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Biomedical subjects

J Mercier

Publications and source records attributed to J Mercier.

At least 163 records · Page 9Linked to original sources
PubMed1993

[Evaluation of velopharyngeal function using an aerophonoscope before and after surgery for snoring].

Following surgery for snoring, regardless of the technique used, velopharyngeal insufficiency remains an infrequent but disabling complication. In an attempt to assess the risk of velopharyngeal insufficiency, we used a new, simple, rapid, and noninvasive method of evaluating palatal function, the aerophonoscope. Pre and postoperative aerophonoscopic studies were carried out in 25 chronic snores undergoing a single step uvulopalatoplasty with a laser under local anesthesia. The aerophonoscope revealed signs of palatal dysfunction in 2 patients (8%) preceding surgery and confirmed the absence of palatal dysfunction in all patients following our technique of uvulopalatoplasty. We also present the aerophonoscopic findings in 3 patients with nasopharyngeal stenosis and 2 patients with velopharyngeal insufficiency following surgery for snoring.

Humans↗
PubMed1993

[Saethre-Chötzen syndrome. A study apropos of 17 cases].

Case reports of seventeen patients with the Saethre-Chötzen syndrome treated at the Stomatology and Maxillofacial Surgery Clinic, Nantes, France are analyzed, together with clinical and paraclinical signs of this syndrome, included within the framework of the acrocephalosyndactylies. Results of cases reported in the published literature are reviewed and compared with those of the present series. The characteristic craniofacial equilibrium of the Saethre-Chötzen syndrome is discussed, together with findings of a teleradiographic study performed according to Delaire's analysis. A discussion on the differential diagnosis of this syndrome is enlarge to include all acrocephalosyndactylies.

Acrocephalosyndactylia↗
PubMed1993

Cardiac role in exercise limitation in asthmatic subjects with special reference to disease severity.

We wanted to assess limitations in cardiorespiratory fitness of asthmatic subjects, acclimatized to 1,300 m altitude and in a clinically stable state. We therefore studied 16 young asthmatic and 8 normal young subjects during an incremental bicycle exercise test. The asthmatics were divided into two groups, according to the Aas classification: a moderate asthma group (degree 2 and 3, no pulmonary impairment during symptom-free intervals), and a severe asthma group (degree 4 and 5, with persistent airway obstruction). The results showed that cardiorespiratory fitness is limited in severe asthmatic subjects acclimatized to an altitude of 1,300 m, due to decreased cardiac output and stroke volume. At submaximal exercise, the lower stroke volume is compensated by an increased arteriovenous oxygen content difference, but this compensation no longer exists at maximal exercise, which explains the lower maximal oxygen uptake in the severe asthma group. The hypothesis that the high tidal volume in the severe asthma group could lead to a decrease in left ventricular performance is considered. In conclusion, with respect to cardiorespiratory response to exercise, asthmatics should not be considered as a homogeneous group. Furthermore, relationship between ventilatory requirement and its consequences upon cardiac stroke volume provides a strong argument for the physical rehabilitation of asthmatics. Indeed, aerobic training can decrease the ventilation level for a given workload, and thus reduce inappropriate adaptations to exercise.

Adolescent↗
PubMed1993

[Chronic and neglected luxation of the temporomandibular joint].

The authors propose their experience about 6 cases of chronic dislocation of the temporo-mandibular joint. They underline the part of edentulous status as a predisposing factor also that of the anatomopathological injuries of the dislocated joint. According to the literature, they insist about the importance of surgery to set the dislocation, that in association with a temporal aponevrosis flap and occlusal adjustment, accompanied by immediate postoperative rehabilitation.

Adolescent↗
PubMed1993

[Our experience using free vascularized bone flaps in mandibular reconstruction. The external brachial flap, the fibular flap, the para-scapular flap].

New techniques developed over the last decade use vascularized bone flaps for maxillofacial reconstructive surgery. Indications for use of three recently described flaps (external brachial, fibular, parascapular) are discussed as a function of the regions to be reconstructed. Three clinical cases are presented, each patient having received one type of flap.

Adult↗
PubMed1992

Age and training effects on the lactate kinetics of master athletes during maximal exercise.

To study the effects of age and training on lactate production in older trained subjects, the lactate kinetics of highly trained cyclists [HT, n = 7; 65 (SEM 1.2) years] and control subjects with low training (LT, n = 7) and of similar age were compared to those of young athletes [YA, n = 7; 26 (SEM 0.7) years], during an incremental exercise test to maximum power. The results showed that the lactacidaemia at maximal oxygen uptake (VO2max) was lower for HT than for LT (P < 0.05) and, in both cases, lower than that of YA (P < 0.001). The respective values were HT: 3.9 (SEM 0.51), LT: 5.36 (SEM 1.12), and YA: 10.3 (SEM 0.63) mmol.l-1. At submaximal powers, however, the difference in lactacidaemia was not significant between HT and YA, although the values for lactacidaemia at VO2max calculated per watt and per watt normalized by body mass were significantly lower for HT (P < 0.001) and LT (P < 0.02). These results would indicate that the decline in power with age induced a decline in lactacidaemia. Yet this loss in power was not the only causative factor; indeed, our results indicated a complementary metabolic influence. In the older subjects training decreased significantly the lactacidaemia for the same submaximal power (P < 0.01) and from 60% of VO2max onwards (P < 0.05); as for YA it postponed the increase and accumulation of lactates. The lactate increase threshold (Thla-,1) was found at 46% VO2max for LT and at 56% VO2max for HT.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Breathing pattern and ventilatory response to CO2 during exercise.

The aim of this study was to determine during moderate exercise whether response to the CO2 rebreathing test was dependent on differences in breathing pattern components among individuals recorded before the test and whether differences in tidal volume response and/or breathing frequency response to CO2 during the test could influence their ventilatory response to CO2. Ten healthy, sedentary male subjects, 20 to 34 years old, participated in the study. Ventilatory response to CO2 was measured by the CO2 rebreathing method (7% CO2, 50% O2). The measurements of breathing pattern components and CO2 rebreathing were made during mild steady state exercise: VCO2 = 20 ml.kg-1.min-1. We measured the following: 1) tidal volume (VTex) and breathing frequency (fex) before CO2 rebreathing and 2) ventilatory response to CO2 (SVEex), tidal volume response to CO2 (SVTex), and breathing frequency response to CO2 (Sfex) during the CO2 rebreathing test. The results showed that SVEex was correlated with VTex (r = 0.89, p less than 0.001), fex (r = -0.79, p less than 0.01), and Sfex (r = 0.83, p less than 0.01). There was no correlation between SVEex and SVTex. A curvilinear relationship existed between SVEex and alveolar ventilation calculated during exercise (r = 0.87, p less than 0.001), but there was no correlation with dead space. Sfex was positively correlated with VTex (r = 0.68, p less than 0.05) and negatively with fex (r = -0.70, p less than 0.05). We concluded that, during moderate exercise, higher tidal volumes measured before CO2 rebreathing were associated with higher response to the CO2 rebreathing test and consequently with higher ventilatory response to CO2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Maximal anaerobic power: relationship to anthropometric characteristics during growth.

The purpose of this study was to determine the effects of age in relation to anthropometric characteristics upon maximal anaerobic power of legs in sixty-nine young boys aged 11 to 19 years. Maximal anaerobic power (Wmax) was measured by the force-velocity test. Lean body mass (LBM) was determined from all four skin-fold thickness measurements, leg volume (LV) was estimated by anthropometric method, and anthropometric measurements were used to determine total muscular mass (TMM). Wmax increased significantly (F = 44.1, p less than 0.001) between 11 and 19 years and was correlated with LV (r = 0.84) and TMM (r = 0.88). It was most highly correlated with LBM (r = 0.94), which best explained the percentage of the total variance of Wmax (88%). Normalized Wmax (Wmax/LBM) also increased significantly between 11 and 19 years (F = 21.9, p less than 0.001). In conclusion, Wmax determined by the force-velocity test was closely related to anthropometric characteristics, especially LBM, during the growth period. Furthermore, even when corrected for lean body mass, maximal anaerobic power was always found to increase. This suggests that other undetermined factors, in addition to the amount of lean tissue mass, may explain the increase of Wmax during the force-velocity test.

Adolescent↗
PubMed1992

[Biopsy of the salivary glands. The importance and technic of biopsy of the sublingual gland on its anterio-lateral side].

A new method of taking a sublingual gland sample is suggested by the authors in the fore pole. They emphasize on this straightforward operating act and on the amount of tissue removed. The aim of the removal could be etiologic within the framework of the Gougerot-Sjögren's syndrome, diagnostic in the sarcoidosis and rheumatoid arthritis, prognostic in the graft versus host disease.

Biopsy↗
PubMed1992

[Relation between the change of slope of heart rate and second lactic and ventilatory thresholds in muscular exercise with large load].

The time-course of heart rate, blood lactate, and ventilatory gas exchange was studied during an incremental exercise test on cycloergometer in order to ascertain whether heart rate deflection occurred at the same load as the second lactate S[La]2) and ventilatory (SV2) thresholds. Twelve moderately trained subjects, 22 to 30 years old, participated in the study. The initial power setting was 30 W for 3 min with successive increases of 30 W every min except at the end of the test where the increase was reduced to 20 and 10 W.min-1. Ventilatory flow (VE), oxygen uptake (VO2), carbon dioxide production (VCO2, ventilatory equivalents of O2 (EO2 = VE/VO2) and CO2 (ECO2 = VE/VCO2), and heart rate (HR) were determined during the last 20 s of every min. Venous blood samples were drawn at the end of each stage of effort and analyzed enzymatically for lactate concentration ([La]). The HR deflection, S[La]2, and SV2 were represented graphically by two investigators using a double blind procedure. Following the method proposed by Conconi et al. 1982, the deflection in HR was considered to begin at the point beyond which the increase in work intensity exceeded the increase in HR and the linearity of the work rate/HR relationship was lost. S[La]2 corresponded to the second breaking point of the lactate time-course curve (onset of blood lactate accumulation) and SV2 was identified at the second breaking point in the increase in VE and ventilatory equivalent for O2 uptake accompanied by a concomitant increase in ventilatory equivalent for CO2 output. We observed that the deflection point in HR was present only in 7 subjects. The work load, VO2, HR, and [La] levels at which heart rate departed from linearity did not differ significantly from those determined with S[La]2 ans SV2. The VO2 and HR values at HR deflection point were significantly correlated with those measured at S[La]2 and SV2. It is concluded that deflection in heart rate does not always occur, and when it does, it coincides with the second lactate and ventilatory gas exchange thresholds. It can thus be used for the determination of optimal intensity for individualized aerobic training.

Adult↗
PubMed1991

[Morphological accidents other than labio-maxillary clefts].

In neonates and infants facial and/or craniofacial involvement occurs in a large number of malformative syndromes the pathogenesis of which is obscure in most cases. This, added to clinical polymorphism, hinders all attempts at classification. However, chromosomal aberrations, as demonstrated by karyotype analysis, can be distinguished from other congenital conditions where the predominant site of the anomaly may help clinicians in their research. Thus, among congenital syndromes of probable genetic origin, the author studies those that are most frequent or most characteristic, i.e. craniostenosis (or craniofaciostenosis) with its neurocerebral risk; lesions that are predominant in the upper part of the face (osteochondrodysplasia, systematized neurocristopathies); lesions affecting mainly the lower part of the face (bilateral and unilateral mandibular lesions) and anomalies of the tongue. Among syndromes of epigenetic origin, only alcoholic embryofoetopathy is presented. Diagnosing such morphological accidents does not only suggest possible cranial and/or dentofacial therapeutic measures, sometimes applied at an early stage, but it also enables clinicians to inform, whenever possible, the parents on the potential genetic risk.

Child, Preschool↗
PubMed1991

Influence of anthropometric characteristics on changes in maximal exercise ventilation and breathing pattern during growth in boys.

The aim of this study was to investigate the effect of growth on ventilation and breathing pattern during maximal exercise oxygen consumption (VO2max) and their relationships with anthropometric characteristics. Seventy six untrained schoolboys, aged 10.5-15.5 years, participated in this study. Anthropometric measurements made included body mass, height, armspan, lean body mass, and body surface area. During an incremental exercise test, maximal ventilation (VEmax), tidal volume (VTmax), breathing frequency (fmax), inspiratory and expiratory times (tImax and tEmax), total duration of respiratory cycle (tTOTmax), mean inspiratory flow (VT/tImax), and inspiration fraction (tI/tTOTmax) were measured at VO2max. A power function was calculated between anthropometric characteristics and ventilatory variables to determine the allometric constants. The results showed firstly, that VEmax, VTmax, tImax, tEmax, tTOTmax, and VT/tImax increased with age and anthropometric characteristics (P less than 0.001), fmax decreased (P less than 0.001), and tI/tTOTmax remained constant during growth; secondly that lean body mass explained the greatest percentage of variance of VEmax (62.1%), VTmax (76.8%), and VT/tImax (70.6%), while anthropometric characteristics explained a slight percentage of variance of fmax and timing; and thirdly that VEmax, VTmax, and VT/tImax normalized by lean body mass did not change significantly with age. We concluded that at VO2max there were marked changes in ventilation and breathing pattern with growth. The changes in VEmax, VTmax, and VT/tImax were strongly related to the changes in lean body mass.

Adolescent↗
PubMed1991

Blood lactate increase during the force velocity exercise test.

Venous blood lactate concentration was measured during the force velocity exercise test in order to determine whether this test is strictly alactic or whether it draws upon lactic anaerobic metabolism. Nine trained male subjects, aged from 23 to 29 years, participated in this study. Two blood samples were drawn at rest, and then for each work load (1 kg to 10 kg): at the end of each sprint (S1) and at the 5th minute of recovery (S2). From the first braking force, venous blood lactate concentration increased very significantly during the force velocity test (p less than 0.001) and, once the peak of power has been obtained, the venous blood lactate concentration remained steady. The lactate increase for each load (delta[LA]) decreased significantly (p less than 0.01). From the beginning of the exercise to the peak of power, a significant positive correlation between the increase of power and the increase of blood lactate concentration measured at S2 existed (r = 0.71, p less than 0.001), whereas there was a negative correlation between the decrease of delta[LA] and the increase of power (r = -0.45, p less than 0.01). In conclusion, the repetition of sprints during the force velocity test induced a recruitment of lactic anaerobic metabolism. Maximal power must be considered as an alactic and lactic anaerobic power. The consequences of lactate accumulation in muscle may be a limitation of the maximal anaerobic power.

Acceleration↗
PubMed1991

Effect of resistive loads on pattern of respiratory muscle recruitment during exercise.

In healthy subjects, we compared the effects of an expiratory (ERL) and an inspiratory (IRL) resistive load (6 cmH2O.l-1.s) with no added resistive load on the pattern of respiratory muscle recruitment during exercise. Fifteen male subjects performed three exercise tests at 40% of maximum O2 uptake: 1) with no-added-resistive load (control), 2) with ERL, and 3) with IRL. In all subjects, we measured breathing pattern and mouth occlusion pressure (P0.1) from the 3rd min of exercise, in 10 subjects O2 uptake (VO2), CO2 output (VCO2), and respiratory exchange ratio (R), and in 5 subjects we measured gastric (Pga), pleural (Ppl), and transdiaphragmatic (Pdi) pressures. Both ERL and IRL induced a high increase of P0.1 and a decrease of minute ventilation. ERL induced a prolongation of expiratory time with a reduction of inspiratory time (TI), mean expiratory flow, and ratio of inspiratory to total time of the respiratory cycle (TI/TT). IRL induced a prolongation of TI with a decrease of mean inspiratory flow and an increase of tidal volume and TI/TT. With ERL, in two subjects, Pga increased and Ppl decreased more during inspiration than during control suggesting that the diaphragm was the most active muscle. In one subject, the increases of Ppl and Pga were weak; thus Pdi increased very little. In the two other subjects, Ppl decreased more during inspiration but Pga also decreased, leading to a decrease of Pdi. This suggests a recruitment of abdominal muscles during expiration and of accessory and intercostal muscles during inspiration. With IRL, in all subjects, Ppl again decreased more, Pga began to decrease until 40% of TI and then increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

The effect of institutionalization on nursing home populations.

Two groups of institutionalized aged, the mentally ill and the frail elderly, were studied for differences in observable behaviors. The mentally ill group showed no significant decline in behavior as years spent in an institution increased. This finding reflects improvement in mental health care. The mentally ill nursing home resident does need to be maintained on appropriate psychotropic medications. Limit-setting approaches to caregiving will help maintain expected behaviors. The frail elderly showed a decline in neatness and an increase in negative behaviors with longer institutional stays. Caregiving needs to focus on helping the resident maintain a sense of mastery and control in the nursing home environment.

Activities of Daily Living↗
PubMed1990

Hyperpnoea and CO2 sensitivity of the respiratory centres during exercise.

The aim of this study was to specify whether exercise hyperpnoea was related to the CO2 sensitivity of the respiratory centres measured during steady-state exercise of mild intensity. Thus, ventilation (VE), breathing pattern [tidal volume (VT), respiratory frequency (f), inspiratory time (TI), total time of the respiratory cycle (TTOT), VT/TI, TI/TTOT] and CO2 sensitivity of the respiratory centres determined by the rebreathing method were measured at rest (SCO2re) and during steady-state exercise (SCO2ex) of mild intensity [CO2 output (VCO2) = 20 ml.kg-1.min-1] in 11 sedentary male subjects (aged 20-34 years). The results showed that SCO2re and SCO2ex were not significantly different. During exercise, there was no correlation between VE and SCO2ex and, for the same VCO2, all subjects had very close VE values normalized for body mass (bm), regardless of their SCO2ex (VEbm0.75 = 1.44 l.min-1.kg-1 SD 0.10). A highly significant positive correlation between SCO2ex and VT (normalised for bm) (r = 0.80, P less than 0.01), TI (r = 0.77, P less than 0.01) and TTOT (r = 0.77, P less than 0.01) existed, as well as a highly significant negative correlation between SCO2ex and (normalised for bm-0.25) (r = -0.73, P less than 0.01). We conclude that the hyperpnoea during steady-state exercise of mild intensity is not related to the SCO2ex. The relationship between breathing pattern and SCO2ex suggests that the breathing pattern could influence the determination of the SCO2ex. This finding needs further investigation.

Adult↗