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Biomedical subjects

Eric Mortier

Publications and source records attributed to Eric Mortier.

16 recordsLinked to original sources
PubMed2005

In vitro evaluation of microleakage of indirect composite inlays cemented with four luting agents.

STATEMENT OF PROBLEM: Microleakage around dental restorations is implicated in the occurrence of secondary carious lesions, adverse pulpal response, and reduced restoration longevity. PURPOSE: The aim of this in vitro study was to evaluate the microleakage of indirect resin composite inlays cemented with 4 luting agents. MATERIAL AND METHODS: Standardized Class V inlay preparations overlapping the cemento-enamel junction were prepared on the buccal and lingual surfaces of 40 extracted human mandibular third molars. Eighty postpolymerized, heat-treated resin composite inlays (Targis, 72 specimens, 8 controls) were processed in stone replicas and cemented into the preparations using 4 luting agents (n = 18 + 2 controls for each cement group): a resin composite used with a bonding agent (Variolink II/Excite), a resin composite used with a self-etching primer, but without bonding agent (Panavia F/ED Primer), a modified resin composite used with a bonding agent (Resinomer/One Step), and a resin-modified glass-ionomer cement (Fuji Plus). Thirty-six inlays (n = 9 + 1 control) were subjected to thermal cycling (2000 cycles, 5 degrees C/55 degrees C), whereas the other 36 were not. All the teeth were then immersed in 1% methylene blue dye solution for 48 hours. Microleakage score, margin location (enamel/cementum), thermal cycling history, and preparation location (buccal/lingual) were analyzed using a multivariate model (alpha = .05). Multivariate analysis was performed using a polychotomous logistic regression. RESULTS: The preparation location had no significant effect on dye penetration. The margin location (enamel or cementum) and the thermal cycling had a significant effect on microleakage (odds ratios [ORs] = 17.6 and 8.04, respectively). In comparing the 3 resin-based luting agents (Variolink II, Panavia F, and Resinomer) to Fuji Plus, Panavia F exhibited the lowest significant overall microleakage (OR = 0.09), followed by Variolink II (significant OR equal to 0.43), whereas Resinomer demonstrated the greatest significant overall microleakage (OR = 1.35). CONCLUSION: Within the experimental conditions of this in vitro study, thermal cycling significantly increased microleakage (OR = 8.04). The overall microleakage at the enamel margins was significantly lower than the overall microleakage at the cementum margins for the 4 luting agents tested (OR = 17.6).

Acid Etching, Dental↗
PubMed2005

Influence of initial water content on the subsequent water sorption and solubility behavior in restorative polymers.

PURPOSE: To evaluate the water sorption characteristics and solubility behavior of two resin-based composites, an ormocer, a compomer and a resin-modified glass-ionomer, according to ISO 4049 specifications and also without the initial desiccation cycle. METHODS: After polymerization, five disks (15 x 1 mm) of each material [Filtek P60 (P60), Solitaire 2 (SOL2), Admira (ADM), Compoglass F (COF) and Fuji II LC (FLC)] were desiccated until a constant mass (ml) was obtained. They were immersed in distilled water for 7 days and immediately weighed after that period (mass m2). Then disks were again desiccated and weighed every day for 35 days (mass m3). Sorption and solubility values were deduced from these different measures. Without initial desiccation mass m1 was obtained just after polymerization. RESULTS: Without initial desiccation, all the materials absorbed less water and solubility was 1.5 to 8 times greater than in standard experiment. For the two protocols, water sorption and solubility were significantly greater in FLC, and ADM showed the least weight loss of all the materials tested.

Absorption↗
PubMed2003

Criteria for immediate postoperative extubation in adult recipients following living-related liver transplantation with total intravenous anesthesia.

STUDY OBJECTIVE: To evaluate whether our criteria for immediate postoperative extubation predicts successful extubation in living-related liver transplantation of the right lobe, and to test the effects of our standardized anesthetic technique on the success of immediate postoperative extubation. DESIGN: Open-label, descriptive study. SETTING: University hospital. PATIENTS: 6 ASA physical status III and IV patients with end-stage liver disease undergoing living-related liver transplantation of the right lobe. INTERVENTIONS: Patients received a standardized anesthetic technique with propofol, remifentanil, and cisatracurium. They were extubated when they met our criteria for immediate postoperative extubation: good donor liver function, <10 U packed red blood cells administered, hemodynamic stability, and alveolar-arterial oxygen gradient <200 mmHg. MEASUREMENTS AND MAIN RESULTS: At the end of surgery, four of the six patients fulfilled our criteria for immediate postoperative extubation. They were uneventfully extubated rapidly after surgery and soon arrived in the intensive care unit. Their postoperative stay in the operating room was only 36 minutes (range: 30 to 42 min). No patient required reintubation in the operating room or the intensive care unit. They had no recorded hemodynamic or respiratory problems postoperatively. CONCLUSIONS: Immediate extubation of selected living-related liver transplant recipients can be a safe procedure. Anesthetic management to immediate extubation seems appropriate and the derived guidelines appear acceptable.

Adolescent↗
PubMed2003

Ambulatory electrical external cardioversion with propofol or etomidate.

STUDY OBJECTIVE: To compare, in pairwise fashion, the effects of propofol and etomidate during ambulatory cardioversion and early recovery. DESIGN: Clinical, prospective, randomized, blinded, monocenter, pairwise, comparative study SETTING: OR and recovery area of the electrophysiological department, University Hospital Ghent, Belgium. PATIENTS: 34 patients with atrial arrhythmia who were scheduled for repetitive electrical cardioversion, of whom 25 patients completed the study. INTERVENTIONS: Nonpremedicated patients received during the first cardioversion either propofol (1 mg/kg) or etomidate (0.2 mg/kg) until loss of consciousness, followed by electrical external cardioversion. If after restoration of sinus rhythm for at least 1 day, atrial arrhythmia reoccurred, a second session was performed a week later, using the other induction drug. MEASUREMENTS: Systolic and diastolic blood pressure values taken before drug administration, at loss of consciousness, 60 seconds after cardioversion, and awake; the number of shocks, the total amount of energy, the number of patients in which we failed to restore sinus rhythm, the time before opening eyes, answering simple questions and be able to sit, were all noted. Aldrete scores and the Steward postanesthetic recovery scores were noted every minute until 10 minutes after the external cardioversion. Recovery tests were performed and evaluated 5, 10, 15, and 20 minutes after energy delivery. MAIN RESULTS: Number of shocks, amount of energy, and blood pressure values were comparable in both groups. Recovery times and Aldrete and Steward postanesthetic recovery scores showed a faster awakening in patients who were induced with propofol. Overall performance of the psychomotor test was better in the propofol group, and most pronounced at 10 and 15 minutes. CONCLUSIONS: Etomidate and propofol are both useful during ambulatory external electrical cardioversion. The described doses maintain stable hemodynamic conditions in nonpremedicated patients. Recovery scores and psychomotor test indicate a faster recovery in the propofol group. However, no intergroup differences were noted at 20 minutes after the cardioversion. A safe discharge of all patients from the critical care unit or postanesthesia care unit to the ward can be considered after 30 minutes.

Ambulatory Care↗
PubMed2003

Comparison of the LMA-classic with the new disposable soft seal laryngeal mask in spontaneously breathing adult patients.

BACKGROUND: The laryngeal mask airway LMA-Classic has been used widely in clinical practice. A new disposable supraglottic airway device, the Soft Seal LM, has been introduced recently. In a randomized study, the authors compared the LMA-Classic and the disposable Soft Seal LM in terms of their clinical performance, cuff pressures during nitrous oxide anesthesia, position of the laryngeal mask in situ by fiberoptic evaluation, and morbidity in a wide range of routine general surgery procedures. METHODS: A total of 200 adult patients were randomly assigned to a size 4 laryngeal mask in two equal-sized groups for airway management during surgery: (1) LMA-Classic (Intavent Orthofix Ltd., Maidenhead, Berkshire, United Kingdom); or (2) Soft Seal LM (Portex Ltd., Hythe, Kent, United Kingdom). Anesthesia was administered with fentanyl, propofol, nitrous oxide, oxygen, and sevoflurane. The variables studied were ease of insertion, fiberoptic view, time in situ, incidence of blood on the laryngeal mask at the time of removal, and the incidence of postoperative sore throat at 2 and 24 h. The laryngeal mask cuff pressures were measured continuously. Intracuff pressure limitation was not attempted. RESULTS: The LMA-Classic and the Soft Seal LM showed similar clinical performances, as shown by their insertion time (successful insertion at first attempt was achieved within 20 s in 97% with LMA-Classic trade mark vs. 95% with Soft Seal LM), fiberoptic evaluation of the anatomic position of the laryngeal mask, and satisfactory anesthesia conditions. Laryngeal mask cuff pressures increased from 45 to 100.3 mmHg in the LMA-Classic and from 45 to 46.8 mmHg in the Soft Seal LM (P < 0.001). Macroscopic blood was seen on only four occasions in the LMA-Classic group. The incidence of sore throat was significantly increased at 2 h postoperatively when using the LMA-Classic, although there was no difference at 24 h after surgery. CONCLUSIONS: In spontaneously breathing adult patients requiring a size 4 laryngeal mask airway, the new disposable Soft Seal LM device is an acceptable alternative to the reusable LMA-Classic trade mark, resulting in a good laryngeal seal and offering similar clinical performance. Cuff pressures increase substantially when the LMA-Classic is used but not when using the Soft Seal LM. There was less trauma to patients using the Soft Seal LM, as assessed by the incidence of sore throat in the early postoperative period.

Adolescent↗
PubMed2003

Modulation of portal graft inflow: a necessity in adult living-donor liver transplantation?

OBJECTIVE: To evaluate the clinical significance of modulating the recipient portal inflow (rPVF) through perioperative ligation of the splenic artery in adult living-donor liver transplantation (ALDLTx) by focusing on vascular complications, intractable ascites production, and the prevention of small-for-size syndrome (SFSS). SUMMARY BACKGROUND DATA: In ALDLTx, portal graft flow is enhanced to at least twice the donor value, raising the total liver inflow. Recipient hepatic arterial flow (rHAF) is lower than expected. Portal hyperperfusion of small grafts in larger recipients is thought to be one of the main causes of posttransplant graft dysfunction/SFSS. METHODS: Seventeen ALDLTx were reviewed for a minimum of 2 months. Patients were divided retrospectively into two groups: G1 (n = 7), without modulation of rPVF, and G2 (n = 10), with splenic artery ligation to decrease rPVF perioperatively. Donor and recipient hepatic hemodynamics were evaluated against graft function and outcome, including correlations between rPVF, graft weight, graft:recipient body weight ratio, and recipient weight. RESULTS: Following portal and arterial reperfusion, mean rPVF and rPVF/graft weight were much higher than in the donors, whereas mean rHAF and rHAF/graft weight were much lower. No differences were found between groups, except for rPVF and rHAF, which were much more higher and lower, respectively, before splenic artery ligation. In G1 patients, SFSS was seen in two patients and vascular complications occurred in two others. In G2 patients, splenic artery ligation permitted a significant decrease in rPVF, an improvement in rHAF, and the resolution of refractory ascites. Neither SFSS nor vascular complications were seen in G2 patients. CONCLUSIONS: When a suboptimal graft:recipient body weight ratio is accompanied by high rPVF in ALDLTx, the portal flow should be modulated perioperatively; splenic artery ligation is a simple and safe method that is sufficient to allow this modulation in most patients.

Adult↗
PubMed2003

Intermittent nitric oxide combined with intravenous dipyridamole in a piglet model of acute pulmonary hypertension.

UNLABELLED: Continuous administration of inhaled nitric oxide is now widely used as a potent and selective pulmonary vasodilator. We have evaluated the effects of IV dipyridamole, a cyclic guanosine monophosphate (cGMP) phosphodiesterase inhibitor, on the magnitude and duration of action of inhaled nitric oxide (NO)-mediated pulmonary vasodilation. We hypothesized that inhibition of cGMP degradation could augment and prolong the pulmonary vasodilating effects of NO and allow for intermittent NO inhalation. In eight anesthetized and mechanically ventilated piglets, IV U-46619, a thromboxane A(2) analog, was used to induce pulmonary hypertension. The effects of 2, 5, and 10 ppm of NO, delivered during 4 min for each concentration and followed by a 10-min NO-free interval after each NO concentration, were evaluated without and with dipyridamole. Pulmonary vascular resistance decreased from 825 +/- 49 dynes. s. cm(-5) (U-46619) to 533 +/- 48 dynes. s. cm(-5) (10 ppm NO) (P < 0.05 versus U-46619) and 396 +/- 42 dynes. s. cm(-5) (dipyridamole 10 microg kg-1x min-1 and 10 ppm NO) (P <0.05 versus NO), and cardiac output increased from 1.93 +/- 0.09 L/min to 2.03 +/- 0.13 L/min and 2.60 +/- 0.30 L/min (P < 0.05 versus NO). Mean arterial blood pressure decreased from 90 +/- 5 mm Hg (10 ppm NO) to 75 +/- 3 mm Hg (dipyridamole plus 10 ppm NO) (P < 0.01). The pulmonary vasodilation obtained with NO alone could be prolonged from 12 to 42 min when inhaled NO was combined with IV dipyridamole, accounting for a time-weighted reduction in NO exposure by 72%. We conclude that dipyridamole augments the effects of NO on right ventricular afterload, allows for intermittent NO inhalation, and can significantly reduce exposure to NO. IMPLICATIONS: IV dipyridamole prolongs the action of inhaled nitric oxide (NO) in a piglet model of acute pulmonary hypertension. Intermittent NO inhalation combined with IV dipyridamole decreases pulmonary artery pressure for a prolonged period of time and reduces exposure to NO.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed2002

Dose requirements and recovery profile of an infusion of cisatracurium during liver transplantation.

STUDY OBJECTIVE: To examine the dose requirements and recovery profile of an infusion of cisatracurium during liver transplantation. DESIGN: Open-label, descriptive study. SETTING: University hospital. PATIENTS: 6 ASA physical status III and IV patients with end-stage liver disease, undergoing liver transplantation. INTERVENTIONS: Neuromuscular transmission was monitored electromyographically. After recovery of T1/T0 to 10%, cisatracurium was infused at an initial rate of 1.5 microg/kg/min. The infusion rate was adjusted to maintain T1/T0 at 10%. At the end of surgery, spontaneous recovery from the neuromuscular block was awaited. MEASUREMENTS AND MAIN RESULTS: The infusion rate of cisatracurium was 1.6 +/- 0.4 microg/kg/min. Before the anhepatic phase, this rate was 1.5 +/- 0.4 microg/kg/min; during the anhepatic phase it was 1.7 +/- 0.5 microg/kg/min; and after reperfusion it was 1.9 +/- 0.4 microg/kg/min. There was a significant difference between the cisatracurium infusion rates before and after the anhepatic phase (p < 0.05). Following termination of the infusion, the time to 25% recovery of T1/T0 was 19.2 +/- 6.1 minutes, the recovery index (25% to 75%) was 28.8 +/- 7.0 minutes, and the time for the train-of-four (TOF) ratio to reach 0.7 was 50.2 +/- 7.1 minutes. The time for the TOF ratio to reach 0.9 was 61.4 +/- 6.6 minutes. There was no difference in body temperature or pH during the consecutive stages of transplantation. CONCLUSIONS: The infusion dose requirement for cisatracurium during liver transplantation tended to be higher than previously reported in healthy patients; recovery appeared prolonged. In continuous infusion of cisatracurium during liver transplantation, the tendency toward higher dose requirements, the protracted duration of infusion, the non-Hofmann elimination and/or other pharmacokinetic changes during transplantation might influence recovery from the neuromuscular block. Potential temperature or pH change during surgery seemed irrelevant in explaining the delayed recovery.

Adolescent↗
PubMed2002

Intravenous dipyridamole enhances the effects of inhaled nitric oxide and prevents rebound pulmonary hypertension in piglets.

Inhaled nitric oxide (NO) is increasingly used in the treatment of pulmonary hypertension, despite its potential toxicity and the risk of life-threatening rebound pulmonary hypertension upon its discontinuation. We investigated whether i.v. dipyridamole, a cGMP phosphodiesterase inhibitor, increased the effects of inhaled NO and prevented rebound pulmonary hypertension. In 14 anesthetized and mechanically ventilated piglets, pulmonary hypertension was induced with U-46619, a thromboxane A(2) analogue. Response to NO and rebound pulmonary hypertension were evaluated without and with i.v. dipyridamole. Low-dose dipyridamole (10 micro g/kg/min) increased cardiac output and augmented the effects of inhaled NO on pulmonary vascular resistance, with marginal additive effect on mean pulmonary artery pressure. Pulmonary vascular resistance decreased from 904 to 511 (20 parts per million NO) (p < 0.0005) and 358 dyne s cm(-5) (20 parts per million NO + dipyridamole) (p < 0.001 versus NO alone), and mean pulmonary artery pressure decreased from 29.0 to 20.5 (p < 0.0001) and 19.3 mm Hg (NS versus NO), respectively. Mean arterial pressure decreased from 85 to 74 mm Hg (dipyridamole + NO) (p < 0.01). High-dose dipyridamole (100 micro g/kg/min) with inhaled NO reduced pulmonary vascular resistance to 334 dyne s cm(-5) but also decreased mean arterial pressure to 57 mm Hg. Eight piglets developed rebound pulmonary hypertension. Two died of acute right ventricular failure and, in five, rebound pulmonary hypertension was prevented by low-dose dipyridamole. In conclusion, low-dose i.v. dipyridamole augments the effects of inhaled NO on right ventricular afterload with moderate changes in systemic hemodynamics, and can prevent rebound pulmonary hypertension.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed2002

Central pain: an overview.

Central pain is a particular form of neuropathic pain. Due to lesions in the spinothalamocortical pathways, ectopic neuronal discharges can occur into different neurons of the spinal cord and brain. Functional MRI, and positron emission tomography might be able to visualize ongoing pain activity which is, sometimes the consequence of spinothalamocortical lesions. Sometimes the patient experiences a burning ice-like sensation. This is more frequent in spinal cord lesions than in brain injuries. Some adrenergic, gabergic neurotransmitters, glycine, prostanoids and glutamate may play a role in pain transmission. These transmitters can induce changes in the neuronal membrane potential. Consequently, amitriptyline as an adrenergic reuptake inhibitor and the sodium channel blockers are the drugs of first-choice. A test procedure with placebo, opioids, lignocaine, propofol and ketamine might give some insight into advanced drug treatment. If oral or transdermal drug delivery is not indicated or ineffective, the intrathecal administration route can be attempted with baclofen, clonidine, opioids and midazolam. Invasive electrostimulation is the last treatment option. Thalamic stimulation can be tried in spinal cord injuries, and sensory motor cortex stimulation is sometimes the last resort for brain lesions associated with pain.

Adrenergic Uptake Inhibitors↗
PubMedDate not supplied

The epidural fibrous sheath: a guide for the replacement of a spinal cord stimulation electrode.

BACKGROUND AND OBJECTIVE: During spinal cord stimulation there is sometimes a need to replace defective leads. Percutaneous lead replacement by recannulating the epidural space and "steering" the new lead to the prior location is sometimes very difficult, resulting in diminished analgesia. Since fibrous deposits are known to form around epidural catheters and epidural obstructions have been noted with other techniques, we have inserted the new lead through the well-dissected opening in the interspinal ligament. We will report the results of our case series. METHODS: In 11 patients with lead malfunction we reinserted a new electrode into the epidural space by first withdrawing the lead with one hand and inserting the new one through the interspinal ligament with the other. In using this method, we found we could position the new electrode almost identically to the first. In only 3 patients did we experience difficulty in identifying the opening for the insertion. In the successfully cannulated patients identical stimulation parameters and paresthesia areas were obtained. By experimentally injecting contrast dye through an epidural catheter inserted into the interspinal opening and epidural pathway, we could visualize a thin dense line representing the fibrous sheath. CONCLUSION: Foreign bodies in the epidural space lead to fibrous deposits. Spinal cord stimulation, when those deposits form a sheath, the sheath is useful for lead revision. The procedure, if meticulously performed, has a high success rate.

Chronic Disease↗
PubMedDate not supplied

Importance of water sorption and solubility studies for couple bonding agent--resin-based filling material.

This study investigated the water sorption and solubility of two light-cured resin composites (Filtek P60 and Solitaire 2), one compomer (Compoglass F), one ormocer (Admira) and the associated bonding agents (Scotchbond 1 [Scotchbond 1 = Scotchbond Single Bond in USA], Gluma One Bond, Excite and Admira Bond, respectively) and of a RMGIC (Fuji II LC). Five disks of each product type were subjected to water sorption and solubility tests based on ISO 4049 requirements. The data were subjected to Kruskal-Wallis and non-parametric multiple-comparison tests using ranked sums at 95% confidence interval. Fuji II LC showed the highest water sorption (167.5 microg/mm(-3)). Fuji II LC and Compoglass F had higher solubility values (8.3 and 10.0 microg/mm(-3), respectively) than the other materials. Bonding agents have very high water sorption and solubility values (between 77.4 and 355.4 microg/mm(-3) and between 75.9 and 144.9 microg/mm(-3), respectively) compared to the restorative materials. Gluma One Bond and Admira Bond showed lower sorption and solubility than Excite and Scotchbond 1.

Absorption↗