Biomedical subjects
M Cloarec
Publications and source records attributed to M Cloarec.
[Lipid overload of the liver].
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[Metabolic overload. Risk factors and overload].
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[Metabolic overload. Overload: introduction and definitions].
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[Importance of the health care team in the control of overload syndromes].
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[Indispensable concepts for the understanding of calories and a balanced diet].
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[Care of the metabolic patient by the health care team. Conclusions].
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[Profile of the metabolic patient and concept of prevention].
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[Discrete distal gangrene].
The authors present their statistical findings from 114 cases of discrete distal gangrene. They stress the importance of a rigorous methodology to detect mechanical causes from the thoracic outlet syndrome and immunological causes, predominantly scleroderma, especially in women. It is important not to overlook blood diseases nor those cases which are a presentation of underlying cancer. Finally, the iatrogenic cause is now well known. Treatment depends on the causes of this distal lesion. However, in cases of severe connective tissue disease, the use of plasmapheresis is beginning to give interesting results.
[Alpha blockers and microcirculation (author's transl)].
The new compounds such as Prazosin are antihypertensive agents. Their action on blood pressure are a consequence of a direct action on vascular smooth muscle with little or no effect on cardiac output. This action is very important to reduce total peripheral resistance. In our Vascular Laboratory, we study 14 patients treated by Prazosin. They were all studied by capillaroscopy, ultrasonic investigations and plethysmography. Since Prazosin is primarily an alpha receptor blocker, it might be expected to have an action in microcirculation and in vasospastic diseases. We don't find modifications of microcirculation in seven people treated for hypertensive disease. Among seven patients with Raynaud phenomenon, we have only a good result in one case (Buerger disease) and two cases with a little increase of the fingertips blood flow.
Extracorporeal plasma therapy for homozygous familial hypercholesterolaemia.
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[Beta blockers and disturbances of the microcirculation (author's transl)].
Study of 192 cases of hypertensive patients, 89 of whom were treated by diet, general advice and correction of risk factors for an average period of 8 months. The group of patients treated beta blockers consisted of 103 subjects, 28 of whom received Propranolol, 29 Oxyprenolol, 20 Atenolol and 26 Practolol. The prevalence of Raynaud's phenomenon was markedly greater in the patients treated with beta blockers, in comparison with the group not receiving any drugs. The highest incidence of vasomotor problems was seen in the group of subjects treated with Propranolol, with 57% of patients having a Raynaud-type paroxysmal acrosyndrome. In more than half of the cases attributed to Propranolol, the clinical picture of Raynaud's syndrome was severe. Discussion of the mode of action of beta blockers on the microcirculation.
[Behçet's disease. Circulating immune complexes and abnormalities of polynuclear chemotaxis].
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[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.
[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.
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.
[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.