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Biomedical subjects

M Zicot

Publications and source records attributed to M Zicot.

At least 19 recordsLinked to original sources
PubMed1999

[Venous diseases and pregnancy].

The pregnancy and the puerperium are critical conditions for the venous system of the lower limbs. The risk of venous thromboembolism is important in the presence of contributing factors. The management of the disease (diagnosis, treatment, prophylaxis) has to be tailored to each individual patient. This period is also characterized by the appearance of specific varices or the aggravation of preexistent lesions. The treatment is mostly conservative including the use of elastic stockings. The post-partum condition is no contraindication for pregnancy, but requires a specific management.

Female↗
PubMed1996

The quantitation of blood flow/metabolism coupling at rest and after exercise in peripheral arterial insufficiency, using PET and 15-0 labeled tracers.

Regional blood flow and oxygen uptake of the lower limbs were studied in 11 patients with arterial insufficiency (10 with severe unilateral, 1 with bilateral intermittent claudication). Regional muscle blood flow (F), oxygen consumption rate (R), and oxygen extraction fraction (E) were evaluated by positron emission tomography (PET) and bolus inhalation of C15O2 and 15O2 by the patient. Tomograms were recorded at the greatest diameter of legs, at rest and ten minutes after a treadmill walk test leading to the development of ischemic pain in the affected leg. In 5 patients, F and E were correlated with the results of occlusive venous strain gauge plethysmography and with the measurements of blood gases in one brachial artery and in the femoral vein of the affected limb. Blood flow values measured at rest and after exercise by PET were poorly correlated with the plethysmographic findings. This may be because PET does not interfere with flow as venous occlusion plethysmography does in low peripheral pressure conditions. The results show that F, R, and E were not significantly different in normal and pathologic legs at rest. The values of F and R were significantly higher in pathologic than in normal lower limbs, ten minutes after exercise, whereas E was not significantly altered by exercise at any side. This suggests that, during the recovery from a walk test, the delayed increase in oxygen uptake is proportional to the delayed hyperemia in the ischemic muscles ("oxygen debt") and probably not linked to a luxury perfusion.

Aged↗
PubMed1995

[Effect of the frequency of neuromuscular electric stimulation of the leg on femoral arterial blood flow].

In a previous work we have demonstrated that the transcutaneous neuromuscular electrical stimulation of the muscles of the leg in the human increases largely the arterial femoral blood flow. This elevated flow is stable during the stimulation. The present work deals with the influence of the frequency of the stimulation on the level of this hyperaemia. The neuromuscular electrical stimulation is applied to the internal and external branches of the sciatic nerve in order to stimulate the whole muscles of the leg and the foot. The stimulus is yielded by a Compex stimulator for seven minutes with frequencies in random order between 3 and 15 Hz. The intensity of the current (mean: 31 mA) is set up at such a level to increase blood flow by at least 100% at 5 Hz. The femoral arterial flow velocity and the pulsatility index are assessed during the last minute of the stimulation by a duplex ultrasound method. The peripheral vascular resistance is calculated on the base of the femoral blood flow and the mean arterial pressure. Seven healthy volunteers are studied (6 males and one female, aged 26.9 years, +/- 6.9). The haemodynamic variables are recorded at rest (table I). We observe a linear increase of the blood flow with increasing frequencies of stimulation (181% of the rest value at 3 Hz and 276% at 9 Hz) (fig. 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Musculo-venous pump in the elderly].

We study the musculo-venous pump in an elderly population, free of venous disease, by use of a digitized photoplethysmograph. We measure the venous refilling time (To) and the venous drainage (Vo) during active and passive movement. In the first part, we measure Vo and To during active and passive ankle flexions among 17 patients (34 limbs) aged 82.2 years. These variables are compared to the results of the same measurements obtained among 15 young adults aged 45.1 years (30 limbs). We find that To and Vo are significantly lower in the oldest population (To j 35.9 +/- 4.8 sec, To aged 16.1 +/- 5.2 sec, p < 0.001, Vo j 4.98 +/- 1.1%, Vo ag 2.97 +/- 1%, p < 0.001). In the second part of this work, a passive massage of the calf is substituted to the ankle flexions. This technique is applied to 19 elderly people aged 80.4 years (37 limbs) compared to 6 young adults aged 24 years (12 limbs). In these conditions the comparison is no more in favour of the younger group (To j 37 +/- 7.5 sec, To ag 30.6 +/- 4.1 sec, Vo j 4.03 +/- 1.5%, Vo ag 3.8 +/- 0.06%). The values measured in the elderly group are in the range of normal values. We conclude that senescence does not alter the venous system itself. The present work confirms the influence of extravascular factors as muscles, understanding and coordination of the motions, articular flexibility, on the performance of the musculo venous pomp. As far as possible, the muscular and articular activity has to be encouraged in elderly people in order to reduce the venous stasis.

Adult↗
PubMed1991

Assessment of flow and oxygen delivery to the lower extremity in arterial insufficiency: a PET-scan study comparison with other methods.

The authors studied muscular blood flow (F), oxygen consumption rate (R), and oxygen extraction fraction (E) in 5 patients suffering from severe intermittent claudication (stage II). They applied the bolus technique of H2150 and 1502 with a detection by positron emission tomography (PET). Tomograms were recorded at the greatest diameter of the calves, at rest and ten minutes after a treadmill walk test leading to the development of ischemic pain in the affected extremity. F and E data were compared with the values obtained by more usual methods, namely occlusive venous strain gauge plethysmography and femoral venous blood sampling. During the study, these patients received naftidrofuryl, a vasodilatator drug, in an intravenous dose of 600 mg diluted in 250 mL saline infused over a six-hour period in a placebo-controlled, double-blind, crossover protocol (two consecutive experiments, a week apart). The results showed that all blood flow values measured at rest and after exercise by PET were in close correlation (r = 0.71) with the plethysmographic findings. The agreement between the two methods of measuring blood flow was less obvious with an Altman's presentation of the data: there was a tendency to measure higher values with PET scan. Concerning E, the correlation was poor at rest. After exercise, the values were more elevated with PET and no correlation was found with blood samples. The authors found no significant effect of naftidrofuryl either on flow or metabolic data.

Double-Blind Method↗
PubMed1989

Giant cell arteritis (Horton's disease) of the axillary artery--case reports.

The authors recently observed 2 elderly female patients with ischemic pain of the upper extremity as the first manifestation of giant cell arteritis. They presented with rest pain of both upper extremities and even gangrene of the thumb in 1 case. Subclavian and radial pulses were absent while peripheral pulses in the lower limbs were preserved. The angiography was so typical that the diagnosis of inflammatory arteritis was made, despite negative temporal artery biopsy. The patient with thumb gangrene was successfully operated on, the occlusive axillary lesions being bypassed by a long venous carotid humeral bypass graft. A biopsy of the axillary artery showed a granulomatous lymphoplasmocellular infiltration. A high-dose corticotherapy (24 mg daily) was begun in both cases, with dramatic improvements of general state, lowering of the erythrocyte sedimentation rate, and even reapparition of a reduced radial pulse in 1 patient. The authors discuss the incidence, symptoms, diagnosis, and treatment of systemic giant cell arteritis, with special attention to extracranial involvement. These case reports may broaden the knowledge of the diverse manifestations of giant cell arteritis and of its systemic character with widespread vascular involvement.

Aged↗
PubMed1989

[Arterial pathology of the limbs. Tests for hyperemia].

We consider the walk test on the treadmill (ET), and the postocclusive reactive hyperemia (HR). The determinations are limited to the peripheral pressures measured by the sphygmomanometric-Doppler technique. It is the method of choice for diagnostic purposes, but is necessary only for selected cases. For epidemiology, HR is interesting because it is simple to apply and the sensitivity and specificity to recognise moderate obstructions is good. The determination of the ankle pressure at rest is generally enough in the routine practice. It is reproducible and safe. ET may be applied in certain conditions taking into account some problems of interpretation due the complexity of the phenomenon.

Ankle↗
PubMed1988

[Venous plethysmography in a sitting position].

We studied the venous capacity of the lower limbs by strain gauge plethysmography during venous occlusion (delta v60) and by a dependency test (delta v postural) (from the supine to the sitting position). We were also interested by the performance of the calf musculovenous pump, assessed in two positions: sitting and standing (delta v exercise). The volume changes are increasing when we consider limbs with sequelae of deep vein thrombosis, normal lower limbs and extremities with primary varices. delta v60: 2.13%, 2.84%, 4.24%; p less than 0.01. delta v postural: 1.32%, 1.94%, 3.66%; p less than 0.01. delta v exercise: 0.48%, 1.47%, 2.09%; p less than 0.01. The study of the expelled volume during calf muscle exercise is easier in the sitting than in the standing position and it leads to a better discrimination between normal limbs and limbs suffering from sequelae of deep vein thrombosis. The dependency test with measurement of the venous capacity when going from the supine to the sitting position (with the leg dependent) and the assessment of the calf muscles pump, also in the sitting position, are the basis of a simple approach to the quantitation of venous insufficiency.

Blood Volume↗
PubMed1988

[Regional blood flow and oxygen consumption in the leg muscles of normal subjects and in those with arterial insufficiency. Study of the distribution of C15O2 and of 15O2 using positron emission tomography].

We first studied the distribution of radioactivity during continuous inhalation of C15O2 and 15O2 in traverse tomograms of the greatest diameter of legs, at rest and immediately after exercise (ankle flexions). C15O2 and 15O2 were distributed homogeneously and symmetrically in both legs of normal subjects at rest. The activity accumulated in the anterolateral region after exercise. In patients, this pattern of distribution was similar but asymmetrical, depending on the arterial pathology. No systematic distribution of either C15O2 or 15O2 was observed. In a second step, we studied quantitatively blood flow (F), oxygen uptake (R) and oxygen extraction (E) in 11 subjects: 5 normals (23 +/- 1 years) and 6 patients (60 +/- 11 years) suffering from unilateral intermittent claudication. We used the bolus inhalation technique of C15O2 and 15O2. In the normal leg at rest, ranges were 2.5 to 8.0 ml/min.hg for F, 0.9 to 21.3 mumol/min.hg for R and 3.6 to 33.4% for E. In the pathological leg at rest, ranges were 3.7 to 11.3 ml/min.hg for F, 3.8 to 10.6 mumol/min.hg for R and 7.1 to 24.5% for E. After exercise, ranges were 6.4 to 62.8 ml/min.hg for F, 66.0 to 386.3 mumol/min.hg for R and 29.2 to 89.5% for E in both legs. There was no straight difference between normal and pathological legs soon after exercise. This study allows us to expect that the demonstration of such a difference implies a longer delay of data acquisition following the slow post-ischemia recovery.

Adult↗
PubMed1987

[Scintigraphic study (81mKr) of venous return activation using intravenous dihydroergotamine].

We study by 81mKr radionuclide phlebography 13 normal lower limbs and 22 limbs suffering from sequelae of deep vein thrombosis. We assess the spontaneous venous return and the effect of an intravenous injection of 0.5 mg dihydroergotamine (DHE), a powerful venoconstrictor agent. The phlebograms are analysed on a morphological basis. Dynamic data are also collected: the delay of arrival of the radioactivity at the groin and the regional radioactivity level at steady state (during the steady 81mKr perfusion). This segmental radioactivity is a positive marker of the venous stasis because it increases when the venous system dilates and when the flow goes down. It is normalized with regard to the radioactivity measured in the proximal segment (lower vena cava and proximal iliac vein). The influence of DHE on the delay of arrival of the radioactivity in the groin is variable: it is regularly and significantly shortened in the normal limbs (mean decrease of 6.5 s, table II). The segmental radioactivity is relatively low among these limbs (2.76 at the pelvic level, 9.68 at the high, tables IV and V). It drops significantly with DHE in all segments (tables IV and V: -44% in the pelvic veins, -57% in the great saphenous vein and -46% in the femoral tract). The post-thrombotic limbs showing spontaneously an abnormal deep network are characterized by a high radioactivity level (total in the high: 14.25, deep system 5.70 and 8.55 in the saphenous vein, table V). This segmental total radioactivity does not decrease significantly under the influence of DHE; even more it increases in the deep tract (+24%, table V).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Dynamic isotopic phlebography using soluble krypton-81m.

Intravenous peripheral injection of krypton-81m in an isotonic solution permits venous scintigraphy of the lower limbs to be carried out. An anatomic definition of the obstructions and the collateral pathways is therefore easily displayed from the popliteal vein to the vena cava. The physical characteristics of the radionuclide permit iterative or sustained perfusions without accumulation of an excessive background noise and the method is used to obtain scintigraphic images in changing physiological conditions. Analysis of the dynamic data permits venous stasis to be assessed in terms of regional radioactivity at a steady state and transit rate. Various physiological and pathological conditions are analyzed by this method.

Hemodynamics↗
PubMed1985

[Value of the treadmill exercise test for long-term monitoring of lower-limb arteriopathies].

The use of the treadmill exercise test is envisaged only as a means of chronic surveillance of the arteriopathy. The walking distance measured in this way is a complex factor to analyze due to interference of non-vascular phenomena and the effect of training. Manometric data (distal arterial pressure, normalized by determination of the distal pressure/central pressure quotient expressed as percent) were collected during recuperation. Variability (of the order of 18% after 5 min) was studied and compared with that of manometric data at rest (approximately 10%). Fifty-one unoperated patients with arteriopathy were studied prospectively one year after their first visit, and an attempt made to establish a clinical judgement, as to the course of the disease, on the basis of hemodynamic tests, taking into account their variability. Examination at rest is usually sufficient for a valid clinical judgement to be made. However, certain types of treatment such as transluminal angioplasty produce effects that appear to evaluate it with greater precision by examination of dynamic data. Certain specific cases also reveal enhanced sensitivity of variables recorded in hemodynamic parameters after effort. In these cases both manometric and femoral Doppler signal data should be studied.

Angioplasty, Balloon↗
PubMed1984

[Arterial and venous circulation of the leg after intermittent venous occlusion].

We study the arterial and venous circulation of the normal leg by strain gauge plethysmography and venous occlusion (thigh tourniquet). We propose the application of a simplified linear physical model of the venous circulation. It helps to analyse the plethysmographic data recorded during and after the congestion. It ignores the arterial inflow and consider the post-occlusive venous volume decay in function of time as being monoexponential. The venous compliance (C) is measured when the volume has reached a steady-state level during the congestion (known pressure). The time-constant (T) characterizes the volume decay in function of time when the occlusion is released. The tourniquet is successively inflated with two levels of pressure (30 and 60 mm Hg) in order to check if the system is actually linear as predicted by the model. The venous outflow is not strictly monoexponential and the model is only suitable to describe the beginning of the curve. The compliance does not behave linearly, the values measured at 30 mm Hg, being higher than at 60 mm Hg ($ 26%). The time-constant T is slightly influenced by the level of pressures. The calculated resistance is therefore lower at low pressure. We also study the arterial inflow before and after the venous congestion (3 min, 60 mm Hg). We observe a post-venous occlusion hyperaemia (mean rest flow: 5.2%/min, mean hyperemic flow: 12.1%/min) followed by a drop of the inflow (mean minimal flow: 3.4%/min). We evaluate the quantitative influence of neglecting the arterial inflow on the computing of the venous properties. The simplification appears acceptable.

Constriction↗