[On the morphology of sympathetic ganglionic nerve cells during various diseases. (Buerger's disease. Raynaud's disease, frostbite, megadolichocolon)].
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: To investigate the prevalence of headaches and recurrent chest pain in patients with primary Raynaud disease. DESIGN: Postal survey. SETTING: Raynaud disease clinic at the Lahey Clinic Medical Center, a tertiary care hospital. PARTICIPANTS: A consecutive series of 120 patients with primary Raynaud disease who had been observed for at least 2 years, 97 of whom received and 93 of whom completed the questionnaire, and a control group of 93 age- and sex-matched hospital employees without Raynaud phenomenon. RESULTS: Migraine was diagnosed in 57 (61%) patients with primary Raynaud disease and in 21 (23%) of the control group (odds ratio, 5.4; 95% CI, 2.8 to 10.3). Migraine with aura and migraine without aura were more common in patients with Raynaud disease than in the control subjects (27% compared with 5%; P less than 0.001 and 34% compared with 17%; P = 0.008, respectively). Nonmigrainous headaches were more common in the control group (51% compared with 25%; P = 0.003). Chest pains were reported by 44 (47%) of the patients with Raynaud disease and by 15 (16%) of the control group (odds ratio, 4.4; CI, 2.4 to 9.3). Chest pains were more frequently reported by patients with Raynaud disease who had migraine (34 of 57, 60%) than by patients without migraine (10 of 36, 28%; P = 0.003). CONCLUSIONS: An increased prevalence of migraine was found in patients with primary Raynaud disease. Chest pain, often diagnosed as musculoskeletal or nonspecific, was common in patients with primary Raynaud phenomenon, especially in patients who had coexisting migraine.
Explore the source record for details and available documents.
Concerning the question whether a correlation between the vasospasm and morphological changes in the neuro-myo-arterial glomerular (Hoyer-Grosser-Organ) exists also in Dupuytren disease, a series of 18 patients with Dupuytren and 5 patients with Raynaud disease were studied by finger venous occlusion plethysmography and finger tip biopsies. No typical histological changes were found in Dupuytren's Contracture, particularly none in the 13 cases (70%) which had a latent vasospasm and none in the 5 cases (30%) which had a normal plethysmogram, whereas in all the patients with Raynaud disease the typical morphological changes of wall, lumen and morphometric counts of the "Suquet-Hoyer" canals were found in correspondance to the abnormal plethysmogram. According to these results the vasospasm of Dupytren and Raynaud disease seems to be pathogenetically different.
Explore the source record for details and available documents.
Raynaud's disease is characterized by excessive cutaneous vasoconstriction in response to ambient cold. A functional disturbance in the local regulation of digital vasomotion has been proposed. The purpose of this study was to determine whether there is an alteration in the postjunctional adrenergic receptors in the digital circulation of patients with Raynaud's disease. Furthermore, we sought to determine whether this abnormality was responsible for the excessive cold-induced vasoconstriction in these patients. Finger blood flow was measured by strain-gauge venous occlusion plethysmography in 10 patients with Raynaud's disease and in 10 normal volunteers in a 22 degrees C room. Measurements of finger blood flow and mean systemic arterial pressure were made during intra-arterial infusions of the alpha 1-adrenergic antagonist, prazosin, or the alpha 2-adrenergic antagonist, yohimbine, at room temperature and during local cooling of the hand. Basal finger blood flow in normal subjects was significantly greater than that of patients (8.6 +/- 2.7 vs 1.7 +/- 0.5 ml/100 ml per min; normal vs Raynaud's subjects; p < 0.05). In normal subjects, either prazosin or yohimbine induced dose-dependent increases in finger blood flow. The maximal increase in finger blood flow induced by prazosin was significantly greater than that in response to yohimbine (29.2 +/- 10.1 vs 2.8 +/- 2.1 ml/100 ml per min; prazosin vs yohimbine; p < 0.05). By contrast, in the Raynaud's patients, prazosin or yohimbine induced maximal increases in finger blood flow that were not significant (7.1 +/- 1.8 vs 5.0 +/- 2.2 ml/100 ml per min; prazosin vs yohimbine; p = NS). The response to prazosin in Raynaud's patients was significantly less than that of the normal volunteers (p < 0.05). In normal subjects, during intra-arterial infusion of vehicle alone, cooling induced a 52.6 +/- 5.8% reduction in finger blood flow. This cold-induced vasoconstriction was blunted, but not qualitatively altered, by either adrenergic antagonist. In the Raynaud's patients, during the intra-arterial infusion of the vehicle, cooling induced a 68.2 +/- 7.8% reduction in finger blood flow. Infusion of either adrenergic antagonist blunted, but did not qualitatively alter, the response to cold. Finger blood flow is less in patients with Raynaud's disease than in normal subjects when studied in a 22 degrees C room. In normal subjects, postjunctional alpha 1-adrenergic receptors appear to predominate in the control of digital vasoconstriction. Postjunctional alpha 1- and alpha 2-adrenoceptors play an equal role in adrenergic regulation of finger blood flow in patients with Raynaud's disease. In both normal and Raynaud's subjects, selective antagonism of alpha 1- or alpha 2-adrenergic receptors does not abolish local cold-induced vasoconstriction. Therefore, it is likely that a nonadrenergic mechanism contributes to local cold-induced vasoconstriction.
The effect of indoramin was investigated on finger circulation in 20 patients with primary Raynaud disease. After placebo run-in, indoramin (50 mg t.i.d. per os) and placebo were given double-blind and in randomized order, each for 6 (protocol 1) and 3 weeks (protocol 2). No significant changes in blood pressure and heart rate were observed. Finger blood flow, measured with venous occlusion plethysmograph, increased significantly (p less than 0.025) with indoramin as compared with placebo, and local calculated resistance decreased when measured at room temperature (protocol 1). In protocol 2 flow was measured at the end of a 6-min contact with water temperature of 40, 30, 20, 10 and 5 degrees C, respectively. It was shown that the difference between indoramin and placebo was largest at high temperatures and was clearly decreased at lower temperatures. Thus, the present data objectively document that indoramin is capable of favorably influencing skin circulation, but this effect is less pronounced at lower temperatures.
Raynaud's disease is characterized by intermittent peripheral vasoconstriction leading to pallor, cyanosis and reactive vasodilation of the arterioles of fingers and toes. These phenomena are accompanied by sensations of cold or warmth, pain and difficulty in manipulating the palms. Ulcerations of the fingertips can occur in severe cases. Since conservative medical treatment, consisting of preventive measures and changing various habits, results in alleviation in only half the patients, sympathectomy is often required. Psychological intervention, including biofeedback, also has a significant role. Biofeedback involving relaxation techniques, guided imagination, and in parallel, computer-assisted monitoring of sympathetic arousal, might lead to symptom reduction as a unique treatment or in conjunction with other treatment modalities.
Explore the source record for details and available documents.
A 64-year-old woman presented with a serious Raynaud's disease affecting all four extremities and resulting in fingertip necroses. The symptoms had initiated after her second pregnancy in association with anorexia requiring treatment in a psychosomatic clinic and necessitating parenteral feeding. After successful sympatholysis a sympathectomy was performed. After initial success a recurrence in the right arm was treated by intraarterial prostaglandin infusion. This treatment brought a temporary benefit whereas intravenous infusions had been without effect. A further medical blockade of the stellate ganglion was followed by a complete disappearance of the symptoms. A subsequent re-operation was performed. Since all the cervical branches of the sympathetic nerve cord had been resected during the first intervention, a partial resection of the stellate ganglion (ganglion cervical inferior) was performed. There was a temporary benefit which lasted a few months. Medical long term treatment was unsuccessful. However, no further necroses occurred and the intermittent pain is tolerable.
The article reviews available pathophysiological evidence for a multifactorial etiology of the Raynaud type of peripheral circulation disorder in persons exposed to vibration from handheld tools and discusses the consequences this viewpoint may have for diagnostics, preventive work, and research.
A young women with a history of Raynaud phenomenon, without underlying disease, manifested spasms of the tongue at times when the episodes of the hands were most severe. Striking changes in the appearance of the tongue occurred.
Thirteen patients with Raynaud's phenomenon were studied; six patients had the primary disorder and in the other seven progressive systemic sclerosis was diagnosed. Each patient received 10 mg of nifedipine; telethermographic evaluation of the hands was performed in basal conditions and 30 minutes after the administration of the drug. A more marked increase of hand tissue temperature was observed in the patients with progressive systemic sclerosis than in those with the primary disorder.
Explore the source record for details and available documents.
Explore the source record for details and available documents.