Blood flow and blood pressure in fingers in generalized scleroderma.

Sympathetic hyperactivity cannot be implicated in the peripheral vascular disturbances in patients with generalized scleroderma. On the contrary, there seems to be some evidence for a sympathetic hypoactivity in these patients and there seems to be good reason to abandon sympathectomy in the treatment. Vasodilator drugs can be hazardous in late-stage scleroderma due to the possibility of redistribution of blood flow and a decrease in systemic blood pressure.

Treatment of chlamydial urethritis in men and Chlamydia trachomatis-positive female partners: comparison of erythromycin and tetracycline in treatment courses of one week.

Seventy-one consecutive men who had Chlamydia trachomatis-positive nongonococcal urethritis were assigned randomly to treatment for one week with either tetracycline or erythromycin (1g daily). Seventy men completed the study. At follow-up, there were two therapeutic failures among 36 patients treated with erythromycin, and two failures among 34 patients treated with tetracycline.

The effect of leukotriene C4 and D4 on cutaneous blood flow in humans.

Using a laser-Doppler-flowmeter the microvascular response to LTC4 and LTD4 was measured. Intradermal injection of 1 microgram LTC4 and LTD4 caused an increase in the microvascular cutaneous bloodflow. The increase in flow was equal to that caused by histamine in equimolar amounts.

Propylthio-uracil-induced cutaneous vasculitis.

Three cases of cutaneous vasculitis, leukocytopenia and arthralgia, presumably caused by the antithyroid drug Propylthio-uracil, are presented. Acute vasculitis of the superficial and deep dermal blood vessels accompanied by vascular thrombus formation were found in biopsy specimens. Direct immunofluorescence studies demonstrated deposits of C3 or IgM and C3 in the walls of vessels in affected and unaffected skin, suggesting immune complex deposition.

Blood flow in fingers in generalized scleroderma with Raynaud's phenomenon: influence of arterial blood pressure reduction and proximal vasodilatation.

Maximum reactive hyperemia following vascular occlusion can be taken as an estimate of tissue blood flow capacity. Ten patients with generalized scleroderma and Raynaud's phenomenon and 7 normals were studied. Blood flow was estimated in subcutaneous tissue of fingers by the local 133Xenon washout technique.

CT in retroperitoneal fibrosis.

Of 23 cases of surgically proven retroperitoneal fibrosis evaluated by computed tomography (CT), 11 were examined preoperatively, while 12 were examined by CT in a retrospective study. The fibrosis appeared as a prevertebral retroperitoneal mass or as a fibrous sheet covering the central vessels and the ureters in 15 patients. The CT appearance corresponded well with the surgical findings in these cases.

Regional differences in microvascular responses in generalized scleroderma.

In 7 patients suffering from generalized scleroderma of the acrosclerosis type, a decreased reactivity towards changes in vascular transmural pressure was observed in subcutaneous tissue of finger, as compared with arm. Clinically, the fingers were regularly found to be more severely involved in the sclerodermal process, and the pathologic microvascular responses seem to parallel the tissue pathology.

Influence of orthostatic pressure changes on blood flow in fingers in generalized scleroderma.

Autoregulation of blood flow, i.e. tendency towards the maintenance of constant blood flow during changes in arterial perfusion pressure head, has previously been demonstrated in human cutaneous and subcutaneous tissue.

Excess cumulative blood flow and repayment during reactive hyperemia in human cutaneous tissue.

The influence of duration of vascular occlusion upon the reactive hyperemic response in human cutaneous tissue was studied in 6 subjects. Blood flow in cutaneous tissue was measured dorsally on the distal phalanx of the second finger by the local 133Xenon washout technique. Post-occlusive blood flow, calculated from the steepest part of the 133Xenon washout curve just after release of vascular occlusion, reached a maximum value when duration of vascular occlusion was 12 min.

Abdominal aortic aneurysm in combination with retroperitoneal fibrosis.

During the 10 year period 1969-1979 145 patients with abdominal aortic aneurysm and 21 patients with retroperitoneal fibrosis were surgically treated in our department. Five patients had both disorders simultaneously. In four of them one or both ureters were involved in the fibrotic process and ureterolysis was performed in three and a nephrectomy in one.

Abdominal ultrasound angiography.

It is possible with modern high-resolution gray-scale static and dynamic ultrasound scanners to visualize the abdominal aorta with most of its branches, the inferior vena cava with tributaries, and the portal venous system. The demonstration of aortic aneurysms is the major indication for ultrasonic scanning in relation to vascular surgery, but an ultrasound examination may also visualize a number of inferior vena caval and portal venous system abnormalities. A number of nonvascular disorders may be disclosed as well and a suspicion of hematoma or abscess formation postoperatively can be readily confirmed by ultrasonic scanning.

Vibratory perception in patients with generalized scleroderma.

The vibratory perception threshold (VPT) was measured on eight different test-spots in 13 patients suffering from generalized scleroderma of the acrosclerosis type without clinical evidence of peripheral neuropathy. VPT was significantly elevated in skin areas severely involved in the sclerodermic process, whereas normal on test-spots with less affected skin. The pattern of impaired vibratory perception differs from that usually seen in peripheral neuropathy and it is concluded that the pattern most probably reflects the viscous-elastic properties of the test-spots, indicating that cutaneous sclerosis exerts a damping effect on external vibrations.

Computed tomography in the evaluation of a pelvic tumor.

A case of a pelvic tumor evaluated preoperatively by computed tomography (CT) is reported. Conventional radiology suggested pelvic lipomatosis, but CT revealed a solid tumor without fat deposits.

'Distensibility' of the papaverine-relaxed vascular bed in human subcutaneous tissue.

The effect of an increase in vascular transmural pressure upon the blood flow in two subcutaneous vascular beds, maximally dilated by papaverine was studied in 6 healthy humans. Blood flow was measured on the dorsum of the hand and at the lateral malleolus by the local 133Xe washout technique. Increase in vascular transmural pressure was induced by lowering the labelled area various distances below heart level.

Local regulation of digital blood flow in generalized scleroderma.

A decreasing activity of the vascular bed upon changes in vascular transmural pressure and changes in arterial perfusion pressure head was observed from hand to fingers and from subcutis to cutis in patients suffering from generalized scleroderma. These findings are expressions of deteriorating vascular smooth muscle function. The reactive hyperemia response was decreased in subcutaneous as well as cutaneous tissue in patients fingers and in 4 of 7 patients the response was absent from the finger tip.