[Stemmer's sign--possibilities and limits of clinical diagnosis of lymphedema]. / Das Stemmersche Zeichen--Möglichkeiten und Grenzen der klinischen Diagnose des Lymphödems.

The sign of the thickened cutaneous fold of the second toe is typical for the early and differential diagnosis of a primary ascending lymphedema without false positive findings. It appears in the late stages of the descending lymphedema.

[Theoretical and practical bases of compression]. / Bases théoriques et pratiques de la compression.

The pressure applied by rigid or elastic compression of the skin surface of a limb is exerted as a function of two parameters. Pressure applied by an elastic tissue acts according to Laplace's law, varying with the tension of the elastic tissue and the radius of the curve of the area compressed. A rigid dressing acts solely by alternating working and resting pressures. Superficial pressure is transmitted to the extra- and intra-fascial compartments through the intermediary of an increase in tissue pressure. This pressure extension acts on all the compressible structures of the limb. It reduces the caliber of the veins in all compartments, and therefore the total venous blood volume of the limb, and increases the rate of circulatory return. The venous pressure adapts itself to the pressure of the dressing. The action on the vessel wall is seen as an increase in fibrinolytic activity and the proliferation of contractile myocytes. Its principal effect, however, is on vascular-tissue integrity: it diminishes interstitial edema and compacts the connective tissue fibrils, decongests the capillary endothelium and reduces the pericapillary sleeve of mucopolysaccharides. But it increases basal membrane thickness. Too high a pressure provokes collapse of the lymphangions. The rheologic action of the compression results in a decrease in blood viscosity. The effect of the compression is to induce local reabsorption of venous edema, while lymphatic edema is displaced towards the root of the limb to a zone where it may be reabsorbed. All these phenomena are reversible on removal of the compression treatment.

[The postphlebitic syndrome in the obese]. / Le syndrome postphlébitique chez l'obèse.

It has been shown that the frequency of deep thromboses of the lower limbs increases with the weight of the patient. Post-phlebitic syndromes ought, therefore, to occur more frequently in obese patients. On the other hand, the role of ponderal overloading as an exacerbating factor in post-phlebitic syndrome can only be proved indirectly.

[Anatomical study on the constancy of Cockett's perforating veins]. / Etudes anatomiques sur la constance des perforantes de Cockett.

The tenet of the constancy of Cockett's perforating vessels does not hold against anatomical studies. They perforate the fascia at various levels as their relationship to Linton's line also vary. Finally, they originate, most of the time, from the communicating veins connecting the posterior leg branch and the internal saphenous vein.

[Dosage of O-beta hydroxyethylrutoside in chronic venous insufficiency]. / Posologie de l'O-beta hydroxyéthylrutoside dans l'insuffisance veineuse chronique.

45 patients suffering from varicose veins with or without a chronic insufficiency up to stage II, took 1, 2 or 3 g of Oc-beta hydroxyerhylrutoside P.O. Photo reflexometry and plethysmography with mercury gauge demonstrated the results. The various parameters showed the medication to be effective after 10 and 21 days of treatment. A dosage adjusted to the gravity of the venous involvement improves the venous pump of the leg and therefore the venous return.

[Junctions of the saphenous vein. Anatomy and treatment concepts]. / Les crosses saphéniennes. Anatomie et concepts thérapeutiques.

The anatomic account brings to bear particularly on anomalies of the affluents and the various forms of long saphenofemoral junctions. The different anastomoses of short saphenous veins are also described. Following the anatomic account there is a run-down of the history of these disorders and of mainstream current views of their treatment.

[Ultrastructure of the media and biochemistry of the intercellular substance of the wall of varicose veins]. / Apercu de l'ultrastructure de la média et de la biochimie de la substance intercellulaire de la paroi des veines variqueuses.

A description using electronic microscope examinations the ultrastructural modifications affecting myocytes and the intercellular substance of the walls of varicose veins. They also have an effect on the biochemical composition of the intercellular substance.

[Noninvasive functional exploration using photoreflexometry]. / Exploration fonctionnelle non-invasive par photoréflexométrie.

Photoreflexometry measures the filling time of the intradermic venous plexus and quantifies the function of the venous pump in the leg. Thus it completes the other methods of venous functional investigation and provides data-figures on the seriousness of post-phlebitic illness. The essential interest of the non-invasive examination is that it makes it possible to read the phlebographic and therapeutic indications more discerningly.