Συμβολή εις την διαγνωστικήν διερεύνησιν των μικροαγγειοπαθειών

Abstract

The present doctoral thesis deals with the diagnostic investigation of microangiopathies in patients, who were hospitalized in the 1st Surgical Department of the University of Athens, in the last five years. The first part of this investigation concerns elements of the history, anatomy and histology, physiology, pharmacology and haemodynamics of the systemic circulation and, mainly, the microcirculation. The term «microangiopathy» is analysed and the classification of microangiopathies in groups is attempted. In the second part, the diagnostic protocol of microangiopathies is illustrated in detail. The technic and instruments used during the investigation are reported. The 121 cases studied by the author are analysed and the characteristic features of each group of disease is described. The third part deals with the discussion of the various diagnostic problems of microangiopathies as well as the weak points in the technical diagnosis of some cases in spite of the exhaustive diagnostic investigation and the clinical experience of the doctor. Thus, in 16 out of the 121 cases no definite diagnosis was placed. In conclusion, it should be pointed out that microangiopathies, in their great majority, are a somewhat more generalized disease which are at an estimate of 25% considered a connective tissue disease. However, independent to the subjective disease, timely diagnosis increases the possibilities of the correct aetiological treatment. It must also be pointed out that Raynaud's disease is less often frequent than is usually diagnosed, according to the Allen and Brown criteria. Finally, the few cases of Raynaud's disease which are diagnosed following an assiduous treatment should be followed-up systematically for a number of years for a possible appearance of a later systemic disease.