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Biomedical subjects

G Vanderstraeten

Publications and source records attributed to G Vanderstraeten.

At least 19 recordsLinked to original sources

Spinal cord monitoring. State of the art. Results in Harrington and C.D. instrumentation for scoliosis.

In scoliosis surgery, it is of paramount importance to obtain extensive correction of the curve without compromising the integrity of the spinal cord. Up to now, the wake-up test has been used for the intra-operative assessment of spinal cord function. Besides the fact that the test only provides a single evaluation, it is also encumbered with some potential hazards related to the anesthetic procedure. An additional problem arises when the technique is applied in psychiatric patients. An alternative approach is the continuous recording of evoked potentials obtained from sensory stimulation. The method permits uninterrupted intra-operative monitoring of the neurological status of the cord.

Adolescent

Postsynaptic neuromuscular dysfunction in organophosphate induced intermediate syndrome.

A 65-year-old Caucasian female developed an intermediate syndrome seven days after an acute cholinergic crisis, caused by the ingestion of fenthion. Cholinesterase activity in the blood, plasma and red cells was monitored daily by the method according to Nenner and serial serum fenthion levels were measured by capillary gas chromatography. Electromyographic studies showed fade on tetanic stimulation by means of surface electrodes at 20 Hz of the left M. abductor digiti quinti at day 7, which could no longer be observed at day 19. Fade on low-frequency stimulation and post-tetanic facilitation were both absent. A biopsy of the N. suralis was normal. A biopsy of the M. tibialis anterior revealed a limited rhabdomyolysis with a very weak staining for cholinesterase. It is hypothesized that the pathophysiologic process underlying the syndrome is the result of a time-confined phenomenon, which includes both changes in the postsynaptic structures by a desensitization process and a gradually restoring ratio of acetylcholine to acetylcholinesterase. This hypothesis is suggested by the similarity in the EMG-findings of this patient and those in myasthenia gravis, which is known to be characterized by a postsynaptic transmission defect.

Acetylcholinesterase

The neurophysiologic examination in organophosphate ester poisoning. Case report and review of the literature.

A 65-year-old woman who has been admitted after organophosphate-induced poisoning (Fenthion), develops pareses as a result of neuromuscular junctional dysfunction 7 days post-exposure. These findings are consistent with an intermediate syndrome, which may appear within 24 to 96 hours of exposure and subsides after 5 to 18 days. Delayed polyneuropathy develops within 1 to 3 weeks and abates after 6 to 12 months. A distal axonopathy can be demonstrated. Several authors have attempted EMG monitoring of pesticide-workers in agricultural and industrial settings. The electrophysiologic examination is an important diagnostic adjunct in the development and course of muscle paresis following organophosphate-ester poising.

Aged

Entrapment neuropathies of the foot. Electromyographic techniques.

Entrapment neuropathies frequently involve the foot. The diagnosis can be established by electrophysiological techniques for the exploration of muscles and nerves. Needle recording from the intrinsic foot muscles is a valuable asset in the detection of neurogenic syndromes. The motor and sensory nerve conduction velocities are determined using surface electrodes. The sensory nerve conduction study can be supplemented with somatosensory-evoked-potential studies. Based on these investigations, the location, severity and prognosis of the nerve lesion can be determined. In the presence of tunnel and compression syndromes involving the foot, studies of the tibial nerve (tarsal tunnel - Morton), peroneal nerve and sural nerve are of particular interest.

Electromyography

A retrospective electrodiagnostic evaluation of footdrop in 303 patients.

In this retrospective study the authors have analysed the results of electrophysiologic examinations in patients with paresis or paralysis of the foot dorsiflexors. Two groups have been distinguished. A first group consists of 217 patients, investigated between April 1st 1986 and September 30th 1987. Several etiologic categories have been recognized and the relative frequency of each of them in the group as a whole has been described. Footdrop has been found to be either of central neurogenic origin (31%) or of peripheral neurogenic origin (68%). The latter group has been further subdivided, the most important subgroups being common peroneal nerve lesions (30.6%), L5-radiculopathies (19.7%) and polyneuropathies (18.3%). In a second group, the authors have studied the results of 34 electrophysiologic examinations for footdrop due to a sciatic nerve lesion and of 109 examinations for footdrop due to common peroneal nerve palsy. The period covered was from January 1st 1980 to September 30th 1987 The authors have been able to draw a parallel between these two categories of footdrop patients; 76.5% of the sciatic nerve lesions and 67.0% of the common peroneal nerve lesions are traumatic in origin; in both groups there is a striking preponderance of young male patients, which is even more pronounced when only the traumatic lesions are considered. In the majority of cases with sciatic nerve damage the peroneal portion is involved. In the common peroneal nerve lesions, the deep structures are more frequently injured than the superficial aspect.2=

Adolescent

Study on the effect of etofenamate 10% cream in comparison with an oral NSAID in strains and sprains due to sports injuries.

In this 60 patient study of sports traumatology due to football injuries, etofenamate gel proved equally effective as oral naproxen on the overall pain scores (65% none to mild pain for etofenamate versus 86% for naproxen; p greater than 0.05). The global clinical impression results have been rated as good or excellent in 44% in the naproxen group versus 50% in the etofenamate group. The incidence of side effects in the etofenamate group (3%) was lower than in the naproxen group (20%). This study demonstrates that etofenamate gel has equal efficacy as oral NSAIDS but a better side effect profile in sport injuries in football players.

Administration, Topical

Electric current distribution in tissues upon electrotherapy.

The authors have used computer simulations to study electric current distribution in tissues upon electrotherapy. The results are shown on a computer plot and apply to various types of current. Simulations on a simplified circular structure (as a model of a limb cross section) give a better understanding of the problem and clearly demonstrate the influence of electrode position and geometry. Simulations have established the possibility of directing the current density at particular internal areas. The greatest current density occurs close to the surface of the bone in an area midway between the electrodes, and larger electrodes may make treatment more effective. These conclusions are verified in the more realistic structure of a thigh cross section and extrapolation to a length section is made. Finally, the influence of metallic implants is considered. The conclusions of this work are of great practical interest to electrotherapy, particularly electrode techniques.

Computer Simulation

[Meralgia paresthetica].

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Diagnosis, Differential