Biomedical subjects
Publications and source records attributed to F Joyal.
Explore the source record for details and available documents.
With advertisers spending millions of dollars for a share of consumers' disposable income, dentistry is up against fierce competition for patients. Dentistry will have to sell itself to keep up. One way to do this is to focus on the area in which consumers are increasing their spending--esthetics. Patients are drawn to a practice by appeals to their desire to look good. They can then be assessed for necessary work to improve their overall dental health.
With millions of dollars being spent by advertisers seeking a share of consumers' disposable income, dentistry is up against fierce competition for patients. Dentistry will have to sell itself to keep up, and one way to do that is to focus on the area in which consumers are increasing their pending-esthetics. Once patients are drawn into a practice by appeals to their desire to look good, they can then be assessed for necessary work to improve their overall dental health.
OBJECTIVE: To evaluate an enzyme-linked immunosorbent assay (ELISA) for anticentromere autoantibodies (ACA). METHODS: Sera from 611 patients with scleroderma, CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias), Raynaud's disease, and connective tissue disease control patients were studied by ELISA using the fusion protein CENP-B, by immunofluorescence on dividing HEp-2 cells, and by immunoblotting on chromosomes and CENP-B. RESULTS: Compared with immunofluorescence, the CENP-B ELISA sensitivity was 94% and the specificity was 93%. In 19.7% of the cases, there was a probability of a false-positive result and in 1.9%, a probability of a false-negative result, yielding positive and negative predictive values of 0.80 and 0.98, respectively. CONCLUSION: The CENP-B ELISA is a sensitive and specific assay for ACA.
The authors used nailfold capillary microscopy (NCM) to evaluate 112 patients with systemic sclerosis spectrum disorders (SSc). Patients were classified as S1 if they had skin involvement proximal to the metacarpo-phalangeal joints. S2 if they had at least two minor SSc American Rheumatism Association criteria, and S3 if they had at least two CREST criteria (calcinosis, Raynaud's, esophageal motility disorder, sclerodactyly, telangiectases), without S1 or S2 criteria. Disease duration from the first symptom was similar in all groups (7.17 +/- 8.98 years). Disease severity was determined by a total score of seven target organ involvements. S1 patients had a greater degree of skin and pulmonary involvement, with a mean score of 26.2 +/- 17.3. S2 patients had a mean score of 13.8 +/- 12.4, and had mostly vascular and digestive involvement, in comparison with S3 patients (7.2 +/- 7.2; p less than 0.001 and p less than 0.01 respectively). NCM sensitivity for S1 and S2 was 93.6%. NCM correlated with the degree of target organ involvement (p less than 0.01). Three NCM profiles established were: "mild," normal or borderline capillaries; "moderate," other abnormalities with no capillary telangiectases; and "severe," abnormalities other than those of the mild profile, with capillary telangiectases.
Seventy-seven patients with Raynaud's disease were studied for a mean of 4 years (range 1-11 years) to determine the relationship between autoantibodies and long-term clinical outcome. Anticentromere antibodies (ACA) were assayed by indirect immunofluorescence and by immunoblotting of HeLa cell chromosome extracts. Antibodies to topoisomerase I (anti-topo I) were assayed by immunodiffusion and immunoblotting. Antibodies to the major centromeric protein, CENP-B, and anti-topo I were studied by enzyme-linked immunosorbent assay (ELISA). Eight patients developed telangiectasias, 4 developed skin tightening, and 4 developed a connective tissue disease other than scleroderma. The presence of ACA at the start of the study was associated with the development of telangiectasias (P less than 0.003). An initial 100-kd band on immunoblot in conjunction with a positive anti-topo I ELISA result was associated with the development of tight skin (P less than 0.0025), while a 100-kd band with a negative anti-topo I ELISA result was associated with the subsequent development of a connective tissue disease other than scleroderma (P less than 0.0073). Patients who were initially ACA positive, had the 100-kd band on immunoblot, or had positive ELISA results for anti-topo I or for anti-CENP-B were 63-fold more likely to develop signs of connective tissue disease by the end of the study (P less than 0.000009). The presence of any of these autoantibodies was more sensitive (100%), although less specific (75%), than were findings from nailfold capillaroscopy (sensitivity 67% and specificity 95%) in predicting subsequent clinical progression. We conclude that findings of assays for anti-topo I and ACA complement the findings from nailfold capillaroscopy in providing useful prognostic information in Raynaud's disease.
Actin microfilaments are anchored to the plasma membrane at focal contacts. Using an indirect immunofluorescence method, we detected an autoantibody reactive with focal contacts in PtK2, HEp-2, and BHK-21 cells in serum from two patients with early systemic sclerosis. With double immunofluorescence, using the actin-binding drug phalloidin, we localized the plaques decorated by these sera specifically at the termini of microfilament bundles. The reactive antigens were identified by immunoblotting as proteins of 80,000- and 75,300-mol wt in PtK2, and of 53,500-mol wt in HEp-2 and BHK-21 cells. The 53,500-mol wt protein was also identified in rat skeletal, myocardial, and smooth muscle tissues. The detergent solubility of these proteins suggested that they may be linked to the plasma membrane. The autoantigens were immunologically distinct from vinculin and alpha-actinin, two major proteins also known to be concentrated at the ends of microfilament bundles. Our observations suggest that this novel anticytoskeletal autoantibody may identify a novel family of vertebrate cell proteins involved in the linkage of microfilaments to the plasma membrane at focal contacts.
Variations in blood pressure (BP), heart rate (HR) and peripheral arterial blood flow (BF) were measured during the "roll-over" test (ROV) by impedance plethysmography. With these parameters, the peripheral vascular resistance (PR) was estimated in 17 normotensive and 8 hypertensive women between 28 and 32 weeks of pregnancy. In the normotensive women, a mean drop of 10.97% in BF and mean increase of 49.85% in PR were observed. Chronic hypertensive women with good evolution during pregnancy had a 96.30% (p less than 0.01) drop in their BF and a 399.38% (p less than 0.01) increase in their mean PR. Changes in BF and PR in chronic hypertensive women with obstetrical complications were similar to the normotensive women: BF increased by 4.50% and PR decreased by 0.04%. The increase in PR in the normotensive group could be due to a release of circulating vasopressive agents. In the chronic hypertensive group without complication this release could be more important or there might be an increase in the peripheral vascular sensitivity. In contrast, the lack of variation in PR in the chronic hypertensive group with obstetrical complications could be due to already established arterial vasospasm.
Arterial occlusions after cardiac catheterization are usually treated surgically. We report four patients with femoral thrombosis or distal emboli that developed after cardiac catheterization. Each patient was treated successfully with intravenous streptokinase. Therapy was initiated 1-60 hr after the procedure. The duration of infusion lasted 4-42 hr (mean 27 hr). Pulses were restored 4-19 hr (mean 10 hr) after the beginning of infusion. There was no major hemorrhagic complication, even in patients with very early streptokinase infusion. Thus intravenous streptokinase may be an alternate choice to surgery for arterial occlusions after invasive procedures.
Hemodynamic parameters, after administration of three different beta-blockers, were measured in fifteen hypertensive, and five normotensive, subjects. The non-invasive hemodynamic measurements were made prior to drug administration, after the first dose, and after prolonged treatment with either: metoprolol (M) 100 mg b.i.d., propranolol (Pr) 80 mg b.i.d., or pindolol (P) 10 mg b.i.d. With the parameters of blood pressure (B.P.), pulse rate (H.R.), blood flow in the leg at rest were determined with the plethysmographic impedance technique; venous compliance (V.C.), and flow in the leg after reactional hyperemia (F.R.H.) were evaluated by the mercury gauge technique. The pneumoplethysmographic technique was used to measure digital flow (D.F.). During administration of metoprolol, the B.P. and H.R. decreased significantly in the first few hours, and remained so during the prolonged treatment period of 4 weeks; the other parameters did not change significantly. Propranolol, after short-term treatment, decreased H.R. and blood flow in the leg at rest. Also, modifications in the venous compliance occurred but are difficult to interpret. After administration of pindolol, except for a decrease in H.R. and reactional hyperemia that occurred during the 2nd hour, no significant changes occurred in the other parameters. The digital flow showed non-significant variations. These preliminary results demonstrate that the changes registered through non-invasive techniques, although very small, affect pindolol less than metoprolol or propranolol.