Biomedical subjects
Publications and source records attributed to J Payan.
The author recounts the lessons taught by single-fiber electromyography that reached him through the medium of low-frequency attenuation and a small concentric needle electrode. He concludes that it is difficult to imagine practicing electromyography today without the benefits that have flowed from the work of Erik Stålberg and his colleagues.
OBJECTIVES: The physical properties of the resin-modified composite resin Dyract (Detrey Dentsply) and the resin-modified glass ionomer cement Fuji II LC (GC) were compared, and the effect of water sorption on these properties was studied. METHODS: Compressive, diametral compressive and flexural strengths were measured using specimens aged up to three months. The Vickers hardness and the water erosion were also determined. The specimens were stored at 37 degrees C under five different conditions, chosen to vary the water sorption of the samples. The results were analyzed using a multi-factor analysis of variance. RESULTS: Dry specimens of Dyract and Fuji II LC showed similar properties. However, the two materials behaved differently when stored in presence of water. In contrast to Fuji II LC, Dyract showed very little expansion for the first 24 h (1.5 +/- 0.3 and 0.03 +/- 0.01%, respectively), leached small quantities of ions and retained its mechanical strength. Those differences are related to their chemical composition. Fuji II LC is hydrophilic, as it contains polyHEMA. In the presence of water, Fuji II LC behaves like a hydrogel, but the network resulting from the copolymerization of acidic and UDMA monomers is less hydrophilic, and the effect of water on Dyract is retarded. SIGNIFICANCE: The significant properties of Dyract are determined by its composite character. This certainly represents some advantages, for instance, a higher mechanical strength, a better protection against initial dehydration and subsequent water effects. However, Dyract shows some disadvantages over Fuji II LC, like a lower amount of fluoride release or the interference of oxygen during polymerization.
OBJECTIVES: Resin-modified glass ionomer cements (GIC) are available for clinical use as restorative materials or as liners and bases. This work was conducted to study the effect of water sorption on the physical properties of several resin-modified GIC, by changing the samples' storage conditions. METHODS: The water sorption, the flexural strength, the flexural elastic modulus, the Vickers hardness and the dimensional changes of five resin-modified GICs were measured using specimens aged for 24 h to 3 mon. The specimens were stored at 37 degrees C, either in a dry environment (A), immersed in water (B), stored in a humid environment (C), stored in a humid environment for 1 h and then immersed in water (D), or immersed in water and subsequently dried (B + A). An analysis of variance was used to compare the results. RESULTS: The resin-modified GIC absorb during the first 24 h large amounts of water (114-172 mg/cm3) compared to the conventional GIC (30-63 mg/cm3). Water alters the physical properties of resin-modified GICs: With regard to dry specimens, a decrease in the flexural strength of 20 to 80% was observed for samples immersed in water. Decreases in their flexural elastic modulus (50 to 80%) and in their hardness (approximately 50%) were also observed. Water sorption also provoked an expansion in volume of the immersed specimens, ranging from 3.4 to 11.3% after 24 h. SIGNIFICANCE: The flexural strength and Vickers hardness of the resin-modified GICs are sensitive to the water contained in the tested specimens. A correlation was established between the decrease in their physical properties and the water uptake. However, it should not be concluded that these materials are not adequate for use in applications in direct contact with oral fluids. Probably, resin-modified GIC placed in oral cavities would not be affected to the same extent as in in vitro tests. In an oral environment, the constituents of saliva will certainly decrease the rate of water sorption and will hence delay its effects.
OBJECTIVE: To determine whether patients with the clinical phenotype of multifocal motor neuropathy but without the electrophysiological criteria for conduction block would respond to intravenous immunoglobulin (IVIg). METHODS: Ten patients were selected with a slowly progressive, asymmetric, lower motor neuron disorder, and were treated prospectively with IVIg at a dose of 2g/kg over 5 days. All subjects had neurophysiological testing to look for evidence of conduction block before treatment. Muscle strength was assessed by MRC grades and hand held myometry, measuring pinch and grip strength. A 20% increase in both pinch and grip myometry was considered a positive response. RESULTS: In no patient was conduction block detected. Four of the 10 patients showed a positive response to IVIg, with the best response occurring in two patients who presented with weakness but without severe muscle wasting. Three of the four responders have continued to receive IVIg for a mean period of 17 months (range 15-24 months), with continued effect. The response to IVIg was not related to the presence of anti-GM1 antiganglioside antibodies, but responders had a selective pattern of muscle weakness and normal (>90% predicted) vital capacity. CONCLUSION: The findings suggest that a course of IVIg should be considered in patients with the clinical phenotype of multifocal motor neuropathy but without neurophysiological evidence of conduction block.
The purpose of this study was to observe the effect of different conditions of storage on the surface and in the depth of luting glass ionomer cement by measuring microhardness. The hardness of a glass ionomer cement was measured after storage in wet and dry conditions and in an atmosphere of 80% relative humidity, for times up to 1000 h. Storage in distilled water produced a softening effect, but the depth hardness increased progressively. The penetration of the water is a surface phenomenon and does not affect the depth of the cement. However, the cement is vulnerable to moisture to a depth of 600 microns and marginal gaps evolve in the range of 40 to 80 microns when the luting cement at the tooth crown margin is always destroyed.
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Subacute combined degeneration of the spinal cord due to vitamin B12 deficiency invariably has been associated with a low serum vitamin B12 level. We describe a young man who presented with a unique syndrome of subacute combined degeneration associated with high serum vitamin B12 level, low red blood cell vitamin B12 level, and an abnormal plasma vitamin B12-binding protein. Uptake of cobalamin by his leukocytes in vitro was inhibited by his own but not by normal control plasma. Intensive hydroxocobalamin (vitamin B12) treatment was associated with clinical and electrophysiologic recovery accompanied by normalization of mean corpuscular volume, red blood cell vitamin B12 level, plasma homocysteine, and urinary methylmalonic acid. The subacute combined degeneration was probably precipitated by treatment with folic acid as the significance of his high serum vitamin B12 level was not apparent when he first presented with megaloblastic anemia 3 years earlier. To our knowledge, this is the first example of neurologic disease associated with high serum vitamin B12 level and provides further evidence that sometimes a serum vitamin B12 level may not be a reliable guide to vitamin B12 deficiency.
A 21 month old girl presented with a short history of frequent falls and a right sided foot drop. She went on to suffer recurrent episodes of distal weakness in her arms and legs with hyporeflexia. Electrophysiological studies were consistent with inflammatory demyelinating polyradiculoneuropathy (IDP) and treatment with corticosteroids appeared to lead to an improvement. However, the development of hypertension, evidence of tubulopathy, and hepatomegaly led to re-evaluation. A diagnosis of type I tyrosinaemia was made, based on increased urinary excretion of succinylacetone and decreased activity of fumarylacetoacetase in her cultured skin fibroblasts. A low tyrosine diet did not prevent life-threatening exacerbations of neuropathy but intravenous haemarginate appeared to aid her recovery from one exacerbation. An immediate improvement in strength was seen after starting treatment with 2-(2-nitro-4-trifluoro-methyl-benzoyl)-1,3-cyclohexanedione (NTBC), an inhibitor of 4-hydroxy-phenylpyruvate dioxygenase. A liver transplant was performed but the patient died of immediate postoperative complications. Tyrosinaemia needs to be considered in a child with recurrent peripheral neuropathy because (i) the signs of liver disease and renal tubular dysfunction may be subtle; (ii) acute exacerbations may be life threatening; (iii) specific forms of treatment are available.
OBJECTIVE: To compare the effects of placebo and GLA on the course of mild diabetic neuropathy over 1 yr. RESEARCH DESIGN AND METHODS: We entered 111 patients with mild diabetic neuropathy from seven centers into a randomized, double-blind, placebo-controlled parallel study of GLA at a dose of 480 mg/day. MNCV, SNAP, CMAP, hot and cold thresholds, sensation, tendon reflexes, and muscle strength were assessed by standard tests in upper and lower limbs. RESULTS: For all 16 parameters, the change over 1 yr in response to GLA was more favorable than the change with placebo, and for 13 parameters, the difference was statistically significant. Sex, age, and type of diabetes did not influence the result, but treatment was more effective in relatively well-controlled than in poorly-controlled diabetic patients. CONCLUSIONS: GLA had a beneficial effect on the course of diabetic neuropathy.
The incidence and type of neuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed. In a selected group of 89 patients, abnormal nerve conduction studies were found in 44%. Electrophysiological signs of a generalized peripheral neuropathy were found in 5-18%, depending on diagnostic criteria. Lesions which were thought to be due to compression or other forms of trauma were present in a further 24%. In the patients with peripheral neuropathy, the changes were distally predominant, affected mainly sensory fibres, and were consistent with an axonal type of neuropathy. There was a significant correlation between age and the incidence of peripheral neuropathy. Electrophysiological evidence of neuropathy was three times as common as clinical evidence. Much of the variation in the reported incidence of neuropathy in COPD is probably due to imprecise diagnostic criteria.
We describe two sisters who each presented in infancy with acute, severe, generalised weakness and are-flexia in association with an intercurrent infection. The clinical picture resembled acute polyneuritis, but EMG findings and the later clinical features were consistent with a diagnosis of spinal muscular atrophy. Although symptoms in SMA may be exacerbated by infection, immunisation or trauma, this unusual presentation of the condition in siblings suggests that this may constitute a genetically distinct subgroup of the disorder.
Sural nerves were examined in 3 childhood cases of Leigh's disease (from 2 families), each with electrophysiological documentation of peripheral neuropathy. Postmortem confirmation of Leigh's disease was made in 2 cases; the third had characteristic CT scan appearances. Myelinated fibre densities were within normal limits, with no evidence of degeneration or regeneration. The myelin sheaths, however, appeared thin and this was confirmed quantitatively. In teased fibres there was no demyelination in 2 cases but some in 1 case. The findings suggest that there is hypomyelination of peripheral nerves leading eventually to demyelination.
23 eyes underwent vitrectomy for diabetic proliferative retinopathy complications: vitreous hemorrhage with or without tractional retinal detachment. After 6 months of follow-up, 64% of eyes had final visual acuities of 1/40 or better. Preoperative iris neovascularization and preoperative detachment of the macula have a worse prognosis. Decrease of peroperative complications is allowed by checking of intraocular pressure during vitrectomy.
23 eyes underwent vitrectomy for diabetic proliferative retinopathy complications: vitreous hemorrhage with or without tractional retinal detachment. After 6 months of follow-up, 64% of eyes had final visual acuities of 1/40 or better. Preoperative iris neovascularization and preoperative detachment of the macula have a worse prognosis. Decrease of peroperative complications is allowed by checking of intraocular pressure during vitrectomy.
Photographic study of retinal nerve fiber (RNF) in glaucoma and ocular hypertension. Photographic study of retinal nerve fiber layer try to show defects in case of glaucoma or ocular hypertension. After describing the method used and the different aspects met, we present the results of confrontation between the exam and campimetry for 49 eyes, with control of the evolution for 30 eyes during an average time of thirty months.
Photographic study of retinal nerve fiber layer try to show early defects in case of glaucoma or ocular hypertension. Among the recent techniques trying to indicate the first marks of glaucoma, this method appears easy, reproducible, objective, and uses a very common equipment. We describe the equipment and the technic used, and present the main physiological and pathological aspects. Our series includes 49 eyes (30 patients) and, for 30 among them (17 patients), a control of the evolution has been done within an average period of thirty months. In each case, visual field was studied, principally with the programs of early detection of glaucomatous damage available on the Octopus 2000 R (prog. No 31, 33 and G1). We explore and comment upon the results obtained by the confrontation between these exams.
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