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Biomedical subjects

M Cloarec

Publications and source records attributed to M Cloarec.

At least 19 recordsLinked to original sources
PubMed1992

[Endoscopic study of reflux of the saphenous valve].

Saphenous venous endoscopy, invasive and non-physiological, enables the in vivo and in situ observation of the valve system. A saphenous vein has a preferential flattening axis parallel to the outside of the skin with two walls, internal and external, and two borders. A valve is inserted on one vein wall, with the valve horns being on the borders. The free borders of a bivalve are parallel with the surface of the skin. The valve system has an antireflux function. There are three main causes of reflux in the saphenous veins: 1. Transitory functional incompetence affecting valves of normal appearance. This incompetence results from valve inertia, flattening of the valve against the sinus wall and loss of co-adaptation. Do active factors producing closure of the valve cup exist against such transitory incompetence? 2. Incongruity between the vein wall and valves. The intercorneal or commissural space allows reflux on the border of the vein. This is the commonest cause of reflux in varicose disease of the vein wall. 3. Actual valve lesions. A distinction is drawn between lesions due to thinning, elongation, stretching, splitting or tearing and those due to thickening, retraction or adhesion. Endoscopy has enabled us to discover cases of varicose disease with predominantly valvular lesions in young individuales in whom early lesions of the valve cup cannot be explained by venous wall disease and has led us to complete the classification of varicose disorders.

Endoscopy↗
PubMed1991

Effect of dietary treatment on the lipid, lipoprotein and fatty acid compositions in type IV familial hypertriglyceridemia.

The effects of a 2-month dietary treatment (1,625 +/- 177 kcal, 40 +/- 2.3% carbohydrate, 35 +/- 3.7% fat, 25 +/- 2% protein, polyunsaturated/saturated fat ratio = 1.02 +/- 0.06) on the overall composition of serum lipids, lipoproteins and the fatty acid composition of cholesterol esters and phospholipids in very low (VLDL), intermediate (IDL), low (LDL) and high (HDL) density lipoprotein in 5 patients with primary familial hypertriglyceridemia type IV were assessed. The data were compared with those for 9 normolipidemic subjects. Treatment decreased serum triglycerides (-52%) and total cholesterol (-12%) due to decrease in free cholesterol (-30%). It produced a significant decrease in all the constituents of VLDL (-58%), but the VLDL remained significantly higher after treatment than those of control subjects. The diet caused a decrease in triglycerides (-16%, -29% and -33%, respectively), and an increase in cholesterol in IDL, LDL and HDL. The IDL level in the treated patients remained significantly higher than in the controls. The LDL cholesterol/HDL cholesterol ratio was unchanged after treatment. The fatty acid compositions of the patients before treatment and the controls were not significantly different. The diet caused a decrease in palmitoleic and oleic acids in the cholesterol ester fraction and an increase in linoleic acid, but this was significant only in VLDL and HDL. The diet decreased the eicosapentaenoic acid but the drop was only significant in IDL and LDL. There was also a decrease in linolenic acid, only significant in IDL. The diet induced only minor changes in the phospholipid fractions. We concluded that a single nutritional regimen can effectively decrease the serum lipids and normalize the lipoprotein composition of type IV hypertriglyceridemic patients.

Adult↗
PubMed1991

[Venous endoscopy].

The miniaturization of endoscopic equipment now allows exploring the superficial venous system and visualizing the endovein in situ and in vivo. This type of venous endoscopy is an ambulatory procedure, performed during a simple outpatient consultation of angiology, after which the patient is immediately discharged. Although this examination is invasive, non-physiological and expensive, it allows the video recording of the morphology, dynamics and kinetics of the values, of the endovein and of the liquid flows (blood, washing fluid and sclerosing products). The new examination has already enabled us to propose an functional classification of the parietal valves of the great saphenous vein. It makes an intraoperative three-dimensional mapping of the vessels possible, which is sometimes difficult in such particular anatomical regions as the popliteal fossa. It allows performing sclerosis with a visual control and following up the evolution of the immediate endoparietal lesions in situ.

Ambulatory Care↗
PubMed1990

Treatment of stage II chronic arterial disease of the lower limbs with the serotonergic antagonist naftidrofuryl: results after 6 months of a controlled, multicenter study.

A study was carried out in patients with intermittent claudication (Fontaine's stage II). The atheromatous origin of the disease was confirmed and localized by angiography or Doppler. One hundred eight-three patients were selected initially (day -30) with a pain-free walking distance on a treadmill (at a speed of 3 km/h and a slope of 10%) ranging from 150 to 300 m. During the first month (washout period) all patients received two placebo tablets daily. At the end of this run-in period (day -30; day 0) and after checking walking distance stability (allowed variation: 20% between the two measurements), patients were included in the study. According to this criterion, 112 patients were selected and 94 remained during the whole study. The study was designed in double-blind, using two parallel, randomly selected groups. Fifty-two patients received naftidrofuryl (2 x 316.5 mg tablets daily with meals) for 6 months; 42 patients received placebo under the same conditions. During this period, clinical and paraclinical examinations were carried out every quarter (day 90 and day 180). After checking the initial homogeneity of the naftidrofuryl and placebo groups, the comparison between the two groups indicates a significant improvement in the naftidrofuryl group after 3 months and 6 months of treatment, for the pain-free walking distance. For the maximal walking distance, a significant improvement was found at day 180. Nonparametric analysis (chi 2 test) also indicated a significant improvement for the naftidrofuryl group. These results confirm that naftidrofuryl is beneficial in the treatment of patients with chronic arterial disease.

Adult↗
PubMed1989

[Capillaroscopy and wound healing].

Capillaroscopy is a very simple examination which allows good evaluation of the superficial micro-circulation of the skin. The authors consider that this new examination constitute a method to evaluate the risks of skin necrosis after facelift and abdominoplasty and, may possibly change the strategy of operations.

Capillaries↗
PubMed1979

[Raynaud's syndrome: study of fingertip blood flow by plethysmography with venous occlusion (author's transl)].

The fingertip blood flow was measured by venous occlusion plethysmography in a room at 22 degrees C, in 52 patients with Raynaud's syndrome and 24 healthy controls. In severe Raynaud's syndroms (24 cases incuding: scleroderma: 7 cases, thromboangitis: 5 cases, disabling syndrom without known etiology: 12 cases), the flow was significantly lower than in moderate Raynaud's syndroms (19 cases including 10 primary and 9 secondary syndroms) i.d. 7.5 +/- 7.3 ml versus 25 +/- 15 ml (p < 0.001). Controls had significantly higher flow (35 +/- 12.3 ml) than moderate Raynaud's syndroms (p < 0.05). Raynaud's syndroms with permanent acrocyanosis had a low flow (8.7 +/- 5.3 ml) not different from severe syndroms.

Adolescent↗
PubMed1978

[Merits of the assay of plasma catecholamines in a glucagon test to diagnosis of pheochromocytoma (author's transl)].

In one female patient suffering from an extra-adrenal pheochromocytoma, a stimulation test with glucagon was performed. In spite of the absence of an increase in heart rate and blood pressure, a pronounced increase in plasma catecholamines showed this test to be positive. The authors discuss the reliability criteria of this test, and confirm its good tolerance.

Adrenal Gland Neoplasms↗
PubMed1978

Abnormal lipoproteins in a case of primary biliary cirrhosis.

The serum of a patient diagnosed as a primary biliary cirrhosis was studied during the various evolutive stages of the disease. During the non-icteric period, the serum lipoprotein had the chemical composition (rich in cholesterol and phospholipids) of that found in cholestasis; however the bilirubinemia was normal, and no LPX was detected; there was a normal esterified to total cholesterol ratio and the alphaLP had not decreased, as expected, but increased and was divided into two fractions; immunoelectrophoretic studies of ultracentrifugal fractions showed some LP with HDL immunological properties, but with lower densities than that of normal HDL. We suggest that the phospholipid overloading of some of these HDL in the patient's serum could explain the changes in density. Some months after this study, the patient's serum exhibited the characteristics found in cholestasis, with disappearance of HDL and appearance of LPX. During the subsequent period, the serum again contained phospholipid rich HDL and LPX. In fact several LPX with different densities were found. It seems, therefore, that in cholestasis, LP undergo modification in which the HDL peptide chains play an important role.

Bilirubin↗
PubMed1977

[Platelets fatty acid variation in patients with atherosclerosis (author's transl)].

Plasma linoleic acid levels were found to be low in the atherosclerosis patients investigated. In contrast, platelet arachidonic acid levels were decreased only when atherosclerosis was combined with diabetes or mixed hyperlipidemia. In acute vascular thrombosis, a marked decrease in platelet arachidonic levels occurrrd, irrespective of whether the patient had atherosclerosis or not.

Arachidonic Acids↗
PubMed1976

[Epileptic seizure revealing a cerebral arterial accident during administration of oral contraceptives with platelet function disorders].

The authors observed the onset of an epileptic fit in a 27 year-old woman, ten months after starting treatment with the contraceptive pill. Carotid arteriography revealed the existence of non-obstructive lesions in the area supplied by the left anterior cerebral artery. Disorders of platelet aggregation and disaggregation were demonstrated 15 days after stopping the contraceptive treatment. The significance of these abnormalities is discussed in the light of data in the literature.

Adult↗
PubMed1976

[Circulatory disorders induced by amantidine].

Amantadine has been used since 1969 in the treatment of Parkinson's disease. In 1970, were described the special symptoms noted in the lower limbs due to this drug. The authors, after a review of the various disturbances, have studied 10 cases by Capillaroscopy. They emphasize the interest of the study of this abnormality of the micro-circulation, producing vaso-constriction of the arterioles and venules.

Aged↗
PubMed1976

[Mixed hyperlipoproteinemias. Importance of diet].

The interest of diet is particularly clear in mixed hyperlipemia. In fact, the authors were only able to define the type of lipid abnormality after a test diet and prolonged supervision. One should never treat mixed hyperlipemia straightaway with hypocholesterolemic agents. The authors studied 22 patients with a form only demonstrable in the laboratory. There were no clinical signs of arteriosclerosis. In the group of dyslipemic subjects with minor hyperlipemia, they obtained normal figures for serum cholesterol and triglyceride. The results remained stable after 4 months supervision.

Adult↗
PubMedDate not supplied

[Venous pain, 30 years after the 1st International Congress of Phlebology in Chambéry].

In 1960, the first International Conference of Phlebology, organised at Chambéry by Jean Marmasse under the egis of R. Tournay included only three subjects in its programme, one of which was: "venous pain". What is the status of venous pain thirty years on? Can we compare our current concepts with work from past years? Have we advanced in knowledge and in its clinical and therapeutic applications? All these questions are even more worthy of consideration bearing in mind world-wide increased interest in Phlebology and its even richer future. The Chambéry Conference established a clear pattern with: two basic reports: "pain due to essential varicose veins and to trophic disorders" (C. Huriez, F. Desmons, M. Thoreux) and "pain in phlebitis" (R. Fontaine); three analytical and differential reports "pain due to interlinked arterial and venous disorders" (F. Piulachs), "pain in the lower limbs due to interlinked gynecological and venous disorders" (A. Bret, R. Legros) and "pain due to the association of osteoarticular and rheumatic disorders or of neuralgia in venous disease patients" (J. Forestier); and nine other studies, the following being worthy of particular attention: a very interesting report by R. Tournay: "Pain in venous disorders of the lower limbs related to their treatment"; and two papers: "pain of "cellulite" type and the metameric disposition of the lower limbs in relation to functional disorders of the ovary" (S. Bourgeois), and "exercise pain and rest pain in varicose vein sufferers" (J. Marmasse); three German reports (F. Jaeger, F. Maid-Fischer and D. Gross) on the pathogenesis and mechanisms of venous pain; and the report of M. Comel "epiesthesia and histoangeological correlations". Since that time, venous pain has no longer figured in the same format on the programme of any international conference, nor at meetings of the French Society of Phlebology. Progress has thus occurred insidiously... Mention may be made of the following with regard to essential varicose veins: some progress in knowledge of cramps, phlebalgia and venous paresthesiae; attribution to venous syndromes of "restless legs", which have been such a source of intrigue for the past hundred years, and interest in inflammatory pain of the superficial venous system and of subcutaneous cellular tissue in relation with venous insufficiency, as well as ulcer pain. However, it is in the area of acute deep venous thrombosis that everything has been disrupted. Firstly, with the established certainty that the clinical picture leads to errors in more than 50 p. cent of cases, both by excess and default.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMedDate not supplied

[Ostial valves in a patient with varicose veins. Endoscopic examination].

Twenty three endoscopies were performed, including six of the great saphenous region, fourteen of the small saphenous region and three involving the region of the medial gemellar perforators. Two types of valves may be seen on the basis of their endoscopic appearances: certain valves have a transparent appearance with very thin valvular tissue which tears easily when a catheter is passed against the direction of venous flow. These valves are located in the main saphenous veins and their collaterals, at a distance from bifurcations and the point of entry of perforating veins. The only type of lesion seen affecting these valves was tearing of their tissue. Their sole role appears to be to favourize the progression of venous flow in an anterograde direction. Other valves have an opaque appearance with valvular tissue thickened by an actual fibromuscular skeleton and strengthening of the free edge to form a lip. These resist counter-grade catheterisation and may prevent progression of the endoscope or of a stripper. These valves are located at the ostium of the terminal portions of the saphenous veins and directly proximal to the point of entry of certain collaterals and perforators. The latter, when reflux is present, behave as ostial valves, playing the role of an anti-reflux system as well as favourizing preferential hemodynamic circuits which explain certain varicose cartographic patterns.(ABSTRACT TRUNCATED AT 250 WORDS)

Endoscopy↗