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Biomedical subjects

M Maraval

Publications and source records attributed to M Maraval.

At least 19 recordsLinked to original sources

Synthesis of glycoconjugates by human diseased veins: modulation by procyanidolic oligomers.

Venous diseases become steadily more common and severe with age, and are often accompanied by venous lymphatic oedema. We have investigated the role of glycoconjugates in this disorder and the action of procyanidols used to treat these diseases. Explants of vein wall from patients with or without venous lymphatic edema were cultured for 24 hours and the incorporation of radioactive glucosamine into total glycoconjugates and into hyaluronan was measured. The explants from patients with oedema incorporated more glucosamine than those without oedema (+42% expressed as c.p.m./mg dry weight into total glycosaminoglycans and +12% expressed as c.p.m./mg dry weight into hyaluronan). The explants from oedematous patients secreted less glycoconjugates into the culture medium than those from non-oedematous veins (-63% of total incorporated radioactivity into hyaluronan and -66% into hyaluronidase-resistant glycoconjugates). Explants placed in medium containing procyanidols (1 mg/ml, 2.8 mM) incorporated less glucosamine (-19%) and secreted more into the medium (+119%). Glycoprotein and sulphated glycosaminoglycan synthesis were mainly affected which may well explain the beneficial effect of procyanidols on vein disorders.

Adult↗

[Hyaluronic acid (hyaluronan) levels in pathological human saphenous veins. Effects of procyanidol oligomers].

We investigated the hyaluronan content in the pathologic human venous wall using an ELSA assay with hyaluronectin according to the method of Delpech et al. The mean hyaluronan content in the 74 fragments from 12 venous walls studied was 596 +/- 528 ng/mg dry weight. These 12 venous walls could be separated in 3 distinct groups according to their hyaluronan content, low (277 +/- 141 ng/mg dry weight), moderate (552 +/- 361 ng/m dry weight) or high (1299 +/- 568 ng/mg dry weight). The differences between these groups are significant (p < 0.001). The presence of a veino-lymphatic oedema was generally associated with a high hyaluronan level (in 65% of cases). The 3H-glucosamine incorporation in cultured venous wall explants showed a 35% increase (p < 0.002) in varicosis as compared with the non or less modified segments of the vein and a 29% (p < 0.001) increase in presence of a veino-lymphatic oedema. The addition of 1 mg/ml of PCO (Procyanidolic Oligomers) to the culture media induced near to 20% decrease of the 3H-glucosamine incorporation and a 34% decrease of the hyaluronan content. Our results confirm the role of local overproduction of hyaluronan in the establishment of oedema and the potential effect of PCO to counteract it.

Age Factors↗

[Surgery of essential varicose veins].

Idiopathic varicose veins of the lower limbs are a frequent but benign disorder. Surgery is only a moment in the course of the disease. Although not the only treatment of essential varicose veins, surgery by an experienced team performing crossectomy, stripping by intussusception using a stripper, and phlebectomy gives fully satisfactory results, both to patient and to physician, in over 80% of cases. New techniques were recently developed that, at present, have not confirmed early hopes.

Humans↗

Evaluation of different systems for clinical quantification of varicose veins.

One hundred twenty-five lower limbs with varicose veins were studied clinically, essentially by palpation. Two specialists in venous pathology scored the severity of the varicose veins from 0 to 20. Comparison between the different clinical parameters and the scores of the specialists showed that two systems of clinical quantification gave good results and were easy to use. One system is the maximum diameter of the largest varicose vein; the other system is the sum of maximum diameters over 7 sections (3 for thigh, 3 for leg, 1 for foot). This latter system gives a more precise evaluation of the clinical severity of the varicose veins.

Adult↗

[Current status of the surgery of carotid stenoses].

In a series of 472 operations performed in 420 patients between 1981 and 1982, the mortality rate was 1.1% in asymptomatic patients (stage 0) and 2.1% in patients with transient ischaemic attacks (stage I) or with minor neurological sequelae (stage III). The morbidity rate of serious sequelae was 1.05%. The long term mortality is 30% at 5 years and 50% at 10 years, in most of the major statistical studies. The major cause of death (more than 50%) is myocardial infarction. The study of the local evolution of the operated artery reveals that about 10% of the patients who survived between 5 to 10 years had a recurrent carotid artery stenosis. Comparative studies of the course of the atherosclerotic disease operated patients and in patients treated medically are difficult to evaluate. However, most authors agree with Fields that an operation is justified in asymptomatic patients and in those presenting transient ischaemic attacks, provided the mortality and morbidity rate is less than 3%. Finally, recent studies stress the value of non-invasive investigations for determining the prognosis of tight stenoses: in asymptomatic patients with tight stenoses, the risk of a cerebrovascular accident is 5 times greater than in patients with a minor stenosis.

Arteriosclerosis↗

[Surgical treatment of chemodectomas of the neck (author's transl)].

About 16 cases of chemodectomas of the neck, with surgical management during the five past years, the authors present an actualisation about surgery of these tumors of the paraganglionnary system at the level of the neck. After recording the different means of the diagnosis, particulary carotid arteriography, they insist about the necessity of a complete excision of these tumors because of local risks due to the neurovascular compression and infiltration, and because of general risks due to malignant metastasis. Three major risks run with surgery in these cases: hemorrhagic, neurologic, and vascular risks (because of the possible extension to the carotidian axis). 14 total excisions and 1 incomplete excision were performed; 1 no-operated tumor was noted because of the death of the patient before surgery due to a metastatis paraplegia. 4 resections of the carotidian axis with 1 repair by end to end anastomosis and 3 by a vein graft were necessary. No mortality after surgery in these patients was encountered. No recurence, no metastatic phenomen in our patients after the total excision of the primary chemodectoma of the neck even for one histologically maligant tumor, three years ago.

Adult↗

[Splenic trauma complicating translumbar aortography : a report on 2 cases (author's transl)].

Two very rare cases of splenic trauma following high translumbar aortography are described. Two types of clinical picture are observed : severe intraperitoneal hemorrhage, subcapsular and then intraperitoneal, from rupture of the spleen, and septic peritonitis following rupture of an intra- and perisplenic abscess. The authors review the frequency, mechanism, and prevention of complications following translumbar aortic puncture.

Aged↗

[Aneurysm due to an exostosis of the upper end of the tibia (author's transl)].

The authors describe a case of aneurysm of the popliteal artery which developed in the vicinity of a solitary bony exostosis. In a review of the literature they found 33 other cases, in the majority of which the aneurysm was a false aneurysm. Diagnosis was made by arteriography. The results of treatment were good unless complications such as thrombosis or emboli were already present. In the authors' case, resection of the exostosis and arterial grafts were performed with a good end result.

Adult↗

[Right renal arteriovenous fistula after nephrectomy with streptococcal endarteritis].

The authors add a new case, to the 41 already published, of arterio-venous fistula of the renal pedicle after nephrectomy, with the peculiarity of its presentation as a prolonged fever resulting from streptococcal bacterial endarteritis at the site of the fistula (3rd case in the literature). Surgical treatment in association with massive and prolonged antibiotic therapy resulted in recovery.

Adult↗