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Biomedical subjects

A M Sarteel

Publications and source records attributed to A M Sarteel.

At least 19 recordsLinked to original sources
PubMed1985

[The nail in vascular pathology].

The nail is part of the ungual unit; it is affected indirectly and late in vascular disease. The authors recall the anatomy and the blood supply of the ungual unit and describe the alterations in terms of the level of the lesion. They describe the changes seen in systemic diseases such as the collagen disease, in vascular disease, venous, arterial and lymphatic disease and in vascular acrosyndromes. These alterations are often a result of several diseases, but may, nevertheless, help orient the diagnosis.

Collagen Diseases↗
PubMed1985

[Evolution of vasomotor tone in chronic obstructive arteriopathy of the lower limbs].

Progressive degradation in the appearance of digital plethysmogram tracings occurs during acute episodes of occlusive arteriopathies, and is of importance for establishing the diagnosis and the choice of therapy. The distal microvasculotissular score is of major interest during the stages defined by R. Fontaine in 1966. Changes are in fact those of rheologic factors in the terminal network. It is logical to incriminate variations in "tone" and of vasomotor response, the final relay being at the site distal to the circulatory units and their endothelial receptors. The problem should be envisaged at each stage in the course of the disease. Vasoplasticity is a function of the severity of the arteriopathy.

Arterial Occlusive Diseases↗
PubMed1983

[Acute symmetric polygangrene of the extremities].

The authors stress the importance, in acute symmetric polygangrene of the extremities, of systemic disease accompanied by decreased perfusion with its physicochemical consequences on parietal structures and the liquid contents of vessels and tissues developing rapidly in the extremities. In the first chapter, they recall the various aetiologies proposed in the literature. They then describe 3 personal case studies which they have chosen for their extreme age range and their varying aetiology. They present the various pathogenic factors which can occur either in isolation or in combination: parietal factors, abnormalities of the various elements of the blood, plasma factors, all of which are responsible for rheological disturbances which, when combined with decreased perfusion, lead to the development of gangrene. Finally, they present their ideas about treatment which sould be a function of the aetiology and the stage of the disease at the time of diagnosis.

Acute Disease↗
PubMed1980

[Diagnosis value of Doppler signal. From the finger pulp (author's transl)].

Receiving of Doppler signal from the pad is able to make complete the diagnosis of vascular acrosyndromes beside clinics, functional processes and above all capillaroscopy at the fingertip, conjunctiva and skin surface. There is not any signal in acrocyanosis, generalized sclerodermia, sharp's disease and chronical arteriopathy. There is a signal in P.A.N., dermatomyositis and L.E.D., likewise in primary form of Raynaud, in acroparestesias, in erythralgias... On the other and, in case of acrocyanosis mixed with Raynaud, the signal vanishes.

Adult↗
PubMedDate not supplied

[Incidents and accidents due to sclerotherapy. Prevention of pigmentation].

Even though sclerotherapy is a method which, in careful and experienced hands, is entirely harmless, the assault on the venous endothelium can, nevertheless, precipitate incidents and accidents, which the authors enumerate briefly in order to pinpoint that of pigmentation. The authors consider that, although this is not certain, venous stasis is responsible for this, venous stasis causing erythrodiapedesis followed by the formation of haemosiderin and the increased activity of the dermic melanocytes, a process which is exacerbated by subjacent inflammation. An axon reflex releasing P substance (Van Euler and Gaddum) modulating the chemical influx on the endothelial receptors in the microcirculation. Prevention will be achieved by combatting the venous hypertension and stasis, and the formation of heamosiderin, melanoids, and the inflammatory process.

Catecholamines↗
PubMedDate not supplied

[Disseminated essential telangiectasis].

The authors report on their observation of disseminated primary telangiectasia over fifteen years. Many results, all negative, have been necessary in order to eliminate a subjacent auto-immune affection caused by the associated Raynaud's phenomenon. Attempts at treatment using tetracyclin and ketoconazol have been thwarted by failures.

Female↗
PubMedDate not supplied

[Tissue pressure of the leg].

The underlying concepts of the study of subcutaneous and intramuscular tissue pressure, which began in 1952, have been highly modified. Three types of methods are now used: direct needle puncture, the perforated capsule, and the microcatheter. The capsule and the catheter are sensitive to osmotic and hydrostatic tissue pressure, and the needle indicates an interstitial hydrostatic T.P. We prefer the latter method, which allows the total T.P. to be measured.

Catheterization↗
PubMedDate not supplied

[Muscular compartment leg syndrome].

Certain forms of claudication are due to excess tissue pressure of the muscles of the aponeurotic chambers of the leg. These have been well described by Reneman, especially in their chronic form and for the anterior and lateral chambers. The claudication is due to an overworking of the muscles caused by walking, running or effort. It has its own characteristics, with direct measurement of the tissue pressure and phlebography aiding the diagnosis and attention being drawn by the presence of a "muscular hernia of the leg". Fasciotomy is the corrective treatment for cases of hyperalgia and beginning with a certain gradient of muscle pressure. The pathogenic reasons for this are discussed.

Anterior Compartment Syndrome↗
PubMedDate not supplied

[Cellulitis, a conjunctive microvascular disease].

While the term cellulitis is incorrect, it is commonly used and deserves a nosological classification. "Cellulitis is a dermohypodermosis and an oedemato-sclerous panniculopathy- It is indeed a true histangiography in which the fibroblastic reaction predominates over capillaro-veinular changes. Adipocytes of exaggerated size interpenetrate into micro- and later into macronodules marked off by more or less structured conjunctive fibrilla, thereby making treatment difficult.

Cellulitis↗
PubMedDate not supplied

[Hemodynamic relations between capillary and venule].

Following a nosological discussion of the varicose vein, its histological, biochemical and immunological elements are detailed. The hydraulic conditions are described, and attention is drawn to the microvasculartissue consequences of the stasis, the degree of constraint exercised by the interstitial tissue, and the role played by the intricate "micro fiber" network of the microcirculation: only a part of the capillaries reconnect with the veinlet of the same circulatory unit, the others having to flow toward the veinlet of other units and only one initial lymphatic vein contributing to the evacuation of 3 to 4 veinlets. The slightest hydraulic imbalance due to the stasis, sets of a whole series of chain reactions that can rapidly become harmful, with chronic veinous deficiency setting in.

Capillaries↗
PubMedDate not supplied

[Postphlebitic disease, stasis microangiopathy].

The terminology of this is incorrect, but hallowed by usage; it is an old thrombosis of the deep veins, and therefore part of the venous zone; it terminates distally in the zone of the terminal circulatory units, that is, at a microangiopathy of interstitial and lymphatic venous stasis, and the interstitium is involved. There is a polyangiopathy, all the vascular systems being involved, and there is a panangiopathy, every coat of the wall being damaged. The hydraulics of the blood, tissular liquids and lymph are progressively and permanently thrown into disorder; losses of head, pressure surges, choking and failure of the pumps, obliteration of the valvular canal all follow one another and tractage occurs. Microangiopathies of stasis are not only situated in the skin, the aponevrotic spaces and the vascular walls, but are situated also in the distribution "networks" which affect the flow-conditions and the interstitial restraint from which the treatment indications derive.

Blood Viscosity↗
PubMedDate not supplied

[Pigmentation and venous stasis].

Local pigmentations can occur in the course of venous diseases and are said to be secondary to venous stasis and due to blood pigment. Most often, the pigment is haemosiderin and more rarely melenin pigments. Haemosiderin is a result of dermal biligenesis of extravasated red blood cells, the erythrodiapedesis being due to alterations in the vessel wall. Melanin pigments remain a mystery. Meaanoid may stimulate dermal melanocytes more than the true melanocytes of neural origin which have migrated to the epidermis. Above all, the problem is dominated by stasis and its microvascular and tissue consequences. The pigmentation is part of the "microangiopathy of stasis", as are the pigmentations occurring after therapeutic sclerosis.

Capillaries↗
PubMedDate not supplied

[Angiodysplasias].

The angiodysplasias represent a "disease of the vasculo-connective tissue system", the cells of the primitive area vasculosa being simultaneously histoblastic and haemoblastic. This accounts for the many facets of the clinical picture and the nosology. The slightest deviation in ontogenetic organization involves one or more malformations which embryology unfolds in the course of the various stages of development, provided that the importance of vasculo-connective tissue correlations and hydraulic factors is never forgotten. The problem of nosological classification is very difficult ; many have attempted it, including the School of Nancy with Kissel and André, that of Milan with Puglionisi, that of Schobinger and Leu, that of J. Natali... it remains to classify the clinical picture presented in one or another list.

Angiomatosis↗
PubMedDate not supplied

[True or false varicose veins in sportsmen? (Result of a survey)].

The incidence of varicose veins remains high, as is proved by official statistics, particularly those of the Army, the average level being given at about 35 per cent, at least in France. A recent statistic produced at the Centre for the Detection of Cardiovascular Disease of the Urban Community of Lille, fairly homogeneous and representative of the North Region, has shown that the incidence is 20 per cent for one or the other saphenous vein in a population of more than 1 500 subjects of mean age 34 years. This study was permitted a distinction between true varicose veins and simple venous swellings, and we can now raise the question of the responsibility of swelling in the high level of varicose veins sometimes reported in competitive athletes, especially in elevated places. The study concerns three population groups, the first unselected (20 per cent varicose veins, 11 per cent swellings), the second consisting of 120 licensed athletes (14 per cent varicose veins, 12 per cent swellings), and the third group consisting of 330 Brigade Firemen (14 per cent and 11 per cent). Swelling was assessed in part by an electronic processor though not with statistically valid precision and the search for valvular incompetence was carried out simply and economically by listening to the Doppler Signal. Very often a very small localised double souffle was heard at the exact site of the venous projection. This raises again the spinous pathogenesis of Piulachs and Vidal-Barraquer, which is discussed and accepted in the unambiguous case.

Adult↗
PubMedDate not supplied

[Venous participation in gonarthrosis, rheumatoid arthritis, and gout].

The authors describe three major rheumatological classifications together with an account of the phlebological aspects of these phenomena. They deal with gonarthrocace, which is predominantly stasis; rheumatoid arthritis, which may be induced by inflammatory injuries to the vein wall, by endothelitis of the venulo-capillary segments, or racemose lividity; and gout which mainly involves turgescence, and mural phlebitis. This is not forgetting the secondary classifications, associated with polyglobulism, anemia, and foranioplasia.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Capillaroscopy in rheumatoid arthritis].

Three capillaroscopic features to be found at the base of nails are recognizable in rheumatoid arthritis. This is in conjunction with the clinical picture, the biological data, and the course of development. In the first, the tissue is transparent, there are many small comma-shaped capillary loops; the second feature is characterized by extreme transparency, pale base and long "hair-pin" loops spread in treillis form over the venular plexus in slow, granular circulation. A third feature recalls from the start a state of collagenosis, because of the inhomogenous opacity of the tissue, the presence of capillary hemorrhage and the irregular appearance of the loops, often of the "megacapillary" variety (I.E. congenital capillary dilatation). This division into three categories determines the character prognosis and treatment. It corresponds histologically to "pulp" biopsy and to the region of glomie arterio-venous anastomosis. There is therefore a real rheumatoid histoangiopathy.

Arthritis, Rheumatoid↗