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Biomedical subjects

A Maurel

Publications and source records attributed to A Maurel.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Leg volumetry: a precise method for quantification in phlebology].

UNLABELLED: Chronic venous insufficiency is usually quantified by venous pressure measurement, which is an invasive method. Air plethysmography has also been used, but it is expensive, time consuming and only suitable for sophisticated research laboratories. Leg volumetry might be suitable for routine use, as it is simple, inexpensive, fast, non invasive and can be performed by non medical personnel. Here, we only evaluated its practicability, accuracy and reproducibility. PATIENTS: The study group included 28 legs of 14 healthy volunteers, and 22 legs of 11 patients suffering from varicose veins. METHOD: The device used was a plexiglass boot, 50 cm high, 20 cm wide. It was filled with water at 24 +/- 2 degrees C. The leg was immersed and the volume of water displaced recorded. RESULTS: Normal legs displaced a volume of 2,449 +/- 153 ml (mean +/- SD), range: 2,080-2,720, and variability 6.2%. Patients' legs displaced a volume of 2,576 +/- 290, range: 2,110-3,120, (p = 0.05 vs normals) and variability 11.2%. Accuracy was 0.7%, as from 2 consecutive measurements of the same patients' legs by 2 different observers. Intra-individual variability was 1.3%, as recorded in 12 repeated measurements of the same leg on different mornings. In normal legs, the difference between morning and evening volumes was statistically significant (18 +/- 15 ml, p = 0.0001), a finding consistent with the deterioration of the venous function in normal extremities during daily activities. CONCLUSION: This simple, cheap, objective, non-invasive reproducible and accurate method of leg volume measurement might be useful in routine practice for chronic venous insufficiency quantification.

Adult↗
PubMed1993

Comparative evaluation of laser Doppler flux metering, bulbar conjunctival angioscopy, and nail fold capillaroscopy in sickle cell disease.

Eleven adult patients with stable sickle cell disease (SCD) were investigated twice at a 15-day interval by nail fold capillaroscopy (NFC), bulbar conjunctival angioscopy (BCA), and laser Doppler flux metering (LDF). NFC and BCA are essentially descriptive. NFC revealed, in some patients, network patterns similar to those observed in vasculitis. BCA provides a reproducible method for the visual assessment of the microcirculation. When using a rating scale with five criteria it identified abnormalities related to both altered red blood cells and vascular morphology but failed to discriminate between patients. LDF, in contrast, is quantifiable and showed reproducible characteristic reactive alterations of vasomotion in response to ischemia after 3 min of occlusion. The SCD patients had a delayed response, best measured by the recovery half time, which was four to five times longer than that of normal subjects. In addition, the cold provocative test was always abnormal, as evidenced by a significant drop in the contralateral flux, and was often poorly tolerated. The observed trends suggest that BCA and LDF should be performed in a large cohort of patients, both in the steady state and during vasoocclusive crises. These methods seem to be useful complementary noninvasive procedures to cellular and clinical evaluation monitoring for therapeutic trials.

Adult↗
PubMed1993

Improvement of microcirculation abnormalities in sickle cell patients upon buflomedil treatment.

The efficacy of the vasoactive compound buflomedil on previously described microcirculation abnormalities observed in sickle cell disease (SCD) was investigated using bulbar conjunctival angioscopy (BCA) and laser doppler flux metering. Eleven sickle cell disease patients at steady state were studied in a double-blind randomized parallel-versus-placebo study (5 patients were given placebo and 6 patients received 600 mg buflomedil per day for 21 days after a washout period of 15 days). The blood flux score measured by BCA improved, indicating reduced entrapment of sickle red blood cells. There was a striking improvement of reactive alterations of vasomotion in the buflomedil group, particularly in postocclusive reactive hyperemia; the half return time was also significantly reduced. These results encourage further studies with buflomedil to investigate long-term effects of this compound in SCD, potential prevention of acute vaso-occlusive events, and degenerative complications.

Adult↗
PubMed1993

Observations on experimental flow-through venous flaps.

The aim of this work was to compare the survival of an arteriovenous island flap with the survival of an island flap with a flow-through venous supply. Our experimental studies were performed on 95 Wistar rats randomised into six groups: Group 1: Indian ink injection of flow-through venous flaps with capillary network; Group 2: control group deprived of vascularisation; Group 3: control group with arteriovenous supply; Group 4: flow-through venous flaps of group 1; Group 5: epigastric flow-through venous flaps with a main venous trunk; Group 6: histological examination of flow-through venous flaps. The survival of flaps was monitored by direct examination, histological examination, capillaroscopy, and laser Doppler. Three out of 50 flow-through venous flaps survived. There was a statistically significant difference in the delay of clinical necrosis between the composite non vascularised free grafts (2.8 +/- 1.2 days) and the flow-through venous flaps (4.1 +/- 1.3 to 4.9 +/- 1.1 days depending on the type of flap). A 20% decreased venous blood flow was observed in the flow-through venous flaps.

Adipose Tissue↗
PubMed1991

[Microcirculatory hemodynamic effects of Urapidil (Eupressyl)].

A laser Doppler measurement of the microcirculatory flow rate was performed in 10 patients with moderate arterial hypertension before the delivery of a 30 mg capsule of Urapidil and 3 hours later. A significant increase in this flow rate was evidenced, thus demonstrating the arteriolar vasodilative action of Urapidil.

Adult↗
PubMed1990

In vitro studies of the effect of buflomedil on platelet responsiveness.

The effect of buflomedil (Fonzylane; Laboratoire Lafon, Maisons-Alfort, France) on platelet function, a drug used clinically for the treatment of peripheral vascular diseases, was investigated in vitro. The compound significantly inhibits epinephrine-induced aggregation at the micromolar level. At higher doses (approximately 1 mM), a weak inhibition of ADP- and collagen-induced aggregation was observed; at these concentrations, buflomedil inhibits granular secretion and the interaction of fibrinogen with its receptor on platelet. Further investigations indicate that the drug affects calcium uptake at the membrane level and inhibits the binding of [3H]-yohimbine to the same extent as observed with phentolamine. The IC50 determined from competition binding assays was 1 +/- 0.5 microM. This value was consistent with the affinity constant approximated for the binding of [3H]-buflomedil to non-stimulated platelets. Taken-together, these results indicate that the vasoactive compound buflomedil is a weak antiaggregating agent which exhibits alpha 2-adrenergic antagonistic properties.

Adenosine Diphosphate↗
PubMed1989

[Edematous syndromes caused by capillary hyperpermeability. Diffuse angioedema].

Edema due to increased capillary permeability (ICP) may be diffuse or localized. Local edemas (Quincke edema, angioneurotic edema) are most often allergic or very rarely due to a defect in C1-inhibitor. Generalized edemas due to ICP share the following clinical features: Fluid retention (subcutaneous edema and diffused swelling) is predominant in lower limbs; it is worsened by orthostatism and warmth and alleviated by decubitus and cold, with important weight variations between morning and evening. It is associated with enhanced thirst, hypotension, oliguria, headaches and blood volume reduction; secondary hyperaldosteronism is the main mechanism. These troubles are due to ICP, associated with lymphatic drainage abnormalities; ICP is measured by the isotopic Landis Test. This abnormality is present in several diseases. Idiopathic orthostatic edema (IOE) is frequent and often unrecognized, occurring mainly in women, often associated with luteal insufficiency. Iatrogenic complications (diuretic and laxative abuses) are frequently superimposed. ICP may be corrected by vitamins P (rutin, anthocyanosides, diosmin, Ginkgo biloba extracts...) Cyclic shock due to ICP is rare. It is characterized by cyclic edema and shock with hypovolemia, hypoproteinemia; the mechanism of shock is a severe loss of fluid and protein from the vascular bed. It is often associated with monoclonal gammapathy and complement activation. In our personal case, the trouble in CP was present all along the disease with permanent edema and low blood pressure (especially in orthostatism). Vit "P" and Ginkgo biloba extracts were able to partially improve CP and the clinical troubles. However, in spite of this treatment a fatal shock occurred after ten years follow-up. Episodic angioedema associated with eosinophilia was first described by Gleich.(ABSTRACT TRUNCATED AT 250 WORDS)

Capillary Permeability↗
PubMed1988

[Conjunctival and peri-ungual angioscopy in noninsulin-dependent diabetes mellitus. Informational value of observed anomalies].

Microangiopathy is one of the most frequent and serious complications of diabetes. Its diagnosis is based on fundus of eye and fluorescein angiography findings, but several teams have emphasized the value of conjunctival angioscopy (CA) and peri-ungual capillaroscopy (PUC), describing suggestive anomalies: microectatic venous dilatation (V/A greater than 4.5), sludge on CA, "fish shoal" capillaries on PUC. Up to the present, however, the diagnostic value of these anomalies has not been evaluated based on data that are sensitive, specific and indicate predictive positive and negative values of a sign (Se, Sp, PPV, NPV). Anomalies of CA and PUC as a function of presence or absence of "diabetes" were studied in 114 patients with moderate hypertension, including 46 "diabetics" (33 with glucose regulation disorders and 13 non-insulin dependent diabetics). "Diabetes" was observed more predominantly in males of more advanced age and with a significantly higher global CA score (4.25 +/- 1.44 as against 2.65 +/- 1.35), and this in an increased manner as the "diabetes" was severe. Some anomalies had themselves a major orientation value with an Sp greater than 80% and an Se close to 40% (global score greater than 4; V/A greater than 4.5, microectasia, rheologic changes). For the fish shoal appearance the Sp was 73.5% and the Se 43.5%. The Sp was greater than 95% when at least 4 of the following 6 signs were present: global score greater than 4, V/A greater than 4.5, microectasia, rheologic disorders, fish shoal, gerontoxons. The more signs associated the more the Sp increased; the Se decreased from 40% for one sign to less than 10% for 4 associated signs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Laser-Doppler velocimetry: a new technic for evaluating of microcirculation. A reproducibility study].

The recent introduction of the laser-Doppler technique to measure capillary flow velocity offers new prospects in clinical pharmacology. We used this technique in 45 healthy volunteers (23 women and 22 men) to study the capillary network at the distal end of the third finger of the non-dominant hand. Each subject was tested twice at one-week interval. The results showed that the data concerning flow velocity and amplitude were perfectly reproducible, under standard conditions, after one week in each subject. No correlation was found between the microcirculation parameters and the subjects age, weight and, paradoxically, blood pressure and heart rate. We would suggest that this innocuous, sensitive and reproducible technique be used more systematically to evaluate the haemodynamic effects of drugs on capillary blood flow.

Adult↗