Biomedical subjects
Publications and source records attributed to U Wiemers.
From the point of view of the dermatologist vasculitides of the superficial and deep vascular stage of the skin relevant to practice are described. The author enters the etiology, the clinical picture, the differential diagnosis as well as the external and internal treatment.
The diagnosis of the lymphatic oedema is possible by means of non-invasive methods. The degree of severity of the lymphatic oedema can already be assessed within the basic diagnostics (anamnesis, clinical findings). The recognition of secondary lymphatic oedemas is important, particularly of those due to tumours of pelvic organs. Indications and contraindications of other diagnostic methods (plethysmography, dye test, computer tomography, sonography, lymphography) in diseases of the lymphatic vessels are presented.
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Plethysmographic examinations on 47 females with slight primary varicosis to primary varicosis of medium degree resulted in excessive values of the swelling inclination and the change of the venous capacity V30 compared with the normal values reported in literature, whereas the venous regurgitation was in the superior normal region. By sclerosation treatment no significant change of the pathological venous measuring values could be achieved. In a good cosmetic success and directed influence of the locally disturbed haemodynamics could, therefore, not be spoken about the restoration character of the sclerosation treatment for the disturbed venous haemodynamics.
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Acute diseases of the veins, in most cases thromboses, cause inability to work in almost all cases; in profound phlebothromboses hospital treatment is indicated. In the chronic venous insufficiency the functional capacity can be decreased especially bey pains, inclination to swelling and changes of the skin (congestive dermatoses, ulcera). Eventual basic diseases and concomitant diseases render the judgment difficult. Experienced treatment under active collaboration of the patient may improve the functional capacity in most cases. The daily load of the patient by profession and so on, and the often changing course of chronic diseases of the veins must be taken into consideration in the estimation. On the basis of a stage-plan proposed by Kornotzki and coworders the evidence of selected phlebological methods (anamnesis, state, tourniquet-tests, measurement of the venous pressure, functional phlebography) is discussed. It is particularly referred to plethysmographic functional tests of the veins.
From 1970 to 1974 in the dermatological clinic of Leipig University in 17 women and 3 men a necrobiosis lipoidica was established. Of these patients hitherto 12 female patients with histologally ascertained diagnosis underwent a clinico-angiological follow-up examination. Apart from this metabolic disturbances were thought for. In two thirds a disturbance of the carbohypdrate metabolism, in three fourths a disturbance of the lipometabolism was found; hyperlipoproteidaemia and diabetic change of the metabolism were simultaneously present in 7 out of 12 female patients. Uric acid level of the serum and rheumatic serology were, however, rarely pathological. A disturbance of the arterial blood supply of the legs could be ascertained in three fourths of the women who underwent a control examination. In these cases 15 to 19 extremities affected with necrobiosis had a disturbance of the blood supply. The microangiopathy histologically provable in foci of necrobiosis was to be seen only in one long-term diabetic also on the eye-ground. One third of the female patients suffered from hypertension. In all cases disturbances of the carbohydrate metabolism or of the lipometabolism and/or of the local blood supply could be proved. On the basis of these findings adequate examinations are recommendable in patients with necrobiosis lipoidical with regard to therapeutic consequences.
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