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Biomedical subjects

J N Fiessinger

Publications and source records attributed to J N Fiessinger.

At least 217 records · Page 12Linked to original sources
PubMed1982

[Takayasu's disease. Diagnostic criteria (author's transl)].

Retrospective analysis of the records of 86 patients with Takayasu's disease confirmed that the condition is more common in women, that it is frequently associated with a history of tuberculosis and that angiography is of considerable help in showing vascular lesions that are characteristic by their location (common carotid artery, post-vertebral subclavian artery) and by their diffusion to various areas. Histological examination of 20 surgical specimens confirmed the diagnostic value of sclerosis of the media and adventitia (associated or not with inflammatory lesions) and therefore radically different from the lesions of the intima observed in Horton's disease. Diagnostic criteria based on clinical, radiological and histological data are proposed.

Aortic Arch Syndromes↗
PubMed1982

[Takayasu's disease involving the vessels arising from the arch of the aorta and those of the upper limbs (author's transl)].

Lesions localized to the vessels arising from the aortic arch and those in the upper limbs were observed in 72 out of 84 patients with Takayasu's disease. In 54% of these 72 cases, other regions were affected, while only the vessels arising from the arch of the aorta were the site of lesions in the other 46% (isolated axillo-post-vertebral subclavian lesions were present in 14% of cases). Semiological features, long-term complications, and prognosis are discussed. 53 revascularizations were performed in 47 patients without mortality. Surgery is definitely indicated when severe stenosis of the brachiocephalic vessels or the main carotid arteries or their division exists. Revascularization of a subclavian artery stenosis should be limited to cases with ischemia of the upper limb on effort or when a histological diagnosis is required. Controversy exists as to the need for this operation in ectatic forms.

Aortic Arch Syndromes↗
PubMed1982

Endothelial cell renewal in skin of patients with progressive systemic sclerosis (PSS): an in vitro autoradiographic study.

The labelling index of endothelial cells of the dermal microvessels was studied by in vitro autoradiography with [3H] thymidine. 14 patients with PSS were compared with 7 control subjects, by sampling the upper-third of the forearm skin. One patient had a second biopsy in this area, on a telangiectasis. Microvessels from patients showed a significant increase in endothelial cell labelling. Within the PSS group, no difference was found between the indurated and the non-indurated skin. There was no correlation between the labelling index and the duration of the disease. A very high uptake was found in the telangiectasis. Such an increased labelling index in PSS is consistent with a response to the endothelial cell destruction as described in electron microscopy and in cultures with patient's serum.

Adult↗
PubMed1982

Impaired primary in-vitro antibody response in progressive systemic sclerosis patients: rôle of suppressor monocytes.

The primary in-vitro antibody response developed by peripheral blood mononuclear cells (PBM) towards trinitrophenyl coupled to polyacrylamide beads (TNP-PAA) was evaluated in 17 untreated patients with progressive systemic sclerosis (PSS). This response was markedly depressed as compared with that of 19 control patients and 28 normal subjects. In eight PSS patients and eight normal controls the anti-TNP response was measured before, and after, a PBM filtration on nylon wool columns. This procedure dramatically reduced the proportion of monocytes identified as mononuclear cells staining positively for peroxidases, and restored the response of PSS PBM to the level observed in normal PBM. In four experiments, plastic-adherent cells from either normal subjects of PSS patients were added to autologous nylon-passed PBM. This did not modify the response from normal PBM but inhibited the response of PSS PBM. The inhibitory effect of PSS plastic-adherent cells was insensitive to a 2,000 R X-ray irradiation. These results strongly suggest that the impaired in-vitro antibody response observed in PSS can be attributed to a suppressor monocyte. The concanavalin-A-induced suppressor cells of the antibody response were assayed in PSS. They exerted a suppressive effect to the same extent as in controls.

Adolescent↗
PubMed1982

[Systolic arterial hypertension: demonstration and mechanism in obliterating arteriopathy of the lower extremities].

Hemodynamic parameters were measured in 24 patients with arteriosclerosis obliterans of the lower limbs, in comparison with 16 normal subjects of same age. Systemic arterial compliance was estimated from a simple visco-elastic model. In patients with arteriosclerosis obliterans, systolic pressure was significantly increased (P less than 0.001) while diastolic pressure remained within normal ranges. Arterial compliance was reduced (P less than 0.01) and was negatively correlated with systolic pressure (r = -0.72). Intravenous administration of nitroglycerin significantly decreased systolic pressure (P less than 0.05) and increased arterial compliance (P less than 0.01) without any change in mean arterial pressure. This study provided evidence that, in patients with arteriosclerosis obliterans of the lower limbs, the reduced systemic arterial compliance contributes in the increase in systolic pressure.

Arterial Occlusive Diseases↗
PubMed1982

Systolic hypertension in arteriosclerosis obliterans of the lower limbs.

Hemodynamic parameters were measured in 24 patients with arteriosclerosis obliterans of the lower limbs (AOLL) in comparison with 16 normal subjects of same age. Systemic artérial compliance was estimated from a simple visco-elastic model. In patients with (AOLL), systolic pressure was significantly increased (P less than 0.001) while diastolic pressure remained within normal ranges. Arterial compliance was reduced (P less than 0.01) and was negatively correlated with systolic pressure (r = - 0.72). Intravenous administration of nitroglycerin significantly decreased systolic pressure (P less than 0.05) and increased arterial compliance (P less than 0.01) without any change in mean arterial pressure. The study provided evidence that, in patients with AOLL the reduced systemic arterial compliance contributes in the increase in systolic pressure largely.

Arteries↗
PubMed1982

[Systemic scleroderma : salivary immunoglobulins and the Gougerot-Sjögren syndrome].

The concentrations of immunoglobulins (Ig) A, G and M were measured in saliva using an electro-immunodiffusion technique at pH 5 with carbamylation of the antisera. Thirty-one controls and 20 patients with generalised scleroderma (10 with and 10 without Sjögren's syndrome) were studied. The three classes of immunoglobulins were in normal saliva. A concentration of IgG greater than 55 mg/l in whole saliva was associated with Sjörgren's syndrome. This is the consequence of the reduction of the rate of saliva production, as well as an increased local synthesis of IgG. The measurement of IgG in unconcentrated saliva could be useful in the detection of Sjögren's syndrome.

Humans↗
PubMed1981

Effect of local urokinase on arterial occlusion of lower limbs.

Sixty nine patients were treated with local intra-arterial urokinase (37,500 U/CTA. hr-1) for recent severe ischemia of lower limbs: 27 (40%) ultimately required amputation. The difference of amputation rate between the groups with and without thrombolysis was not significant (33% v. 42%). A biological study in 6 patients showed that local arterial plasminemia occurred in only 1 patient. Local urokinase does not strongly stimulate "endogenous" thrombolysis and enhances "exogenous" thrombolysis only very inconstantly. A better adaptation of urokinase dosage or the use of an agent with higher affinity for fibrin might improve the efficiency of local thrombolytic therapy.

Aged↗
PubMed1981

[Clinical presentations of Cockett's syndrome. 16 cases].

Cockett's syndrome (iliac compression syndrome) results from compression of the common iliac vein by the aortic bifurcation. The anatomical abnormality is frequent (15-20% of the population), but symptoms only appear when compression is pronounced. In a study of 16 patients, predominantly female, the following clinical presentations were observed: venous oedema of the left lower limb in 4 cases; symptoms suggesting iliac phlebitis in 3 cases; pulmonary embolism as first sign of peripheral venous thrombosis in 6 cases; and deterioration of angiodyplasia in 3 cases. In all patients, the diagnosis of Cockett's syndrome was confirmed by cavography. Surgical treatment, successfully performed in 13 patients, consists of uncrossing the artery and vein and placing a clip on the vena cava in case of pulmonary embolism

Adolescent↗
PubMed1981

[Quantitative assessment of labial salivary gland sclerosis in patients with diffuse scleroderma (author's transl)].

Biopsies of the lips were performed on 27 patients (7 male and 20 female; mean age, 58 years) with diffuse scleroderma and on 10 healthy subjects serving as controls. The degree of intralobular sclerosis in labial salivary glands was measured on tissue sections by an automated morphometric analysis technique. Collagenous compared with controls. It was independent from the type of cell infiltrating the gland and from the evolution potential of the disease, but it correlated with its duration and seemed to be specific to scleroderma.

Adult↗
PubMed1981

[Evaluation of the spread of atherosclerosis in patients with arteritis. Implications for the therapeutic indications (author's transl)].

The immediate prognosis (operative risk of a revascularization) and also the long-term prognosis for the patient with arteritis depends on the spreading of the atheroma to other vascular regions (coronary or carotid arteries). Conventionally the initial evaluation is made by cervical Doppler examination, effort ECG and profile aortography. Cervical Doppler examination revealed in the present group of 402 patients significant stenoses on the arterial vessels leading to the brain in 67 cases (16.6%), including 13 asymptomatic stenoses. The effort ECG carried out in 140 cases was assurable in 72% of these, being positive in 19% of the cases in patients with no clinical or ECG history of coronary insufficiency. Profile aortography of 125 patients revealed atheromatous lesions in 39 (31%), in many cases multiple lesions: 13 cases in the coeliac trunk and mesenteric artery. The implications of these discoveries, as they affect therapeutic indications and in particular the justification of multiple revascularizations, have been discussed.

Angiography↗
PubMed1981

[Diffusion of atherosclerosis in patients with arterial disease of the lower limbs (author's transl)].

In patients with arteriosclerosis obliterans of the lower limbs immediate (operative risk) and long term prognosis depend on the diffusion of the atheroma to other arterial beds (coronary and carotid). Basic investigations were completed by doppler ultrasonography of the cervical arteries, exercise electrocardiogram and lateral aortogram. Doppler ultrasonography revealed significant degrees of stenosis of the cervical arteries in 67 out of 402 patients (16.6 p. 100). The stenosis were totally latent clinically in 13 patients. Valid results were obtained in 72 p. 100 of 140 after an exercise electrocardiogram. It was positive in 19 p. 100 of patients without clinical or electric sign of coronary heart disease. Lateral aortogram in 125 patients showed atheromatous lesions in 39 cases (31 p.cent). These were often multiple and involved the coeliac and superior mesenteric arteries in 13 cases. These investigations are of great importance in making the therapeutic decision, indications related with risk and resulting priorities. Alarming coronary or carotid lesions may indeed require treatment before arterial disease of the lower limbs.

Aortography↗