The human saphenous vein in pharmacology: effect of a new micronized flavonoidic fraction (Daflon 500 mg) on norepinephrine induced contraction.

Local acidosis (pH 6.4) depresses reactivity of vascular smooth muscle and especially the response of human isolated saphenous veins to exogenous norepinephrine. Experiments were performed to study, under acidosis conditions, the interaction between Daflon 500 mg, a micronized fraction of 90% diosmin and 10% hesperidin, and norepinephrine on human rings of veins. Varicose veins were obtained by conservative varicose veins surgery and normal veins from patients undergoing coronary artery bypass graft surgery. Isometric tension was recorded from venous rings in organ chambers filled with Krebs-Henseleit solution (pH 7.4; 37 degrees C). Metabolic acidosis (from pH 7.4 to 6.4) was obtained by lowering the HCO3- concentration of the Krebs-Henseleit solution. Cumulative concentration-response curves for norepinephrine (10(-7) to 10(-5)M) were obtained at pH 6.4 in the presence or in the absence of Daflon 500 mg (10(-5)M) added 20 min previously to the organ bath. Under acidotic conditions, Daflon 500 mg induced a shift to the left of the concentration-response curves for norepinephrine. This potentiation was significant in both normal and varicose veins and was increased in proportion with the pathological status of the venous rings. These results support the therapeutic benefits of Daflon 500 mg in chronic venous insufficiency.

[Ultrasonic, arteriographic and anatomopathological correlation in 59 cases of carotid atherosclerosis]. / Corrélations ultrasoniques, artériographiques et anatomopathologiques dans 59 cas d'athérosclérose carotidienne.

This study was carried out on 49 patients who underwent an ultrasound study by continuous Doppler and echotomography B real-time, an angiography of supra-aortic arteries, and a carotid endarterectomy. Thirteen had had transient ischemic attacks and 20 a stroke. A quantification of the carotid stenosis in 4 stages was established for each method. For detection of lesion an excellent correlation was observed between the results of echotomography and pathology. For the quantification of lesion the correlation between echotomography and pathology was excellent also in 79,7 p. 100 of the cases, discordant in 20,3 p. 100. It was similar to the correlation between arteriography and pathology (excellent in 83 p. 100 of the cases). The correlation with pathology enabled to distinguish for stages of atherosclerotic lesions, to clarify their type of complications, and to evaluate their functional significance, particularly those with a high risk of embolism.

[Validation of quantitative and qualitative data of real-time carotid echotomography in comparison with standard Doppler tests, arteriography and anatomopathology. On 59 carotid endarterectomies]. / Validation des données quantitatives et qualitatives de l'échotomographie carotidienne (en temps réel) par confrontation avec celles de l'examen Doppler standard. De l'artériographie et de l'anatomopathologie. Sur 59 endartériectomies carotidiennes.

Findings on ultrasound, arteriography and pathology examinations were compared in 49 patients undergoing 59 carotid endarterectomies between December 1981 and April 1983. Carotid artery lesions were investigated routinely by cervical Doppler, high resolution rapid ultrasound and either direct or more usually venous arteriography (with photographic subtractions). Postoperative endarterectomy specimens were examined to determine the exact degree of stenosis, and also qualitatively (gross pathology and histology of ulcerations and thromboses, the biochemical nature of the plaques, etc.). With respect to detection, that is demonstration of the existence or not of an atheromatous lesion, the ultrasonographic findings could always (100% of cases) be correlated with pathology data. Qualitative analysis of atheromatous lesions showed certain to be diagnosed with ease: calcified, fibrous or chondroid and lipidic plaques, while those complicated by hemorrhage, ulceration or mural thrombosis were less constantly diagnosed by ultrasound imaging. Occlusive plaques were easily detected, while recent intraluminal thrombosis was more difficult to diagnose by ultrasound alone. In this case the combined use of Doppler is a valuable aid, and is a routine procedure, in fact, in the department. Results of quantitative analysis showed good correlation between ultrasound and pathology findings in 79.7% of cases (insufficient in 20.3%). However, if ultrasonography is combined with other ultrasound methods of examination (standard Doppler and spectral analysis of Doppler) correlation is of the order of 95%, close to morphological data supplied by arteriography, with in addition a functional and qualitative approach not possible with arteriography alone.