[Edema of the hand during secondary swelling of the arms: primary etiopathogenic hypotheses].

Iatrogenic swollen arms following surgery and radiation therapy after breast cancer, may be -or not- associated with a swollen hand: the percentage is approximately 50%. This study attempts to formulate a few hypotheses regarding the pathogenesis of this distal edema. Clinical examination, lympho-phlebography, isotopic scintigraphy and exploration of the microcirculation (periungual capillaroscopy, distal plethysmography and distal Doppler) were performed in ten patients with hand edema.

[Lymphopathy in postphlebitic disease].

Embryology, anatomy and physiology clearly demonstrate the relationship and interactions between the venous and lymphatic systems. It was therefore logical to expect mutual repercussions of the two systems on the pathological process. In the course of the post-phlebitic disease, structural and functional anomalies of the superficial and deep lymphatic system are demonstrated y microfluoroscintigraphy and isotopic lymphoscintigraphy.

[Iatrogenic venous pathology and post-radiosurgery swollen arm. Apropos of 100 cases].

Lymphostasis of the upper limb, succeeding the radiosurgical treatment of breast cancer, has been known for some time, along with the clinical entity generally called "swollen arm". Post radiosurgical venous disorders have, however, been much less studied, and so the author's survey is based on a systematic, clinical, and phlebo-lympho-scintigraphical study of 100 case histories. Out of the 100 cases studied, almost 80% presented mixed lympho-venous anomalies, whilst 25% of the cases proved to be "swollen arm" of purely venous origin.

[Comparative study of the clinical examination and the Doppler examination of the external saphenous vein: apropos of 191 cases].

The systematic investigation of the short saphenous vein, from its terminal anastomosis in the popliteal space to the retromalleolar sulcus, using a doppler examination, produces a number of contradictions in comparison with the traditional clinical examination using palpation and succussion sign. In fact, 207 contradictory cases have been detected in which 2/3 of the Doppler examinations were positive without obvious clinical signs, then only 1/3 were positive at clinical examination, and 2/3 negative using the Doppler. These contradictory results ought, in the author's opinion, to mean the systematic use of the Doppler, at least the ultrasound, in standard examinations of the short saphenous areas.

[Lymphatic involvement in postphlebitic disease].

Veins and lymph ducts are closely linked anatomically, embryologically and physiologically. It is therefore not surprising that such a close relationship should reemerge in the pathology of each. Post-phlebitic disorders provide a classic example of this.

[New local therapy in the treatment of leg ulcers: Biostim cream].

The treatment of leg-ulcers involves two sections which are theoretically distinct but in practice closely related: aetiological therapy which aims at correcting the causal factor or factors, and local treatment which is intended to facilitate detersion, granulation, and finally epidermization. Amongst the new local therapies, glycoproteins extracted from Klebsiella pneumoniae (Biostim cream) have immunostimulant properties and have a detersive action, facilitating the granulation, and because of their indirect bactericidal action mean that local antibiotics can be avoided.

[Therapeutic principles of lymphostasis of the extremities].

After a short reminder of the posological classification of the lymphoedema of the limbs, the author describes the channels of lymphatic return and their anatomical structure. The medication of lymphostasis aims to increase the lymphatic flow. It is often the association of the various forms of medication (antialdosterone-benzopyrones) that leads to the increased lymphatic evacuation.