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Biomedical subjects

P Granier

Publications and source records attributed to P Granier.

At least 19 recordsLinked to original sources

Aerobic and anaerobic contribution to Wingate test performance in sprint and middle-distance runners.

We investigated the aerobic and anaerobic contributions to performance during the Wingate test in sprint and middle-distance runners and whether they were related to the peak aerobic and anaerobic performances determined by two commonly used tests: the force-velocity test and an incremental aerobic exercise test. A group of 14 male competitive runners participated: 7 sprinters, aged 20.7 (SEM 1.3) years, competing in 50, 100 and 200-m events and 7 middle-distance runners, aged 20.0 (SEM 1.0) years, competing in 800, 1,000 and 1,500 m-events. The oxygen uptake (VO2) was recorded breath-by-breath during the test (30 s) and during the first 20 s of recovery. Blood samples for venous plasma lactate concentrations were drawn at rest before the start of the test and during the 20-min recovery period. During the Wingate test mean power (W) was determined and three values of mechanical efficiency, one individual and two arbitrary, 16% and 25%, were used to calculate the contributions of work by aerobic (Waer,ind,16%,25%) and anaerobic (Wan,ind,16%,25%) processes. Peak anaerobic power (Wan,peak) was estimated by the force-velocity test and maximal aerobic energy expenditure (Waer,peak) was determined during an incremental aerobic exercise test. During the Wingate test, the middle-distance runners had a significantly greater VO2 than the sprinters (P < 0.001), who had significantly greater venous plasma lactate concentrations (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Semi-quantitative analysis of 3-phase bone scintigraphy data in algodystrophy of the limbs].

Three-phase bone scanning of the extremities (foot or hand) was performed in 40 normal subjects and in 56 patients with an unequivocal clinical diagnosis of reflex sympathetic dystrophy. Ten patients were in the "cold" or atrophic stage of the disease process, whereas 46 were in the "hot" or acute phase. The scintigraphic parameters studied were the ratios of tracer activity in the affected side over the healthy side established for blood flow (BF), blood pool (BP), early vasculo-tissular fixation (EF), and late bone fixation (LF). In the controls, blood flow, blood pool, and early fixation showed considerable interindividual variation and only the variation of late fixation remained within narrow limits. Among the patients, those at the hot stage of the disease had significantly higher values for all four parameters than those at the cold stage. The group at the cold stage did not differ from the controls except for a significantly higher late fixation value. Furthermore, among hot stage patients, 15% to 25% had normal or diminished blood flow, blood pool and early fixation values. At the cold stage of the disease, radionuclide parameters were similar in affected feet and hands, whereas at the hot stage values at the feet were double those at the hands. Finally, statistical analysis revealed that late fixation was most closely correlated with early fixation, which in turn was most close correlated with blood pool. The clinical and pathophysiological significance of these data is discussed.

Adult

Maximal anaerobic power: relationship to anthropometric characteristics during growth.

The purpose of this study was to determine the effects of age in relation to anthropometric characteristics upon maximal anaerobic power of legs in sixty-nine young boys aged 11 to 19 years. Maximal anaerobic power (Wmax) was measured by the force-velocity test. Lean body mass (LBM) was determined from all four skin-fold thickness measurements, leg volume (LV) was estimated by anthropometric method, and anthropometric measurements were used to determine total muscular mass (TMM). Wmax increased significantly (F = 44.1, p less than 0.001) between 11 and 19 years and was correlated with LV (r = 0.84) and TMM (r = 0.88). It was most highly correlated with LBM (r = 0.94), which best explained the percentage of the total variance of Wmax (88%). Normalized Wmax (Wmax/LBM) also increased significantly between 11 and 19 years (F = 21.9, p less than 0.001). In conclusion, Wmax determined by the force-velocity test was closely related to anthropometric characteristics, especially LBM, during the growth period. Furthermore, even when corrected for lean body mass, maximal anaerobic power was always found to increase. This suggests that other undetermined factors, in addition to the amount of lean tissue mass, may explain the increase of Wmax during the force-velocity test.

Adolescent

Normalization of stress and delayed thallium-201 myocardial SPECT: where is the normal reference area?

We describe an unusual uptake pattern in a thallium SPECT study performed after dipyridamole infusion in a patient with a documented history of prior inferior infarction and recent typical chest pain. The stress study exhibited maximum uptake in the inferior wall. The delayed study showed an inferior defect more consistent with the notion of inferior necrosis, with a maximum uptake in the anterior wall. The authors propose a pathophysiologic interpretation consistent with coronary angiography findings, based on the assumption of coronary steal suggested by the occurrence of chest pain at the end of the dipyridamole infusion. The problem of selecting myocardial normal reference area(s) necessary to normalization prior to quantitative comparison stress and delayed studies is discussed.

Aged

Improvement in left ventricular hypertrophy and left ventricular diastolic function following verapamil therapy in mild to moderate hypertension.

We evaluated the effect of verapamil therapy on left ventricular hypertrophy and left ventricular diastolic function in 13 patients with mild to moderate hypertension. Left ventricular hypertrophy was determined by M-mode echocardiographic measurements of interventricular septal thickness (IVST), posterior wall thickness (PWT) and left ventricular mass index (LVMI) both before (T0) and after 3 months (T3) of verapamil therapy. Left ventricular diastolic transmitral flow was measured by pulsed Doppler indices of early (E) and atrial (A) velocity, E/A ratio, total area (Ta), A area (Aa), Aa/Ta ratio, E-pressure half-time (E-PHT). A-pressure half-time (A-PHT) and E-PHT/A-PHT ratio both before and after 3 months of verapamil therapy. No significant changes occurred in mean heart rate, systolic function or body weight. We conclude that 3 months' therapy with verapamil resulted in an improvement in left ventricular hypertrophy and left ventricular diastolic function and a normalization of blood pressure, without a corresponding deterioration in left ventricular systolic function.

Adult

[Force-velocity test: effect of a heavy-load start on maximal anaerobic power and blood lactate levels].

The purpose of this study was to determine the effect of starting the force-velocity test with a heavy load on both maximal anaerobic power and blood lactate concentration. Nine male subjects aged 23.4 +/- 1.3 yr (mean +/- sem) participated in a first force-velocity test (FV1) which had an initial load of 1 kg (classical protocol). Then a week later in a second force-velocity test (FV2) which had an initial load corresponding to maximal power developed during FV1 (W1). The increase in load was of 1 kg for FV1 and FV2. Our results show that during FV2, compared to FV1: 1) maximal anaerobic power developed (W2) is superior to W1 (W1 = 1,165.2 +/- 70.4 W; W2 = 1,278.6 +/- 92.3 W; p less than 0.02); 2) blood lactate concentration after the first load is inferior (p less than 0.001); 3) blood lactate concentration is not significantly different at the peak of power. Thus, starting the force-velocity test with a heavy load allows an increase of maximal anaerobic power until a blood lactate concentration which may be compared to the one obtained during the classic force-velocity test. In conclusion, maximal anaerobic power measured during the force-velocity test seems to depend on protocol used.

Adult

Correlations between M-mode markers of left ventricular hypertrophy and radionuclide angiographic indices of left ventricular diastolic function in mild to moderate hypertension.

This study was undertaken to determine the correlations between left ventricular hypertrophy and left ventricular diastolic function in mild to moderate essential hypertension. M-mode echocardiography and rest equilibrium radionuclide angiography were performed in 53 hypertensive subjects. The following M-mode echocardiographic parameters were measured: interventricular septal thickness, posterior wall thickness, left ventricular mass index, left atrial diameter and relative wall thickness. The following radionuclide angiography parameters were measured: ejection fraction, peak filling rate, time to peak filling rate, first third filling fraction and atrial contribution to total filling. Weak correlations were shown between left ventricular diastolic function and the M-mode echocardiographic parameters. The peak filling rate was negatively correlated with the interventricular septal thickness (r = -0.345; P less than 0.05), with the sum of the interventricular septal thickness and the posterior wall thickness (r = -0.395; P less than 0.01), with the left atrial diameter (r = -0.345; P less than 0.05), and with the relative wall thickness (r = -0.297; P less than 0.05). The time to peak filling rate was positively correlated with the left ventricular mass index (r = + 0.310; P less than 0.05) and with the left atrial diameter (r = + 0.323; P less than 0.05). These findings suggest that diastolic abnormalities in hypertensive heart disease are only in part related to the degree of left ventricular hypertrophy.

Adult

[Study of left ventricular diastolic function using pulsed Doppler in myocardial infarct in hypertensive subjects].

To determine if impairment of left ventricular filling is influenced by acute myocardial infarction in patients with arterial hypertension, left ventricular diastolic function was assessed by pulsed doppler echocardiography in 46 patients (pts) subdivided into four groups (Gr): G.1 (n = 12 pts) with acute myocardial infarction and hypertensive heart disease. G.2 (n = 12 pts) acute myocardial infarction without arterial hypertension. G.3 (n = 10 pts) arterial hypertension without history of coronary artery disease. G.4 (n = 12 pts) healthy subjects. Coronary angiography and left ventricular cineangiogram was performed in 24 pts (G.1 + G.2). Peak mitral flow velocity (cm/s) in early diastole (E), atrial systole (A), A/E and int A/int E ratios were measured by pulsed doppler. Age and heart rate were statistically similar in all groups. No difference was found among G.1 and G.2 in ejection fraction, and left ventricular segmental kinetic. (tables; see text) Conclusion left ventricular filling is impaired in pts with arterial hypertension and in pts with acute myocardial infarction; acute myocardial infarction increase the impairment of left ventricular diastolic function in pts with hypertensive heart disease.

Aged

[Hemodynamic and hormonal study of electronarcosis and neuroleptanalgesia. Clinical study in 17 surgical patients].

The blocking effect of electropharmaceutical anesthesia (EPA) and neuroleptanalgesia (NLA) on adrenergic and hormonal reactions to abdominal surgery were compared in 17 ASA class I to III randomized patients. This study was intended to define the indications for each of these techniques in patients with heart diseases. Each individual received the same anesthetic premedication and induction and was submitted to iterative identical measurements and biological dosages. Before and during surgery, both groups were catheterized with a Swan-Ganz and a radial catheter. Blood sampling for catecholamines, cortisol, glycemia, blood gases dosages were regularly drawn. Electrical stimulation was performed in the EPA group, and fentanyl injections were repeated in the NLA group patients only. The same doses of pancuronium and droperidol were given to every patient. A circulatory hyperkinesia and hyperadrenergia were observed during surgery in all of the subjects but, during EPA, the tachycardia, the cardiac index and the rate-pressure product were higher than during NLA. The body temperature increased towards normal in EPA, not in NLA. Adrenergic and hormonal levels were equal in both groups. The slow variations of all the important parameters demonstrate that the measured phenomenons have a long time-course what legitimates this kind of prolonged on-the-spot observation. The role of droperidol, pancuronium and fentanyl in the observed variations is discussed. The characteristic high hyperkinesia in EPA may be due partly to an inefficacious analgesia because of the fentanyl suppression after induction, partly to the preserved thermogenesis partly to a direct effect of the electrical stimulation on cerebral tissues.

Adult

[Obstructive hypertrophic myocardiopathy and Osler's endocarditis].

Four cases of bacterial endocarditis (BE) complicating hypertrophic obstructive cardiomyopathy (HOCM) were observed between 1978 and 1980. The causal organism was a streptococcus in all cases and the portal of entry, dental. The mitral regurgitation (MR) observed in HOCM as an epiphenomenon of the obstruction became autonomous in 2 patients as shown by phonocardiography with methoxamine. In one case, the MR became severe and justified mitral valve replacement; at surgery, the chordal rupture suspected on echocardiography was confirmed. Antibiotic therapy was effective on the infectious process in all cases. However, 2 of the 4 patients died, one of thrombosis of the mitral prosthesis on the 15th postoperative day, and the other of a cerebrovascular accident. None of the patients had a detectable aortic or septal infectious lesion. Eight of 27 reported cases (30 p 100) of HOCM complicated by BE were operated; 10 (37 p. 100) died as a result of the endocarditis. These cases underline the incidence of BE in HOCM (5 p. 100) its gravity and the necessity for systematic antibiotic prophylaxis, especially before dental treatment.

Adult

Treatment of cirrhotic hepatic encephalopathy with L-dopa. A controlled trial.

It has been suggested that hepatic encephalopathy could be due to the accumulation of false neurotransmitters and that the administration of a neurotransmitter precursor such as L-dopa would be beneficial to cirrhotic patients with hepatic encephalopathy. A prospective randomized controlled study was carried out to determine whether L-dopa has any effect on the course of cirrhotic hepatic encephalopathy. L-Dopa, L-Dopa and dopa-decarboxylase inhibitor, or placebo was given orally for 7 days to 75 cirrhotic patients with hepatic encephalopathy. The effect was assessed by clinical parameters as well as serial electroencephalograms. There was no statistically significant difference with respect to clinical improvement or deterioration in patients treated with either L-dopa or L-dopa and dopa-decarboxylase inhibitor or placebo. It is concluded that L-dopa is ineffective in the treatment of cirrhotic hepatic encephalopathy. Inefficacy was not due to late onset of treatment, to poor intestinal absorption of L-dopa, to destruction of L-dopa in the blood, or to impaired passage of L-dopa into the cerebrospinal fluid.

Adult