Biomedical subjects
Publications and source records attributed to J C Netter.
Allergy to milk proteins may be responsible for the syndrome of unexplained, sudden death of infants, but well-documented cases are rare. The authors report an observation where clinical history and complementary investigations support the incrimination of this factor.
Eleven children with seizures were treated with clonazepam by rectal route. Thirty minutes after the administration, the plasma (8 to 28 ng/ml) and CSF (0.9 to 2.26 ng/ml) levels were satisfactory and correlated with a good clinical result. Since the tolerance of the drug was excellent, clonazepam appears to be as useful as diazepam in the management of childhood seizures.
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The authors relate one case of fibrous dysplasia limited to one bone and affecting the lower jaw, bilaterally. They put a stress on the slow evolution of the disease, as well as the diagnostic importance of the histological findings. Commenting on this case, they present a review of the main manifestations of this condition.
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A case of Recklinghausen's neurofibromatosis of predominantly buccal localization is reported, lesions being apparent on gums and tongue. The rareness of such localizations is emphasized, results of surgical excision and histology of lesions described and manifestations of the disease outlined.
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The authors review the lesions which may be seen during orthopedic treatment involving multi-attachment dentures which they use for their clinical cases. They emphasise that these iatrogenic lesions can be avoided by the use of moderate forces appropriately applied and the functional conception of orthopedic treatment.
A new lethal case of nemaline myopathy is reported. Muscle biopsy at 20 days of age permitted the diagnosis but this boy died at the 35th day of life. In a review of the literature (15 similar cases) the authors analyse the diagnostic, histopathogenic, genetic and evolutive aspects of this heterogeneous disorder, apparently less "benign" than previously thought.
Leigh's disease is a subacute metabolic encephalopathy characterized by bilateral and symmetrical lesions of basal ganglia, mid-brain and pons. Lesions are related to an abnormal pyruvate metabolism which mechanisms remain still uncertain. This disease is rare and the authors present a case with complete anatomic study.
The author emphasises the need for aetiological diagnosis in incisor infra-alveolisms. Treatment must take into account the cause of the deformity (interposition of the tongue) which must be corrected by rehabilitation, more often than by surgery. In the greatest number of cases, this type of deformity may disappear with simple rehabilitation. Wassmund osteotomy is reserved for failures of rehabilitation.
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The author point out that periodontitis is a disease of multiple aetiology and indicate two types of pitfall: traps in conceiving the plan of treatment and traps in carrying out treatment. The treatment plan may be incomplete. The authors show that the deepest types of vertical alveolysis are always related to occlusal or functional imbalance and that treatment based only upon hygiene and periodontal surgery represents a pitfall. They stress the importance of functional treatment. However such complex functional treatment itself has a number of pitfalls when it is being carried out. It is essential to restore balance of the oro-facial musculature before any treatment of occlusion. These are also types of non-occlusal musculo-dental imbalance which may plan an important role in the course of periodontitis. In conclusion, the authors note that functional treatment of the manducatory apparatus is as important as controlling inflammation. This must not be underestimated nor be allowed to go unrecognised.
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A case of mucocutaneous lymph node syndrome in a 7 month-old boy in whom the usual therapy (acetyl salicylic acid, dipyridamole) could not prevent impairment of the clinical evolution is reported. As the role of circulating immune complexes had been suggested, and similarly with periarteritis nodosa in adults, 4 exchange transfusions were attempted. Their spectacular result, with a follow-up of 6 months, even though no circulating immune complex was detected, is a further argument for the immunologic pathogenesis of this syndrome.
The authors describe the various etiological types of periodontopathies and discuss those due to inflammatory conditions in greater detail. The original studies that enabled the role of the bacterial plaque to be demonstrated are reviewed, and new data presented which attributes a specific pathogenic action to certain bacterial strains in this particular form of the disease, without suggesting that they are the only etiological factor involved. The importance of occlusal injury in periodontal disease is then evaluated, results of clinical studies tending to confirm the role of traumatic factors in the progression of alveolysis. The occlusal factor should therefore be integrated into the stomatognathic system. The results of systematic dentofacial orthopedic examinations in patients with periodontopathies are reported, and other pathogenic factors contributing to disequilibrium of the dental organ outlined. Several clinical cases are presented. The results of these observations are employed to redefine the notion of function equilibrium which must be taken into account when treating the disease prophylactically, and to recognize those cases in which it is disturbed. Neuromuscular reeducation is then necessary to avoid recurrence of the periodontal disease.