Interestingly, a further tool of assessing local FMR, always present in healthy tissue, is the biophysical semeiotic preconditioning (See later on), easy to perform, especially by doctor with poor experience in the new physical semeiotics.
To summarize this essential aspect of Clinical Microangiology, Biophysical Semeiotics allow doctor to recognize, starting from the first decade of life, in easy, quick, and reliable manner, initial EBD dysfunction of whatever biological systems, indicating a defective activation of MFR and, therefore, the “real” risk for the localized disorder, permitting, thus, to perform the primary prevention, in our case, of type 2 diabetes mellitus or NIDDM.
Obviously, the results, referred above, regarding endocrine pancreas, are the same we obtain from every tissue-microvascular-unit, i.e. to EBD of whatever biological system, in both physiological and pathological conditions.
For instance, let’s think over the dysfunction of coronary EBD in healthy individuals, but at “real” risk of coronary disease, as well as the dysfunction of ocular EBD in children of glaucomatous patients.
For these reasons, since a long time, we had foreseen and foretold the origin of a new branch of Clinical Microangiology, exclusively devoted to the study of EBD alterations, both congenital and acquired, by means of original physical semeiotic methods, with favorable influence on primary prevention and diagnosis.
We suggested to term this discipline Clinical Microangiology of Endoaerterial Blocking Devices.
Biophysical-semeiotic signs and syndromes of diabetic constitution and diabetes mellitus.
In diagnosing diabetic constitution and diabetes mellitus, doctor must ascertain the Congenital Acidosic Enzyme-Metabolic Histangiopathy (CAEMH) – a , since this mitochondrial cytopathology represents the conditio sine qua non of type I and II DM, and of commonest human diseases (1, 6, 11).
Briefly, to recognize CAMH in easiest manner, doctor must perform the following maneuver: digital pressure applied upon the right side of skull (= trigger-points of right cerebral hemisphere), of an individual lying down in supine position and pscho-physically relaxed, provokes a gastric aspecific reflex, after a latency time (lt) of 6 sec. (NN = 7-8 sec., in age-dependent manner), more intense of that caused, under identical condition, when doctor stimulates the trigger-points of left cerebral hemisphere, whose lt results 7 sec. (NN = 7-8 sec.) (Fig. 3).
In following, some interesting biophysical semeiotic parameters, easily and quickly observed, are illustrated; they are useful in bed-side diagnosing DM, starting from its very initial stages, including diabetic constitution.
However, the doctor can diagnose, in a “quantitative” manner, the various phases of diabetic syndrome at the bed-side by numerous other methods, more refined, sophisticated and reliable, clinical-microangiologic in nature, as the reader, whose knowledge of this new semeiotics is steady, understands surely.
Cutaneous, prolonged pinching, of “mean-intense” intensity, of pancreatic trigger-points, i.e. VI-VII thoracic dermatomeres (as above referred, at the level of cutaneous crossing of hemiclavicular line and/or para-sternal one and costal arch, at right or at left), in healthy, after latency time of 12 sec. exactly, brings about gastric aspecific reflex of intensity < 2 cm., which lasts for £ 4 sec. and then disappears for > 3 sec. < 4 sec.: i.e. fractal dimension (fD) 3,81 (See above-cited site, Technical Pages, in which auscultatory percussion of both pancreas and stomach is fully described).
Three parameters of this fundamental reflex, well-known to doctor who has steady knowledge of the original semeiotics, play a primary role in the application of Biophysical Semeiotics.
|Fig. 2: Physiologically, cutaneous, persistent pinching of VI (VII) thoracic dermatomere, illustrated above, brings about, simultaneously with previous reflex, increasing of pancreatic size (volume) – in practice, low pancreatic margin lowers – after latency time (lt) of 2 sec. for a duration of 10 sec. exactly (Fig. 2). It is noteworthy that this value (2 sec. + 10 sec.) is the same of the former reflex parameter (NN = 12 sec.), indicating histangium acidosis, and outlining the internal as well as external coherence of biophysical semeiotic theory.||
Fig 2:VI thoracic dematomere-pancreatic reflex.
|Fig. 3: Cutaneous pinching, prolonged and “mean-intense”, at the level of pancreatic trigger-points (i.e. VI-VII thoracic dermatomeres. See above), after a lt. of 12 sec., physiologically provokes also the caecal reflex (caecum dilates: Fig. 4) for a duration of about £ 4 sec., followed by its disappearing, after a “differential” latency time of > 3 sec. > 4 sec.: fD = 3,81.
Once more the diverse values of numerous parameters outline the internal and external coherence of biophysical semeiotic theory, conditio sine qua non of the scientific truth, although really it does not coincide with the second.
Fig 3: Pancreatic-caecal reflex.
|4) Bilancini-Lucchi’s sign. In healthy, both digital or manual pressure of “light” intensity, applied upon the internal side of an arm (= specific occlusion of lymphatic superficial vessels), after lt. of about 6 sec., brings about the gastric aspecific reflex (Fig. 3), which increases again after further 3-4 sec. (7) (Fig. 2). An interesting “variant” of this sign is the manual pression on lymphatic vessels at the base of breast quadrants, e.g. external upper breast quadrant, which causes gastric aspecific reflex, showing identical parameters. Really, these two signs are based on identical patho-physiological mechanism, whose discussion is beyond the aim of this paper.||!http://www.indmedica.com/cyberlecturespics/diab_constit_fig4.jpg"(Missing Image)! Fig. 4|