Clinical Observations on the Capillary Circulation

Freedlander, Samuel O.; Lenhart, C. H.

doi:10.1001/archinte.1922.00110010017002

Cited by 32 publications

(19 citation statements)

References 13 publications

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“…Cases of cardiac decompensation, however, showed marked dilatation of the venous limb and the blood stream was slow and had a granular appearance. These findings were in the main confirmed by Schur (2), Jurgensen (3), Neumann (4), Secher (5), Freedlander and Lenhart (6). Secher, however, described a normal capillary picture in this condition in spite of symptoms of cardiac insufficiency.…”

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confidence: 59%

Studies on Human Capillaries

Crawford

Rosenberger²

1927

J. Clin. Invest.

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In previous studies of the capillary circulation it was found that changes in the calibre of the capillaries took place continuously, both in health when the rhythm of the heart is regular, and in auricular fibrillation. The extent of these changes appeared to depend on the state of circulatory compensation and was independent of the rate or regularity of the pulse. Similar variations were observed in advanced decompensation both in cases of regular and of irregular rhythm. The present investigation was undertaken to study the changes which take place in heart disease with regular rhythm from the early to the late stages of the disease. Weiss (1) found in his studies of the capillaries in living subjects that cases of mitral insufficiency without cardiac decompensation showed a normal picture, while in the early stages of mitral stenosis a distinct slowing of the stream was observed. Cases of cardiac decompensation, however, showed marked dilatation of the venous limb and the blood stream was slow and had a granular appearance. These findings were in the main confirmed by Schur (2), Jurgensen (3), Neumann (4), Secher (5), Freedlander and Lenhart (6). Secher, however, described a normal capillary picture in this condition in spite of symptoms of cardiac insufficiency. HisingerJagerskiold (7) studied a large number of cases of valvular and myocardial heart disease with regular rhythm. He stated that cases with full compensation or with only slight decompensation did not differ from normal subjects but those with clinical signs of decompensation as a rule showed the changes described by Weiss in this condition. He 317

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confidence: 59%

Studies on Human Capillaries

Crawford

Rosenberger²

1927

J. Clin. Invest.

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“…The subpapillary plexus was more distinct than in normal subjects. These findings were confirmed by Schur (2), Jurgensen (3), Neumann (4), Secher (5), Friedlander and Lenhart (6). Secher (5) stated that early cases of mitral stenosis showed a normal picture.…”

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confidence: 76%

Studies on Human Capillaries

Crawford¹,

Rosenberger²

1926

J. Clin. Invest.

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In a study of the adjustment of the circulatory mechanism to different abnormal conditions in the heart the changes induced by circulatory failure are of special interest. As auricular fibrillation is an important cause of heart failure the study of cases of this nature is particularly important.The first microscopic studies of the capillaries in living subjects in heart disease were made by Weiss (1) who found that in cases with good compensation the capillaries resembled those of normal individuals. In the early stages of mitral stenosis however a distinct slowing of the stream was often observed while in some cases of pulmonary stenosis there was very marked stasis. Advanced cases of cardiac decompensation showed marked dilatation of the venous limb, a tendency to tortuosity of the capillaries and a dark red color of the tissues in which the capillary loops were situated. The color of the latter varies with the intensity of color of the blood flowing in the deeper lying vessels. The blood stream was slow and discontinuous and the flow had a granular appearance. The subpapillary plexus was more distinct than in normal subjects. These findings were confirmed by Schur (2), Jurgensen (3), Neumann (4), Secher (5), Friedlander and Lenhart (6). Secher (5) stated that early cases of mitral stenosis showed a normal picture. Marked stasis was described by Rominger (7) in a case of pulmonary stenosis. Hisinger-Jagerskiold (8) carried out an extensive study in cases of heart disease of valvular and myocardial origin in some of which the pulse was regular and in others irregular. He stated 365

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“…Embora alguns autores não a correlacionassem com a doença, considerando-a como um achado comum no jovem, a tortuosidade da alça capilar foi significativamente mais freqüente nas crianças com DM por nós estudadas (p< 0,001) (tabela 2) (11,21).…”

Section: Discussionunclassified

“…Entretanto, não encontramos encurtamento de alças na maioria das crianças com DM estudadas. Este fato pode ser explicado pela melhor transparência da pele nesta faixa etária o que permite, ao contrário do adulto, uma melhor visibilidade de alças (21).…”

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Capilaroscopia da prega ungueal em crianças com diabetes mellitus tipo I

Fernandes

Bernardini

Morais

et al. 2001

Arq Bras Endocrinol Metab

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RESUMOO estudo teve como objetivo identificar o aspecto morfológico da microcirculação, em crianças com e sem diabetes mellitus (DM), pela capilaroscopia de prega ungueal das mãos. Foram selecionadas 30 crianças com DM do tipo 1 (DM1) e 24 crianças sem DM, pareadas quanto ao sexo, cor e idade. Encontrou-se aumentos significativos de freqüência de dilatação e tortuosidade de ramos transverso e eferente e microectasias em relação aos controles. Não houve aumento significativo da freqüência de edema nas crianças com DM pela alta freqüência desta alteração no grupo controle. Ao contrário dos adultos com DM, houve predominância de espasticidade do ramo aferente e o longo comprimento das alças foi preservado. O padrão descrito na microcirculação no presente estudo pode ser importante para o diagnóstico das complicações vasculares da doença. ABSTRACTThirty patients with type 1 diabetes (DM1) (target group) and 24 controls were studied through nailfold capillaroscopy. Both groups were age, color and sex matched. Statistically significant high frequencies of edema, dilatation and tortuosity of efferent branches and microectasy were found in microcirculation. Dermal papillae rectification as an isolated finding did not characterize edema because its frequency was high among controls. Rather than is reported in type 2 DM, afferent branch spasticity and long loops were significantly frequent among the target group. These data suggest that nailfold capillaroscopy may be an important method for the diagnosis and follow up of vascular abnormalities in DM1. A DESCOBERTA DA INSULINA, EM 1922, aumentou a longevidade dos pacientes com diabetes (DM) pela melhoria do controle metabólico (2). As complicações vasculares, no entanto, passaram a ganhar importância pelo comprometimento da qualidade de vida, redução da capacidade produtiva e aumento da mortalidade de pacientes com DM. Desde então, as alterações da microcirculação vêm sendo estudadas com mais profundidade.Jager, em 1855, e mais tarde Weiss, em 1916, já haviam observado padrão vascular anormal no fundo de olho de diabéticos, que foi claramente relacionado à doença por Waite e Beetham, em 1935, e descrito no glomérulo por Kimmelstiel e Wilson um ano depois (23,25,44,45).O termo microangiopatia diabética foi criado por Lundbaeck em 1953, que descreveu lesões anátomo-patológicas caracterizadas, inicial-

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Clinical Observations on the Capillary Circulation

Cited by 32 publications

References 13 publications

Studies on Human Capillaries

Studies on Human Capillaries

Studies on Human Capillaries

Capilaroscopia da prega ungueal em crianças com diabetes mellitus tipo I

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