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Biomedical subjects

J F Merlen

Publications and source records attributed to J F Merlen.

162 records · Page 9Linked to original sources
PubMedDate not supplied

[Microcirculation and oral contraceptives].

A microvascular "condition" associated with the contraceptive Pill does exist; it explains in those "priviledged" women certain functional symptoms and minor venous incidence such as telangiectasia. We still have to prove the direct and particular relation. Documents and statistics are few and far between ; the reasons for this are the difficulty in obtaining them, the pharmaceutical form, and individual vascular response. A regional investigation was carried out over four years in a homogenous population shows only four cases of telangiectasia. Clinical and experimental facts enable us to discuss the pathogeny. Excessive permeability and capillaro-venular neogenesis are at its basis and, mutatis mutandis, we can compare gravid histangiopathy and functional histangiopathy of the Pill, there being no fibrinoid necrosis. We are able to observe under capillaroscopy the same phenomenon in the base of the nail, as in the ocular conjunctiva: this stems from excessive permeability and its effects of interstitial constriction on the microvessels when the lymphatic drainage is flooded. Corrective treatment is possible.

Animals↗
PubMedDate not supplied

[Physiopathology of sclerous cellulitis].

Despite the erroneous and inexact term used to describe it (hypodermite scléreuse), sclerous cellulitis is a clinical, microvascular-tissular phenomenon caused by venous stasis and its lymphatico-connective sequelae. It figures in veno-lymphatic polymicroangiohistopathy, and it may be venous in origin, but the end result is cutaneous. Its clinical aspects are polymorphic, its development is long and its treatment difficult because of the histoangial substratum.

Cellulitis↗
PubMedDate not supplied

[Acrorhigosis].

Acroasphyxia is not acrocyanosis and acrocyanosis is not acrorhigosis; this classification was drawn up in 1932 by Comel and his school. It involves persistent sensations of cold in the extremities, often with hypothermia but without cyanosis and without wetness. Young women often suffer from this complaint, classified clinically as sine materia but in fact accompanied if not caused by a slight decrease of the distal flow, by dystonia reactive to the exterior cold, and by acrothermic, poikilothermic behaviour. Digital pulp biopsy shows an abnormally high number of glomic anastomoses. Acrorhigosis may be explained by an atonic, hypertonic syndrome, by hyperactive block dispositives and by excessive anastomosisation. Treatment of acrorhigosis is possible.

Cold Temperature↗
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

[Sclerosis of the external saphenous vein and compartment syndrome].

Despite the precautions taken during sclerosis of the arch of the external saphenous, the authors describe four patients who presented a clinical picture of acute pain, developing about two hours after the injection, accompanied by induration of the internal gemellus and contracture of this muscle, leading to functional disability; recovery from this was not really complete until the end of six months. They explain this picture not by the injection of an artery frequently present at the level of the popliteal junction, but injection of a gemellar ven, giving rise to a compartment syndrome; this hypothesis has not received any confirmation by arteriography or phlebography.

Compartment Syndromes↗
PubMedDate not supplied

[Veno-lymphatic correlations and communications].

We are far from being thoroughly acquainted with lympho-venous pathology, despite minute research in this field. The only physiological lympho-venous communications are macroscopic. The existence of microscopic communications has been proved in animals, but it seems that anastomoses become pathologically normal whenever the lymph flow is at all checked. It should be particularly noted that the vasculo-tissular equilibrium is precariously dependent on the physiological condition. The slightest disturbance can upset this balance, resulting in the formation of lympho-venous anastomoses, which attempt to set up a balance difficult to maintain.

Animals↗
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↗
PubMedDate not supplied

[Thrombophlebitis migrans].

Semantically, the term is correct, because inflammatory involvement of the vein wall predominates over thrombosis, and the indication for anti-inflammatory drugs is absolute while that for anticoagulants is secondary. The nosological characteristics are its relapsing, migratory and primary nature. But, in fact, this is a "signal-symptom", whether involving normal or varicose veins, with nodular or stranded appearance, with patches of hypodermal inflammation or erysipeloid. The major problem is that of aetiology: infections, systemic disease, blood diseases, deep-seated neoplasia... not to mention the gouty diathesis, hiatus hernia, polycythaemia, Buerger's disease and Behçet's syndrome... The author emphasizes the value of capillaroscopy, biopsy of vein and digital pulp and the search for antivein antibodies. Therapy is discussed.

Anti-Inflammatory Agents↗