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1. A Polymer-Free Paclitaxel-Eluting Stent Versus a Bare-Metal Stent for De Novo Femoropopliteal Lesions The BATTLE Trial

Author

Gouëffic, Yann, Sauguet, Antoine, Desgranges, Pascal, Feugier, Patrick, Rosset, Eugenio, Ducasse, Eric, Kaladji, Adrien, Salomon Du Mont, Lucie, Pernès, Jean Marc, Commeau, Philippe, Lermusiaux, Patrick, Leclere, Brice, Guyomarc’h, Béatrice, Hoffmann, Clément T., Maurel, Blandine, Physiopathologie de la résorption osseuse et thérapie des tumeurs osseuses primitives, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinique Pasteur, Clinique Pasteur [Toulouse], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Chirurgie Thoracique Vasculaire [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de Chirurgie vasculaire - Médecine vasculaire (CHRU Besançon), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Institut du thorax, Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Chirurgie cardiaque et thoracique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
[SDV]Life Sciences [q-bio]
Published
2020
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2. Analysis of weather exposure 7 days before occurrence of ST-segment elevation myocardial infarction

Author

Martine Gilard, Bahaa Nasr, Antoine Noel, Pierre Philippe Nicol, Michel Aidonidis, Florent Le Ven, Edward Koifman, Vincent Auffret, Jacques Mansourati, Mehdi Ouchiha, Chaker Oueslati, Yannick Jobic, Romain Didier, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), and Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)

Subjects
Male, medicine.medical_specialty, Time Factors, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Interquartile range, Internal medicine, Humans, Medicine, ST segment, Registries, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Weather, Aged, Retrospective Studies, Univariate analysis, business.industry, Incidence, Incidence (epidemiology), Temperature, Humidity, Retrospective cohort study, General Medicine, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Atmospheric Pressure, Cardiology, ST Elevation Myocardial Infarction, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract

Summary Background Several studies have highlighted the relationship between weather patterns and the occurrence of ST-elevation myocardial infarction (STEMI). Aim To evaluate the statistical association between the occurrence of STEMI and meteorological variables over the preceding 7 days. Methods This was a retrospective study, using prespecified data from the ORBI (Breton Regional Observatory on Myocardial Infarction) registry, which includes all consecutive patients hospitalized for STEMI in the geographical area of Brest, France. Over a 7-year period, we compared the number of STEMIs per week with the mean values of meteorological variables over the preceding 7 days. Results Overall, 7517 patients with STEMI were recorded in the ORBI registry between January 2009 and January 2016. After exclusion of patients not living in the geographical area of interest, 742 patients were included. The weekly incidence of STEMI ranged from 0 to 7 (median 2, interquartile range 1–3). In the univariate analysis, air temperature (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.005–1.01 per 1 °C decrease; P = 0.03) and atmospheric pressure (OR 1.03, 95% CI 1.01–1.06 per 1 hPa increase; P = 0.008) were associated with the weekly incidence of STEMI. In the multivariable analysis, air temperature (OR 1.06, 95% CI 1.01–1.10 per 1 °C decrease; P = 0.01), atmospheric pressure (OR 1.05, 95% CI 1.02–1.08 per 1 hPa increase; P 80% (OR 1.09, 95% CI 1.02–1.15 per 1 hour increase; P = 0.007) in the previous 7 days were associated with the occurrence of STEMI. Conclusions In this specific geographical area, occurrence of STEMI was statistically associated with a decrease in air temperature, an increase in atmospheric pressure and an increase in humidity over the preceding 7-day period.

Published
2020
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3. Thoracic Stent-Graft Migration: The Role of the Geometric Modifications of the Stent-Graft at 3 years

Author

Hadi Fayad, Bahaa Nasr, Michel Nonent, A Badra, Joel Savean, Jacques Braesco, Dimitris Visvikis, Bénédicte Albert, Pierre Gouny, Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Université de Brest (UBO), Laboratoire de Traitement de l'Information Medicale (LaTIM), Institut National de la Santé et de la Recherche Médicale (INSERM)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Service de Radiologie [Brest] (HIA - Radio), and Hôpital d'Instruction des armées

Subjects
Male, medicine.medical_specialty, Time Factors, Endoleak, Computed Tomography Angiography, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Short neck, 030204 cardiovascular system & hematology, Prosthesis Design, Thoracic aortic aneurysm, Aortography, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Aortic aneurysm, Blood Vessel Prosthesis Implantation, 0302 clinical medicine, Foreign-Body Migration, Blood vessel prosthesis, Risk Factors, medicine, Humans, Thrombus, Fixation (histology), Aged, Retrospective Studies, Aortic Aneurysm, Thoracic, business.industry, Endovascular Procedures, Stent, General Medicine, Middle Aged, medicine.disease, Surgery, Blood Vessel Prosthesis, Prosthesis Failure, Treatment Outcome, Cardiothoracic surgery, Female, Stents, Cardiology and Cardiovascular Medicine, business
Abstract

Background To date, clinical and experimental studies on stent graft (SG) migration have focused on aortic morphology and blood flow. However, thoracic endovascular aortic repair (TEVAR) is not an instant fixation of the SG in the aortic lumen but rather a continuous process of deformation and three-dimensional change in the configuration and the geometry of the SG. The aim of this study was to analyze the geometric evolution of the aortic SG in the proximal attachment zone at midterm follow-up and its impact on the SG migration. Methods Sixty-two patients underwent TEVAR for thoracic aortic aneurysm from 2007 till 2013. Thirty patients were treated and had a complete clinical and morphological follow-up at 1 month and 3 years. We calculated the SG radius of curvature (RC) change at the proximal attachment zone “P” on the postoperative computed tomography scan at 1 month and 3 years. Results There were 19 atheromatous aneurysms, 8 postdissection aneurysms, and 3 posttraumatic aneurysms. Two patients were treated at zone 1, seven at zone 2, and twenty-one at zone 3. The median decrease of the RC at “P” was 11 mm (interquartile range, 6.5 mm; range, 1–29 mm. A greater decrease in RC was identified in patients with hostile proximal neck having a large diameter (P = 0.006), short neck length (P = 0.04), and neck thrombus grade II and III (P = 0.02). In the migration group, the RC of “P” decreased significantly at 3 years (27.5 mm vs 18.25 mm; P = 0.03). Three patients had type I endoleak and showed a decrease of the RC at “P” (42 vs 13 mm; 28 vs 15 mm; 24 vs 9 mm). Conclusions The SG seems to have geometric changes in the proximal attachment zone over time. The increase of SG curvature might be a predictor for SG migration and may prompt prophylactic reintervention.

Published
2018
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4. Characterization of the Physiological Displacement of the Aortic Arch Using Non-Rigid Registration and MR Imaging

Author

Nasr, B., Le Ven, F., Savean, J., Ben Salem, D., Nonent, M., Gouny, P., Visvikis, D., Fayad, H., Département de radiologie [Brest] (DR - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Laboratoire de Traitement de l'Information Medicale (LaTIM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Calvez, Ghislaine, Institut National de la Santé et de la Recherche Médicale (INSERM)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), and Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM)

Subjects
[SDV] Life Sciences [q-bio], [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV]Life Sciences [q-bio], [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience

Published
2017

5. The Accuracy of Noninvasive Hemoglobin Measurement by Multiwavelength Pulse Oximetry After Cardiac Surgery

Author

Charles Christian Arvieux, Nicolas Paleiron, Maité Guillouet, Michelle Coat, Mehdi Ould-Ahmed, Emmanuel Nowak, Gildas Gueret, Ba-Vinh Nguyen, Jean Louis Vincent, Pierre Gouny, Department of Intensive Care, Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)-Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie (NP - HIA), Hôpital d'Instruction des armées, Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), and Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)

Subjects
Male, MESH: Monitoring, Physiologic, law.invention, 0302 clinical medicine, MESH: Postoperative Period, 030202 anesthesiology, law, Medicine, Oximetry, Postoperative Period, Prospective Studies, MESH: Aged, MESH: Cardiac Surgical Procedures, MESH: Middle Aged, medicine.diagnostic_test, Pulse (signal processing), Middle Aged, Intensive care unit, 3. Good health, Cardiac surgery, MESH: Reproducibility of Results, Shock (circulatory), Anesthesia, Hemoglobinometry, Cardiology, Female, medicine.symptom, medicine.medical_specialty, Critical Care, Anemia, MESH: Oximetry, MESH: Software, 03 medical and health sciences, Intensive care, Internal medicine, Humans, MESH: Intensive Care, Cardiac Surgical Procedures, Aged, Monitoring, Physiologic, MESH: Hemoglobinometry, MESH: Humans, business.industry, Reproducibility of Results, 030208 emergency & critical care medicine, medicine.disease, MESH: Prospective Studies, MESH: Male, Pulse oximetry, Anesthesiology and Pain Medicine, Regional Blood Flow, MESH: Regional Blood Flow, Hemoglobin, business, MESH: Female, Software, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery
Abstract

International audience; BACKGROUND: In March 2008, a new multiwavelength pulse oximeter, the Radical 7 (Rad7; Masimo Corp., Irvine, CA), was developed that offers noninvasive measurement of hemoglobin concentration. Accuracy has been established in healthy adults and some surgical patients, but not in cardiac surgery intensive care patients, a group at high risk of postoperative bleeding events and anemia in whom early diagnosis could improve management. METHODS: In this prospective, observational study conducted in a cardiovascular intensive care unit, we compared hemoglobin concentrations shown by the Rad7 with arterial hemoglobin concentrations determined by an automated hematology analyzer, XE-2100 (Roche, Neuilly sur Seine, France). Two software versions of Rad7 (V 7.3.0.1 [42 points of comparison in 14 patients] and the updated V 7.3.1.1 [61 points of comparison in 27 patients]) were studied during two 1-week periods. Bias, defined as the difference between the 2 methods (Masimo SpHb-XE-2100 laboratory hemoglobin), was calculated. A negative bias indicated that the Masimo underestimated hemoglobin compared with the laboratory analyzer. Correlation between the perfusion index given by Rad7 and the hemoglobin bias was also studied. RESULTS: Correlations between Rad7 and XE-2100 were weak for both software versions (R2=0.11 for V 7.3.0.1 and R2=0.27 for V 7.3.1.1). Mean bias was -1.3 g/dL for V 7.3.0.1 and -1.7 g/dL for V 7.3.1.1, with wide 95% prediction intervals for the bias (respectively, -4.6 to 2.1 g/dL and -5.7 to 2.3 g/dL). The absolute hemoglobin bias tended to increase when the perfusion index decreased. For the V 7.3.0.1 software, the average absolute bias was 1.9 g/dL for perfusion index2 (P=0.03). For V 7.3.1.1, the mean absolute bias was 2.1 g/dL when the perfusion index was 2 (P=0.26). CONCLUSIONS: Our study demonstrates poor correlation between hemoglobin measured noninvasively by multiwavelength pulse oximetry and a laboratory hematology analyzer. The difference was greater when the pulse oximetry perfusion index was low, as may occur in shock, hypothermia, or vasoconstriction patients. The multiwavelength pulse oximetry is not sufficiently accurate for clinical use in a cardiovascular intensive care unit.

Published
2011
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6. Acute renal dysfunction after cardiac surgery with cardiopulmonary bypass is associated with plasmatic IL6 increase

Author

Gildas Gueret, Eric Bezon, J. Arvieux, Nathalie Guriec, F. Lion, Raoul Baron, Catherine Guennegan, C.-C. Arvieux, Annabelle Dovergne, Jean-Luc Carré, Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Service de Biochimie et Biologie Moléculaire

Subjects
Male, medicine.medical_treatment, 030204 cardiovascular system & hematology, Biochemistry, law.invention, Postoperative Complications, 0302 clinical medicine, law, MESH: Postoperative Complications, Urea, Immunology and Allergy, 030212 general & internal medicine, MESH: Aged, Cardiopulmonary Bypass, MESH: Cardiac Surgical Procedures, MESH: Middle Aged, Ejection fraction, Hematology, Acute Kidney Injury, Middle Aged, 3. Good health, Cardiac surgery, medicine.anatomical_structure, Creatinine, Cardiology, Female, medicine.medical_specialty, MESH: Acute Kidney Injury, MESH: Cardiopulmonary Bypass, Immunology, MESH: Creatinine, Excretion, 03 medical and health sciences, Renal injury, Internal medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Cardiopulmonary bypass, medicine, Humans, Cardiac Surgical Procedures, Molecular Biology, MESH: Urea, Dialysis, Aged, MESH: Humans, Interleukin-6, business.industry, Perioperative, MESH: Interleukin-6, MESH: Male, Ventricle, business, MESH: Female
Abstract

International audience; BACKGROUND: Acute renal dysfunction (ARD) is common after cardiac surgery with cardiopulmonary bypass (CPB). CPB results in a sudden systemic inflammatory response. Systemic and local pro-inflammatory cytokines synthesis has been linked with sub-clinical renal injury, especially tubular lesions. Therefore, we sought to assess the systemic synthesis pro-inflammatory cytokines and its association with perioperative ARD after cardiac surgery with CPB. METHODS: Sixty-two patients undergoing cardiac surgery with CPB were prospectively included. Four groups of patients were defined according to blood creatinine increase: no ARD (less than 25% increase), faint ARD (25-50% increase), moderate ARD (50-100% increase), severe ARD (more than 100% increase). RESULTS: Within the 48 post-operative hours was ARD observed as no dysfunction (41.9%), faint (32.2%), moderate (16.1%), severe (9.6%). One patient had to undergo a dialysis. Pre-operative characteristics were homogenous between the four groups excepted the left ventricle ejection fraction. ARD was associated with a low urinary output with high sodium excretion fraction. Significant increase of IL-6 level occurred when patients underwent a severe ARD despite no significant differences for the CRP and TNF-alpha concentrations. CONCLUSION: Severe acute renal dysfunction after cardiac surgery with CPB is associated with a significant increased IL-6 systemic production.

Published
2009
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7. Concordance Rate Differences of 3 Noninvasive Imaging Techniques to Measure Carotid Stenosis in Clinical Routine Practice

Author

Philippe Douek, Bernard Langella, Michel Lamure, Bruno Guias, Carmen Rotaru, Pierre Gouny, Norbert Nighoghossian, Valérie Buthion, Pierre Chirossel, Jean François Heautot, Jean Michel Serfaty, Michel Nonent, Chahin Pachai, Laurent Derex, Jean-Yves Gauvrit, Charles Veyret, Isabelle Jars, François Rouhart, Département de radiologie [Brest] (DR - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Hémostase, bio-ingénierie et remodelage cardiovasculaires (LBPC), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Galilée, Cerebrovascular Unit [Lyon], Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de Neurologie [Brest], Service de Neurologie [Lyon], CHU Lyon, Service de Radiologie [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), COACTIS (COACTIS), Université Jean Monnet [Saint-Étienne] (UJM)-Université Lumière - Lyon 2 (UL2), Laboratoire d'analyse des systèmes de santé (LASS), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon, Theralys [Lyon], Theralys, Service de radiologie [Saint-Etienne], CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM), Vision, Action et Gestion d'informations en Santé (VisAGeS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE (IRISA-D5), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de Recherche en Informatique et en Automatique (Inria)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA), Plateforme neurinfo [Rennes], Centre de Recherche et d'Application en Traitement de l'Image et du Signal (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut Galilée-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), COnception de l'ACTIon en Situation (COACTIS), Université Lumière - Lyon 2 (UL2)-Université Jean Monnet - Saint-Étienne (UJM), Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Service de Radiologie [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Université de Lyon-Université de Lyon-École Supérieure de Chimie Physique Électronique de Lyon (CPE)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, medicine.medical_treatment, MESH: Magnetic Resonance Angiography, MESH: Ultrasonics, Carotid endarterectomy, Magnetic resonance angiography, 030218 nuclear medicine & medical imaging, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: Carotid Stenosis, Carotid Stenosis, Ultrasonics, Prospective Studies, Stroke, Ultrasonography, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, medicine.diagnostic_test, Middle Aged, MESH: Predictive Value of Tests, MESH: Reproducibility of Results, Predictive value of tests, Female, Radiology, MESH: Image Enhancement, MESH: Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, psychological phenomena and processes, medicine.medical_specialty, Concordance, 03 medical and health sciences, Predictive Value of Tests, medicine, Humans, cardiovascular diseases, Aged, Advanced and Specialized Nursing, MESH: Humans, business.industry, Reproducibility of Results, Digital subtraction angiography, Image Enhancement, medicine.disease, MESH: Prospective Studies, MESH: Male, Stenosis, Angiography, Neurology (clinical), Tomography, X-Ray Computed, business, MESH: Female, Magnetic Resonance Angiography, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery
Abstract

Background and Purpose— To replace digital subtraction angiography (DSA) in carotid stenosis evaluation, noninvasive imaging techniques have to reach a high concordance rate. Our purpose is to compare the concordance rates of contrast-enhanced MR angiography (CEMRA) and CT angiography (CTA) with Doppler ultrasound (DUS) in clinical routine practice. Methods— We evaluated prospectively with DUS, CEMRA, and CTA 150 patients suspected of carotid stenosis. The overall concordance rates of the 3 techniques were calculated for symptomatic stenosis ≥50% and ≥70%, for asymptomatic stenosis ≥60%, and for occlusion. For the carotid arteries treated by surgery (n=97), the results of each method and combined techniques were recorded, and misclassification rates were evaluated from surgical reports. Results— The overall concordance rates of DUS-CEMRA, DUS-CTA, and CEMRA-CTA were not statistically different. However, the concordance rate of DUS-CEMRA (92.53%) was significantly higher than that for DUS-CTA (79.10%) in the surgical asymptomatic stenosis group ( P =0.0258). CTA considered alone would misclassify the stenosis in a significant number of cases (11 of 64) in the surgical asymptomatic group compared with CEMRA (3 of 67) and DUS (1 of 66) ( P =0.0186 versus MRA, P =0.0020 versus DUS). Conclusions— With the techniques as utilized in our study, the overall concordance rates of combined noninvasive methods are similar for measuring carotid stenosis in clinical routine practice, but in asymptomatic carotid stenosis, the decision making for surgery is significantly altered if DUS and CTA are considered in place of DUS and CEMRA.

Published
2004
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8. Alteration of muscle membrane excitability in sepsis: possible involvement of ciliary nervous trophic factor (CNTF)

Author

Emilie Guillard, Jean-Pierre Pennec, Gildas Gueret, Marie-Agnès Giroux-Metges, Fabrice Rannou, Maité Guillouet, Véronique Vermeersch, Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), MUST, Laboratoire Mouvement Sport Santé (M2S), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Immunology, Biology, Ciliary neurotrophic factor, Biochemistry, Membrane Potentials, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Animals, Immunology and Allergy, Ciliary Neurotrophic Factor, Rats, Wistar, Molecular Biology, Protein kinase C, 030304 developmental biology, Membrane potential, 0303 health sciences, Muscles, Sodium channel, Sodium, Hematology, medicine.disease, Resting potential, Rats, 3. Good health, Endocrinology, Cytokine, Anesthesia, biology.protein, Female, Tumor necrosis factor alpha, Ion Channel Gating, 030217 neurology & neurosurgery
Abstract

International audience; One of the main factor involved neuromyopathy acquired in intensive care unit (ICU) appears to be sepsis. It induces the release of many pro- and anti-inflammatory factors which can directly modulate the muscle excitability. We have studied the effects of one of them: the ciliary nervous trophic factor (CNTF) which is a cytokine released in the early phase of sepsis. CNTF induces a decrease in the sodium current and an increase in resting potential as in sodium inversion potential. These effects could participate to the hypo-excitability observed during sepsis and could be involved in the ICU acquired neuromyopathy. As for TNF?, this early effect is mainly mediated by protein kinase C (PKC) activation and appears to be a reversible post-transcriptional effect.

Published
2013
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9. [A case of a carcinoid tumour presenting as an 'upper lobe syndrome']

Author

Noël-Savina, Elise, Tromeur, Cécile, Quere, Gilles, Choplain, Jean-Noël, Leroyer, Christophe, Descourt, Renaud, Service d'Oncologie Thoracique (BREST - ICH), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), and Université de Brest (UBO)-Université de Brest (UBO)

Subjects
Lung Diseases, MESH: Humans, MESH: Middle Aged, MESH: Carcinoid Tumor, MESH: Middle Lobe Syndrome, [SDV]Life Sciences [q-bio], Bronchial Neoplasms, Carcinoid Tumor, Syndrome, Middle Aged, MESH: Radiography, Thoracic, Diagnosis, Differential, MESH: Lung Diseases, MESH: Diagnosis, Differential, Humans, Female, Radiography, Thoracic, MESH: Syndrome, MESH: Lung, Lung, MESH: Female, MESH: Bronchial Neoplasms, Middle Lobe Syndrome
Abstract

International audience; A 53-year-old woman presented with progressive cough related to an endobronchial carcinoid tumour. The location of the tumour in the right upper lobe bronchus could be described as an "upper lobe syndrome" by analogy with the "middle lobe syndrome" or Brock's syndrome. Surgical management consisted of lobectomy and lymph node dissection. This established the diagnosis of typical carcinoid tumour. There was no mediastinal nodal invasion. Three months after surgery all symptoms had disappeared.

Published
2011
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10. Overestimation of moderate carotid stenosis assessed by both Doppler US and contrast enhanced 3D-MR angiography in the CARMEDAS study

Author

A. Pasco-Papon, Jean-Yves Gauvrit, Jean Michel Serfaty, Philippe Douek, Michel Nonent, J.-O. Fortrat, X. Papon, Valérie Buthion, C. Pachai, Y. Le Bras, A Badra, Luc Bressollette, D. Ben Salem, J.-P. Cottier, C. Rotaru, Jérôme Berge, Pierre Gouny, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Département de radiologie [Brest] (DR - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Département de Radiologie [Bichat] (DR- Bichat), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health System Analysis Laboratory (GATE), Université de Lyon, Département de Neuro-Radiologie [Angers] (DNR - Angers), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Département de Chirurgie Vasculaire [Angers] (DCV - Angers), Bioclinica SAS (B SAS), Bioclinica SAS, Département d'Angiologie [Angers] (DA - Angers), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Département de Neuro-Radiologie [Bordeaux] (DNR - Bordeaux), CHU Bordeaux [Bordeaux], Département de Radiologie [Niort] (DR - Niort), CH Niort, Vision, Action et Gestion d'informations en Santé (VisAGeS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE (IRISA-D5), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], CHU Pontchaillou [Rennes], Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de Recherche en Informatique et en Automatique (Inria)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA), and Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon)

Subjects
Male, Contrast Media, MESH: Magnetic Resonance Angiography, Magnetic resonance angiography, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: Carotid Stenosis, Contrast (vision), Carotid Stenosis, media_common, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Radiological and Ultrasound Technology, medicine.diagnostic_test, Middle Aged, MESH: Predictive Value of Tests, Predictive value of tests, cardiovascular system, Female, Radiology, medicine.medical_specialty, media_common.quotation_subject, MESH: Imaging, Three-Dimensional, Sensitivity and Specificity, 03 medical and health sciences, Imaging, Three-Dimensional, Predictive Value of Tests, MESH: Contrast Media, Image Interpretation, Computer-Assisted, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Aged, MESH: Humans, business.industry, Mr angiography, Ultrasonography, Doppler, Digital subtraction angiography, medicine.disease, MESH: Sensitivity and Specificity, MESH: Male, Stenosis, Angiography, MESH: Ultrasonography, Doppler, Neurology (clinical), Doppler ultrasound, business, MESH: Female, MESH: Image Interpretation, Computer-Assisted, Magnetic Resonance Angiography, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; PURPOSE: To evaluate the agreement and diagnostic accuracy of Contrast enhanced magnetic resonance angiography (CE-MRA), Doppler ultrasound (DUS) and Digital subtraction angiography (DSA) in the assessment of carotid stenosis. METHODS: DUS, CE-MRA and DSA were performed in 56 patients included in the Carotide-angiographie par résonance magnétique-échographie-doppler-angioscanner (CARMEDAS) multicenter study with a carotid stenosis ≥ 50%. Three readers evaluated stenoses on CE-MRA and DSA (NASCET criteria). Velocities criteria were used for stenosis estimation on DUS. RESULTS: CE-MRA had a sensitivity and specificity of 96-98% and 66-83% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 94% and 76-84% respectively for carotid stenoses ≥ 70%. The interobserver agreement of CE-MRA was excellent, except for moderate stenoses (50-69%). DUS had a sensitivity and specificity of 88 and 75% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 83 and 86% respectively for carotid stenoses ≥ 70%. Combined concordant CE-MRA and DUS had a sensitivity and specificity of 100 and 85-90% respectively for carotid stenoses ≥ 50% and a sensitivity and specificity of 96-100% and 80-87% respectively for carotid stenoses ≥ 70%. The positive predictive value of the association CE-MRA and DUS for carotid stenoses ≥ 70% is calculated between 77 and 82% while the negative predictive value is calculated between 97 and 100%. CE-MRA and DUS have concordant findings in 63-72%, and the overestimations cases were recorded only for carotid stenosis ≤ 69%. CONCLUSION: Combined DUS-CE-MRA is excellent for evaluation of severe stenosis but remains debatable in moderate stenosis (50-69%) due to the risk of overestimations.

Published
2011
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11. Na v1.4 and Na v1.5 are modulated differently during muscle immobilization and contractile phenotype conversion

Author

Jean-Pierre Pennec, Maxime Gioux, Raphael Leschiera, Gildas Gueret, Marie-Agnès Giroux-Metges, Fabrice Rannou, Julie Morel, Mickaël Droguet, MUST, Laboratoire Mouvement Sport Santé (M2S), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Patch-Clamp Techniques, [SDV]Life Sciences [q-bio], Muscle Fibers, Skeletal, Wistar, Muscle Proteins, Nav1.5, Sodium Channels, NAV1.5 Voltage-Gated Sodium Channel, 0302 clinical medicine, biosynthesis/drug effects/metabolism, Adenosine Triphosphatases, Motor Neurons, 0303 health sciences, biology, Chemistry, Reverse Transcriptase Polymerase Chain Reaction, Skeletal, Organ Size, Contractile phenotype, Phenotype, Muscle Fibers, Slow-Twitch, Biochemistry, Muscle Fibers, Fast-Twitch, Muscle Fatigue, Muscle, Female, Algorithms, Muscle Contraction, Sodium Channel Blockers, Sodium, chemistry.chemical_element, Tetrodotoxin, Slow-Twitch, Muscle Fibers, 03 medical and health sciences, Immobilization, biosynthesis/drug effects/genetics/metabolism, Physiology (medical), Animals, Rats, Wistar, Muscle, Skeletal, Fast-Twitch, 030304 developmental biology, Sodium channel, Electric Stimulation, Electrophysiological Phenomena, Rats, drug effects/physiology, NAV1, physiology, biology.protein, Biophysics, pharmacology, drug effects/metabolism, metabolism, 030217 neurology & neurosurgery
Abstract

Muscle immobilization leads to modification in its fast/slow contractile phenotype. Since the properties of voltage-gated sodium channels (Nav) are different between “fast” and “slow” muscles, we studied the effects of immobilization on the contractile properties and the Navof rat peroneus longus (PL). The distal tendon of PL was cut and fixed to the adjacent bone at neutral muscle length. After 4 or 8 wk of immobilization, the contractile and the Navproperties were studied and compared with muscles from control animals (Student's t-test). After 4 wk of immobilization, PL showed a faster phenotype with a rightward shift of the force-frequency curve and a decrease in both the Burke's index of fatigability and the tetanus–to-twitch ratio. These parameters showed opposite changes between 4 and 8 wk of immobilization. The maximal sodium current in 4-wk immobilized fibers was higher compared with that of control fibers (11.5 ± 1.2 vs. 7.8 ± 0.8 nA, P = 0.008), with partial recovery to the control values in 8-wk immobilized fibers (8.6 ± 0.7 nA, P = 0.48). In the presence of tetrodotoxin, the maximal residual sodium current decreased continuously throughout immobilization. Using the Western blot analysis, Nav1.4 expression showed a transient increase in 4-wk muscle, whereas Nav1.5 expression decreased during immobilization. Our results indicate that a muscle immobilized at optimal functional length with the preservation of neural inputs exhibits a transient fast phenotype conversion. Nav1.4 expression and current are related to the contractile phenotype variation.

Published
2011
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12. TNF? increases resting potential in isolated fibres from rat peroneus longus by a PKC mediated mechanism: involvement in ICU acquired polyneuromyopathy

Author

Fabrice Rannou, Maxime Gioux, Maité Guillouet, Marie-Agnès Giroux-Metges, C.-C. Arvieux, Gildas Gueret, Jean-Pierre Pennec, MUST, Laboratoire Mouvement Sport Santé (M2S), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
medicine.medical_specialty, Digoxin, ATPase, [SDV]Life Sciences [q-bio], Immunology, Wistar, Biology, Biochemistry, Membrane Potentials, Dose-Response Relationship, 03 medical and health sciences, 0302 clinical medicine, Intensive care, Internal medicine, Peroneus longus, medicine, Immunology and Allergy, Animals, Rats, Wistar, Muscle, Skeletal, Molecular Biology, Protein kinase C, 030304 developmental biology, 0303 health sciences, Dose-Response Relationship, Drug, Tumor Necrosis Factor-alpha, Depolarization, Hematology, Anatomy, Skeletal, Resting potential, Rats, Endocrinology, drug effects/physiology, drug effects, biology.protein, Muscle, Tumor necrosis factor alpha, Female, Drug, pharmacology, Microelectrodes, 030217 neurology & neurosurgery, medicine.drug
Abstract

Background and aims Our aim was to investigate the effect of TNFα on muscle resting potential (RP) and then in muscle excitability and to demonstrate another mechanism implicated in intensive care units (ICU) acquired polyneuromyopathy. Methods Experiments were carried out on adult female Wistar rats. After isolation of muscle fibres from peroneus longus , influence of TNFα was tested on RP by using intracellular microelectrodes. Digoxin and chelerythrin were used to determine the mechanism of TNFα action. Results First, we found that TNFα induced a concentration dependent increase of muscle RP and that this mechanism, which was blocked by digoxin, was due to an effect on the Na/K ATPase. As it was also blocked by chelerythrin it was concluded that this effect was mediated by PKC activation of the Na/K ATPase. Conclusions We demonstrated that TNFα leads to a PKC mediated increase in muscle RP. Depolarization needed to reach the threshold voltage for muscle action potential should then be higher and this could be involved in the decrease in muscle excitability observed in acquired polyneuromyopathy.

Published
2011
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13. [Comparison between ETCO₂ values measured by the Smart Capnoline™ and the PACO₂ in intubated then extubated postoperative cardiac surgery patients]

Author

S, Rousselon, M, Coat, B V, Nguyen, P, Gouny, E, Nowak, J-P, Wargnier, C-C, Arvieux, G, Gueret, CHRU Brest - Département d'Anesthésie Réanimation (CHU - BREST - DAR), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, MESH: Postoperative Care, MESH: Carbon Dioxide, Capnography, Intubation, Intratracheal, Humans, Prospective Studies, Cardiac Surgical Procedures, MESH: Respiration, Artificial, Aged, Postoperative Care, MESH: Aged, MESH: Cardiac Surgical Procedures, MESH: Humans, MESH: Middle Aged, MESH: Intubation, Intratracheal, MESH: Capnography, Carbon Dioxide, Middle Aged, Respiration, Artificial, MESH: Prospective Studies, MESH: Male, Oxygen, MESH: Breath Tests, Breath Tests, Female, MESH: Female, MESH: Oxygen, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; OBJECTIVE: To compare the PaCO(2) with the ETCO(2) obtained with the Smart Capnoline™ in the postoperative setting of cardiac surgery during ventilation and after extubation TYPE OF STUDY: Prospective, observational. PATIENTS: Twenty patients after cardiac surgery. METHODS: In the intensive care unit, arterial blood gases were measured concomitantly with ETCO(2), and difference between PaCO(2) and ETCO(2) were calculated. Three CO(2) sensors were utilized: Filterline H set for intubated patients, Smart Capnoline HO(2) (nasal version) and Smart Capnoline O(2) (bucconasal version) after extubation. Data were compared with Wilconson test and the intraclass correlation coefficient was calculated. RESULTS: The difference PaCO(2) - ETCO(2) was significantly larger in extubated patients compared to intubated patients, which is also confirmed for the bucconasal sensor (intubated patients: 6.6 ± 4.3 mmHg, nasal sensor: 9.3 ± 3.5 mmHg, bucconasal sensor: 15,4 ± 12.9 mmHg). CONCLUSION: In the postoperative setting of cardiac surgery, ETCO(2) measurements allow a reliable estimation of PaCO(2) in intubated patients in contrast to measurements in extubated patients. The bucconasal CO(2) sensor does not show more reliable measurements compared to nasal sensors in the postoperative setting of cardiac surgery.

Published
2011
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14. Tumor necrosis factor-? downregulates sodium current in skeletal muscle by protein kinase C activation: involvement in critical illness polyneuromyopathy

Author

C.-C. Arvieux, Gildas Gueret, Jean-Pierre Pennec, Fabrice Rannou, Maité Guillouet, Marie-Agnès Giroux-Metges, Maxime Gioux, MUST, Laboratoire Mouvement Sport Santé (M2S), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
drug therapy/metabolism, Physiology, [SDV]Life Sciences [q-bio], Muscle Fibers, Skeletal, Wistar, Sodium Channels, Membrane Potentials, 0302 clinical medicine, Enzyme Inhibitors, Protein Kinase C, Membrane potential, 0303 health sciences, Skeletal, metabolism/pharmacology, medicine.anatomical_structure, Tumor necrosis factor alpha, medicine.medical_specialty, Sodium, Critical Illness, enzymology, chemistry.chemical_element, Down-Regulation, Biology, drug effects/enzymology, Muscle Fibers, Sepsis, 03 medical and health sciences, Polyneuropathies, Downregulation and upregulation, Internal medicine, medicine, Animals, Rats, Wistar, Protein kinase C, 030304 developmental biology, Benzophenanthridines, Tumor Necrosis Factor-alpha, Sodium channel, Skeletal muscle, Cell Biology, medicine.disease, Rats, Endocrinology, chemistry, drug effects, pharmacology, metabolism, 030217 neurology & neurosurgery
Abstract

Sepsis is involved in the decrease of membrane excitability of skeletal muscle, leading to polyneuromyopathy. This effect is mediated by alterations of the properties of voltage-gated sodium channels (NaV), but the exact mechanism is still unknown. The aim of the present study was to check whether tumor necrosis factor (TNF-α), a cytokine released during sepsis, exerts a rapid effect on NaV. Sodium current ( INa) was recorded by macropatch clamp in skeletal muscle fibers isolated from rat peroneus longus muscle, in control conditions and after TNF-α addition. Analyses of dose-effect and time-effect relationships were carried out. Effect of chelerythrine, a PKC inhibitor, was also studied to determine the way of action of TNF-α. TNF-α induced a reversible dose- and time-dependent inhibition of INa. A maximum inhibition of 75% of the control current was observed. A shift toward more negative potentials of activation and inactivation curves of INa was also noticed. These effects were prevented by chelerythrine pretreatment. TNF-α is a cytokine released in the early stages of sepsis. Besides a possible transcriptional role, i.e., modification of the channel type and/or number, we demonstrated the existence of a rapid, posttranscriptional inhibition of NaV by TNF-α. The downregulation of the sodium current could be mediated by a PKC-induced phosphorylation of the sodium channel, thus leading to a significant decrease in muscle excitability.

Published
2011
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15. The reproducibility of Stewart parameters for acid-base diagnosis using two central laboratory analyzers

Author

Jean-Luc Carré, Jean Louis Vincent, Jean Baptiste Hamm, Gildas Gueret, Ba-Vinh Nguyen, C.-C. Arvieux, Jean-Hervé Abalain, Emmanuel Nowak, Mehdi Ould Ahmed, Hôpital d'Instruction des Armées Clermont Tonnerre, Service de Santé des Armées, Department of Intensive Care, Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)-Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Département de Biochimie et de Pharmaco-Toxicologie (JHA), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Biochimie et Biologie Moléculaire, Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest)

Subjects
Pathology, medicine.medical_specialty, Spectrum analyzer, Analytical chemistry, Acid-Base Imbalance, MESH: Observer Variation, Models, Biological, Strong ion difference, Central laboratory, MESH: Linear Models, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, 030202 anesthesiology, 030225 pediatrics, Humans, Medicine, Prospective Studies, MESH: Acid-Base Imbalance, Acid-Base Equilibrium, Observer Variation, Reproducibility, MESH: Humans, business.industry, Limits of agreement, MESH: Blood Chemical Analysis, MESH: Biological Markers, MESH: Models, Biological, Reproducibility of Results, Equipment Design, MESH: Prospective Studies, MESH: Predictive Value of Tests, Weak correlation, MESH: Acid-Base Equilibrium, MESH: Reproducibility of Results, Anesthesiology and Pain Medicine, Blood chemistry, Strong ion gap, Linear Models, business, Biomarkers, Blood Chemical Analysis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, MESH: Equipment Design
Abstract

International audience; BACKGROUND: Acid-base derangements can be interpreted using the Stewart-Fencl approach, which includes calculation of the apparent strong ion difference (SID(app)), the effective SID (SID(eff)), and the strong ion gap (SIG). These calculations require the measurement of several variables. We hypothesized that the SID and SIG calculated by different analyzers would not be reproducible because of variability in the measured values. METHODS: In this prospective observational study conducted in a biochemistry laboratory, we analyzed 179 routine blood samples from consecutive patients over a 3-mo period using two automated blood chemistry analyzers, the LX20 (Beckman) and the Modular (Roche). Measured and calculated parameters from the two analyzers were compared. RESULTS: Although the correlation between measured values was satisfactory, there were large differences in the limits of agreement for calculated values (SID(app): 9.6 mEq/L, SID(eff): 6.4 mEq/L, and SIG: 11.7 mEq/L) and a weak correlation (SID(app): r(2) = 0.54 and SIG: r(2) = 0.12) between the analyzers. CONCLUSIONS: The results of the Stewart-Fencl approach for interpretation of acid-base status can vary according to the analyzer used. These differences may have important clinical and research implications..

Published
2009
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16. Diabetic critical ischemia of lower limbs: distal arterial revascularisation

Author

Pierre Gouny, G. Gueret, A Badra, A.A. Khalifa, Guerrero, François, Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Institut Brestois Santé Agro Matière (IBSAM), and Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)

Subjects
[SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], medicine.medical_treatment, Fistula, 030204 cardiovascular system & hematology, Severity of Illness Index, 0302 clinical medicine, Ischemia, 030212 general & internal medicine, MESH: Treatment Outcome, MESH: Aged, MESH: Angiography, Angiography, General Medicine, Diabetic Foot, 3. Good health, MESH: Leg, Tibial Arteries, Treatment Outcome, surgical procedures, operative, medicine.anatomical_structure, Dorsalis pedis artery, MESH: Tomography, X-Ray Computed, Artery, medicine.medical_specialty, Revascularization, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, medicine.artery, MESH: Severity of Illness Index, medicine, MESH: Diabetic Foot, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Tibia, MESH: Tibial Arteries, Aged, Retrospective Studies, Leg, MESH: Humans, Vascular disease, business.industry, MESH: Retrospective Studies, MESH: Blood Vessel Prosthesis Implantation, medicine.disease, Diabetic foot, Surgery, MESH: Ischemia, Tomography, X-Ray Computed, business
Abstract

International audience; OBJECTIVES: To evaluate the outcomes of ischemic diabetic foot lesions for which distal arterial bypass grafting was considered as the first-line vascular procedure. PATIENTS AND METHODS: Between November 2004 and November 2006, 19 lower limbs of 17 diabetic patients with lower limb critical ischemia were operated in our department. The bypass grafts included five femoro-popliteal bypass grafts below knee and 14 distal bypass grafts. The 14 distal bypass grafts included; seven venous grafts on the dorsalis pedis artery, four femorotibial PTFE grafts and three femoroperoneal grafts. Arterio-venous fistula was applied to the distal anastomosis site in three limbs. RESULTS: At the time of discharge, the graft patency rate was 93.75%. The mean follow up period was 24 months. The primary cumulative patency rate was 63% at 2 year. The corresponding secondary patency rate was 87%. Among six ischemic ulcers, four ulcers healed within 2 to 12 months (66.6%). At 24 months, the cumulative rate of limb salvage was 76% and that of survival was 74%. CONCLUSION: Distal arterial bypass in diabetic lower limb ischemia improves blood circulation that accelerates foot ulcer healing. It can also avoid amputation or lower its level, and thus improving the patient's quality of life.

Published
2009

17. [MR angiography of peripheral arterial disease of the distal legs: is time resolved MRA (TRICKS) necessary?]

Author

Archambault, E., Gouny, Pierre, Hébert, Thomas, Salley, N., Nowak, Emmanuel, Nonent, Michel, Calvez, Ghislaine, Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service d'Imagerie (CHRU - CB), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
MESH: Aged, Male, Peripheral Vascular Diseases, Leg, MESH: Humans, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Peripheral Vascular Diseases, MESH: Magnetic Resonance Angiography, MESH: Male, MESH: Leg, Humans, Female, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Magnetic Resonance Angiography, Aged
Abstract

International audience; PURPOSE: To demonstrate the added diagnostic value of time-resolved imaging of contrast kinetics (TRICKS) in the evaluation of lower limb arteries compared to standard 3 level MRA with stepping table method. PATIENTS AND METHODS: Forty patients (30% diabetics) with lower extremity peripheral arterial disease (87.5% with chronic ischemia) underwent standard contrast MRA including TRICKS of the distal arteries. Five arterial segments were defined per leg, and 395 arterial segments were compared (one patient with amputation). Two reviewers evaluated the quality of arterial imaging, presence of venous return and degree of stenosis per segment. The degree of interobserver agreement for arterial stenosis measurement was calculated. RESULTS: More arterial segments could be analyzed on the TRICKS sequence (good or excellent analysis in 63.03%-66.32% of arterial segments compared to 41.51%-47.08% on routine MRA). There was less venous contamination on TRICKS images (25.57% to 27.60% gain). The degree of interobserver agreement was superior with TRICKS compared to standard MRA (kappa 0.85 vs 0.69). CONCLUSION: The TRICKS sequence can be added to standard MRA for pre-therapeutic evaluation of distal arteries in patients with peripheral arterial disease, especially with chronic ischemic with rest pain and/or trophic changes.

Published
2008

18. Multi-detector row computed tomography angiography: an alternative imaging method for surgical strategy in lower extremity arterial occlusive disease

Author

G. Gueret, A Verhaeghe, A Badra, Michel Nonent, Pierre Gouny, Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service d'Imagerie (CHRU - CB), and Calvez, Ghislaine

Subjects
MESH: Decision Making, medicine.medical_treatment, MESH: Lower Extremity, Contrast Media, 030218 nuclear medicine & medical imaging, MESH: Aged, 80 and over, 0302 clinical medicine, Computed tomography angiography, MESH: Aged, MESH: Angiography, Aged, 80 and over, MESH: Iohexol, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Middle Aged, MESH: Arterial Occlusive Diseases, medicine.diagnostic_test, Angiography, General Medicine, Middle Aged, Limb Salvage, MESH: Predictive Value of Tests, 3. Good health, Lower Extremity, 030220 oncology & carcinogenesis, Predictive value of tests, Radiographic Image Interpretation, Computer-Assisted, Radiology, MESH: Tomography, X-Ray Computed, Vascular Surgical Procedures, medicine.drug, MESH: Preoperative Care, Adult, medicine.medical_specialty, Iohexol, Decision Making, Arterial Occlusive Diseases, Revascularization, Preoperative care, Sensitivity and Specificity, MESH: Vascular Patency, 03 medical and health sciences, Predictive Value of Tests, MESH: Contrast Media, Preoperative Care, MESH: Radiographic Image Interpretation, Computer-Assisted, medicine, Humans, MESH: Vascular Surgical Procedures, Vascular Patency, Aged, Retrospective Studies, MESH: Humans, Vascular disease, business.industry, MESH: Adult, MESH: Retrospective Studies, Retrospective cohort study, medicine.disease, MESH: Sensitivity and Specificity, MESH: Limb Salvage, Surgery, business, Tomography, X-Ray Computed, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; In order to show the value of CT angiography in the pretherapeutic assessment of lower leg ischemia, we studied 93 CT angiographies in 85 patients. Two groups were defined according to the level of revascularization: 52 angioscanner were made prior to suprainguinal revascularization and 41 prior to infrainguinal reconstruction. Two decision attitudes were chosen by two different physicians, a radiologist and vascular surgeon, members of the same team. The attitudes where then compared in order to evaluate the value of CT angiography. The first attitude was a pragmatic strategy based on the images as interpreted by the first physician and on the intraoperative information including surgical treatment and, if necessary, angiography. This indicates that the results of this attitude cover the performed revascularizations. The second attitude determined a virtual strategy and was chosen by the second physician a posteriori, based solely on the medical file with the same CT angiography images. These two strategies were compared in order to assess the agreement on the level of the lesion and the choice of revascularization. In 84 CT angiographies (90.3%), the analysis of the lesions and the choice of lesions to be treated were identical. In 9.6% of scans the strategies were not comparable because the lesions were interpreted differently or the scans were difficult to read. The sensitivity of CT angiography in detecting lesions and guiding the therapeutic strategy was 96% and its positive predictive value was 93%. Follow-up was reported according to the life-table method to assess the overall outcome and the results in both groups. The overall survival rate at 12 months for 85 patients was 90%. Secondary patency rates at 12 months in the group of patients who underwent a suprainguinal and infrainguinal revascularization were 98% and 71% respectively. Overall limb salvage at 12 months was 94%. In this setting, CT angiography allowed us to select adequate treatment in the majority of cases. These results obtained after a strategy based on CT angiography images are comparable with the results as published in the literature after the strategy based on conventional angiography.

Published
2006

19. Plaque density on CT, a potential marker of ischemic stroke

Author

Serfaty, Jean-Michel, Nonent, Michel, Nighoghossian, Norbert, Rouhart, François, Derex, L., Rotaru, C., Chirossel, P., Thabut, G., Guias, Bruno, Heautot, J.-F., Gouny, Pierre, de La Vega, A., Pachai, C., Ecochard, R., Villard, J., Douek, Philippe-Charles, Renseigné, Non, Département de Radiologie (LYON - Radio), CHU Lyon, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service d'Imagerie (CHRU - CB), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Neurologie (NN), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de Neurologie [Brest], Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Service de Radiologie, Hôpital Louis Pradel [CHU - HCL], Laboratoire Creatis, Compte Général, Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Centre de Recherche et d'Application en Traitement de l'Image et du Signal (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Pathology, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, Contrast Media, 030218 nuclear medicine & medical imaging, Brain Ischemia, 0302 clinical medicine, MESH: Aged, 80 and over, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, MESH: Carotid Stenosis, Carotid Stenosis, Stroke, ComputingMilieux_MISCELLANEOUS, Randomized Controlled Trials as Topic, Aged, 80 and over, MESH: Aged, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Middle Aged, Cerebral infarction, MESH: Brain Ischemia, Middle Aged, Prognosis, MESH: Predictive Value of Tests, [PHYS.MECA.ACOU]Physics [physics]/Mechanics [physics]/Acoustics [physics.class-ph], [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [INFO.INFO-TI] Computer Science [cs]/Image Processing [eess.IV], Ischemic Attack, Transient, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], [PHYS.PHYS.PHYS-MED-PH]Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph], Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, medicine.symptom, [PHYS.MECA.ACOU] Physics [physics]/Mechanics [physics]/Acoustics [physics.class-ph], MESH: Tomography, X-Ray Computed, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Carotid Artery, Internal, medicine.medical_specialty, MESH: Carotid Artery, Internal, [INFO.INFO-TS] Computer Science [cs]/Signal and Image Processing, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Asymptomatic, MESH: Prognosis, MESH: Stroke, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Central nervous system disease, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Internal medicine, MESH: Contrast Media, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, medicine, Humans, Aged, Retrospective Studies, [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing, [SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph], [SDV.IB] Life Sciences [q-bio]/Bioengineering, [SPI.ACOU] Engineering Sciences [physics]/Acoustics [physics.class-ph], [PHYS.PHYS.PHYS-MED-PH] Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph], MESH: Humans, Vascular disease, business.industry, MESH: Biological Markers, Retrospective cohort study, MESH: Retrospective Studies, Odds ratio, medicine.disease, MESH: Male, Stenosis, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, MESH: Randomized Controlled Trials as Topic, Neurology (clinical), business, Tomography, X-Ray Computed, MESH: Ischemic Attack, Transient, MESH: Female, 030217 neurology & neurosurgery, Biomarkers, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; The authors sought to determine in a retrospective analysis whether carotid plaque soft TD on CT is associated with recent ischemic neurologic events. Among 141 patients (99 asymptomatic), 106 plaques with more than 50% stenosis were selected for density measurements. They found an odds ratio for neurologic events associated with a 10-point decrease in density of 1.54 (p = 0.002), showing an association between plaque density and neurologic events.

Published
2006
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20. Heterogeneous geographic distribution of patients with aortic valve stenosis: arguments for new aetiological hypothesis

Author

J-C Cornily, J-A Barra, G. Le Gal, V. Bertault, Eric Bezon, J-J Blanc, Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Service de Cardiologie (BREST - Cardio)

Subjects
Male, MESH: Chi-Square Distribution, 030204 cardiovascular system & hematology, MESH: Calcinosis, 0302 clinical medicine, Aortic valve replacement, Residence Characteristics, Risk Factors, MESH: Risk Factors, Epidemiology, MESH: Censuses, Prevalence, 030212 general & internal medicine, MESH: Residence Characteristics, ComputingMilieux_MISCELLANEOUS, MESH: Aortic Valve Stenosis, Heart Valve Prosthesis Implantation, MESH: Aged, Calcinosis, Censuses, 3. Good health, Aortic valve stenosis, Female, France, Cardiology and Cardiovascular Medicine, MESH: Heart Valve Prosthesis Implantation, medicine.medical_specialty, 03 medical and health sciences, Scientific Letters, medicine, Humans, MESH: Prevalence, Aged, Chi-Square Distribution, MESH: Humans, Interventional cardiology, Vascular disease, business.industry, General surgery, Calcific aortic valve stenosis, Aortic Valve Stenosis, medicine.disease, MESH: Male, Surgery, MESH: France, Etiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Chi-squared distribution, MESH: Female
Abstract

Calcific aortic valve stenosis is by far the most common valve disease in developed countries.1 The first clinical symptoms usually appear in the late 60s. Prosthetic aortic valve replacement is the only effective treatment at present.2 The reasons for the occurrence of calcifications of the aortic cusps leading eventually after many years to aortic valve stenosis are unknown. Some risk factors, mainly those already recognised in vascular disease, have been found to be associated with aortic valve stenosis and are considered to cause the disease.3,4 However, these factors are totally non-specific and may be confounded with factors leading to other illnesses. Recently a genetic hypothesis has been proposed after observation of a few familial cases5 but remains largely challenged in the absence of gene determination. The aim of our study was to evaluate whether epidemiological data collected in a selected region of France could provide evidence in favour of this hypothesis. The list of all patients who had undergone aortic valve replacement for calcific aortic valve stenosis in the cardiac surgery department of the Brest University Hospital between January 1996 and June 2003 was obtained from the central computerised registration of medical diagnosis and surgical procedures of the hospital, coded according to the International classification of diseases , 10th revision. This list was compared, and if necessary completed, with the diary registries of all the surgical interventions performed in the cardiac surgery department. For each patient, the following data were collected: name, sex, date of surgery, date of birth, and social security number. The social security number is a 15 digit number allowing identification for sex, year and month of birth, and geographic origin (region and commune). France is administratively divided into 22 provinces, about 100 regions, and 36 000 communes. The commune is the …

Published
2005
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21. Hemodynamic effects of lipid emulsion after local anesthetic intoxication may be due to a direct effect of fatty acids on myocardial voltage-dependent calcium channels

Author

C.-C. Arvieux, Fabrice Rannou, Gildas Gueret, Jean-Pierre Pennec, Maité Guillouet, MUST, Laboratoire Mouvement Sport Santé (M2S), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-École normale supérieure - Cachan (ENS Cachan)-Université de Rennes (UR)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Fat Emulsions, medicine.drug_class, [SDV]Life Sciences [q-bio], Fat emulsion, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Animals, Humans, Medicine, ComputingMilieux_MISCELLANEOUS, Hemodynamic effects, Direct stimulation, Anesthetics, Voltage-dependent calcium channel, business.industry, Local anesthetic, Myocardium, Fatty Acids, Myocardium metabolism, 030208 emergency & critical care medicine, General Medicine, Rats, poisoning, Anesthesiology and Pain Medicine, Local, Anesthesia, Lipid emulsion, Calcium Channels, pharmacology, drug effects/metabolism, Intravenous, business, metabolism
Abstract

The authorsconsidered two hypotheses regarding the mechanism ofaction of lipid emulsions. The first hypothesis was phar-macological, wherein a circulating lipid sink extractslipophilic local anesthetic from either plasma or tissues.The second hypothesis was metabolic, invoking reversionof the local anesthetic inhibition of the myocardial fattyacid oxidation. We suggest that a third mechanism could beinvolved, i.e., a direct stimulation of the voltage-gatedcalcium channels (Ca

Published
2010
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