[Rehabilitation of children with muscular disorders].
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Breathing Exercises↗
Biomedical subjects
M Donner
Publications and source records attributed to M Donner.
[Hemorrheology in clinical practice. Applications in an in vitro study of troxerutin].
It is now well established that blood behaves like a non Newtonian fluid varying with the shear rate. Blood viscosity pattern relative to various shear rates shows a high viscosity at low shear rate (due to rouleau formation or erythrocyte aggregation) with a decrease at high shear rate. This high blood viscosity will be of a great importance only while pathological blood flowing with low output or stasis. Pathological variations of one factor determining blood viscosity and clinical signs define hyperviscosity syndrome. From an hemodynamical point of view, the appearance of an hyperviscosity syndrome, may, as a result of feedback mechanism, aggravate the disorders leading to a slowing down and even to a stop in local blood flow, subsequently encouraging ischemia. Moreover hyperviscosity also leads to a theoretical lowering capacity of oxygen transport by blood approximatively in proportion with the haematocrit/blood viscosity ratio. With regard to therapeutic aspect, the pharmacology of rheological influence drugs must be displaced into the wider outline proposed by Virchow. So we could distinguish between therapeutic action of drugs upon haematocrit, plasmatic proteins level, red blood cell deformability and erythrocyte aggregation. Among this last category disaggregating effect of rutosides has been first pointed out by Schmid-Schöenbein and Col. Our results of an in vitro study of troxerutine effect with ranging concentrations from 10(-5) to 10(-2) M upon blood viscosity and erythrocyte aggregation are reported.
Anticoagulants↗
Clinical and electroretinographic comparison between Aland Island eye disease and a newly found related disease with X-chromosomal inheritance.
Two subjects representing AIED (Aland Island Eye Disease) and a family with 5 males affected with an AIED related X-linked hereditary eye disease were studied clinically and electrophysiologically. The clinical picture of AIED includes myopia and astigmatism, reduced visual acuity, nystagmus, ocular albinism, hemeralopia and dyschromatopsia (No. 300600, McKusick 1990). The subjects with the related disease showed astigmatism with or without myopia, reduced visual acuity, slight hemeralopia, normal color vision in 3/5 subjects, no ocular albinism and nystagmus only in one case. In both diseases the ERG was abnormal showing defective a- and b-waves, but there were also differences. The most notable was the greater reduction of the b-wave amplitude in the mixed (rod and cone) responses for the white stimulus in the ERG of the AIED related disease. With regard to the pathogenesis we propose that in both diseases rod and cone functions are defective but in an AIED related disease a defective cone function inhibits the transmission of the rod signals to the rod bipolars, causing greatly reduced mixed responses. The clinical and ERG findings of this study suggest that the 5 subjects of our family do not represent AIED but another X-linked hereditary eye disease. The investigation to find out the gene locus of this disease is going on.
Adolescent↗
New trends in clinical hemorheology: an introduction to the concept of the hemorheological profile.
It has now been clearly established that blood behaves like a non-Newtonian fluid exhibiting specific features with the probable existence of a plasticity threshold, a viscosity that varies as a function of shear rate and a non-homogeneous nature of the medium during flow. When apparent blood viscosity is represented as a function of shear rate, a high viscosity is observed at low shear rates, mainly due to rouleaux formation or red cell aggregates. At high shear rates, viscosity decreases. Apparent blood viscosity is mainly dependent on the following parameters: cell volume concentration (hematocrit); plasma viscosity (which is itself dependent on the type and concentration of the proteins); mechanical properties of the red cells, the main determinants being the cell membrane and internal viscosity; red blood cell aggregation; shear stress applied. Pathological changes in one of the factors controlling blood viscosity and the resulting clinical symptoms constitute the hyperviscosity syndromes. The field of hyperviscosity syndromes concern the situations where the increased blood viscosity and the accompanying modifications in flow resistance must be considered as being the result of the overall rheological behaviour of blood. In this general context, hyperviscosity syndromes can be divided into 4 main groups: 1. Increase in the number of blood cells (mainly red cells) 2. Increase in the plasma protein concentrations or the appearance of high amounts of a monoclonal protein 3. Increase in internal red cell viscosity or a change in the mechanical properties of the erythrocyte membrane 4. Increase in erythrocyte aggregation (formation of barely or in no way dissociable aggregates). Considered from a hemodynamic viewpoint, the appearance of a hyperviscosity syndrome could (by 'feed back' mechanisms) enhance the phenomenon and slow down blood flow or even stop flow completely, thus making ischemia and thrombosis easier. Further, the appearance of the syndrome also results in a decrease in the blood's overall oxygen transport capacity, which, at a primary approach, is proportional to the ratio hematocrit/blood viscosity.
Animals↗
[Hemorheology in clinical practice. Introduction to the notion of hemorheologic profile].
Although the non-Newtonian characteristics of blood have now been accurately defined, the influence and effect of a hyperviscosity syndrome at the onset of ischemia and in oxygen transport to the tissues remains within the realm of assumptions. Using a simple theoretical approach it can be shown that oxygen transport capacity to the tissues is proportional to the radio H/eta s (where H = hematocrit, eta s = blood viscosity), as long as vascular bed geometry remains constant (with no sign of compensatory vasodilation). With the help of examples, the authors show the changes in oxygen transport as a function of various rheological parameters (red cell aggregation ans deformability). Further, the authors introduce the concept of a hemorheological profile for taking all the hemorheological parameters into consideration and for standardising the presentation of the results for hyperviscosity syndromes.
Blood Viscosity↗
[Erythrocyte aggregation in patients with monoclonal gammopathies: effect of plasma exchange treatment].
Analyses of erythrocyte aggregation have been carried out in 15 patients with multiple myeloma or Waldenström's macroglobulinemia before and after plasma exchange. The volume of exchanged plasma was about 1.2-1.5 plasmatic mass. It was replaced by the same volume of a 4% solution of human albumin. Each treatment included at least 3 plasma exchanges at 48 hours intervals. The kinetic (aggregation times) and rheological (dissociation threshold) parameters of erythrocyte aggregation were determined before and immediately after each plasma exchange using a device based on the analysis of the backscattered light by a blood suspension. Before the first plasma exchange, erythrocyte aggregation measurements revealed a pronounced reduction in time aggregation and high values of dissociation thresholds indicating an hyperaggregation of red cells. The successive plasma exchanges produced very different changes in erythrocyte aggregation. For some patients, the aggregation parameters presented normal values from the first plasma exchange when similar changes were only noted after the second plasma exchange in other patients. Finally, in some cases, an hyperaggregation state was maintained after a series of three plasma exchanges. The influence of the nature and the concentration of monoclonal immunoglobulin as well as plasmatic fibrinogen are discussed.
Blood Viscosity↗
Erythrocyte membranes alteration in a shear stress measured by fluorescence anisotropy.
An experimental setup has been designed to allow fluorescence anisotropy measurements on labeled cell membranes under shear stress. An important change is observed when increasing the shear stress and varying the experimental parameters indicates that a decrease in membrane cohesion leads to a subsequent increase in the membrane alteration under shear stress. A model has been developed that shows, in agreement with experiment, that the effect observed is mainly the result of the alteration of the membrane, elongation, and orientation with respect to the fluid flow, which can be estimated.
Cholesterol↗
Rheological properties and membrane fluidity of red blood cells and platelets in primary hyperlipoproteinemia.
Lipid fluidity of the erythrocyte membrane and intact platelets was examined in 32 male patients affected by types IIA, IIB and IV primary hyperlipoproteinemia and 15 control subjects. Lipid fluidity was determined by fluorescence polarization using two probes: DPH and TMA-DPH which are localized in different lipid areas of the cell membrane. Classical haemorheological tests were also performed including plasma viscosity, whole blood viscosity and erythrocyte aggregation. As compared to a control group, plasma viscosity and whole blood viscosity at low shear rate was significantly increased in types IIB and IV, but not in type IIA patients. In contrast, the increase in erythrocyte aggregation was significant in all HLP types. Concerning lipid fluidity, the results recorded with red cells and platelets were not significantly different for type IIA HLP compared to the control group. In contrast, erythrocyte membranes from patients with types IIB and IV HLP had a significantly higher level of fluidity in lipid regions characterized by TMA-DPH. Using DPH as a fluorescent probe, identical results were only noted in type IIB patients. Regarding intact platelets of IIB and IV patients, an increase in lipid fluidity was noted for two fluorescent probes. These findings suggest that HLP associated erythrocyte and platelet fluidity alterations are not related to hypercholesterolemia but to the triglyceride level.
Adult↗
Genetics of congenital nemaline myopathy: a study of 10 families.
In order to investigate the inheritance in congenital nemaline myopathy (CNM), we studied the family histories and pedigrees of 13 patients with CNM from 10 families, and the 20 patients, by physical examination, single fibre electromyography, ultrasonography of muscles, measurement of serum creatine kinase, muscle biopsy, and electrophoresis of muscle proteins. None of the parents was affected. In three families there were two affected children. Of the parents, 15 showed deficiency of type 2B muscle fibres, and all except one father showed some other minor neuromuscular abnormality. These may represent heterozygous manifestations of recessive gene. Most of the ancestors came from sparsely populated rural communities in the west of Finland. We conclude that in the Finnish CNM patients, the mode of inheritance appears to be recessive. Apart from a few instances of dominant inheritance, most cases published also seem compatible with recessive inheritance.
Adolescent↗
Fluorescence depolarization method in the study of dynamic properties of blood cells.
Fluorescence polarization is the most commonly used method to approach a property of cell membrane, the so-called "fluidity". Whether time resolved determinations may be of potential interest to get precise information on the behaviour of fluorescent probes incorporated into biological membranes, steady state measurements are still the most accessible for biologists. Steady-state anisotropy value may be considered as a semi-quantitative indication of the cohesion of the lipid chains. However, meaningful interpretation of the anisotropy values requires a careful sample preparation and a suitable use of fluorescent probes. This paper reviews the properties and uses of several hydrophobic membrane fluidity probes. In the case of intact cells, the potential interest of the association of fluorescence polarization with quenching fluorescence method in giving information on the "actual" membrane fluidity is outlined.
Diphenylhexatriene↗
[Importance of membrane fluidity determination].
Translational motions of lipids and proteins and molecular motions within the lipid hydrocarbon chains of biological membranes can be approached by spectroscopic methods. The electron spin resonance (ESR) spectra of spin labels bound on proteins or grafted on fatty acids and incorporated into biological membranes undergo characteristic changes which may be resolved in terms of modifications of membrane environment. However, the method is still scarcely used in routine clinical studies. In contrast, fluorescence methods such as intermolecular excimers or fluorescence polarization might join the ranks of routine analyses. The labeling of lipid compartments with fluorescent probes and the study of their spectroscopic properties give informations on the cohesion of their immediate environment. Polyenic molecules (DPH and TMA-DPH) which are located in different lipid compartments characterize deep and superficial areas of cell membrane, respectively. A set of probes in which a 9-anthroyloxy group is attached to different positions of a long chain fatty acid provides a means of measuring a fluidity gradient into membrane bilayer. Thus, these fluorescence methods which are simple and rapid represent a semi-quantitative approach of the so called "membrane fluidity". Modifications in membrane fluidity can control the expression of proteins, receptors exposed on cell surface and alter functional properties of cells. Moreover, pathological processes can also be related to fluidity modifications. In particular, in hypertension and vascular diseases, a decrease in membrane fluidity has been shown in platelets and red cells. Nevertheless, further investigations combining biophysical, biochemical and immunological methods are needed to determine the exact relations between membrane fluidity, classical rheological properties and cell functions.
Biophysical Phenomena↗
Two cases of Dandy-Walker syndrome and chronic polyneuropathy.
The paper describes a so far unreported combination of Dandy-Walker syndrome and chronic hereditary polyneuropathy in 2 boys. One of the boys has a de- and remyelinating motor and sensory polyneuropathy, with either an autosomal recessive mode of inheritence or a sporadic occurrence. The other has an autosomal dominant form of mild polyneuropathy with tomaculum formations in myelinated fibers, corresponding to hereditary neuropathy with liability to pressure palsies.
Adult↗
Phagocytosis and membrane fluidity: application to the evaluation of opsonizing properties of fibronectin.
The uptake of particles by phagocytic cells involves an increase in the membrane fluidity determined by steady-state fluorescence polarization. Binding and endocytosis of target particles is in vivo enhanced by humoral factors called opsonins. In this work, fluorescence polarization was used to detect in vitro the opsonic activity of a plasma protein: fibronectin. The assay is based on the analysis of membrane fluidity variations following the uptake of gelatinized latex beads by phagocytic cells in the presence or in the absence of fibronectin. Using TMA-DPH as fluorescent probe, it was observed that the increase in membrane fluidity was enhanced in presence of fibronectin and depended upon the enhanced in presence of fibronectin and depended upon the opsonic activity was related to the integrity of the molecule. Using this method, the opsonic activity of various plasmas could be also determined.
Cell Line↗
[Cell cycle analysis of hybridoma cultures: study by cytofluorimetry].
An hybridoma cell line cultivated in flasks has been used as a model to study the loss of cell viability in high density cell cultures. Cell cycle analysis by cytofluorimetry has shown that a new hypochromosomic cell population appeared as soon as the viability began to decrease. However there is no evidence that this new population is constituted of dead cells.
Animals↗
[Calcium and citrate excretion by patients with calculi and healthy probands during induced acidosis].
Acidosis induced increase in renal calcium excretion and decrease in renal citrate excretion was produced by means of ammonium chloride load in 15 patients with recurrent oxalate lithiasis and in 15 control subjects. The expected increase in the calcium citrate relationship in urine is more marked and more lasting in stone patients. Stone formers obviously respond to an acidotic metabolic situation by a more clear relative decrease in citrate excretion, in addition to more intensive calcium excretion, which is known. A certain individual sensitivity of renal tubular mechanisms is discussed with regard to acid base changes.
Acid-Base Equilibrium↗
Neurodevelopmental screening of 5-year-old children.
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Child Development↗
Pathology of congenital nemaline myopathy. A follow-up study.
This study was undertaken to review the development over 5-18 years of pathologic changes in 13 patients (4 male and 9 female) with congenital nemaline myopathy. Follow-up biopsies were compared with earlier biopsies and with published normal values as to quantity and location of nemaline bodies, secondary signs of myopathy, and in 6 patients as to muscle fiber type and size. Biopsy findings were correlated with the mobility and muscle power of the patient. The main differences in myofiber maturation in the patients as compared with normal myofiber maturation were: (1) deficient differentiation of type 2 fibers, (2) further increase of variation in fiber size with age, and (3) skewing in early adulthood of fiber size distribution curves toward the atrophic end. In ambulant patients, this skew seemed to be compensated with a population of hypertrophic fibers. The nemaline bodies tended to be located beneath the sarcolemma in the younger patients and inside the muscle fibers in the older patients. The quantity of nemaline bodies seemed to have increased with age. The clinical deterioration and the defective myofiber maturation in the patients together with an increase in internal nuclei and endomysial fat or fibrosis indicate an active disease process. This speaks against the generally held view that congenital nemaline myopathy is static.
Adolescent↗
Optic neuritis in children and its relationship to multiple sclerosis: a clinical study of 21 children.
The optic neuritis of 21 children aged between four and 14 years generally was characterized by bilateral involvement (62 per cent) and papillitis (76 per cent). Often acute infections or vaccinations were preceding events. Frequently there was pleocytosis during the disease process, with production of IgG, oligoclonal and viral antibodies, which increased during follow-up. Nine of these children (eight female) later developed multiple sclerosis, with unilateral involvement of the optic nerves and HLA Dr2 positivity. Disseminated effects on the central nervous system were similar to those of adults with multiple sclerosis. In all cases these relapses occurred within one year of the optic neuritis. EEGs did not differentiate those who developed multiple sclerosis from those who did not, but four of five patients with multiple sclerosis who were followed-up for a year or more had paroxysmal discharges, and one of the four had manifest epilepsy. Magnetic resonance imaging, visual and sensory evoked potentials and CSF studies were helpful in diagnosing multiple sclerosis. The visual prognosis was good in most cases. 17 children had no or only slight neurological disability at the end of follow-up; the other four had moderate to severe disability. This study suggests that optic neuritis is a diffuse disease, not merely affecting the optic nerves, and that the immunological events typical of multiple sclerosis can start in childhood.
Adolescent↗