34.6%), resection with anastomosis in 11 patients (21.2%) and an ileostomy in 5 patients (9.6%). The average length of hospitalization was 21.74 days. Postoperative morbidity and mortality were 32.7% and 17.3% respectively. Conclusion: Perforations of the terminal ileum are common and affect young people. Surgical procedures are varied. Reducing consultation and care times and respecting treatment principles could improve postoperative morbidity and mortality, which remain high.

关键词： Perforation of the Terminal Ileum Simple Suture Resection Morbidity Mortality

Thoracic Spinal Cord Stab Injury: A Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2015年第4期5卷 113-117页

作者： Aurélien Ndoumbe marc leroy guifo Mathieu Motah Samuel Takongmo Faculty of Medicine & Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine & Biomedical Sciences University of Yaoundé I CHU of Yaoundé Yaoundé Cameroon Faculty of Medicine & Pharmaceutical Sciences University of Douala Douala General Hospital Douala Cameroon

Thoracic spinal cord stab injuries are rare lesions. A 17-year-old boy was stabbed on his back by his classmate when he bent forward to pick up his cloth from the ground. On admission, he presented with: complete paraplegia with muscle strength of zero on all muscle groups, complete anesthesia from dermatome 10 and below, acute urinary retention, and a four-centimeter wound on the thoracolumbar region from which cerebrospinal fluid mixed with blood was oozing out. A high-dose methylprednisolone protocol was started (30 mg/kg in one hour and then 5.4 mg/kg over 23 hours) an indwelling urinary catheter placed and sterile dressing of the wound done. Antibiotics and analgesics were also administered. The computed tomography scanning revealed a spinal cord transection at T10-T11 level with incarceration of the broken knife blade. An emergency thoracic laminectomy was performed. Removal of the broken knife blade revealed complete spinal cord transection with a compressive hematoma within the spinal cord which was removed by smooth suction. The spinal dura was sutured and the wound closed in many layers. On day 14 after surgery, sensitivity was recovered with 3 on 5 muscle strength in both lower limbs except for both feet where motor function remained null. Urinary retention and fecal incontinence persisted. The patient was discharged from our service for a rehabilitation center. At 32-month follow-up, neurological examination was unchanged although patient noticed a slight improvement of sphincter disturbances.

关键词： Spinal Cord Injury Thoracic Spine Stab Wound Knife Seventeen-Year-Old Boy

Potential Association between Anterior Cruciate Ligament Tear and “Bi-Collateral” Ligamentous Rupture: A Retrospective Study

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Open Journal of Radiology 2015年第4期5卷 217-223页

作者： Jean Roger Moulion Tapouh Boniface Moifo Cathy Monabang Zoé marc leroy guifo Haoua Tebere Annick Laure Edzimbi Samuel Nko’o Amvene Department of Radiology and Radiation Oncology Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaounde Cameroon Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH) Yaounde Cameroon Yaounde University Teaching Hospital Yaounde Cameroon Department of Surgery and Sub-Specialties (FMBS) Yaounde Cameroon

Background: Anterior cruciate ligament (ACL) tears are common complications of knee trauma. This entity can be reliably diagnosed by Magnetic Resonance Imaging. There is a lack of data on the epidemiology of ACL tears in Sub-Saharan Africa. The aim of this study is to describe the radiological aspects of post traumatic ACL tears in a black African setting (Yaounde Teaching Hospital). Methods: ninety six (96) MR studies of the knee were retrospectively reviewed. They were realized on a low field device (0.2T) from July 2012 to December 2013. All the examinations were indicated for knee trauma. Ligamentous, meniscal, bony and joint lesions were sought on coronal and sagittal sections. Results: the sample consists of 70% (68/96) of men. The mean age is 35.36 ± 11.86 years. The prevalence of ACL tears is 45.8% (44/96) of which 36 (81.81%, 36/44) are total tears. 23 (24%) have associated meniscal lesion and 8 (8.3%) have a simultaneous damage of the collateral ligaments. The most frequently injured part of the meniscus is its posterior horn (12/23 cases). Meniscal and “bi-collateral” ligament injuries are independently associated to ACL tears. Conclusion: The prevalence of ACL tears at the Yaounde Teaching Hospital is 45.8%. It is independently associated to meniscal tears and concomitant injury of the tibial and fibular collateral ligaments.

关键词： Anterior Cruciate Ligament Magnetic Resonance Imaging Meniscal Tears Knee Trauma

First characterization of endophytic Corynespora cassiicola isolates with variant cassiicolin genes recovered from rubber trees in Brazil

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Fungal Diversity 2012年第3期54卷 87-99页

作者： Marine Déon Ana Scomparin Aude Tixier Carlos R.R.Mattos Thierry leroy marc Seguin Patricia Roeckel-Drevet Valérie Pujade-Renaud CIRAD UMR AGAP63000 Clermont-FerrandFrance Clermont Université UniversitéBlaise PascalUMR 547 PIAF63000 Clermont-FerrandFrance Plantações Michelin de Bahia Box 0245435-000 ItuberáBahiaBrazil CIRAD UMR AGAP34398 MontpellierFrance

Corynespora cassiicola is the causal agent of Corynespora Leaf Fall(CLF)*** is one of the most important fungal diseases of rubber trees in Asia and Africa but disease outbreaks have not been reported in South ***,a small cysteine-rich glycoprotein secreted by the pathogenic *** isolate CCP,was previously identified as a potential disease effector in rubber ***,the cassiicolin-encoding gene(Cas1)was characterized and shown to be expressed in the early phase of *** this study,we investigated whether previously undetected strains of *** are present in South American rubber plantations by examining the fungal endophyte population found in asymptomatic rubber tree *** isolates were identified as *** encoding new forms of the cassiicolin precursor protein(Cas3 and Cas4)were identified from these *** of four isolates were able to induce symptoms on the cultivar they were isolated from in a detached leaf assay,with different kinetics and *** isolate had the same pathogenicity profile as the pathogenic isolate CCP;the other two isolates developed symptoms late during the course of infection,suggesting saprotrophic ***,no Cas3 or Cas4 transcripts could be detected upon inoculation with the endophytic isolates,whereas the reference gene Cas1 was expressed upon inoculation with the CCP *** work demonstrated that *** is present in South America in an endophytic form and that it may evolve from an endophytic to a saprophytic or even potentially pathogenic life style.

关键词： Corynespora cassiicola Rubber tree Endophyte Brazil Cassiicolin

儿童首次发热性泌尿道感染后膀胱输尿管反流的预测:对一项临床决策准则的检验

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世界核心医学期刊文摘（儿科学分册） 2006年第8期2卷 23-24页

作者： leroy S. marc E. Adamsbaum C. M.Chalumeau 刘莉 Clinical Epidemiology Unit Department of PaediatricsSaint-Vincent-de-Paul Hospital74-82 avenue Denfert-Rochereau75014 ParisFrance Dr.

Aims:To test the reproducibility of a highly sensitive clinical decision rule proposed to predict vesicoureteral reflux(VUR)-after a first febrile urinary tract infection in *** rule combines clinical(family history of uropathology,male gender,young age),biological(raised C reactive protein),and radiological(urinary tract dilation on renal ultrasound)predictors in a score,and provides 100%***:Aretrospective hospital based cohort study included all children,1 month to 4 years old,with a first febrile urinary tract *** sensitivities and specificities of the rule at the two previously proposed score thresholds(≤0 and ≤5)to predict respectively,all-grade or grade ≥3 VUR,were ***:A total of 149 children were *** prevalence was 25%.The rule yielded 100%sensitivity and 3%specificity for allgrade VUR,and 93%sensitivity and 13%specificity for grade ≥3 *** methodological weaknesses explain this lack of ***:The reproducibility of the previously proposed decision rule was poor and its potential contribution to clinical management of children with febrile urinary tract infection seems to be modest.

关键词：膀胱输尿管反流泌尿道感染临床决策发热性感染后预测儿童回顾性队列研究检验首次