[Intra-arterial thrombolysis with the combination of urokinase and lysyl-plasminogen. 27 cases of acute arterial obliteration of the lower limbs].

Twenty-five in situ thrombolysis using Lysyl Plasminogen and low doses of urokinase were performed on 25 acute, recent and severe arterial occlusion of lower limbs. Early success were 56% and 44% with a follow up of 5 months. Complications were very limited.

[Multiple arterial lesions in von Recklinghausen's disease. A case].

Arterial lesions are thought to be rare in neurofibromatosis. In the case reported here full vascular exploration demonstrated diffuse lesions of the aorta, splenic artery, renal arteries, left internal carotid artery, right common iliac artery and arteries of the legs. This underlines the usefulness of thorough angiographic exploration when arterioplasty is envisaged in a patient with neurofibromatosis.

[Spontaneous pneumoperitoneum in scleroderma].

A spontaneous and asymptomatic pneumoperitoneum was observed in two women presenting with pseudoileus resulting from severe gastrointestinal involvement in progressive systemic sclerosis. In the first case, pneumoperitoneum was associated with pneumatosis cystoides intestinalis and remained unchanged during 3 years. As obstruction resisted to medical management, surgery was performed; however at laparotomy neither perforation nor obstruction of the bowel could be found; the patient died during the postoperative course.

Diabetes and insulin: actions and interactions upon the glucose metabolism of rat aorta.

We studied the glucose oxidation to CO2 and the incorporation of glucose into lipids by thoracic aorta from streptozotocin-diabetic rats in two circumstances: 9 minutes exposure of the isolated aorta to insulin, perfused in situ; and one-week treatment with either low--4 units (U)--or high--12 U--daily doses of insulin. Diabetes inhibited the glucose metabolism of media and adventitia. Perfusion with insulin did not influence the depressed metabolism of media but increased that of adventitia.

Fine structural capillary changes and basal lamina thickening in scleroderma (progressive systemic sclerosis) and Raynaud's disease.

Capillary abnormalities were found by electron microscopy in labial salivary gland biopsies obtained from 20 patients with progressive systemic sclerosis (PSS). They consisted of marked thickening and multilayering of basal lamina, degenerative and adaptative endothelial cell changes, alterations of pericytes and perivascular mononuclear cell infiltration. There was no correlationship between the intensity of the capillary abnormalities and the duration of the disease.

[Sclerodermal microangiopathy: a cause or a consequence?].

Microangiopathy is an essential clinicopathological feature of systemic scleroderma, comprising capillary thinning, thickening of the basement membrane and abnormalities of the endothelium which has an abnormally high uptake of radioactive thymidine. The identification of a circulating cytotoxic factor for endothelial cells suggests that the microangiopathy may play a role in the physiopathogenesis of the disease. In practice, microangiopathy can be fully assessed by capillaroscopy in patients with systemic scleroderma.

[Recurrent venous thrombosis].

This report is concerned less with the clinical characteristics of recurrent venous thrombosis than with the current revolution in research into its etiology. Progress in knowledge of hemostasis has advanced the diagnosis of venous thrombosis from the risk factor epoch to that of molecular pathology. In this respect, venous thromboembolic disorder constitutes a particularly stimulating model for increasing understanding of vascular diseases.

Antithrombin III synthesis in rat liver parenchymal cells.

We have previously demonstrated by immunoperoxydase the presence of immunoreactive antithrombin III (AT III) in rat hepatocytes. We now present direct evidence that rat hepatocytes in culture synthesize AT III like immunoreactive material : 35S-methionine was added to the culture medium and incubated with hepatocytes. After incubation, AT III was immunologically characterized in the medium.

[Epidemiologic relations between arteriopathy of the lower extremities and chronic gastroduodenal ulcer].

The authors report the results of a study of 3 565 consecutive patients over 30 years of age, of French nationality living in the Paris region, hospitalised over a 5 year period in a Department of internal medicine and vascular pathology. The incidence of gastroduodenal ulcer was compared in each sex in 10 year age groups in 764 patients with arterial disease and 2 801 patients without arterial disease. The incidence of ulcers was higher in patients with occlusive arterial disease in men in the 50 to 59 year age group (20,4 p.

[Erasmus syndrome in a dental technician. Importance of the prevention of occupational hazards].

A case of generalised scleroderma is reported in a dental technician exposed to the risk of silicosis. A study of the occupational toxic risks in this patient showed pulmonary overload with silica and metallic particles composed of chromium, cobalt and tungsten. The job also involved the handling of vinyl chloride and its stable polymer.

[Aortic insufficiency and Takayasu disease].

Six cases of this rare association (7 to 10 p. 100 of Takayasu's disease) are reported. The authors also review 73 previously reported cases.

[Takayasu's disease: diagnosis].

Takayasu's disease is a syndrome of inflammatory arteritis involving the aorta and its branches due to varying etiologies. The diagnosis is usually made after clinical, radiological and biological investigations, but the pathognomonic sign of the disease is inflammatory sclerosis of the adventitial media. There appear to be five prognostic factors: hypertension, arterial aneurysm, aortic regurgitation, coronary insufficiency, and retinopathy.

[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.

Systemic arterial compliance in patients with arteriosclerosis obliterans of the lower limbs. Observations on the effect of intravenous propranolol.

Hemodynamic parameters and systemic arterial compliance were measured in patients with arteriosclerosis obliterans of the lower limbs before and after acute administration of propranolol. Arterial compliance was evaluated from a simple viscoelastic model, enabling the calculation of diastolic drainage and diastolic blood flow as indices of the reservoir role of the larger arteries in overall circulation. In comparing basal conditions with normal subjects of the same age, patients with arteriosclerosis obliterans exhibited a significant decrease in arterial compliance (p less than 0.

[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.