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Biomedical subjects

A Bollinger

Publications and source records attributed to A Bollinger.

At least 109 records · Page 6Linked to original sources
PubMed1989

Microvascular flow distribution and transcapillary diffusion at the forefoot in patients with peripheral ischemia.

Transcapillary diffusion of Na-fluorescein injected by the intravenous route was measured by a videomicroscopy system in the skin of the dorsum of the forefoot in healthy controls (n = 21) and in patients with moderate (n = 35) and severe (n = 29) ischemia secondary to lower extremity arterial occlusive disease. Systolic ankle blood pressure and transcutaneous PO2 at the forefoot were significantly decreased in both groups of patients according to the severity of ischemic disease (p less than 0.001). The difference of the mean filling times between the first and last capillaries was used as a parameter for inhomogenous microvascular perfusion. It was significantly increased in moderate and severe ischemia (p less than 0.05). Transcapillary diffusion measured with a large window densitometer in a skin area of 2.8 mm2 was significantly enhanced in both groups of patients. The increase was more pronounced in the patients with severe ischemia (p less than 0.001) than in those with moderate ischemia (p less than 0.05). Among the patients with severe ischemia the diabetics exhibited significantly higher mean values of pericapillary fluorescence light intensity than the non-diabetics (p less than 0.001). At high magnification (550 times) distinct sites of increased transcapillary diffusion were detected in both groups of patients. They were most often localized at the apex of the capillary loops ("candle light phenomenon") and were more frequent in patients with severe than with moderate ischemia. In conclusion microvascular blood flow distribution is inhomogeneous and transcapillary diffusion increases at the level of single capillaries and skin areas in patients with moderate and especially severe foot ischemia.

Adolescent↗
PubMed1989

[Local thrombolysis of acute and subacute forearm, hand and finger artery occlusions. Early and late results].

21 patients with acute or subacute severe ischemia at the digits due to occlusions of forearm, hand and/or finger arteries were treated by local thrombolysis with urokinase. The medicament (0.6-1.1 million units per day during 1-3 days) was applied by the intraarterial route after cannulation of the cubital or radial artery. Simultaneously, heparin (20,000 units/24 hours) was infused by the same intraarterial catheter. Complete recanalization was obtained in 5 out of 21 patients, partial recanalization with significant clinical improvement in 9 additional patients. Therapeutic success was best with mean duration of symptoms lasting less than 4 weeks and in patients with embolic occlusions. After one year half of the patients had no remaining symptoms. There were no patients with acral necrosis.

Acute Disease↗
PubMed1988

[Practical importance of capillary microscopy].

Vital capillaroscopy has been successfully used for many years to study the microcirculation of human skin capillaries. The presence of typical capillary abnormalities is helpful in distinguishing scleroderma from other connective tissue diseases. Application of a local cold exposure test to finger nailfold capillary microscopy reveals the functional difference between normal subjects and patients with Raynaud's syndrome on the level of the microcirculation. Transcutaneous intravital fluorescence videomicroscopy may be helpful in the sometimes difficult differential diagnosis of lower limb edema. Microlymphangiography offers a new approach to depiction of the intravital anatomy of human lymphatic skin capillaries. Further the technique of intravital fluorescence videomicroscopy provides a noninvasive method of studying morphologic and functional abnormalities in diabetic microangiopathy.

Capillaries↗
PubMed1988

[Drug therapy in peripheral arterial occlusive disease].

Drugs used for improvement or stabilization of peripheral circulation include antiaggregants or anticoagulants for secondary prevention of arteriosclerosis, vasoactive substances and fibrinolytic agents. -Two prospective trials document that aspirin or the combination of aspirin and dipyridamole reduce progression of arterial occlusive disease significantly in comparison to placebo. Aspirin is best suited for secondary prevention of recurrent stenoses or occlusions after carotid or femoral endarterectomy, whereas anticoagulants are preferred in patients with embolism and after peripheral implantation of venous bypasses. -Significant improvement of walking distance is achieved by several compounds influencing blood rheology. The effect does not exceed that obtained by physical training. If reconstructive arterial surgery or percutaneous transluminal angioplasty are not possible, some patients with rest pain or gangrene may be successfully treated by intraarterial administration of prostaglandin E1.

Anticoagulants↗
PubMed1988

[Duplex sonography in the diagnosis of peripheral arterial circulation disorders].

From January 1984 to June 1986, 621 duplex scans of the arteries of the lower extremities were performed. 54.8% of the examinations were performed for clinical reasons. In 45.2% the indication was strictly scientific. Clinical and non-invasive examinations including pulse-volume recordings and Doppler pressure measurements preceded duplex-scanning. The analysis shows that duplex scanning may replace arteriography in patients with localized stenosis and short occlusions where catheter therapy is possible. Patients with insignificant stenosis or long occlusion may be selected for conservative treatment without arteriography.

Adolescent↗
PubMed1988

[Idiopathic cold agglutinin disease. Clinical aspects, therapy and course in 6 patients].

Clinical features, diagnostic procedure, therapy, course of the disease and prognosis in 6 patients with severe idiopathic chronic cold agglutinin disease are described. In 5 patients the main complaint was cold mediated acrocyanosis. The cold agglutinin in all patients was of anti-I type and belonged to IgM immunoglobulin. Keeping warm provided symptomatic relief and the hemolysis decreased to a milder form. Treatment with glucocorticoids alone failed in two patients but succeeded in combination with chlorambucil or cyclophosphamid. One patient developed a lymphoproliferative disorder 11 years after diagnosis of idiopathic chronic cold agglutinin disease.

Aged↗
PubMed1988

Analysis of flow motion by the laser Doppler technique in patients with peripheral arterial occlusive disease.

Laser Doppler flux was measured at the forefoot in 12 healthy subjects and in 36 patients with different degrees of ischemia due to peripheral arterial occlusive disease. Two characteristic patterns of flow motion waves were observed: Large waves with a mean amplitude of 0.77 +/- 0.4 arbitrary units and a mean frequency of 3.03 +/- 1.0 c/min (0.051 +/- 0.02 Hz) and small waves with a mean amplitude of 0.21 +/- 0.1 arbitrary units and a mean frequency of 21.7 +/- 4.2 c/min (0.362 +/- 0.07 Hz). The prevalence of large waves tended to decrease with more advanced ischemia, whereas small waves occurred almost exclusively in ischemia and most frequently in severe cases. Large flow motion waves were enhanced during reactive hyperemia after arterial occlusion or appeared after peak flux had been reached. Time to peak flux or to vasomotion were reliable parameters for characterizing skin ischemia. The previously undescribed small flow motion waves might represent a compensatory mechanism involved in pathophysiology of ischemia.

Adult↗
PubMed1987

[Intermittent venous claudication: a rarely diagnosed walking disability].

Intermittent venous claudication occurs mostly in young, physically active people after iliac vein thrombosis. In 20 healthy volunteers and 4 patients with venous claudication, plethysmographic volume measurements of the thigh and calf were made during treadmill work (10 degrees gradient, 7 km/h). The mean volume of the calf in the 20 healthy controls decreased at the beginning of exercise, climbed again later and reached a plateau after 100 sec, indicating a balance between arterial inflow and venous drainage. In the 4 patients with status after iliac vein thrombosis the volume of the affected leg rose continuously during exercise without reaching a plateau, until leg pain forced the patient to stop. The measured volume of the affected leg at the point of pain was higher than that of the patients' contralateral leg and higher than that of the controls (p less than 0.01). Strain-gauge plethysmography during treadmill work permits non-invasive, objective diagnosis of the venous drainage abnormality that leads to intermittent venous claudication.

Adult↗
PubMed1987

Infrared fluorescence videomicroscopy with indocyanine green (Cardiogreen).

After intravenous injection indocyanine green binds almost completely to the plasma proteins and may be detected in the skin capillaries by an infrared sensitive fluorescence videomicroscopy system. The technique opens a way to measure full capillary diameter and dimension of the plasma layer in an almost atraumatic way.

Adult↗
PubMed1987

Laser-Doppler probes for the evaluation of arterial ischemia.

Rhythmic variations of microvascular flux have been studied at the forefoot of patients with arterial occlusive disease by laser-Doppler flowmetry. Two patterns of flow motion with characteristic amplitudes and frequencies could be observed. The prevalence of small waves with a mean amplitude of 0.21 +/- 0.1 AU and a frequency of 21.7 +/- 4.2 c/min increased with the degree of ischemia. Big flow motion waves with a mean amplitude of 0.77 +/- 0.4 AU and a frequency of 3.0 +/- 1.0 c/min were found in both controls and patients with different degrees of ischemia. The small waves may represent a compensatory mechanism in skin ischemia.

Blood Flow Velocity↗
PubMed1987

Cryofibrinogenemic purpura.

A 50-year-old male patient had three episodes of acrally located purpura within 12 years without any other symptoms. The first two episodes which lasted several months coincided with the intake of beta-blockers; the third episode developed after a respiratory infection. A cryofibrinogenemia was found without any evidence of an underlying primary disease, especially not of a neoplasm. The clinical, histological, immunohistological, and electron microscopical findings, as well as the results obtained by intravital fluorescence videomicroscopy are presented.

Cryoglobulinemia↗