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Biomedical subjects

I Sarkany

Publications and source records attributed to I Sarkany.

At least 19 recordsLinked to original sources
PubMed1990

Venous leg ulcers and arthropathy.

Reduced ankle mobility impairs the venous muscle pump and this leads to an increase in mean venous pressure in the lower leg. We have previously shown that pressure-induced venous distension leads to cutaneous hypoxia which is caused by arteriolar vasoconstriction in response to a spinal reflex. The prolonged cutaneous hypoxia which is thus a consequence of sustained elevation of venous pressure is an important factor in the development of gravitational ulcers. It is postulated that the increased incidence of leg ulcers in patients with rheumatoid arthritis is the result of impairment of the efficiency of the venous muscle pump by reduced ankle mobility. Conversely, the elevation of venous blood pressure in patients with venous insufficiency may lead to arthropathy in the ankle. The hypothesis is presented that prolonged elevation of venous blood pressure causes injury to both the ankle joint and veins leading to chronic reciprocal damage to both. This explains the frequent association between arthropathy of the ankle and venous leg ulcers.

Ankle Joint↗
PubMed1990

Metastatic Crohn's disease.

We have reported two further cases of metastatic Crohn's disease (MC), one of whom presented with a widespread symmetrical perifollicular papular eruption on the arms and legs not previously reported. In view of the varied clinical appearances the incidence may be underestimated and consequently we feel that more patients with Crohn's disease who develop skin lesions should be biopsied.

Adult↗
PubMed1989

The short-term benefit and long-term failure of ultraviolet light in the treatment of venous leg ulcers.

Ultraviolet light has in the past been advocated for the treatment of venous leg ulcers on the assumption that it increases skin blood flow and reduces skin hypoxia. Our results show that UV light increases skin-oxygen tension of the lower leg and inhibits the normal vasoconstrictor response on standing. However, this effect is short lived and is followed after 2 days by a return of the vasoconstrictor reflex and a marked decrease in skin oxygenation which continues for at least 2 weeks. Since UV irradiation improves skin oxygenation for only 48 h, it cannot be recommended as a form of treatment for venous leg ulcers.

Adult↗
PubMed1989

Urethral fistula and sinus formation in hidradenitis suppurativa.

Two patients with severe hidradenitis suppurativa are reported. In Case 2, with widespread and superficial disease without communication with internal organs, there was a good response to intensive surgical intervention. In the patient with hidradenitis suppurativa and urethral fistula formation adequate surgical treatment was not technically feasible and treatment had to be continued for at least 2 years without permanent cure in sight. A search of the literature confirms that this differentiation is important as the cases with fistulous involvement of internal organs tend to have a bad prognosis.

Adult↗
PubMed1989

Surgical correction of venous incompetence restores normal skin blood flow and abolishes skin hypoxia during exercise.

Posture has long been recognized to be a crucial factor in the etiology of venous leg ulcers. Activation of the stretch receptors in the veins by venous distention induces reflex vasoconstriction and hypoxia. In patients with defective venous return, exercise fails to reduce venous pressure when the legs are dependent; therefore, hypoxia persists during exercise. Surgical treatment of venous incompetence abolishes the abnormal venous reflux and restores the normal vasodilator response to exercise, thereby correcting the sustained hypoxia observed in patients with venous leg ulcers.

Bandages↗
PubMed1988

Erythropoietic protoporphyria exacerbated by oral iron therapy.

Four patients with erythropoietic protoporphyria (EPP) are reported, in whom oral iron produced clear-cut clinical and biochemical deterioration. This suggests that there are two biochemically and genetically distinct sub-groups of EPP patients distinguished by their dramatically different response to oral iron.

Adult↗
PubMed1988

Transcutaneous oxygen tension in legs and feet of diabetic patients.

Transcutaneous oxygen tension (tcPO2) of the legs and feet was measured at 37 and 44 degrees C in 21 patients with diabetes mellitus, 9 of whom had peripheral neuropathy. At 37 degrees C, tcPO2 in the legs and feet of diabetic patients with peripheral neuropathy was significantly higher (P less than .02) than in control subjects and diabetic patients without neuropathy. Whereas tcPO2 in the legs of control subjects and nonneuropathic diabetic patients was greater than in the feet (P less than .02), this leg-to-foot difference was absent in diabetic patients with neuropathy. After an increase in skin temperature to 44 degrees C, tcPO2 increased in the legs and feet of all three groups, but the increase was smallest in diabetic patients with neuropathy and greatest in control subjects. In neuropathic (P less than .02) and nonneuropathic (P less than .02) diabetic patients, tcPO2 was significantly lower than in control subjects. These data are consistent with a loss of vasoconstrictor tone in the blood vessels perfusing skin and subcutaneous tissue at 37 degrees C and an inability of these vessels to vasodilate and increase blood flow at 44 degrees C in diabetic patients in general and neuropathic diabetic patients in particular. This inability to increase tcPO2 after an increase in temperature and possibly other vasodilatory stimuli may contribute to the pathogenesis of nonhealing ulcers, protracted infections, and gangrene, which characterize the diabetic foot.

Adolescent↗
PubMed1987

The use of the Hellige Oxymonitor to study skin blood flow changes.

Transcutaneous oxygen tension is a flow related parameter. Detailed analysis of the physiology and physical chemistry of oxygen consumption and diffusion indicates that tcPO2 is not proportional to skin blood flow. Measurement of tcPO2 at 37 degrees C allows changes in skin blood flow to be clearly demonstrated and is of use in many areas of clinical medicine. Transcutaneous oxygen tension recorded using a polarographic oxygen electrode depends on skin blood flow, skin respiration, arterial oxygen concentration, temperature, skin and electrode permeability and the oxygen consumption of the electrode. Applying clearance principles, the relationship between blood flow, respiration and the difference between arterial and venous oxygen concentrations is well established. This has long been used to measure cardiac output, since the other three parameters are readily determined. Arterial saturation is normally greater than 95% of maximum in subjects without lung disease and it may thus be considered to be constant. Tissue respiration is independent of oxygen concentration when PO2 exceeds 2 mm Hg. If skin respiration is invariant at constant temperature, when the tissue oxygen tension exceeds 2 mm Hg, then blood flow is inversely proportional to the difference in concentration between arterial and venous blood. It has recently been directly shown that the inference that tissue respiration is independent of tissue blood flow is accurate. Correcting for the oxyhaemoglobin dissociation curve and for the deviation from zero order respiration kinetics when tissue PO2 less than 2 mm Hg, the relationship between venous oxygen tension and blood flow at 37 degrees C is shown when arterial oxygen concentration is constant (Figure 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗