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Biomedical subjects

J Battino

Publications and source records attributed to J Battino.

At least 19 recordsLinked to original sources
PubMed1992

[Echogenicity of blood].

The echogenicity of blood is dependent of the back scattering of the ultra-sound beam by the flowing blood-stream. This black scattering is, according to the Rayleigh theory, proportional to the fourth power of the frequency and to the size of the particles. So, for the frequencies in clinical use, the size of the particles is essential. Micro bubbles and aggregates of red cells can be echogenic. Micro bubbles are scare. Echoes are mainly generated by blood cells aggregated from a given size for each wave length. For instance, 225 for 7.5 MHz frequency. High degree hematocrits and big molecules induce aggregation, but the main factor is the flow speed or more exactly the shear rate, i.e. 8/3 of speed/vessel radius. In clinical practice, blood becomes echogenic if flow slows and if the vessel radius increases. This happens for instance for venous or even arterial aneurysms, for dilated and dyskinetic cardiac cavities, an above all, in veins when flow slows. Echogenicity appears proximal to an organic or hemodynamic obstacle and is reversible when flow is restored. The technical conditions are important, too. Blood becomes more echogenic when the scan benears, the frequency increases and the resolution of the device goes higher. It can be expected that hemodynamic and even rheologic information will be obtainable in big vessels with computerized techniques quantifying blood echogenicity. Blood clots will be echogenic under the same conditions: red blood cells aggregated non hemolyzed. Their echogenicity appears more dependent of their structure than of the chronology. Better technical conditions will increase the clot echogenicity, too. Therapeutic and prognostic conclusions can be expected by better evaluation of prethrombotic stages and of structure of blood clots.

Blood↗
PubMed1991

[Echogenicity of blood].

The echogenicity of blood is dependent of the back scattering of the ultra-sound beam by the flowing blood-stream. This back scattering is, according to the Raleigh theory, proportional to the fourth power of the frequency and to the size of the particles. So, for the frequencies in clinical use, the size of the particles is essential. Micro bubbles and aggregates of red cells can be echogenic. Micro bubbles are scare. Echoes are mainly generated by blood cells aggregated from a given size for each wave length. For instance, 225 for a 7.5 Mhz frequency. High degree hematocrits and big molecules induce aggregation, but the main factor is the flow speed or more exactly the shear rate, i.e. 8/3 of speed/vessel radius. In clinical practice, blood becomes echogenic if flow slows and if the vessel radius increases. This happens for instance for venous or even arterial aneurysms, for dilatated and dyskinetic cardiac cavities, an above all, in veins when flow slows. Echogenicity appears proximal to an organic or hemodynamic obstacle and is reversible when flow is restored. The technical conditions are important, too. Blood becomes more echogenic when the scan nears, the frequency increases and the resolution of the device goes higher. It can be expected that hemodynamic and even rheologic information will be obtainable in big vessels with computerized techniques quantifying blood echogenicity. Blood clots will be echogenic under the same conditions: red blood cells aggregated non hemolysed.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood↗
PubMed1990

[Cerebral reserve. A method for evaluating cerebro-vascular hemodynamic risk].

Together with embolic risk, hemodynamic risk tends to play an important role in cerebrovascular pathology. Studies of cerebral reserve have resulted from the difficulty of accurately estimating the repercussions of arterial lesions. The vascular reserve of a given region is the ratio between maximum and baseline flow. Maximum cerebral flow is obtained by inhalation of a gaseous mixture containing CO2 5%. An excellent correlation was found between lesion size and a decrease in the reserve. Three stages could be defined by positron emission transaxial tomography: a zone of hemodynamic reserve without modification of oxygen extraction; a zone of extraction reserve in which inflow insufficiency is compensated by increased oxygen extraction (this is the critical zone requiring action); and a zone of actual ischemia in which the extraction reserve is not exhausted. However, this technique is cumbersome and difficult to apply. Protocols are now being developed using the transcranial Doppler examination to define "a limit of autoregulation reserve", in which case it will be possible to assess the effects of arterial lesions. In fact, it would appear that cerebral irrigation depends on a very large number of factors, many of which are variable, whereas only a "snapshot" of the vascular situation can be obtained. Nevertheless, hemodynamic risk can be better assessed through an association of different explorations.

Brain↗
PubMed1989

[Diagnosis of varicocele by Doppler effect].

Varicoceles, which may produce oligo-astherospermia are a curable cause of subfertility in the male. Doppler velocimetry of the anterior spermatic venous plexus or pampiniform plexus allows the diagnosis of clinical and infraclinical varicoceles to be confirmed. It can also assess and quantify the spontaneous increase in flow due to venous distension and Valsalva reflux related to valvular incompetence. 50 patients investigated for conjugal infertility and suffering of oligo-astherospermia were included in this study. All underwent clinical examination by an andrologist, spermatic venography and Doppler examination before and after embolization. Doppler examination was performed with patients in the dorsal decubitus position using an 8 MHz transducer. Varicocele was confirmed in 84% of patients suffering of oligo-astherospermia. --Comparison with the results on clinical examination demonstrated a specificity of 100% but a sensitivity of only 66%. --Compared with venography taken as a reference, Doppler had a sensitivity and specificity of 94% and 100% for the examinations carried out after embolization. In the hands of a suitably trained doctor, Doppler examination is today the most rapid, simplest, least costly and most reliable non invasive method for diagnosis of varicoceles. In recent months Doppler hemodynamic data have been complemented by ultrasonographic images obtained using a high resolution apparatus emitting at 7.5 MHz. In the presence of varicocele, the pampiniform plexus has an alveolar appearance and the diameter of the principal draining vein is greater than 3 mm. These dates should be compared with those obtained on venography.

Embolization, Therapeutic↗
PubMed1989

[Management of patients with varicose veins presenting with a history of deep venous thrombosis].

The notion of a history of deep venous thrombosis in patients with varicose veins has often been at the origin of a contemplative attitude toward this pathology. What used to be an act of vigilance has now become plain negligence, if not a therapeutic error. Indeed, the difficulty in diagnosing an acute episode explains the many false positive results obtained; moreover, the variability of the evolution of true venous thrombosis should no longer cause one to adopt a monolithic attitude. In this indication, noninvasive investigating procedures allow distinguishing quite different situations occurring in these patients. In a substantial number of cases, no deep vein circulatory abnormality can be found. Treatment should address primary varicose veins. For those patients with deep venous thrombosis sequelae, such studies allow us to differentiate between occlusion/restriction states from devalvulation, and to detect the precise location of such sequelae, as well as their impact on circulatory function. When occlusion is found, varicose veins, which may be supplementary veins, are left untouched. When devalvulation occurs as an isolated phenomenon, superficial vein insufficiency is of primary importance. Treatment is the more complete that deep reflux will promote relapse through all existing leakage points. If, regardless of this treatment, deep reflux causes significant disturbances, surgical revalvulation should be recommended. More complex cases combining persisting occlusion with devalvulation call for a graded attitude. Noninvasive investigating procedures coupled with phlebography allow us to assess the part played by the various anomalies in causing the disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1988

[Scanner and carotid artery surgery].

The utility of CT scan imaging in patients with hemispheric cerebrovascular accidents suspected of being of carotid artery origin was investigated by analysis of case reports of 57 patients treated recently. A low density image was found in 38.5% of cases, superficial and deep localizations being of equal number. A silent infarct was detected in 13.6% of the patients and a meningioma was able to be diagnosed by the scanner. CT scan imaging is indispensable for care of these patients: --dissuasive in case of cerebral tumor, severe infarction or extensive cerebral destruction; --persuasive in case of major carotid artery lesions and/or those threatening with normal scanner image. Carotid artery surgery can then protect cerebral capital; --directive in case of "watershed" infarct, of enhancement, of silent infarct or an occurring accident. In all such cases, it appears indispensable.

Aged↗
PubMed1985

[Non-invasive exploration of the deep veins. Therapeutic implications in varicose patients].

The functional investigation of patients with varicose veins allows essential varicose veins to be distinguished from secondary varicose veins, so that appropriate therapy can be instituted. These investigations include global evaluation of the venous function, plethysmography and segmental ultrasonography. The authors propose a protocol combining Doppler with photoplethysmography: - if the deep channels are normal on the Doppler examination and the filling time of the PPG is normal after a venous tourniquet has been applied, the varicose veins are essential; - if the deep channels are abnormal: in the case of an obstructive or restrictive syndrome, the PPG can determine whether the varices act as collaterals and should be left intact or whether saphenous incontinence is partially or totally responsible for the disorders, in the case of reflux diagnosed on the Doppler, the PPG can decide whether or not this deep reflux is pathological. This simple, non-invasive protocol can be proposed in the majority of patients with varicose veins. It allows a better evaluation of the pathogenic influence of deep reflux, which is currently an subject of debate.

Hemodynamics↗
PubMed1985

[Carotid surgery, indications, results and perspectives].

A series of 215 patients who had undergone 250 carotid artery operations were followed up for a mean of 30 months. Perioperative mortality was 2%, neurologic morbidity was 7% but with permanent sequelae in 1.39% of cases. Recurrence of stenosis was detected in 0.8% of patients but there were no cases of postoperative thrombosis. Indications for surgery were based on the existence of hemispheric ischemic accidents corresponding to the territory supplied by the artery operated upon, and on anatomic and evolutive arguments drawn from results of non-invasive review examinations: ultrasonography and Doppler. Results obtained: 81.9% of patients were asymptomatic after 30 months, appear to be superior to those of the natural history of carotid artery lesions.

Adult↗
PubMed1983

[Acute ischemia of the lower limbs. Clinical diagnosis].

Acute ischemia of lower limbs is severe: 25% lethality, 34% amputations (mean of 42 recent statistics). Initial clinical examination is the main point: it diagnoses acute ischemia, localizes the point of occlusion, picks up etiologic informations, assesses the repercussion of ischemia on the local and general status. The therapeutic decision is an emergency. Some particular aspects are pointed out: diagnostic between embolization and thrombosis, arterial spasm, distal ischemia with present pulses ("blue toe syndrom"), arterial dissections, complications of aneurysms. Prognosis depends on age, general condition, localization of ischemia, status of the limb, multiplicity or recurrence of embolization, but above all on early diagnostic and therapeutic.

Acute Disease↗
PubMed1982

[Continuous emission Doppler ultrasonography in the study of varicoceles].

Because of their anatomical situation and their physiology, spermatic veins are a privileged site for Doppler ultrasonography examinations. By applying an 8 MHz sound above the testis at the level of the hilum before the entrance into the inguinal canal, recordings can be made by means of the respiratory phases, of spermatic vein blood flow rate. Reflux can be demonstrated by employing Valsalva's manoeuvre. Normal spermatic veins can be differentiated from loops, varicoceles with reflux and spermatic and/or iliac spermatic vein thromboses of 95 patients with oligo-asthenospermia examined in this way, 77 (81%) had a reflux to Doppler, and 55 (nearly 75%) had a bilateral reflux.

Humans↗
PubMed1981

[Doppler velocimetric study of the arteries involved in erection. A new diagnostic approach to sexual impotence of arterial origin].

With the aim of diagnosing possible arterial causes of sexual impotence, a Doppler study of the arteries of erection (dorsal arteries of the penis, left and right cavernous arteries) was performed according to an original protocol on 132 patients with cardiovascular disease. The Doppler study included recording of mean arterial flow and the measurement of the systolic pressure of the arteries of erection with a specially designed cuff connected to a manometer. In 60 out of 132 cases the investigation demonstrated an arterial component in the cause of the impotence and was able to determine whether the disease was uni- or bilateral. The disturbance of penile irrigation was constantly associated with a lengthening of the decceleration phase of the arterial flow curve. Aortography was carried out in 46 of these 60 cases and confirmed the results by showing arterial disease and its location: aortic bifurcation (33 cases) ischio-perineal trunk and/or the perineal branch of the hypogastric artery (7 cases), hypogastric artery (6 cases). Reliable and atraumatic, our protocol allows a precise diagnostic of possible arterial components in sexual impotence; it should therefore be an integral part of investigation of impotence of recent onset.

Adult↗
PubMed1980

[Subclavian-carotid anastomosis: a new technique for treating obliterations of the proximal subclavian artery (author's transl)].

A new technique for treating obliterations of the proximal subclavian artery is described. It consists of anastomosing the cervical part of the artery with the common carotid artery. The authors have used this technique in 4 patients. The operation and post-operative course were uneventful. The functional disorders regressed and velocimetric tracings returned to normal. The technique has the advantage of treating the lesions without having recourse to thoracotomy or insertion of foreign material.

Arterial Occlusive Diseases↗
PubMed1980

[Organic sexual impotence or arterial origin (author's transl)].

With the aim of identifying the arterial origin of secondary sexual impotence, a velocimetric study by Döppler effect of the arteries involved in erection, was carried out in 132 patients aged between 32 and 58 years, and collected in a cardio-vascular department. 46 of these patients showed evidence of disturbance in arterial irrigation of the penis, as demonstrated by: -- flattening or disappearance of the special rate curve (46 cases out of 46); -- decreased pressure in the cavernous arteries (43 cases out of 46); -- prolongation of the time taken by the pulsatile wave (40 cases out of 46); Arterial involvement was confirmed in all 46 cases by aortography, completed in 35 cases out of 46 by selective angiography.

Adult↗