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Biomedical subjects

P Desvaux

Publications and source records attributed to P Desvaux.

10 recordsLinked to original sources
PubMed1992

[Endoscopic study of reflux of the saphenous valve].

Saphenous venous endoscopy, invasive and non-physiological, enables the in vivo and in situ observation of the valve system. A saphenous vein has a preferential flattening axis parallel to the outside of the skin with two walls, internal and external, and two borders. A valve is inserted on one vein wall, with the valve horns being on the borders. The free borders of a bivalve are parallel with the surface of the skin. The valve system has an antireflux function. There are three main causes of reflux in the saphenous veins: 1. Transitory functional incompetence affecting valves of normal appearance. This incompetence results from valve inertia, flattening of the valve against the sinus wall and loss of co-adaptation. Do active factors producing closure of the valve cup exist against such transitory incompetence? 2. Incongruity between the vein wall and valves. The intercorneal or commissural space allows reflux on the border of the vein. This is the commonest cause of reflux in varicose disease of the vein wall. 3. Actual valve lesions. A distinction is drawn between lesions due to thinning, elongation, stretching, splitting or tearing and those due to thickening, retraction or adhesion. Endoscopy has enabled us to discover cases of varicose disease with predominantly valvular lesions in young individuales in whom early lesions of the valve cup cannot be explained by venous wall disease and has led us to complete the classification of varicose disorders.

Endoscopy↗
PubMed1991

[Venous endoscopy].

The miniaturization of endoscopic equipment now allows exploring the superficial venous system and visualizing the endovein in situ and in vivo. This type of venous endoscopy is an ambulatory procedure, performed during a simple outpatient consultation of angiology, after which the patient is immediately discharged. Although this examination is invasive, non-physiological and expensive, it allows the video recording of the morphology, dynamics and kinetics of the values, of the endovein and of the liquid flows (blood, washing fluid and sclerosing products). The new examination has already enabled us to propose an functional classification of the parietal valves of the great saphenous vein. It makes an intraoperative three-dimensional mapping of the vessels possible, which is sometimes difficult in such particular anatomical regions as the popliteal fossa. It allows performing sclerosis with a visual control and following up the evolution of the immediate endoparietal lesions in situ.

Ambulatory Care↗
PubMed1991

[Maxillary cyst of dental origin with uncommon ocular complication].

A 23-year-old woman was referred for decreased vision and central scotoma. Fundus examination disclosed unilateral acute oedematous optic neuritis. A nasolabial cyst was diagnosed, probably of dental origin, because numerous apical granuloma were noticed. The abscess did not produce any fistula which explained the absence of clinical and radiological dental sinusitis. Treatment included excision of the nasolabial cyst and systemic antibiotics. The prognosis was excellent with recovery of a normal visual acuity and normal fundus appearance. There was no evidence of any recurrent episode. The nasolabial cyst was the cause likely of the neuritis. Nevertheless, multiple sclerosis must be considered. Only long-term absence of neurological signs could prove that the maxillary lesion was directly responsible for the optic disorder.

Acute Disease↗
PubMed1989

[Capillaroscopy and wound healing].

Capillaroscopy is a very simple examination which allows good evaluation of the superficial micro-circulation of the skin. The authors consider that this new examination constitute a method to evaluate the risks of skin necrosis after facelift and abdominoplasty and, may possibly change the strategy of operations.

Capillaries↗
PubMed1989

[Results and indications of curietherapy of the eustachian tube with iridium 192 in chronic otitis in the adult].

Between January 1985 and January 1988, 56 patients received radioactive implant therapy of the Eustachian tube with Iridium 192 in the context of tympanoplasty for chronic otitis with tubal dysfunction. After reviewing the method used, we present the results by category of chronic otitis and attempt to propose its indications. Tubal dysfunction was assessed on clinical and otoscopic data and tubal manometry in each patient. A randomised study would appear to be necessary to confirm the interesting results obtained in chronic mucous otitis, in the sequelae of chronic otitis, in evolving retraction pockets and finally for certain manifestly discharging cavities.

Adolescent↗
PubMed1987

[Modification of the level of adenosine triphosphate in digital pulp capillary blood in patients with microcirculatory disorders following i.v. injection of coenzyme A (CoA 1000)].

Capillary blood ATP assay was performed in 2 groups of patients (diabetic and non-diabetic) with disorders of microcirculation, before and several minutes after 2 mg I.V. of Coenzyme A (CoA 1000). Values obtained showed a significant increase in both groups. The hypothesis advanced, based on previous experimental data indicating an action of CoA on intracellular calcium movement, is that CoA 1000 acts by elevation of the membrane ATP/Ca+ ratio of red corpuscles, and possible activation of their deformability and flow rate in the microcirculation.

Adenosine Triphosphate↗
PubMedDate not supplied

[Sclerotherapy of the external saphenous vein under endoscopic control].

The contribution of investigative venous endoscopy is essential. This out-patient endoscopic technique visualises the venous endothelium, valve systems and collaterals. For example, this technique enabled J.F. Van Cleef and C. Ribreau to draw up an anatomo-physiological classification of the parietal valves of the long saphenous vein on the basis of video films. From a therapeutic standpoint, venous endoscopy has yet to show its value. We chose the short saphenous since treatment of incontinence of this vessel is difficult and controversial: difficult because of anatomical variations, notably its ending and because of its course in the popliteal fossa; controversial because of its relations with the gemellary veins. Treatment of the short saphenous, whether medical or surgical, is not always entirely satisfactory. In case of surgical treatment, together with J.P. Hugentobler, we had already noted the value of three-dimensional localisation by transcutaneous illumination of the precise course of a vein using the cold light of the distal tip of the endoscope. "Venous ligatures" which can be placed intravenously are not currently available. In case of medical treatment by sclerosing injections of the short saphenous junction under endoscopic control, the product used can be injected with great topographical precision and strictly intravenously. Large amounts of product can easily be injected. However, this technique has at least three disadvantages: it is expensive; there is no parallel between endovenous lesions immediately visible by endoscopy and the mid-term results of sclerosing injections; the relations between the gemellary veins and the short saphenous can be identified precisely only by prior ultrasonography. As a result, sclerosing injections under endoscopic control remain within the domain of research.

Catheterization, Peripheral↗
PubMedDate not supplied

[Hormones and venous system].

Sex hormones have an effect on venous "content" and "container" according to their chemical nature, their dosage and their mode of administration: 17 beta-estradiol (endogenous): protective effect; synthetic estrogens, at normal or low doses: thrombogenic; oral natural estrogens: thrombogenic; extra-digestive natural estrogens: non thrombogenic; non steroid progestagens (androgenic): thrombogenic; non androgenic progestagens: non thrombogenic. Clinically, the venous disease si characterized by sudden episodes occurring at key-periods of the hormonal life: puberty, pregnancy, menopause, oral contraceptives intake, substitute treatments of menopause, premenstrual syndrome. Evaluation of these different situations shows that an early treatment is possible and needed, which, although not providing a new venous wall for these constitutionally fragile patients, may act effectively at two levels: 1) correction of the haemodynamic disorder (venous reflux in the saphenous arches and the perforators; 2) resorption of tissue infiltration. As primary prevention, in a patient with hormonal disorders or who must be treated with estrogens or progestagens, the objective of our treatment is to protect the venous wall and encourage the return circulation. One must: 1) reinforce the vaso-constrictive effect and the parietal tone, 2) limit collagen and elastin alteration, 3) reinforce capillary permeability and decrease the interstitial edema, 4) normalize the haemorheological constants, 5) restore the balance hemostasis-fibrinolysis. The opinion of a phlebologist seems essential before prescribing a hormonal treatment and monitoring the effects of the treatment. Cooperation between gynaecologists and phlebologists is particularly essential in the interpretation of the clinical disorders as well as discussing the venous risk, the dosage and the administration route of sex hormones.

Catecholamines↗