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Biomedical subjects

A Bollinger

Publications and source records attributed to A Bollinger.

At least 181 records · Page 10Linked to original sources
PubMed1982

Lymphatic microangiopathy: a complication of severe chronic venous incompetence (CVI).

The lymphatic capillary network was visualized by fluorescence microlymphography (subepidermal injection of 0.01 ml of FITC-dextran 150000 under a fluorescence microscope) in the medial ankle region of 21 patients with chronic venous incompetence (CVI) and of 15 healthy controls. In severe CVI leading to trophical changes of the skin lymphatic microangiopathy was detected. Obliterations of parts of the superficial capillary network, phenomena of cutaneous reflux and increased permeability of capillary fragments occurred. These findings contrast to primary lymphedema where the rete remains intact in most cases.

Adult↗
PubMed1982

Transcapillary and interstitial diffusion of Na-fluorescein in chronic venous insufficiency with white atrophy.

White atrophy (atrophie blanche) in the medial ankle region due to chronic venous insufficiency (stasis syndrome) was studied in 12 patients by fluorescence video microscopy [1,8]. After intravenous bolus injection of 1 ml of 20% Na-fluorescein the dynamic phenomena of transcapillary and interstitial diffusion of the dye were analyzed by a videodensitometer which has moved on single frames of the TV-recordings across white atrophy at different times after dye appearance. White atrophy is characterized by 3 main areas: 1) the avascular field sensu strictu, 2) the border region with enlarged and tortuous capillary loops, and 3) the more remote capillaries showing less altered morphology. The dye reached the ankle skin after 39.2 +/- 13.3 S and leaved rapidly the intravascular compartment. In the region of the border capillaries, the maximal fluorescent light intensity was reached after 5 min, in the centre of the avascular field only after 40 min. Initially, the densitometer curves show a 'valley' which is slowly filled up by the dye. At 40 min and later on the highest light intensities were measured in the central parts of the avascular field ('mountain'), where the clearance was just beginning. The slow diffusion of the small tracer into the avascular field explains that white atrophy is a predilection site for venous ulcer formation.

Adult↗
PubMed1981

[Incidence and clinical significance of thromboses and thrombo-embolic complications in nephrotic syndrome patients].

Chest X-ray, pulmonary isotopic photoscanning. Doppler sonography of iliac and femoral veins, inferior venacavagram and phlebography of the renal veins have been performed in 26 patients with nephrotic syndrome in order to determine the frequency and localization of thromboses and thromboembolic complications in these patients. 7 of 26 patients (26.9%) exhibited thromboses or thromboembolic complications (2 left sided renal vein thromboses, 1 right sided ileofemoral thrombosis and 1 bilateral ileofemoral thrombosis with occlusion of the vena cava inferior). In one patient renal vein thrombosis caused pulmonary embolism. In 3 other cases with life-threatening severe episodes of pulmonary embolism, the origin of the emboli could not be detected. Serum albumin level was found to be an appropriate parameter to assess the risk of thrombosis development in these patients. In 7 patients with thromboses or thromboembolic complications the serum albumin level was below 2 g/dl, whereas in 19 patients without these complications the serum albumin level was, with one exception, higher than 2 g/dl (1.5 +/- 0.3 g/dl vs. 2.6 +/- 0.5 g/dl; p less than 0.001). The possible pathophysiologic mechanisms for this observation are discussed. Our results help to identify the population of nephrotic patients who are most likely to experience thromboembolic disease. It therefore would be justifiable to carry out a prospective controlled study examining the question, whether this group of patients with benefit from prophylactic anticoagulation.

Adult↗
PubMed1981

Fluorescence microlymphography.

Microneedles, 0.2 mm o.d., were connected to a microsyringe and mounted on a micromanipulator. Under microscopic control, 0.01 ml of a 25% solution of FITC-labeled dextran-40 or dextran-150 were injected into the subepidermis at the big toe near the nailfold or in the medial ankle region. Fluorescence intravital microscopy revealed a network of lymphatic microvessels. The comparison with recent anatomic studies reveals that the reticular network visualized by FITC-dextran corresponds to the network in the stratum papillare. In 20 healthy subjects lymphatic capillaries were detected in a restricted area on the lateral aspect of the big toe. In 10 patients with primary lymphedema, the dye expanded to almost the entire dorsal skin surface of the big toe. In two cases, enlarged and tortuous microvessels of pathologic shape were observed. Fluorescence microlymphography is a simple and nearly atraumatic approach for depicting the intravital anatomy of human skin lymphatic capillaries.

Adult↗
PubMed1981

[New ways of studying the cutaneous microcirculation in clinical medicine (author's transl)].

Transcutaneous video microscopy opens a way to measure capillary red blood cell speed, to analyzed transcapillary diffusion and pericapillary distribution of Na-fluorescein injected i.v. and to depict the superficial lymphatic capillaries by subepidermal microinjection of FITC-labelled dextran in human skin. The dynamic phenomena may be quantitiated by video densitometers provided the information is stored on video tape. Already, some physiological and clinical data have been obtained. The velocity pattern of erythrocytes in nailfold capillaries is continuous or intermittent with flow stops. Standardized cold provocation tests are useful to evaluate Raynaud's disease. In patients with scleroderma the transcapillary passage of Na-fluorescein is increased, the physiological pericapillary halo partially destroyed and the interstitial distribution of the dye asymmetrical. In primary lymphedema the lymphatic network filled from the deposit of fluorescent dextran extends much more than in healthy controls. Pathological lymphatic microvessels occur.

Adult↗
PubMed1979

[Modern aspects of the physiopathology of arteriosclerosis obliterans].

In a shortened survey new points of view concerning the pathophysiology of disturbances of the peripheral arterial blood supply are discussed. Here the author deals in short with the new hypothesis of the atherogenesis, according to which on the basis of a lesion of the endothelium an aggregation of thrombocytes with following stimulation of the smooth muscle cells of the media develops. The haemodynamic changes by vascular stenoses and obstructions with the possibilities of their recognition are discussed in detail, in which especially examinations under load and phasic measurements of flow are taken into consideration.

Arteriosclerosis Obliterans↗
PubMed1979

[Thrombangiitis obliterans: diagnosis and therapy in light of new immunological findings].

Thrombangiitis obliterans, a segmental, multilocal, inflammatory disease of the small and medium-sized arteries and veins, is characterized by the relatively juvenile onset of the disease, the peripheral localization of the arterial occlusions and by phlebitis saltans. Other diagnostic criteria are the absence of risk factors typical of atherosclerosis (except smoking), strictly localized occlusion on angiography, phasic clinical course, and exclusion of either collagen disease or essential thrombocytosis. A possible immunopathogenesis for the disease is increasingly favored. In our own study of 33 patients the complement factor C4 was increased in 54.6%, the antielastin antibodies were found at a titre of 1:8 in 57.1% and the immuncomplexes in 23.3%. In only 1 case was the histocompatibility antigen HLA B 12 absent. In view of these immunologic findings and also the fact that phlebitis saltans as a symptom of the disease can be suppressed by salicylates and corticosteroids, but not by anticoagulants, the following therapy is proposed: high doses of acetylsalicylic acid during the acute stage of the illness, or, if this regimen fails, a trial with corticosteroids or immunosuppressive agents.

Adult↗
PubMed1979

[Primary thrombocythemia: clinical, pathophysiology and therapeutic possibilities].

The course of primary thrombocythemia has been observed in 22 patients over a period of 1-19 years. In contrast to experience with primary thrombocythemia in the literature, thrombotic complications were far more common than hemorrhage. 20 out of 22 patients complained of pain in toes and fingers due to disturbances of microcirculation, whereas bleeding disorders were present only in 5. Studies on spontaneous aggregation of platelets revealed a close association between platelet hyperaggregability and ischemic attacks. 500 mg acetylsalicylic acid every second day normalized the hyperaggregability in vitro and removed pain completely. The indication for antiaggregating substances in the therapy of primary thrombocythemia is discussed.

Adult↗
PubMed1979

Diffusion, pericapillary distribution and clearance of Na-fluorescein in the human nailfold.

An intravital fluorescence videomicroscopy technique is described in an attempt to develop non-invasive methods for the study of transcapillary exchange in human physiology and clinical medicine. The apparatus used consists of a Ploemopak incident light fluorescence microscope and a low light level television camera with linear output. After intravenous bolus injection of Na-fluorescein in 12 healthy subjects the movement of the dye particles in the nailfold was observed and stored on video-tape. Immediately after arrival the dye leaks into a halo-like section and later into the more remote parts of the pericapillary space. By moving a densitometric window on an axis transversal to the capillary loop (single frames of the tape), characteristic patterns of fluorescent light intensity distribution were obtained at different time intervals. At the edge to the halo the high pericapillary light intensity decreases abruptly moving further away from the capillary (mean: 10.0 micron) for 20 min and more in each individual indicating the presence of a diffusion barrier at this location between halo and more remote areas. Clearance of the dye is much slower than transcapillary diffusion and lasts approximately 2 h.

Adult↗