A Study Comparing Gait and Lower Limb Muscle Activity During Aquatic Treadmill Running with Different Water Depth and Land Treadmill Running.

Aquatic treadmill running is a partial weight-bearing exercise for rehabilitation. The purpose of this study was to investigate the surface electromyography activities of the rectus femoris, tibialis anterior, biceps femoris and medial head of gastrocnemius, and gait kinematics during aquatic treadmill running in water levels at waist, mid-thigh and mid-shin and on land. Seventeen healthy subjects (9 males and 8 females) were recruited by convenience sampling. Participants performed 2-min aquatic treadmill running at a specific speed for each water depth. The test speed was selected based upon the speed that elicited 110 steps per min. The surface electromyography data of lower limb muscles and the joint angles at three different water depths and on land were collected to evaluate the muscle activity and gait kinematics using a waterproofed surface electromyography system and inertial measurement unit for each muscle. Results showed that rectus femoris electromyography was different between depths during the swing and stance phases. Likewise, biceps femoris and tibialis anterior electromyography were different between depths for the swing phase. However, it was not the case for gastrocnemius electromyography. Peak flexion angles in both left and right hips were different between depths. A significant increase in a stance/swing ratio was observed with rising water depths. Water depth influenced muscle activity as well as kinematics. Aquatic treadmill running in the mid-thigh level should be further evaluated for its effectiveness, training value and applicability.

Presentación clínica de coartación de aorta, relato de casos: revisión de manejo actual / Clinical presentation of aortic coarctation: review of current management: a case series report

La coartación de Aorta es una cardiopatía congénita que se presenta con insuficiencia cardiaca congestiva precozmente sobre todo en la edad neonatal y que, de no ser diagnosticada oportunamente evoluciona con elevadísima morbi-mortalidad. Cuando sobrevive a la barrera de la primera infancia, cursa con hipertensión arterial sistémica, pudiendo debutar incluso con un accidente cerebrovascular, con resultado fatal para el paciente, ó dejarlo con incapacidades como secuela. Resaltamos la importancia del correcto y detallado examen clínico cardiovascular, que incluya la palpación adecuada de los pulsos periféricos así como la medición de la presión arterial sistémica, debido a que siempre cursa con hipertensión arterial en los miembros superiores y ausencia de pulsos en los miembros inferiores. Tratado correctamente presenta bajo riesgo de complicaciones y de mortalidad.

Aortic coarctation is a congenital heart defect that presents with early congestive heart failure, especially during the neonatal stage, and which if not opportunely diagnosed progresses with a high degree of morbidity and mortality. When patients survive the barrier of early childhood, they continue having such problems as systemic arterial hypertension, and run risks of outcomes such as fatal or incapacitating cerebrovascular accident. We emphasize the importance of a careful and detailed clinical cardiovascular examination, to include adequate taking of the peripheral pulses and measurement of systemic blood pressure, since this always presents with hypertension in the upper limbs and an absence of pulses in the legs. Treated adequately, it presents little risk of complications or mortality.

[Epithelioid sarcoma manifesting as chronic plantar arch ulceration]. / Ulcération chronique de la voûte plantaire révélant un sarcome épithélioïde.

BACKGROUND: Epitheloid sarcoma is an uncommon malignant soft tissue tumor observed in the distal extremities of young men. We report a case of long standing ulceration of the sole which was found to be an epithelioid sarcoma. CASE REPORT: A 78-year-old woman had an indolent ulceration of the left sole for several months. Physical examination disclosed a well demarcated 3-cm ulcerated lesion with a red center and flat edges. Skin sections confirmed the diagnosis of epithelioid sarcoma. Cells stained positively for anti-vimentin, anti-cytokeratin and anti-epithelial membrane antigen, but not for anti-S100 protein and anti-actin antibodies. Wide local excision was performed. DISCUSSION: Epithelioid sarcoma is an uncommon malignant tumor which apparently differentiates from mesenchymatous cells. It is usually observed in the distal extremities in young males, predominantly the hands and forearms. The tumor presents a firm, flesh-colored indolent nodule. Ulceration usually develops and involves the subcutis and deeper soft tissue, particularly fascial planes, aponeuroses and tendon sheaths. Treatment is wide surgical excision with or without radiotherapy. The case reported here on the sole of the foot in a 78-year-old women is unusual. Clinicians should be aware that the initial biopsy may not be contributive and that repeated biopsies may be necessary for positive diagnosis.

[Implant rehabilitation of distal mandibular atrophy using a blade implant]. / Rehabilitation implantaire des atrophies mandibulaires distales par l'implant ramique.

After a brief revision of the anatomy of the posterior mandible and its natural resorption pattern, the ramus plate-form implant would be the implant of choice for the rehabilitation of this region. This "site specific" implant is inserted on the top of the crest and superficially impacted within the residual alveolar bone at the distal segment of the horizontal branch and guided to climb parallel to the anterior aspect of the ascending ramus. Its form and specific dimensions are perfectly compatible with the frequently limited quantity of available bone above the nerve canal in patients with advanced atrophy of the posterior mandible. It provides a predictable abutment for the implant-supported or dento-implant-supported prostheses of the posterior mandible.

Biological and hepatotoxic effects of palladium. An overview on experimental investigations and personal studies.

Workers are occupationally exposed to Pd and Pd-complexes during the refining process, in particular in Pt-refineries. The metal is increasingly used as component in fine jewellery, is commonly present in dental alloys, and is also employed in telecommunication systems.In view of the toxicity of Pd when absorbed and anticipating the possible entry of some of this material into man's environment from the use of automotive catalitic converters, the retention, tissue distribution, excretion and placental transfer of Pd were determined by several authors following different administration routes in animal experiments. Most investigations on Pd and the Pt group metals were performed with simple and complex salts (chlorides and water-soluble ammoniacal compounds of Pt, Ir, Os, Pd, Rh and Ru). The highest retention for Pd was obtained following intravenous dosing, and the lowest retention occured after oral administration. Following a single oral dose, almost all Pd is excreted in the faeces, whereas after i.v. injections, similar quantities are excreted in both urine and faeces. Tissues containing the highest concentrations were the kidneys, spleen and liver. Following i.v. dosing of pregnant rats, a small amount is found in the fetuses.Pd and its compounds are considered to have hepatotoxic and nephrotoxic effects, acting by way of the -SH groups on complex biosystems: proteins, enzymes, etc. Oral administration of PdCh2 has obvious effects on the hepatic mono-oxygenase system and causes notable decreases in hepatic content of cytochrome-P450. Pd++ salts have also metabolic effects on a lot of other enzymes by inhibiting the activity of prolyl-hydroxylase, creatine kinase, aldolase, succinic dehydrogenase, carbonic anhydrase and alkaline phosphatase. These studies suggest that Pd may interfere with energy metabolism, acidlbase and electrolyte eqUilibria. In addition, Pd significantly increases the hepatic Se content and has a strong interaction within the Se-Hg competition. Proposed exposure limit for Pd compounds is 0.03 mg/m3.It is highly important to make the difference between soluble Pd-salts and metallic Pd. Although simple and complex Pd-salts have obvious hepatotoxic and nephrotoxic effects, no biological incidences have been demonstrated for metallic Pd. This is important especially for its increasing use in dental alloys. Our own experiences on cell culture systems with powders of pure metallic Pd and Pd-containing dental alloys have never shown any influence on the cell viability and on the induction of inflammatory effects. Its biocompatibility is comparable to that of Au, Pt or Ti.In the last few years, however, Pd has caused a lot of controversial discussion with respect to its sensitizing effects. The present state-of-the-art of this problem is that Pd sensitization may coincide with Ni sensitization.

[A panorama of current materials for osseous application in maxillofacial surgery and oral implantology]. / Panorama des matériaux actuels pour apport osseux en chirurgie maxillo-faciale et implantologie orale.

Many materials are used in bone reconstruction. According to their physico-chemical structure, their activity is based on one of the three main mechanisms of bone repair: osteogenesis, osteoconduction, osteo-induction. The materials can be classified in two categories: tissues and substitution biomaterials. Tissues may be living ones (mainly, autograft) or non living ones (mainly, allograft or xenograft). Among the substitution biomaterials, we find synthetic materials (calcium based ceramics, vitreous ceramics and bioglasses, polymers) and composite materials made of a mixture of synthetic and natural materials or a mixture of different synthetic materials or a mixture of different synthetic materials. At last, membranes provide a new technic in bone reconstruction. They come from natural origin (human or animal) or synthetic origin (resorbable or non resorbable).

[Risks and regulations related to materials used in implantology and maxillofacial surgery]. / Risques et réglementations relatifs aux matériaux utilisés en implantologie et chirurgie maxillo-faciale.

In the present paper, the authors call in mind the definitions of biocompatibility and the essential qualities required for biomaterials. The materials mostly used in implantology and maxillofacial surgery are numerous alloys, bioceramics, resorbable and non-resorbable polymers, and finally osseous substitutes of human or animal origin. As to synthetic and non-living materials, the risks in patients are generated by the degradation products. These may induce tissular reactions of inflammatory or immune origin owing to toxic effects. Concerning osseous substitutes, rejections are mostly of immune origin, for allografts and in particular for xenografts. Infections may be another major risk and in spite of all precautionary measures viral infections by hepatitis B, HIV and transmissible spongiform encephalopathy are not yet got under total control. It is just in these domains that one can state juristic lacks which national and european organisation of standardisation and homologation have to cover during the next few years.

[Towards a decrease of myocardial infarction in the Bas-Rhin region? Results of the 6 first years of the Strasbourg MONIC Register]. / Vers une diminution de l'infarctus du myocarde dans le Bas-Rhin? Résultats des six premières années du Registre MONICA Strasbourg.

The Bas-Rhin MONICA Register shows trends in myocardial infarction and other acute ischemic events between 1984 and 1989. Coronary heart disease mortality decreased by 27% in men and 30% in women. Morbidity trends were less favourable. The annual event rate for total acute ischemic events remained stable. However, a decrease of 14% for myocardial infarction was seen in men, particularly in patients with a past history of coronary disease. Another positive point is that the 28-day mortality rate in recent infarctions decreased in men by 33% during the 5 year period.

[Non-precious metal dental alloys and allergy]. / Les alliages dentaires en métaux non précieux et l'allergie.

The fundamental basis of allergy, particularly in relation to contact allergy, is described, together with the importance and frequency of sensitization to nickel, chromium and cobalt in both the consultant and general population. 139 published cases of allergy to dental restorations containing these metals are reviewed involving 92 female and 47 male patients, 115 of whom recovered when the restorations were removed. The most frequent symptoms were local (99/139), particularly gingivitis and stomatitis, while general or remote symptoms occurred in 33 cases. This probably underestimates the true prevalence of the condition, because a large number of reported cases have not been due to their "current appearance". The influence of the occupational environment of the patient is described with special reference to dental technicians. The persistence of contact allergy to metals for which no desensitization is possible is also emphasised. The discussion includes experimental investigations and an appraisal of other methods of revealing hypersensitivity. Finally, some simple recommendations for prevention are made which are of value to practitioners.

Nickel, chromium, cobalt dental alloys and allergic reactions: an overview.

Possible correlations between allergic reactions and the significance of a dental prosthesis or restoration made from one or more of the metals nickel, cobalt and chromium are considered. Described clinical cases are reviewed. These allergic reactions may appear either locally as stomatitis or distantly in the form of general or local contact dermatitis.

[Dental amalgams and allergy]. / Amalgames dentaires et allergie.

After a short description of the fundamental basis of allergy, particularly in relation to contact allergy, the authors review the 41 published cases of allergy to dental amalgam consisting of 30 female and 11 male patients. 20 of these patients recovered on removal of the dental amalgam. The most frequent symptoms were of the remote cutaneous type (38/41 cases) while local symptoms, particularly gingivitis and stomatitis, occurred in 17 cases. These probably underestimate the true prevalence of the condition for several reported cases have not been published. The authors then go on to describe the sensitizing property of amalgam in relation to the occupational environment and the length of time that the amalgam has been in the mouth. Mercury is the most common sensitizing agent, but other metals, particularly cooper, zinc or silver could also be implicated. The authors attempted to explain the physio-pathological mechanism of sensitization via the cutaneous as well as the oral, digestive and respiratory tracts by describing the chelating properties of metals with cellular or tissue constituents. In the last chapter, the prevention and clinical treatment of sensitization to dental amalgams is described.

[Gingival pigmentation caused by dental amalgam. An ultrastructural study]. / Les pigmentations gingivales par l'amalgame dentaire. Etude ultrastructurale.

The aim of this investigation is the ultrastructural analysis of biopsies of human gingiva pigmented by the metallic deposits from dental amalgam. The size, the nature and the distribution of the particles are studied by light and electron microscopy and by energy dispersive spectrometry (EDS). Fragments and particles of different size and composition are observed. No traces of mercury are detected in any examined samples. In contrast, very fine grains (0.01 to 0.05 microns in diameter) of a silver compound are observed to be preferentially bound to intracellular membranes and to extracellular structural components. Tissue modifications in the gingival epithelium as well as in the connective tissue can accompany the pigmentation phenomenon. The different metabolic pathways of the metals diffusing from the amalgams are discussed.

Pathological effects of N-methyl-N'-nitro-N-nitrosoguanidine on oral mucosa in Wistar rats after transplacental exposure.

This study examined the effects of N-methyl-N'-nitro-N-nitrosoguanidine (M.N.N.G.) on the oral mucosa of Wistar rats. The rats were born from dams treated by i.p. injections of M.N.N.G. during gestation. Each pregnant rat of a first group received a total dose of 39.60 mg/kg of M.N.N.G. administered throughout the gestation period. Each pregnant rat of a second group received a total dose of 82.50 mg/kg of M.N.N.G. by i.p. injections during the first ten days of gestation. In the progeny of dams from both groups, the morphology of the gingiva was modified. The lingual gingiva from the lower jaw was most impaired. The epithelium always displayed hyperplasia: acanthosis, papillomatosis and hyperkeratosis. These results indicate a pathogenic effect of M.N.N.G. on lingual, mandibular gingiva. This effect was slight but permanent and irreversible. No carcinogenic effect was noticed on the oral mucosa. Similarities between the lesions described in this work and human epithelial dysfunction makes this experimental model interesting.