Biomedical subjects

F Michel

Publications and source records attributed to F Michel.

At least 19 recordsLinked to original sources

PubMed2005

Visually guided reaching: bilateral posterior parietal lesions cause a switch from fast visuomotor to slow cognitive control.

The visually guided reaching of two patients with bilateral optic ataxia was explored in two experiments. In Experiment 1 simple delayed pointing was compared with immediate pointing. In the immediate pointing task both variable and constant errors increased with target eccentricity. In contrast to the performance of control subjects and contrary to their own beliefs, the patients both showed improved accuracy in the delay condition. This improvement was manifest as a reduction in both pointing variability and in the constant angular error towards the point of fixation. Both angular errors and their improvement with the delay were proportional to target eccentricity. Experiment 2 used a task in which the target was pre-viewed 5s prior to its re-exposure for pointing ('delayed real pointing'). On some trials a conflict was introduced between the present and previous visual information by changing the target's location during the delay. In contrast to control subjects, who ignored the pre-viewed location and aimed directly at the current target, both patients with optic ataxia initiated their movements towards the previously viewed target location. Evidently they relied on off-line information in preference to on-line visual information. In addition, the patients often failed to detect the changes in target location. One of the patients sometimes even guessed incorrectly that the target had changed its location, and her movement trajectory was then more affected by her false belief than by the target's actual location. These findings confirm that posterior parietal lesions severely disrupt direct visuomotor transformations, and suggest that the residual performance is mediated indirectly by expectations or beliefs about target position.

Acoustic Stimulation↗

PubMed2005

[Anatomic study and advantages of the free rectus abdominis flap for head and neck reconstruction].

INTRODUCTION: The main goal of using the free flap is to be able to carry out extensive surgical resection resulting in good functional outcome. The aims of this study were to define the best area for free rectus abdominis harvest and to assess its value in head and neck reconstruction. MATERIAL AND METHODS: Twenty rectus abdominis flaps were studied in ten fresh cadavers. A review of the literature of the free rectus abdominis flap in head and neck reconstruction yielded the main recipient sites and complications (flap necrosis and postoperative abdominal hernia). A reconstruction was performed after near total glossectomy. RESULTS: With seven perforators and four cutaneous branches of intercostal nerves, the paraumbilical region is the best area to harvest this flap. The rectus abdominis free flap seems to be adapted for near total glossectomy reconstruction. Previous studies reported that this flap was essentially used for oropharynx and skull base reconstruction. The main complications are flap necrosis (4%) and abdominal hernia (3%). CONCLUSION: The paraumbilical rectus abdominis free flap is reliable and easy to use with a two-team approach in head and neck reconstruction with moderate donor site morbidity. It is useful for reconstruction of large defects of the oropharynx and skull base. Sensory-motor reinnervation superiority for deglutition in tongue reconstruction still needs to be evaluated.

Cadaver↗

PubMed2005

A thromboxane effect of a hydroxytyrosol-rich olive oil wastewater extract in patients with uncomplicated type I diabetes.

OBJECTIVE: To assess the antioxidant/non-antioxidant effects of a hydroxytyrosol (HT)-rich phenolic extract from olive mill wastewaters administered with a breakfast. DESIGN, SETTING AND SUBJECTS: Five type I diabetic patients received 25 mg of HT the first day and 12.5 mg/day the following 3 days. Blood sampling was carried out at T(0) (baseline) and T(4d) just before the breakfast + HT administration and at time points 1, 2, 3 and 4 h after T(0). Urines (24-h) were collected from T(0) to T(4d). Baseline HbA1c was generally inferior to 10%, glycemia was within the range 6-24 mmol/l, whereas total cholesterol, HDL-chol and triglycerides were normal. RESULTS: The major finding was the 46% decrease in the serum TXB(2) production after blood clotting at T(4d). Plasma vitamin A, E, beta-carotene were not changed. Vitamin C tended to increase (P = 0.075). Plasma antioxidant capacity was enhanced at T(0)+1 h only, whereas its main determinants (albumin, bilirubin, uric acid) were not modified. Urinary 8-isoPGF(2alpha) levels were highly variable and were not affected significantly by HT administration. CONCLUSION: The major effect of HT accounts for an antiaggregating platelet action, leading to a possible prevention of thrombotic and microthrombotic processes.

Adult↗

PubMed2005

Size distribution of fat globules in human colostrum, breast milk, and infant formula.

Only a few results are available on the size of human milk fat globules (MFG), despite its significance regarding fat digestion in the infant, and no data are available at <24 h postpartum (PP). We measured the MFG size distribution in colostrum and transitional human milk in comparison with fat globules of mature milk and infant formula. Colostrum and transitional milk samples from 18 mothers were collected regularly during 4 d PP and compared with mature milk samples of 17 different mothers and 4 infant formulas. The size distribution was measured by laser light scattering. For further characterization, the zeta-potential of some mature MFG was measured by laser Doppler electrophoresis. The MFG diameter decreased sigmoidally in the first days. At <12 h PP, the mode diameter was 8.9 +/- 1.0 microm vs 2.8 +/-0.3 microm at 96 h PP. Thus, the surface area of MFG increased from 1.1 +/-0.3 to 5.4 +/-0.7 m2/g between colostrum and transitional milk. In mature milk, the MFG diameter was 4 microm on average and increased with advancing lactation, whereas the droplets in infant formula measured 0.4 microm. The zeta potential of mature MFG was -7.8 +/- 0.1 mV. The fat globules are larger in early colostrum than in transitional and mature human milk and in contrast with the small-sized fat droplets in infant formula. Human MFG also have a low negative surface charge compared with bovine globules. These structural differences can be of nutritional significance for the infant.

Adult↗

PubMed2004

Lack of oxidative stress in a selenium deficient area in Ivory Coast--potential nutritional antioxidant role of crude palm oil.

BACKGROUND: Previous studies have described an important selenium deficiency in a mountain region (Glanle) in the west of Ivory Coast. AIM OF THE STUDY: To assess the antioxidant capacity of subjects from a selenium deficient area in Ivory Coast (Glanle region). METHODS: This study involved 57 subjects, 18 to 69 years old, living in the Glanle region and 56 healthy controls living in the southern coastal region (Bodou). In the Glanle region families consume basically a vegetarian and crude palm oil diet, whereas in the Bodou region, families eat a fish-based diet with principally refined palm oil. Fasting blood samples were collected to assess the following parameters: lipid status (plasma total lipids; total-, HDL and LDL-cholesterol; triglycerides; phospholipids; fatty acid composition), plasma protein status (total protein, albumin, transthyretin, orosomucoid, CRP, transferrin), antioxidant capacity (plasma selenium, uric acid, retinol, alpha-tocopherol and tocotrienols levels, plasma seleno-glutathione peroxidase (GSHPx) activity) and oxidative stress markers (malondialdehyde (MDA) and advanced oxidation protein products (AOPP)). RESULTS: The mountain region samples (Glanle) were characterized by significantly lower plasma albumin, total-, HDL- and LDL-cholesterol, retinol and selenium levels, plasma PUFA content and GSHPx activity, but significantly higher alpha-tocopherol index and total tocotrienol level, than controls from the coastal area (Bodou). These results suggest a higher exposure risk to oxidative stress for the mountain region subjects. However, the absence of oxidative damage in this group provides evidence of a selenium independent protection mechanism against oxidative stress. This protection is related to lower plasma LDL cholesterol and PUFA content, and to higher alpha-tocopherol index, delta and total tocotrienols. CONCLUSION: The long-term consumption of crude palm oil could be considered as an effective protective factor against oxidative stress.

Adolescent↗

PubMed2004

Physicochemical modifications of high-pressure-treated soybean protein isolates.

Changes induced by high pressure (HP) treatment (200-600 MPa) on soybean protein isolates (SPI) at pH 3 (SPI3) and pH 8 (SPI8) were analyzed. Changes in protein solubility, surface hydrophobicity (Ho), and free sulfhydryl content (SH(F)) were determined. Protein aggregation and denaturation and changes in secondary structure were also studied. An increase in protein Ho and aggregation, a reduction of free SH, and a partial unfolding of 7S and 11S fractions were observed in HP-treated SPI8. Changes in secondary structure were also detected, which led to a more disordered structure. HP-treated SPI3 was partially denatured and presented insoluble aggregates. A major molecular unfolding, a decrease of thermal stability, and an increase of protein solubility and Ho were also detected. At 400 and 600 MPa, a decrease of the SH(F) and a total denaturation were observed.

Chemical Phenomena↗

PubMed2004

The effect of garlic on arteriosclerotic nanoplaque formation and size.

OBJECTIVE: In an in vitro biosensor model (PCT/EP 97/05212), the interplay between different lipoproteins in arteriosclerotic nanoplaque formation, as well as aqueous garlic extract (0.2-5.0 g/l from LI 111 powder) as a possible candidate drug against arterio/atherosclerosis were tested within the frame of a high throughput screening. METHODS: The processes described below were studied by ellipsometric techniques quantifying the adsorbed amount (nanoplaque formation) and layer thickness (nanoplaque size). A thorough description of the experimental setup has been given previously. RESULTS: Proteoheparan sulfate (HS-PG) adsorption to hydrophobic silica was monoexponential and after approximately 30 min constant. The addition of 2.52 mmol/l Ca2+ led to a further increase in HS-PG adsorption because Ca2+ was bound to the polyanionic glycosaminoglycan (GAG) chains thus screening their negative fixed charges and turning the whole molecule more hydrophobic. Incubation with 0.2 g/l aqueous garlic extract (GE) for 30 min did not change the adsorption of HS-PG. However, the following addition of Ca2+ ions reduced the increase in adsorption by 50.8% within 40 min. The adsorption of a second Ca2+ step to 10.08 mmol/l was reduced by even 82.1% within the next 40 min. Having detected this inhibition of receptor calcification, it could be expected that the build-up of the ternary nanoplaque complex is also affected by garlic. The LDL plasma fraction (100 mg/dl) from a healthy probationer showed beginning arteriosclerotic nanoplaque formation already at a normal blood Ca2+ concentration, with a strong increase at higher Ca2+ concentrations. GE, preferably in a concentration of 1 g/l, applied acutely in the experiment, markedly slowed down this process of ternary aggregational nanoplaque complexation at all Ca2+ concentrations used. In a normal blood Ca2+ concentration of 2.52 mmol/l, the garlic induced reduction of nanoplaque formation and molecular size amounted to 14.8% and 3.9%, respectively, as compared to the controls. Furthermore, after ternary complex build-up, GE similar to HDL, was able to reduce nanoplaque formation and size. The incubation time for HDL and garlic was only 30 min each in these experiments. Nevertheless, after this short time the deposition of the ternary complex decreased by 6.2% resp. 16.5%, i.e. the complex aggregates were basically resolvable. CONCLUSIONS: These experiments clearly proved that garlic extract strongly inhibits Ca2+ binding to HS-PG. In consequence, the formation of the ternary HS-PG/LDL/Ca2+ complex, initially responsible for the 'nanoplaque' composition and ultimately for the arteriosclerotic plaque generation, is decisively blunted.

Arteriosclerosis↗

PubMed2004

Differential effects of interferon-tau on the prostaglandin synthetic pathway in bovine endometrial cells treated with phorbol ester.

Rationale for these experiments was to evaluate the dose effects of bovine interferon-tau (IFN-tau) on the prostaglandin secretory pathway of immortalized bovine endometrial (BEND) cells in response to phorbol 12, 13-dibutyrate (PdBu) and to characterize similar responses in primary bovine uterine epithelial cells as a biomonitor of embryo-induced antiluteolytic effects on the endometrium. The BEND cells were treated with PdBu (0 or 100 ng/mL) and IFN-tau (0 or 50 ng/mL) for 6 h. The PdBu stimulated secretions of PGF2alpha and prostaglandin E2 (PGE2). Co-treatment of cells with IFN-tau blocked PdBu-induced secretion of both PGF2alpha and PGE2. Treatment with PdBu for 6 h induced expression of prostaglandin H synthase-2 mRNA, prostaglandin H synthase-2 protein, and prostaglandin E synthase mRNA, which were blocked with concurrent addition of IFN-tau. Doses of IFN-tau (0.05, 0.5, 1, 5, 10, and 20 microg/mL) were used with PdBu (0 and 100 ng/mL). The IFN-tau alone failed to stimulate secretion of PGF2alpha and PGE2, whereas IFN-tau doses <5 microg/mL suppressed PdBu-stimulated secretions of PGF2alpha and PGE2. Uterine epithelial cells were isolated from cows at d 17 after estrus and were cultured to confluence in serum-free medium. Cells were treated with IFN-tau (0, 50, or 500 ng/mL) and PdBu (0 or 100 ng/mL) before media were collected after 24 h for PGF2alpha and PGE2 analyses. Treatment of primary uterine epithelial cells with PdBu induced PGF2alpha secretion, and IFN-tau (50 and 500 ng/mL) caused a reduction in PGF2alpha secretion induced by PdBu. In the absence of PdBu, IFN-tau increased basal secretion of PGF2alpha. Concentrations of PGE2 increased in response to PdBu, and the 50-ng/mL dose of IFN-tau had a stimulatory effect on PGE2 concentrations compared with the 500-ng/mL dose in the absence of PdBu. Phorbol ester-induced gene transcription as related to prostaglandin synthesis is regulated by IFN-tau in vitro.

Animals↗

PubMed2004

Pregnancy and bovine somatotropin in nonlactating dairy cows: I. Ovarian, conceptus, and insulin-like growth factor system responses.

Nonlactating dairy cows were used to examine effects of bovine somatotropin (bST) on components of the insulin-like growth factor (IGF) system. Estrus was synchronized in cows with a Presynch + Ovsynch protocol and timed AI (TAI; n = 55) or not TAI (cycling, C; n = 23) on d 0 (time of synchronized ovulation). On d 0 and 11, cows received bST (500 mg) or no bST, and were sacrificed on d 17. Pregnancy rates were less in bST cows (27.2%, 9 of 33) than in controls (63.6%; 14 of 22). In contrast, conceptuses were larger in bST-treated cows (39.2 +/- 4.8 cm) than in controls (20 +/- 4.3 cm). Total interferon-tau in uterine luminal flushings (ULF) was greater in bST-treated cows (7.15 > 2.36 microg). Number of class 2 follicles (6 to 9 mm) was less in bST-C cows on d 7 and 16. On d 17, corpus luteum (CL) weight tended to be greater in bST-treated cows. Concentrations of progesterone were greater after d 10 in C than in pregnant (P) cows. In the ULF, IGF-binding protein-3 was greater in bST-P cows than in pregnant cows. A tendency for an increase in IGF-I hormone concentrations in the ULF was detected on d 17 in bST-treated and cyclic cows. Endometrial mRNA for IGF-I, IGF-II, IGFBP-2, and IGFBP-3 increased in bST-C, but not in bST-P cows. Treatment with bST increased plasma concentrations of insulin, IGF-I, and growth hormone (GH). In conclusion, bST may have hyperstimulated plasma IGF-I and insulin to cause asynchrony between conceptus and uterus that was detrimental to pregnancy.

Animals↗

PubMed2004

Pregnancy and bovine somatotropin in nonlactating dairy cows: II. Endometrial gene expression related to maintenance of pregnancy.

The objective was to evaluate the effects of pregnancy and bovine somatotropin (bST) on endometrial gene and protein expression related to maintenance of pregnancy in nonlactating dairy cows at d 17. In endometrial tissues, treatment with bST increased the steady state concentration of oxytocin receptor (OTR) mRNA; bST-treated cyclic (bST-C) cows had greater OTR mRNA than bST-treated pregnant (bST-P) cows. Estradiol receptor alpha (ERalpha) mRNA was reduced in bST-P cows compared with control P and C (no bST) cows. Western blotting revealed that pregnancy decreased the abundance of ERalpha protein, and bST stimulated an increase in ERalpha protein in C and P cows. Treatment with bST increased steady state concentrations of progesterone receptor (PR) mRNA. No differences were detected in steady state mRNA concentrations of prostaglandin H synthase-2 (PGHS-2), prostaglandin E synthase, and prostaglandin F synthase due to pregnancy or bST treatment. However, PGHS-2 protein was increased in response to pregnancy and bST treatment. Immunostaining indicated that P decreased ERalpha protein in luminal epithelium and increased PR protein in epithelial cells of the uterine glands. The PR protein response in the glands was less in bST-P cows than in P cows. In the stromal layer of the endometrium, bST decreased PR protein abundance in C and P cows. The PGHS-2 protein was localized exclusively in the luminal epithelium cells of endometrium and was increased in P cows. In conclusion, distinctly different mRNA and protein responses were detected between C and P cows related to prostaglandin biosynthesis, and bST-induced changes may potentially impact mechanisms associated with maintenance of pregnancy in nonlactating cows.

Animals↗

PubMed2003

[EMG support in botulinum toxin treatment].

INTRODUCTION: The aim of this work is to sum up how the use of EMG improves BT therapy. METHOD: A systematic review of the literature in the Pub Med computer database, along with a manual biography, allowed us to choose the most synthetic and the most pertinent publications according to our own practical experience. RESULTS: There is no consensus of opinion, but the great majority of authors emphasize the importance of EMG in the different stages of botulinum toxin treatment: before injections, at the time of the injection, and finally during the follow-up after the first injection or after the repeated injections that transient efficiency make necessary. DISCUSSION: A symptomatic therapeutic means recently recognized in focal dystonias and spasticity, BT is injected locally into the muscles to be treated. EMG can be used: at pre-injection for physiopathological evaluation but above all to establish a diagnosis and precise pre-intervention evaluation; at the moment of injection to provide guidance in precise muscle selection and for maximum efficiency with reduced, therefore less costly, doses. It also limits the risk of product diffusion susceptible of causing iatrogenic side effects and/or auto-immunisation resulting in resistance to the toxin; during follow-up, to understand why treatment failed and to look for changes in the dystonia pattern leading to objective re-evaluations and adapted reinjections. Although neglected by some, electrological logistics seem to us, as to many other practitioners who inject, to be a considerably helpful aid, particularly at the moment of injection when targeting the muscle to be treated.

Anti-Dyskinesia Agents↗

PubMed2003

[Sialorrhea, hyperhidrosis and botulinum toxin].

OBJECTIVE: The first clinical studies indicate that Botox provides effective treatment for hyperhidrosis and sialorrhea. The aim of this work is to sum up current evaluation of this use. METHOD: A systematic literature search was conducted on the Pub Med database, along with on chapters in other publications. The most interesting articles in relation to our own personal experience were chosen. RESULTS: Despite recent use of BT to treat focal hyperhidrosis, there have been numerous publications since 1997. However, the injected areas have not been listed so frequently. Axillary hyperhidrosis has been studied most; it is also in this case and in the case of gustatory sweating that the best results have been obtained. Publications about palmar and especially plantar hyperhidrosis are much rarer, almost anecdotic. It has been demonstrated to a lesser extent that BT injections are effective in these cases. Literature about sialorrhea is just beginning. However, the reduction of the production of saliva following intra parenchymatic injection of toxin into the parotid and submandibular glands, thus rarifying drooling, has been demonstrated. For each of the pathological indications, both the injection techniques and the optimal doses remain to be determined. DISCUSSION: Because BT blocks all cholinergic transmission, including the autonomous nervous system, it was plausible to expect a reduction in sweating and salivation on local injection of the product. In fact, the first publications indicated such efficiency without serious side effects. For hyperhidrosis, there has developed a consensus for making intracutaneous injections only. Of the injections in axillary areas, the palms of the hands, the plantar regions, the face or other cutaneous areas, palmoplantar hyperhidrosis is the least accessible, in any case causes the most technical problems, because of difficulty in pain management. For sialorrhea and the drooling that accompanies certain chronical neurological diseases, BT seems to have very promising effects. However, it has not been precisely determined whether to inject the parotid gland, the submandibular gland, or both. Necessary and sufficient means of targeting are still imprecise. It also remains to be determined the number of sites per gland and the doses to be injected.

Anti-Dyskinesia Agents↗

PubMed2003

[Detrusor-sphincter dyssynergia and botulinum toxin].

OBJECTIVE: Botulinum toxin (BT) injection into the external urethral sphincter is a promising therapy for neurogenic voiding disorders due to detrusor-sphincter dyssynergia (DSD). However the optimal treatment protocol remains unclear. METHOD: A PubMed reference search and manual bibliography review were performed, along with a search in the Annales de réadaptation et de médecine physique and in the reports of the International French-language Society of Urodynamics and the International Continence Society, which allowed us to select twelve pertinent articles with PubMed, two articles from the Annales and two conference reports. Our analysis gave special emphasis to assessment criteria, application, dosage and BT injection technique. RESULTS: Used for the first time in 1988 in spinal cord injury patients to reduce outflow obstruction due to DSD, BT injections have been shown to be a valuable alternative management of bladder dysfunction with DSD. They have been proposed in neurological patients unable to perform self-catheterisation, after drug failure and before surgery. Parameters for results assessment are mostly clinical (increased free interval between voiding, decreased post-void residual urine volumes), urodynamic (improvement in bladder emptying, increase in functional bladder capacity and decrease in urethral pressure) and electromyographic (denervation of striated urethral sphincter). The literature data regarding type of BT, dosage and protocol vary widely. Duration of action is from 2 to 12 months. Both transurethral and transperineal injections monitored by EMG are equally effective in improving detrusor-sphincter dyssynergia. CONCLUSION: With few side effects and satisfactory medium-term results, BT should be recommended as a component of DSD therapies. We propose a practical method for BT use.

Anti-Dyskinesia Agents↗

PubMed2003

Exchanging carbohydrates for monounsaturated fats in energy-restricted diets: effects on metabolic profile and other cardiovascular risk factors.

OBJECTIVE: To investigate whether improvements in cardiovascular risk factors, as observed in energy-balance conditions after exchanging carbohydrates (CHO) for monounsaturated (MUFA) fats, are also observed in energy-restricted conditions. DESIGN: Longitudinal, clinical intervention study using two types of energy-restricted diets (-30% of initial energy intake) with similar levels of saturated and polyunsaturated fats: a high CHO diet (55% of energy from CHOs, 10% from MUFAs) and a high MUFA diet (40% of energy from CHOs, 25% from MUFAs). SUBJECTS: A total of 32 overweight subjects (nine males, 23 females, BMI: 26-45 kg/m(2)). MEASUREMENTS: Body weight, serum lipids, fasting plasma insulin and phospholipid fatty acid composition of red blood cells were measured at baseline and after 8 weeks. Various oxidative status parameters (plasma lipid hydroperoxides, total plasma antioxidant capacity, plasma uric acid and vitamin E) and serum-induced smooth muscular cell (SMC) proliferation were also measured at these time points. RESULTS: Weight loss (1.1 kg/week over the first 4 weeks and 6.7 kg at week 8) was not significantly affected by the diet composition. Both diets reduced significantly total serum cholesterol, but the MUFA-rich diet showed better effects on fasting serum triacylglycerol (TG) than the CHO-rich diet: 1.18 vs 1.51 mmol/l for the MUFA-rich diet (after vs before, P<0.05) and 1.42 vs 1.62 for the CHO-rich diet. After 8 weeks, plasma vitamin E concentrations were positively associated with the oleic acid level of red blood cell phospholipids and showed opposite variations in both diets (increase with the MUFA-rich diet and decrease with the CHO-rich diet). Relative changes in SMC proliferation induced by sera were negatively associated with the ratio oleic:linoleic acid of red blood cell phospholipids and were significantly higher with the CHO-rich diet. CONCLUSIONS: The MUFA-rich diet showed better effects on serum TG than the CHO-rich diet, even with energy restriction and weight loss. The results suggest also a protective effect of oleic acid on oxidative stress and SMC proliferation, two other important cardiovascular risk factors.

Animals↗

PubMed2003

[Advantage of virtual endoscopy in the evaluation of the ossicular chain].

PURPOSE: Our study consists of a comparison of traditional computed tomography (CT) data sets with 2 views of virtual endoscopy in the preoperative evaluation of various diseases of the middle ear. MATERIALS AND METHODS: We studied 59 patients, all sent for conductive hearing loss with normal eardrum who underwent a complete CT examination: axial helical acquisition and coronal incremental acquisition: virtual endoscopy with selection of two reproducible views: an external one of the auditory canal and a lower one of the hypotympanum. Reading was performed by 2 independent radiologists. All patients were subsequently operated by the same surgeon. Results were compared with surgical reports. RESULT: Virtual endoscopy is valuable for the evaluation of ossicular and prosthesis dislocations, morphological anomalies of the malleus, incus, and stapes superstructure. Nevertheless, standard axial and coronal CT images remain necessary as confirmed by the poor results of virtual endoscopy in cases of attic obstruction, cholesteatomas and otospongiosis. CONCLUSION: Virtual endoscopy is a valuable technique of the evaluation of some ossicular chain pathologies but it cannot be used alone.

Adolescent↗

PubMed2003

[Montgomery thyroplasty implant under local anesthesia for unilateral laryngeal paralysis].

OBJECTIVES: Based on an inception cohort of 63 patients with unilateral vocal fold paralysis consecutively treated with thyroplasty and Montgomery's implant under local anesthesia during the years 1997-2002, we recorded i) morbidity and mortality, ii) evolution of dysphonia and swallowing impairment and iii) a prospective analysis of selected speech and voice parameters in an attempt to determine their evolution during the first 12 postoperative months and to search for potential statistical relationships with the following variables (age, gender, side of the paralysis, etiology of the paralysis, time between onset of paralysis and thyroplasty, position of the paralyzed true vocal fold, nerve involved, associated pneumonectomy, prior intracordal injection of autologous fat and surgeon). RESULTS: The overall complication rate was 8%. Minor complications occurred in 6.5% of the patients and included 4 cases of laryngeal edema successfully treated with oral steroids. Major complications occurred in 1.5% of the patients. Intralaryngeal hematoma requiring temporary tracheotomy was the major complication. Swallowing was improved in 93.5% of the patients. Immediate improvement of speech and voice was noted in all. Secondary degradation of speech and voice occurred in one patient. At revision thyroplasty lateral displacement of the implant was noted and successfully repositioned. At one month post-operatively, the values of maximum phonation time, speech rate, group phrasing standard deviation of the fundamental frequency, jitter and shimmer were statistically improved while the fundamental frequency did not vary significantly. At 12 months post-operatively the noise to harmonic ratio was improved while the other parameters remained stable. No significant statistical relationship was found between the post-operative speech and voice parameters and the variables under analysis. CONCLUSION: Based on the current series and a review of the medical literature, thyroplasty with Montgomery's implant under local anesthesia appears to be an easy, effective and safe procedure that might be used in all patients with unilateral laryngeal nerve paralysis.

Adult↗

PubMed2002

Luneburg lens approach to nuclear rainbow scattering.

The physical interpretation of nuclear rainbow scattering within the frame of the optical model is critically investigated. Starting from the properties of the Luneburg lens, a gradient index device that displays refractive features similar to those of the nuclear potential, important differences between the mechanisms producing the nuclear and optical rainbows are pointed out.

Journal Article↗

PubMed2002

Divergence in plasmatic and urinary isoprostane levels in type 2 diabetes.

BACKGROUND: Oxidative stress is currently suggested as a mechanism underlying diabetes. The present study was designed to evaluate isoprostane levels in plasma and in urine in type 2 diabetic patients, and to compare them to other currently used biomarkers of oxidative stress. METHODS: The work was performed in a control group (n = 10) and in a type 2 diabetic group (n = 10). Besides the traditional biochemical parameters, we evaluated the plasma and urine levels of isoprostanes and malondialdehyde (MDA) as markers of oxidative stress. RESULTS: We found increased plasma and urine MDA in the diabetic patients and almost significantly decreased plasma vitamin E. Urinary isoprostane levels in diabetic patients were increased but they presented a strong tendency to a decrease in plasma isoprostanes. It is therefore suggested that, in the studied diabetic patients, although the production of isoprostanes in the body was increased (as other plasma oxidative stress biomarkers were altered) it did not lead to an increase in plasma isoprostane levels. It could be hypothesised that this results from an increased elimination of this metabolite and therefore an increased excretion in urine. CONCLUSION: Our results showed that the measurement of same oxidative stress biomarker, isoprostane, in two different biologic fluids, plasma and urine, led to divergent results and emphasised the importance to measure a biomarker both in the circulation fluid (plasma) and in the elimination fluid (urine), to have a general idea of what is occurring in the organism.

Aged↗