Search PubMed⌕ Search

Biomedical subjects

A Chantraine

Publications and source records attributed to A Chantraine.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Treatment of lumbar sciatica with or without neurological deficit using mechanical traction. A double-blind study].

Traction therapy for low back pain with sciatica has been evaluated in a double blind study. 60 patients hospitalized for sciatica with or without signs of sensory or motor deficiency were randomized to 3 treatment groups: "placebo traction" (5 kg), "light traction" (15 kg) and "normal traction" (50 kg). Clinical evaluation after 4, 8 and 12 traction sessions showed no difference between the three groups.

Adult↗
PubMed1986

Bone remodeling during the development of osteoporosis in paraplegia.

Osteoporosis developing during the first weeks after the onset of traumatic paraplegia was studied with cortical and cancellous samples of iliac crest and tibia of 14 patients, and compared to normals. We used a procedure of bone particle fractionation (according to degree of mineralization) that allowed us to establish a profile reflecting the metabolic remodeling of bone and to analyze the organic matrix of the newly synthesized tissue. In paraplegics, we observed a large increase in the proportion of little calcified bone in the cortical as well as in the cancellous bone. Based on amino acid analyses, we found a decreased number of hydroxyproline residues in the newly synthesized organic matrix from paraplegia bone resulting either from an alteration of the prolyl hydroxylation or from the presence of an excess of noncollagen polypeptides. These results, together with previously published data reporting increased urinary hydroxyproline and calcium kinetic parameters, suggest an enhanced rate of skeletal remodeling in acute paraplegia. When investigated 2 years after injury, the patterns of distribution approach that of normal subjects.

Adolescent↗
PubMed1986

Is cortisone iontophoresis possible?

Iontophoresis (iontotherapy) is sometimes employed to permit epidermal medication. Corticosteroids have been recently one of the most frequently employed, although the literature reports no scientific study demonstrating its effectiveness. This work reports our experimentation on steroid iontophoresis both in vitro and in vivo, to determine whether steroids pass through the skin. Using paper electrophoresis, we first studied the electrophoretic mobility of six water-soluble corticosteroids commercially available in Switzerland. Then an experimental model with two cylinders, one containing a steroid solution and the other filled with buffer solution separated by human skins was submitted to ionization. The in-vivo experimentation consisted in a study of steroid iontotherapy in four rabbits and in 188 patients. Our in-vitro and in-vivo studies failed to demonstrate the transcutaneous migration of corticosteroids.

Adult↗
PubMed1986

Painful shoulder in hemiplegia.

Shoulder pain is probably the most frequent complication of hemiplegia. In this study 219 hemiplegia patients were regularly followed up after their cerebrovascular accident (CVA) for one year (166 men, 53 women, with a mean age of 47 years). Criteria and parameters for evaluation of these shoulders were established at the outset. Distinction was made between flaccid and spastic hemiplegia. Other influencing factors were subluxation reflex sympathetic dystrophy syndrome (RSD), isolated tendon lesion cuff rotator tear or association of some of these. Roentgen examinations were done for each patient. In our series of patients, 72% had shoulder pain at least once during the course of their recovery. This problem occurred more often in patients having spasticity (85%) than in those with flaccidity (18%). An evolution towards spasticity was noted in 80% of the patients in this series, whereas 20% remained hypotonic. Among the other possible causes of shoulder pain, anteroinferior subluxation was incontrovertibly the most frequently cited. The RSD syndrome was present in only 23% of all cases but was seen more often in spastic patients, that is 27% compared to 7% among flaccid patients. Whatever the cause, the subluxation with flaccid paralysis should be corrected and spasticity should be combatted as early and as vigorously as possible.

Adolescent↗
PubMed1985

Knee joint in soccer players: osteoarthritis and axis deviation.

The knee joints of 81 veteran soccer players between ages 40 and 74 were examined. An analysis of and relationships between soccer practice at a top level, osteoarthritis, meniscectomy, and leg axes were evaluated. One-hundred and sixty-two knees were assessed through clinical examination and X-ray examination using a large table in order to observe the entire lower extremity's axis in weight bearing. First, it appears that radiological signs of osteoarthritis in soccer players increase with age in a much greater percentage than in a random population of the same age. Second, all players who have had a meniscectomy presented with radiological signs of osteoarthritis. In this series, 91 knees (56%) had X-ray signs of osteoarthritis. 64 knees (70%) in which the roentgenograms showed significant osteoarthritic changes were clinically asymptomatic. Third, the lower extremities displayed a varus angulation of both knees in 73% (meaning that 59 veteran players have a varus of both legs), while 81% of all the knees showed a varus deviation.

Adult↗
PubMed1985

[Striated sphincter of the urethra. 4: Therapeutic possibilities].

Treatment of non-neurologic dyssynergia is aimed at diminishing urethral sensory impulses or the motor component of the dysreflexia. Although formal proof of efficacy is lacking, urethral dilatation or meatoplasty in young girls is still used when an obstacle exists to passage of a balloon catheter. Functional obstruction is treated by Valium for its muscle-relaxant properties, alpha-blocking agents or biofeedback. In recent neurologic dyssynergia good results have been obtained after infiltrations of the para-urethral sphincter by an endo-urethral approach. Sphincterotomy is the treatment of choice when fibrosis has developed, particularly when the upper urinary tract is being affected: it can be performed earlier in cases where the dyssynergia fails to respond to well adapted conservative therapy. The site of section should be at 12 o'clock for anatomophysiologic reasons and to reduce the risk of impotence. The only treatment for rhabdosphincter deficiency is physiotherapy: reeducation and electric stimulation. Correctly instituted reeducation involves several phases: beginning with consciousness and learning of sphincter function it terminates in the automatic activation of the sphincter as for example during certain efforts. Results of several documented series in the urologic literature are encouraging.

Bacterial Infections↗
PubMed1984

[Dichloromethylene diphosphonate in the treatment of lytic bone metastases].

Dichloromethylene diphosphonate (Clodronate) has powerful activity against osteoclasts. We studied its effects on calcium balance in patients with malignant osteolytic lesions. Ten normocalcemic patients with advanced metastatic bone disease or myeloma were evaluated in a baseline 20-day calcium balance and kinetic study. They were then randomized to a clodronate or placebo regimen, treated intravenously for two weeks and orally for a month, and finally re-evaluated in another 20-day balance and kinetic study, conducted while they were still receiving treatment. The results show that both calcium balance and calcium absorption increased from base line in the clodronate group and that these changes were significantly different from those in the placebo group. There was a marginal decrease in bone resorption in the clodronate group and no change in bone accretion. Our results suggest that clodronate may be a useful adjuvant in managing metastatic bone disease.

Adult↗
PubMed1984

Energy expenditure of ambulation in paraplegics: effects of long term use of bracing.

Energy metabolism data were collected in a series of seven male paraplegic patients with complete spinal cord lesions (T9 to L1). Among these four had just been rehabilitated and three had been using their bilateral long leg braces for more than 4 years. A group of five healthy volunteers was used as a control. All the subjects ambulated on a treadmill between parallel bars and in a second trial they ambulated on the floor using forearm crutches. Mean O2 consumption was 1.46 ml O2/kg/m for the unaccustomed paraplegics who had never used long-leg braces before, 0.61 for paraplegics used to walking with braces, and 0.83 for the healthy subjects walking between parallel bars with a swing-through gait. The second trial (on the floor), showed a mean O2 consumption of 0.73 ml O2/kg/m for the paraplegic brace-user with a high heart rate (156/min). This mean O2 consumption was much lower than the values of the paraplegic non-user and slightly higher than the normal subjects.

Adolescent↗
PubMed1984

[The striated sphincter of the urethra. 2: Specific methods for studying the striated sphincter of the urethra].

Radiology and electromyography of the lower urinary tract are specific techniques for exploration of the urethral rhabdosphincter. Retrograde and mictional urethrography provide data on the extent of the membranous urethra. In the presence of rhabdosphincter lesions a mictional urethrogram is often sufficient to establish a diagnosis from the direct and indirect signs of obstruction it supplies. A retrograde urethrography examination can be added validly to the previous exploration to improve precise definition of sclerosis: in contrast it is indispensable when miction is impossible. Differential diagnosis between spasm and stenosis of striated and dyssynergy of smooth muscle sphincter is by pharmacologic tests. Radiologic study of sphincter contraction is generally by cineradiography with arrest of miction. Results are limited, however, when compared with those of a radiodynamic study: the latter supplies information on the functioning of the para- and peri-urethral rhabdosphincter, and allows measurement of contraction. The electromyogram, with its different practical technical modalities, provides details of the urethral rhabdosphincter. The contact electromyogram gives quantitative data but fails to diagnose a neurological lesion. It analyzes behavior of the sphincter in its para-urethral part and can localize its diaphragmatic portion; dynamic electric profiles are of little reliability, in contrast to static profiles which quantify electric activity at all points in the urethra during the same contraction. The standard percutaneous needle electromyography examination provides qualitative data on the peri-urethral rhabdosphincter, but lacks precision as to the region explored, while qualitative information on the para-urethral sphincter requires the use of an endo-urethral approach. A difference in potential between para- and peri-urethral musculature has been demonstrated a fact confirmed by anatomical findings in Goslings study. In normal subjects, the rhabdosphincter differs from other skeletal muscles by its constant activity except during miction; potentials in children differ from those in adults by their duration. In lower motor neurone disease signs of denervation appear after several weeks, while in upper motor neurone affections the potentials are normal but nociceptive and bulbocavernous stimuli provoke bursts of hyperactivity which reappear very shortly after the paraplegia. Striated muscle fibrosis provokes peripheral signs with persistence of regions of increased reflexes. Tests of responses to stimuli provide important information enabling the site of the neurogenic lesion to be determined.

Electromyography↗
PubMed1984

[The striated sphincter of the urethra. 3: Urodynamic and physiopathologic study of the striated sphincter].

Dysfunction of the rhabdosphincter results from an increase (dyssynergia) or decrease in activity of either neurological or non-neurological origin. We have defined dyssynergia as the absence of urethral relaxation and/or sphincter contraction during and/or before detrusor muscle contraction. Non-invasive exploratory methods include flowmetry, anal contact EMG and an abdominal pressure or EMG examination. Invasive techniques are of various types: urethro-cystometry with EMG, via the perineum in males and the endo-urethral approach in females, provides quantitative data on extent of altered function and relative involvement of either smooth or striated muscle sphincters. An essential complement to urodynamic exploration is a conventional mictional cystogram. We have proposed an etiologic classification of dyssynergia: tonic dyssynergia is pathognomonic of supra-sacral medullary lesions while clonic dyssynergia reflects the bladder-sphincter conflict, whether it be of neurologic or other origin. Clonic dyssynergia in patients with neurologic affections is seen mainly in those with supra-sacral medullary lesions at whatever level, and with a 50 to 100% frequency. Its serious nature is not related to the bladder-sphincter equilibrium but to the high pressures developed by the system. The neurologic rhabdosphincter presents characteristic persistent reflex activity at the spinal shock phase and a possible course leading to fibrosis. In patients without neurologic disease the terms dyssynergia or pseudodyssynergia are used depending on whether the sphincter contraction during bladder contraction is involuntary or voluntary. To explain this non-neurologic pseudodyssynergia, Lapides suggested as a basis the theory of the evolution of sphincter control, Tanagho that of sphincter spasticity. In reality it involves a vicious circle centered on the bladder-sphincter conflict, entry being possible at various levels: bladder instability, urethral instability, urethral hypersensitivity, rhabdosphincter spasticity. These disturbed functions induce the urethral syndrome, repeated urinary infections, reflux and sometimes even renal stasis. Deficient sphincter activity of neurologic origin presents pathognomonic electromyographic signs; from a functional point of view valid data can be obtained from measurement of variations in maximum urethral pressure during a retention effort. Among the neurologic etiologies, the rhabdosphincter is only rarely affected by poliomyelitis or amyotrophic lateral sclerosis.(ABSTRACT TRUNCATED AT 400 WORDS)

Ataxia↗
PubMed1984

[The striated sphincter of the urethra. 1: Recall of knowledge on the striated sphincter of the urethra].

The first part of this report is devoted to the anatomy, nerve supply, and physiology of the striated sphincter, three subjects which greatly aroused a great deal of controversies. The conclusions of the authors are as follows. The striated sphincter of the urethra is a muscle of the perineum, arising from the cloacal sphincter. The deep transverse, bulbo-cavernous, anal sphincter, ischio-cavernous and superficial transverse muscles have the same embryological origin and together with the sphincter of the urethra form the accessory pelvic diaphragm. The embryological origin of the levator ani muscles is different. These arise from the caudal muscles and form the principal pelvic diaphragm. The striated sphincter of the urethra is unequally distributed in the male and female fetus. According to our anatomical concept, the urethral sphincter includes two structures: the para-urethral sphincter and the peri-urethral sphincter. The para-urethral sphincter form an integral part of the urethra and is distributed principally along the membranous part of urethra but extends approximately to the bladder neck and distally under the perineum aponeurosis. In the adult as in the fetus, the para-urethral striated sphincter is unequally distributed along the urethra, according to sex. In the male, it surrounds the membranous urethra and is absent from the posterior face of the prostatic urethra. By contrast, in the female, the sphincter surrounds the proximal third of the urethra and the rings are incomplete on the distal third. The peri-urethral striated sphincter includes the other muscles of the perineum and of the principal pelvic diaphragm. These two structures differ from a microscopic stand point; the para-urethral striated sphincter contains only narrow calibre slow fibers, with the absence of the neuro-muscular spindles. By contrast, the peri-urethral sphincter consists of slow and rapid fibers and contains neuro-muscular spindles. The nerve supply of the peri-urethral striated sphincter is insured by internal pudendal nerves. The para-urethral striated sphincter is supplied in great part of the same internal pudendal nerves arising from neurones situated in the nucleus of Onuf. However, the pelvic nerves may contain a group of accessory fibers from the same origin. There is no proof available as to the role played by the sympathetic nervous system. When micturition comes to an end, the para-urethral sphincter causes a constriction of the membranous urethra in the male, and single flattening of the middle part of the urethra in the female.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1983

Use of dichloromethylene diphosphonate in metastatic bone disease.

Dichloromethylene diphosphonate (clodronate), a new compound, has powerful activity against osteoclasts and has been used successfully to treat hypercalcemia associated with cancer. We studied its effects on calcium balance in patients with malignant osteolytic lesions. Ten normocalcemic patients with advanced metastatic bone disease or myeloma were evaluated in a baseline 20-day balance and calcium kinetic study. They were then randomized to a clodronate or placebo regimen, treated intravenously for two weeks and orally for a month, and finally reevaluated in another 20-day balance and kinetic study, conducted while they were still receiving treatment. The results show that both calcium balance and calcium absorption increased from base line in the clodronate group and that these changes were significantly different from those in the placebo group (mean change [+/- S.D.] in calcium balance [clodronate vs. placebo], 203.8 +/- 140.1 vs. -65.2 +/- 98.8 mg [5.1 +/- 3.5 vs. -1.6 +/- 2.5 mmol] of calcium per day, P less than 0.01; change in calcium absorption, 158.8 +/- 158 vs. -38.2 +/- 96.0 mg [4.0 +/- 4.0 vs. -1.0 +/- 2.4 mmol] per day, P less than 0.05). There was a marginal decrease in bone resorption in the clodronate group and no change in bone accretion. Our results suggest that clodronate may be a useful adjuvant in managing metastatic bone disease.

Bone Neoplasms↗