Capillary Fragility Research Articles

Effects of Lemon Bioflavonoid Complex in a Clinical Case of the Hemorrhagic Syndrome

Abstract THE condition known as the hemorrhagic syndrome (Baker and Jaquette, 1953; Cartrite, 1954) or avian aplastic anemia (Hanley, 1962) occurs sporadically in Central Louisiana in both broilers and young pullets. The outbreaks are usually severe and fail to respond to any one or a combination of treatments; mortality has exceeded 20% in some instances with complications such as CRD, coccidiosis, enterohepatitis, and peritonitis expected in most cases. The usefulness and productivity of the surviving birds is greatly reduced. The condition has caused serious economic loss among some of the progressive producers and remains a constant threat (Kaiser, 1958). Warter et al. (1948) reported that hesperidin-C had a beneficial effect on capillary fragility in rheumatoid arthritis patients. Other investigators worked with capillary permeability and the effects of the “vitamin P-like” compounds (Haley, 1951). The role of the citrus bioflavonoids in reducing capillary fragility has been investigated in several fields and has…

Avascular necrosis of bone following systemic steroid therapy.

Avascular necrosis of bone and resultant joint destruction are uncommon and generally unrecognized complications of systemic corticosteroid therapy (1, 3, 7, 12, 14). Few examples with no associated bone or joint disease have been reported in the literature (1, 2, 13). Recently, however, such a case was seen at The Christ Hospital (Cincinnati, Ohio). Case Report Mrs. E. M., a 50-year-old white woman, had a subtotal thyroidectomy in 1929, a pelvic laparotomy for adhesions in 1934, a right salpingo-oophorectomy and appendectomy for tubal pregnancy in 1938, and a total colectomy with an ileostomy in 1945, for what was diagnosed elsewhere as an “elongated, atrophic, atonic colon.” She had been taking desiccated thyroid daily since 1934. In 1955, she noticed the occurrence of easy bruising after only slight trauma and occasional bloody drainage from the ileostomy. Some increase in capillary fragility was demonstrated, but there was no thrombocytopenia. Then, in 1957, there was a recurrent episode of purpura wi...

Permeability of Dermal Connective Tissue in Normal and Scorbutic Guinea Pigs

RECENT work has shown that the permeability of capillary blood vessel walls does not seem to be affected by scurvy1 despite the presence of haemorrhages. However, capillary resistance was shown to decrease2–6 and the corresponding capillary fragility increased6,7. No investigations of the influence of scurvy on the permeability of dermal and connective tissue have been made.

Capillary Permeability as Measured by the Amsler-Huber Fluorescein Test in Bleeder Families on the Åland Islands

SummaryIn a series of 47 subjects aged 6—80 years belonging to bleeder families on the Aland Islands the capillary permeability in the blood-aqueous barrier was studied by the Amsler-Huber fluorescein test and the capillary fragility was simultaneously tested according to the Rumpel-Leede method. In most of the cases investigated, the haemorrhagic diathesis had been thoroughly examined by modern coagulation tests. No consistent correlations were observable between capillary permeability and bleeding time as determined previously or at the time of the present study. Capillary permeability was found to decrease with age, just as does the haemorrhagic tendency itself. Capillary fragility was often, but not invariably, accompanied by capillary permeability. When the probands in the Åland bleeder families exhibited both a history of serious haemorrhages, markedly prolonged bleeding times and pathological capillary fragility, the response to the Amsler-Huber fluorescein test was often, but not invariably, pathological and appeared to be most strongly correlated with capillary fragility (RumpelLeede).Two subjects, mother and daughter, responded to fluorescein injection by a relatively severe allergic reaction. Nonetheless, markedly increased permeability was not observable in the capillary system of their eyes.In the Aland bleeder syndrome there are marked fluctuations in the history of bleeding, bleeding time, capillary fragility and certain coagulation tests. Similarly, there seem to be obvious variations, both intra-familial and intraindividual, in capillary permeability as measured by the Amsler-Huber fluorescein test. No definite correlation was observable between increased capillary permeability and pathological platelet function.

Pterygium in an isolated population.

SUMMARYThe incidence of pterygium was studied in an isolated highly inbred fisher population. A clinical and hematological examination was performed and the blood chemistry was studied. Genealogical tables (pedigrees) were prepared for all probands and the degree of consanguinity in their parents stated. Of the total of 479 subjects studied by random sampling, 19 (4 per cent) had pterygium with a relatively high manifestation age. No linkage was detected between the genes for the blood group systems, serum groups etc. and the gene for pterygium. Increased capillary fragility was established in 10 probands. Capillary permeability was studied in 2 probands by the concentration in the anterior chamber of intravenously administrated fluorescein, and the test was found to be weakly pathological in one of them. The serum cholesterol level was elevated in 5 of the patients studied. Ophthalmological examination indicated the accumulation of degenerative eye diseases. Pingueculum showed a more pronounced development in 10 of the 17 subjects examined than in the rest of the population. The possibility of recessive transmission of the hereditary predisposition is discussed with reference to the high frequency of inbreeding and the accumulation of pterygium within the isolated population. According to the special frequency-raising peristasis conditions in an outer archipelago community and to the mendelian segregation rate, a not sex-linked, simple dominant gene, with low penetrance and no selective disadvantage for the pterygium seems to be the most plausible explanation. Because of the late manifestation age, pterygium was observed only in 2 generations. The expressiveness of the gene was unsteady and asymmetry of pterygium in the eyes of the probands is not uncommon.

Citrus Bioflavonoids in Broiler Diets

CITRUS bioflavonoids are naturally occurring plant pigments characterized by two aromatic rings linked together by a three carbon aliphatic chain (Horowitz, 1957). The various flavonoids may be sugar free aglycones or glycosides characterized by a substituent group of either a mono or disaccharide made up of rhamnose or glucose or both. The classification of these compounds are further governed by the oxidized or reduced state of the third carbon in the aliphatic chain.A number of bioflavonoid materials have been evaluated for their effect on capillary fragility. Warter et al. (1948) reported that the administration of hesperidin (a bioflavonoid) and ascorbic acid was effective in reducing capillary fragility in patients with rheumatoid arthritis. Capillary fragility could be expected to lead to an increase in bruising. Ringrose (1953) and Kaiser and Smith (1958) reported that bruising is one of the major causes of downgrading of broilers. In view of the condemnations …

STUDY OF COLDNESS AND COLD INJURY-CONTINUED-EXPERIMENTAL STUDY ON HOW THE FAMILY LIFE WITH A STOVE INFLUENCES THE HEALTH OF RURAL PEOPLE IN THE COLDEST SEASON-1

We have conducted an experimental study, in the form of both laboratory experiment and field study, with a view to investigating what kinds of injuries the rural people of Tb-hoku District suffer from especially in such places among the mountains as Shinshu, during the coldest season, and to knowing how it may be improved by the introduction of stoves into their family life. As the field we chose Saguchi-buraku, Yachiho-mura, Minami Saku-gun, Nagano Prefecture (a small village 800 meters above the sea). And for the purpose of the experiment we divided the 27 families who were living solely on farming into two groups, one group provided with stoves and the other, the control group, without stoves.a) In the laboratory experiment, the laboratory was kept at 2°-4°C., same as the room temperature in the farm-houses in the coldest season in that district. In this experiment we have obtained the same results as those published in our previous reports on coldness and cold injury, that is, we evidenced such acute cold injuries as the rise of blood pressure, increase of pulse rate, etc., and also such other injuries as the increase of blood sedimentation rate, appearance of blood “sludging” phenomenon of conjunctive bulbi, etc. By staying in the laboratory at 4°C. only for half an hour, the patients with coronal artery sclerosis showed unfavourable changes in ECG findings.b) As mentioned above, we selected 27 families of similar composition, of annual income and of farming scale, from an tig those of Saguchi-buraku who are living solely on farming, and then divided these 27 amilies into two groups, one group provided with stoves (15 families) and the other without them, a control group. Thereupon, all the family members were examined several times, before, during and after the coldest season, as to their physical and mental conditions. It was a matter for regret that the stoves were provided only for two months of the coldest season, but we have succeeded in obtaining some promising results that would corroborate the good effects of stoves on farmers life.1) The results of various physical examinations carried out before and after the coldest season (blood pressure determination, electrocardiogram, phenol red test, blood sedimentation rate, capillary fragility test, gastric juice examination, eye-ground pictures, pressure of arteriae centralis retinae, cold pressure test, blood flow over conjunctiva bulbi, etc.) failed to show satisfactorily convincing difference between the two groups. It may be because the favourable effects on health, which stoves would have produced during the established period, had been blurred once the season was over. However, the fact that the aggravation of eye-ground pictures was definitely less frequent in the subject group than in the control group is considered to be the result worth special mentioning. On the other hand, it was distressing to population, esp. those over 40 years old, who lived in the ordinary stoveless houses during the coldest season.2) Besides, the personal interviews conducted in the midst of the coldest season drew out attention to the marked decrease of neurological symptoms in the subject group. Furthermore, such favourable effect continued to spring time. Another good effect was that the family began to have a happy circle, esp. around the stove.Moreover, in the subject group it has been proved that winter diseases esp. the cases of common cold decreased to less than one third. When we think of the saying “Common cold opens the gate to all diseases.” this fact may also be consideredtobean important good effect.

Radiologic Considerations of the Perinatal Distress Syndrome

During the past decade many articles have appeared in the medical literature describing the causes, symptomatology, and radiologic findings of perinatal distress. Many of these publications include under this terminology any condition responsible for respiratory difficulty in the newborn infant. Consequently, there has developed some degree of confusion regarding the nomenclature of both neonatal and perinatal distress. In the newborn there are many abnormalities, including intracranial lesions, numerous primary pulmonary anomalies, cardiovascular defects, and defects of the diaphragm, which may be responsible for the clinical manifestations of respiratory difficulty. Each of these conditions interferes either mechanically or physiologically with the normal process of respiratory exchange; the cause is usually some anatomical defect which can be recognized by standard clinical, laboratory, or radiographic procedures. Examples include tracheoesophageal fistula, diaphragmatic hernia, congenital heart disease, congenital lobar emphysema, multicystic lung disease, pulmonary agenesis or hypoplasia, intrathoracic masses, and sub-dural hematomas. In addition, in some infants the respiratory distress arises from circumstances which may also affect one or several organs, including the central nervous system, the liver, the adrenal glands, and the alimentary tract. These latter conditions, as well as a select number of primary pulmonary abnormalities which are described below, constitute the perinatal distress syndrome and have the common underlying factor of anoxia and shock (6), occurring in the pre-, intra- or post-partum period. In the perinatal environment a number of obstetrical complications may interfere with the normal circulation across the placenta, resulting in fetal anoxia. It is the purpose of the present paper to discuss the radiologic manifestations of the conditions which in our opinion are the sequelae of hypoxia or anoxia in the perinatal period, i.e., directly prior to delivery, during the birth process, or immediately thereafter: In many instances the obstetrical history will indicate a condition which will be compatible with fetal anoxia. At other times only the effects upon the fetus are evident. Just as there is a common denominator in all of these states, anoxia, there is apparently a common pathogenesis, namely, increased capillary fragility and permeability. Anomalous physiologic responses such as premature respiratory stimulation may also play a role. Neurological influences such as vagal stimulation, with relaxation of the anus, may result in meconium staining of amniotic fluid. The combination of these factors frequently leads to aspiration of amniotic fluid and meconium. The pathologic sequelae of the association of anoxia and increased capillary fragility may be in the form of petechiae or larger hemorrhages.

A Critical Review of the Evidence for a Continuous Hemostasis in vivo

I. ConclusionsInjury to vessels leads to the formation of platelet plugs and fibrin clots. For nearly a century it has been known that these mechanisms stop bleeding and may produce thrombi. They may be triggered by trivial trauma (180), and hemostasis possibly occurs in one or more vessels at all times in the normal body. The blood is capable of removing at least the fibrin part of such deposits; however, some of them may progress into arteriosclerotic lesions (59). The accumulated evidence, therefore, supports the concept of a hemostatic balance on the local level, triggered by an abnormal local factor.In this review, however, we are concerned with a general and continuous hemostasis which takes place on the normal, uninjured endothelium. Direct examinations have suggested that hemostatic products are present on normal endothelium, but these investigations cannot be accepted as conclusive. Much of the indirect evidence is weak or controversial. However, the purpura and increased capillary fragility in platelet disorders strongly suggest that platelets are important for vascular integrity, and animal experiments suggest that both platelets and coagulation influence vascular permeability. At present, therefore, the theory of continuous hemostasis can neither be accepted nor rejected; further evidence must be collected.

The effects of hydrocortisone(11-dehydro-17-hydroxycosticosterone-21-acetate) on the experimental pulmonary edema

Among the various methods proposed for the treatment of acute pulmonary edema, there has been known no definitive method to inhibit permeability of the pulmonary capillaries. On the basis of abilities of adrenocorticoids- to inhibit capillary permeability and to reduce capillary fragility, the author conducted a series of clinical investigations and proved their efficacy. Hydrocortisone was tested for its therapeutic value in experimental pulmonary edema of different pathophysiology produced by three different techniques. A) Materials and Methods 1) Nerogenic pulmonary edema by Reilly phenomenon. (Stimulation of cervical sympathetics in rabbits.) 2) ANTU pulmonary edema in rats. 3) Post-operative acute pulmonary edema produced by the sequence of pneumonectomy, anoxia then intravenous infusion in dogs. B) Methods of administering hydrocortisone. In groups 1 and 2, hydrocortisone 3 mgm per kilogram of body weight was given prophylactically one hour prior to the start of the procedure to produce pulmonary edema. In group 3, hydrocortisone 3 mgm per kilogram of body weight was given by intravenous infusion together with IPPB/i O2 at the establishment of pulmonary edema. A group of dogs was treated with IPPB/i O2 alone as a control. C) Evaluation of therapeutic efficacy. Therapeutic efficacy was compared among the groups mainly on the basis of pathological findings, macroscopically, histologically and by water content of the lungs, upon sacrificing. In addition. prolonged survival time was taken into account in group 2. In group 3, such parameters as respiratory and circulatory functions (pulse rate, femoral arterial pressure, central venous pressure, pulmonary arterial pressure, pulmonary capillary pressure, oxygen saturation and microscopic observation of the omental capillary vessels) as well as X-ray findings of the chest were also considered. Result and Conclusion 1) Excessive stimulation of the cervical sympathetic nerves caused marked congestion in the pulmonary capillaries, hemorrhage and edema into alveoli in rabbits. Hydrocortisone given prophylactically in a dose of 3 mgm. per kilogram of body weight prevented these changes almost completely. 2) The lung of rats given ANTU appeared like liver in consistency, with intense hemorrhage and edema, and all the animals died within four hours. Hydrocortisone given prophylactically in a dose of 3 mgm per kilogram of body weight suppressed those changes and prolonged the survival period to 16 hours or more. 3) Many of the dogs subjected to the sequence of pneumonectomy, anoxia and intravenous infusion developed in typical pulmonary edema. Although improvements in respiratory and circulatory dynamics were noted in the group treated solely with IPPB/i O2, improvements in oxygen saturation, and blood flow in omental capillaries were better in the group treated with hydrocortisone in addition to IPPB/i O2. This was reflected in pathohistological findings and JORDAN II-IV changes still persisted in the control group (IPPB only) whereas in the group treated with hydrocortisone and IPPB only JORDAN C-II changes were noted, and water content of lungs returned to the value noted before edema developed.

Dermatitis with capillary fragility.

In this paper, an attempt is to be made to demonstrate a mechanism of production of progressive pigmentary purpuric disorders, or dermatitis associated with an increased capillary fragility. These capillaroses, as we shall see, are of mixed etiology, but it is hoped in this paper to shed some light in particular on the condition originally described by Schamberg in 1900,1and to which his name is now attached. In Schamberg's first case, the patches are described as sharply defined; of reddish-brown color; varying in size; while at the border are visible a number of small outlying macules of the same color and of the size of pinheads. The borders of other patches show pinhead to pinpoint puncta resembling grains of cayenne pepper. As lesions undergo involution, a slight diffuse yellow-brown staining is left. The disorder began over the shins, and spread over the ankles and feet. There were also

Changes in foot volume and capillary fragility during continuous cold exposure and starvation.

The effects of continuous cold exposure (2 wk. at 60°F) and starvation on foot volume and capillary fragility were studied in six men. The experimental period was preceded and followed by 2-week periods (control and recovery) at 80°F and a caloric intake of 2400 cal. Foot volumes decreased 6.1% in the first 5 hours of cold exposure and remained constant for the remainder of the experimental period. Foot volume was also measured after 3 minutes of elevation of the foot and occlusion of the blood supply. This volume decreased less during the experimental than the preceding or following periods. Capillary fragility decreased slowly during the experimental period and increased in the recovery period. On the third day of recovery, foot volumes were larger than at any other time. For the remainder of recovery, foot volume was the same as the control volume, but there was a greater decrease in volume with foot elevation. The results suggest that there was a constriction of all types of blood vessels during the experimental period while in the recovery period there was apparently a simultaneous dilatation of large blood vessels and a constriction of small ones. One subject had a greatly increased volume of one foot associated with pain and redness during early recovery days. These changes may be indicative of early trench foot or capillary damage. Starvation per se appeared to have no effect on foot volume. Submitted on October 15, 1959

Studies on the Acid Polysaccharides in Blood Vessel Walls (3) : INFLUENCE OF ACID POLYSACCHARIDES ON CAPILLARY FRAGILITY AND CAPILLARY PERMEABILITY IN EXPERIMENTAL HEMORRHAGIC DIATHESIS

The author studied the influence of hi acid and cho sulfate on capillary fragility and permeability of guinea pigs with experimental hemorrhagic diathesis (scurvy, thrombopenic purpura, vascular purpura). Capillary permeability is determined by the concentration of T-1824 in the plasma, and capillary fragility by the Borbely negative pressure method. Capillary permeability and fragility of normal male rats did not increase or decrease by administration of hi acid or cho sulfate. The increase of capillary permeability and fragility in experimental scorbutic guinea pigs was ameliorated by administration of Vitamin C or hi acid. hi acid seemed to inhibit the increase of capillary fragility and permeability in experimental thrombopenic purpuric guinea pigs. Increased capillary fragility of experimental vascular purpura was decreased by administration of hi acid. It seemed that cho sulfate did not ameliorate the increase of capillary permeability and fragility in the experimental hemorragic diathesis. Capillary fragility and permeability were not always parallel each others. In experimental vascular purpura, when the capillory fragility began to increase, the capillary permeability decreased. The contents of acid polysaccharides in blood vessel walls in animals with experimental hemorrhagic diathesis were approximately the same as in normal animals.

Studies of spinal factor in the peptic ulcer, "abdominal neurosis", neurocirculatory asthenia and essential hypertension. : CHARACTERISTICS OF RESPECTIVE PETECHIODERMOGRAPHIC PATTERN AND ANALYSIS OF GENERAL PHARMACOLOGICAL AND NERVOUS FACTORS INFLUENCING THE CUTANEOUS "CAPILLARY FRAGILITY"

-The petechiodermographic pattern characteristic to each of the four diseases was studied. Individuals with the peptic ulcer had rise suggestive, within limits, of a local vasodilatation, frequently in skin areas lateral to D7-D8 spinous process. Individuals with the abdominal neurosis had rise frequently in skin areas lateral to D10-L4 spinous process. Regarding the neurocirculatory asthenia the evidence was not strong, but data indirectly suggested the cranialward concentration of aberrant areas in this condition. Concerning the essential hypertension the evidence was again not strong, but data were suggestive of the presence of localized vasoconstriction in skin areas of lower thoracic to upper lumbar segments. The authors also examined the effect of autonomic drugs on the general capillary fragility and investigated possible relations between the gastrointestinal motility (as an index of vagal activity) and the general capillary fragility. No simple laws could be found to govern the capillary fragility, but the observed variations in capillary fragility in a small number of cases suggested that the cutaneous vasodilatation was the possible cause of increased capillary fragility at least in some cases.

Studies on Petechiodermography : UTILIZATION OF THE CLASSICAL "CAPILLARY FRAGILITY" TEST FOR MAPPING OUT POSSIBLE SEGMENTAL AREAS OF ALTERED SOMATO-AUTONOMIC INNERVATION

-As an approach to the problem of localized segmental alteration in the autonomic or somatic nerve fiber activity, more than a hundred human subjects have been examined for the incidence and distribution of skin areas characterized by abrupt local deviations in "capillary fragility"-skin areas where petechiae count was different with large gradients above or below the level of neighbouring areas and where the local state of blood flow or blood vessels was presumably different with sharp demarcation from that in adjacent skin areas. Such areas (aberrant areas) were elicited even from apparently healthy individuals. Many aberrant areas simulated strips of sensory dermatomes, and their patterns in each individual were reproducible with limited fidelity over a period of weeks and months. The author presented several suggestive evidences that at least some aberrant areas were neurogenic in origin, arising on the basis of localized somato-autonomic alterations in the spinal cord or nerve roots.

STUDIES ON VASCULAR PERMEABILITY AND MUCOSAL ABSORPTION IN THE FIELD OF OTO-RHINOLOGY

The author studied vascular permeability in healthy subjects and in those with various diseases accompanied with spontaneous nasal bleeding, using Landis' method. The Capillary Permeability Promoting Factor of Menkin was also studied at the same time. Results obtained were as follows:1) C.P.P factor level was variable even in healthy subjects.2) Vascular permeability for protein was far less variable compared with that for fluid.3) There was no direct relationship between vascular permeability and bleeding. Vascular permeability and vascular fragility were the characteristics not related each other.4) Vascular permeability for fluid was remarkably increased in those with spontaneous nasal bleeding and allergy. Vascular fragility was also increased in many cases.5) Vascular permeability and C.P.P factor were within normal limits even in the cases with leucemia and purpura in which bleeding tendency was prominent. Capillary fragility in these cases was remarkably increased.6) In cases with chronic sinusitis, fluid permeability was increased in many instances. After the surgery for sinusitis, C.P.P factor was elevated and fluid permeability was further increased. There was no change in C.P.P factor level in cases with simple hemorrhage and blood loss.7) Bleeding tendency observed clinically was related to fragility of the capillaries.

Bleeding tendency in uremia.

Clues as to the reason for hemorrhagic phenomena among uremic patients were sought in a study of 65 men whose blood urea nitrogen levels were either above 24 mg. per 100 ml. or fluctuating about uremic levels. In 49 of the patients the blood urea nitrogen level was over 50 mg. per 100 ml. A series of tests was done, including the clotting time in glass, clotting time in silicone-treated glassware, one-stage prothrombin time, prothrombin consumption, platelet count, and, in some cases, thromboplastin generation, clot retraction, and capillary fragility. No impairment of clot retraction could be demonstrated in any of the patients, and no single test gave consistently abnormal results in these patients. There was, however, a rough correlation in that more of the tests gave abnormal results at the higher levels of uremia.

COLLECTIVE EXAMINATION OF HYPERTENSION

Blood pressure, eyegrounds, capillary fragility were determined or examined on 628 cases of both sexes above 40 years, consisting of rural inhabitants, government office employees, , and internees of the old men's home, and significance of the result of each item of examination and relationship between them were discussed. And the validity of data obtained by collective examination and its limit were critically investigated.It was considered possible to screen those having danger of apoplexy through step by step method of adequate order, that is, first by blood pressure determination, secondly by examination of eyegrounds, and lastly by determination of capillary fragility. It may, however, be impossible to determine ultimately the effectiveness of each one or combination of the above mentioned procedure unless thorough health supervision is duly performed.

Haemorrhagic diathesis due to increased capillary fragility secondary to ovarian deficiency: Wells, Ronald: p. 886

Haemorrhagic diathesis due to increased capillary fragility secondary to ovarian deficiency: Wells, Ronald: p. 886

Effect of total body irradiation on capillary permeability.

IT seems to be generally accepted that increased permeability of the capillary wall is one of the basic changes caused by exposure to massive X-irradiation. It must be emphasized, however, that the proofs for this supposition are very inconclusive. Tendency to bleeding and diffuse haemorrhages may be produced not by increased permeability, but (besides the accompanying haematologic disorders) by an increase of capillary fragility, that is of susceptibility to injuries of the capillary wall.