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Biomedical subjects

A Bollinger

Publications and source records attributed to A Bollinger.

At least 163 records · Page 9Linked to original sources
PubMed1983

[Multisegmental dynamic plethysmography for noninvasive study of venous function with special reference to exercise hyperemia].

Multilevel dynamic strain gauge plethysmography was evaluated in 22 healthy subjects. Venous volume changes were measured at the foot and calf level during tip-toeing exercise and at the thigh level during kneebends. These normal data were compared to those in 26 patients with chronic venous incompetence (CVI). Two types of curve resulted in the healthy subjects: if sensing site and exercised musculature do not correspond (foot sensing and calf-muscle exercise), venous volume decreases during exercise and stays on a constant level. However, if sensing site and exercised muscles are identical (calf--tip-toeings; thigh--kneebendings), venous volume increases again during exercise after a maximum volume decrease. This could be quantified by the volume increase angle beta. These mechanisms can be explained by exercise hyperemia. In patients suffering from CVI with only partially recanalized thrombotic occlusions, venous drainage is not sufficient and results in a significantly reduced (p less than 0.001) decrease in venous volume during exercise at the calf, or even in a volume increase. In the foot segment examined, however, no significant differences were found. Additional measurements at the thigh level are recommended for patients with a history of iliac vein thrombosis, especially for objective evaluation of intermittent venous claudication.

Adult↗
PubMed1983

[Comparative plethymography studies of arterial and venous hemodynamic parameters in the calf and foot in deep venous thrombosis].

In 33 patients with acute deep venous thrombosis of the lower extremity, all verified by phlebography, and in 36 healthy subjects arterial inflow, venous volume and maximum venous outflow were measured by mercury-strain gauge plethysmography. The measurements were performed simultaneously in both legs at the calf and foot level with a cuff pressure of 60 mm Hg for 4 min. In contrast to thrombotic occlusions proximal to the knee and multi-level thromboses, which could be identified by a significantly (p less than 0.001) reduced venous volume and maximum venous outflow (measurement at the calf level), isolated calf vein thromboses could not be detected even by sensing from the foot level or only if all three deep veins of the calf were occluded. The best diagnostic criterion for proximal deep venous thrombosis was the correlation of maximum venous outflow and venous volume (83% right positive), if these parameters were determined from the calf. The results indicate that deep calf vein thrombosis can be detected, even if sensed from the foot, only in cases with cross sectional thrombotic occlusions.

Adult↗
PubMed1983

[Buerger's disease: current diagnostic and therapeutic concepts].

This paper reviews our actual knowledge on Buerger's disease, a segmental inflammatory processors of peripheral, medium sized arteries and veins, and includes 33 patients of our clinic. In more than 50 p. 100 of cases antielastin antibodies were increased and the complement factor C4 decreased. 23 p. 100 had circulating immune complexes. Clinical experience and these immunological findings suggest medical treatment by antiinflammatory drugs like aspirin at relatively high doses or indomethazine. In resistant cases prednisone and azathioprine can suppress the activity of disease. If a limb is threatened by amputation the eventual implantation of a femoro-crural or cruro-crural bypass should be discussed.

Adult↗
PubMed1983

A transparent transcutaneous oxygen electrode for simultaneous studies of skin capillary morphology, flow dynamics and oxygenation.

Transcutaneous PO2 (tcPO2) measurements have become a standard method for a monitoring arterial PO2 of patients with cardio-respiratory problems. Direct heating of a silver/silverchloride anode induces a local hyperemia of the skin, which permits measurements of PO2 on the skin surface polarographically. This technique has been applied recently to quantify skin variability in peripheral arterial occlusive disease, to predict the optimal amputation level or skin transplant survival. However, so far local capillary morphology could not be correlated to tcPO2 data. The purpose of the newly developed electrode was to abolish this disadvantage and to be able to correlate capillary morphology and distribution to local tcPO2 by means of videomicroscopy or dynamic fluorescence videomicroscopy. The middle part of the new electrode consists of a glass cylinder (diameter 4.5 mm) and only one 15 micron Platinum cathode, which provides a negligible O2-consumption of the electrode itself (approx. 5.5 x 10(-3) mmHg/min). The careful optical grinding of the glass cylinder gives a good transparency for observing the capillaries through the incident light microscope of the videomicroscopy system. The electrode is covered by a 25 micron Teflon membrane, which also constitutes no essential optical barrier. By focusing at the tip of the Platinum cathode and the adjacent capillaries the distance between both objects or the intercapillary distance can be measured. The new combined system of transcutaneous PO2 measurements and simultaneous videomicroscopy has great potential as a practical method to provide new insights into local skin oxygen supply and the local microcirculatory flow distribution and capillary morphology.

Capillaries↗
PubMed1983

Aplasia of superficial lymphatic capillaries in hereditary and connatal lymphedema (Milroy's disease).

Four patients with hereditary lymphedema present at birth (Milroy's disease) have been studied by fluorescence microlymphography (1, 7). The videomicroscopy technique failed to visualize any lymphatic capillary in the edematous part of their legs. In sporadic primary lymphedema with late manifestation, however, a well developed superficial capillary network is detected (1, 6). Three family members without lymphedema had normal microlymphatics. Milroy's disease, at least in the family presented, is characterized by aplasia or extreme hypoplasia of both lymphatic capillaries and collectors whereas in the usual sporadic form of primary lymphedema aplasia or hypoplasia is confined to the larger trunks.

Female↗
PubMed1982

Patterns of diffusion through skin capillaries in patients with long-term diabetes.

We used intravital fluorescence videomicroscopy to study the pattern of transcapillary and interstitial diffusion in the nail folds of 13 patients with long-term diabetes and of 12 healthy controls. In both groups intravenously injected sodium fluorescein left the intravascular compartment. Its distribution in the pericapillary space and in the remote parts of the interstitial space was measured on single frames of the television tape by videodensitometers that are sensitive to intensities of fluorescent light. In the diabetics the dye passed both physiologic diffusion barriers--the capillary wall and the pericapillary space--in significantly increased amounts (P less than 0.01). The enhanced penetration of the tracer into the remote area caused an early homogeneous, milky blurring of the capillary image, whereas in the controls the pericapillary space remained clearly delineated for as long as 40 to 50 minutes after the appearance of the dye. The altered pattern of diffusion could be explained by increased permeability of the diffusion barriers, or, alternatively, by either changes of the mobility of the dye due to binding of the dye by intravascular or interstitial proteins or abnormal hemodynamics in the microvascular circulation. This technique provides a quantitative, noninvasive method of studying the natural history of diabetic microangiopathy.

Adult↗
PubMed1982

[Diagnosis of venous thrombosis of the deep pelvic and leg veins].

The clinical diagnosis of deep venous thrombosis is difficult: "signs of thrombosis" described by Homan are not reliable. Edema in the subfascial compartment, livid discoloration of the skin, congested foot veins in the upright position and the search for potential superficial collateral veins provide a more accurate diagnosis. It must be realized, however, that in about one third of the patients there will be unavoidable errors which include hematomas in the muscle compartments, posttraumatic swelling, compression of the veins by tumors, aneurysms or cysts, acute forms of lymphedema, erysipelas, and insufficiency of muscle pump in paresis. Non-invasive tests (Doppler-ultrasound, plethysmographic techniques) increase diagnostic accuracy of 80-95% provided that the thrombosis affect iliac or femoral veins. In the leg region only phlebography and the test using labelled fibrinogen are sufficiently accurate. The diagnostic steps are described in detail. They depend in part on local facilities, severity of disease and the therapy planned (anticoagulation alone, fibrinolysis, thrombectomy). The better the left expectancy and the severe the symptoms, the more thorough must be the diagnostic measures, including phlebography with a view to possible removal of the thrombi by medical or surgical means.

Adult↗
PubMed1982

[Fluorescence microlymphography of the medial malleolus in healthy humans and in patients with primary lymphedema].

Fluorescence microlymphography, a virtually atraumatic procedure, makes it possible to visualize the superficial network of skin lymphatic microvessels. 0.01 ml of 25% solution of FITC-dextran 150,000 were injected into the subepidermal layer using a steel microneedle (outer diameter 0,2 mm) connected to a microsyringe. The region above the medial ankle was examined by microlymphography in 15 healthy volunteers and 24 patients with primary lymphedema. The mean maximal propagation of the fluorescent dye in the lymphatic network, measured from the original deposit, was significantly lower (p lower than 0.001) in healthy volunteers (7.8 +/- 2.6 mm) than in patients with primary lymphedema (22.1 +/- 13.1 mm). Cutaneous reflux phenomena were demonstrated in 20% of the patients. The number of visualized precollectors was lower in patients with primary lymphedema. No significant differences were found between the mean diameters of meshes and of lymphatic capillaries in healthy volunteers and patients. However, definitely enlarged lymphatic vessels were observed in two patients with congenital lymphedema.

Adolescent↗